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A letter to the editor is presented in response to the article "The impact of two-dimensional versus three-dimensional ultrasound exposure on maternal-fetal attachment and maternal health behavior in pregnancy," by B. Sedgmen, C. McMahon, D. Cairns, B. J. Benzie and R. L. Woodfield.

Psychopathy is a personality disorder frequently associated with immoral behaviors. Previous behavioral studies on the influence of psychopathy on moral decision have yielded contradictory results, possibly because they focused either on judgment (abstract evaluation) or on choice of hypothetical action, two processes that may rely on different mechanisms. In this study, we explored the influence of the level of psychopathic traits on judgment and choice of hypothetical action during moral dilemma evaluation. A population of 102 students completed a questionnaire with ten moral dilemmas and nine non-moral dilemmas. The task included questions targeting both judgment ("Is it acceptable to … in order to …?") and choice of hypothetical action ("Would you … in order to …?"). The level of psychopathic traits of each participant was evaluated with the Levenson Self-Report Psychopathy (LSRP) scale. Logistic regression fitted with the generalized estimating equations method analyses were conducted using responses to the judgment and choice tasks as the dependent variables and psychopathy scores as predictor. Results show that a high level of psychopathic traits, and more specifically those related to affective deficit, predicted a greater proportion of utilitarian responses for the choice but not for the judgment question. There was no first-order interaction between the level of psychopathic traits and other potential predictors. The relation between a high level of psychopathic traits and increased utilitarianism in choice of action but not in moral judgment may explain the contradictory results of previous studies where these two processes were not contrasted. It also gives further support to the hypothesis that choice of action endorsement and abstract judgment during moral dilemma evaluation are partially distinct neural and psychological processes. We propose that this distinction should be better taken into account in the evaluation of psychopathic behaviors.

Everyone has experienced the potential discrepancy between what one judges as morally acceptable and what one actually does when a choice between alternative behaviors is to be made. The present study explores empirically whether judgment and choice of action differ when people make decisions on dilemmas involving moral issues. Two hundred and forty participants evaluated 24 moral and non-moral dilemmas either by judging ("Is it acceptable to…") or reporting the choice of action they would make ("Would you do…"). We also investigated the influence of varying the number of people benefiting from the decision and the closeness of relationship of the decision maker with the potential victim on these two types of decision. Variations in the number of beneficiaries from the decision did not influence judgment nor choice of action. By contrast, closeness of relationship with the victim had a greater influence on the choice of action than on judgment. This differentiation between evaluative judgments and choices of action argues in favor of each of them being supported by (at least partially) different psychological processes.

Humans daily face social situations involving conflicts between competing moral decision. Despite a substantial amount of studies published over the past 10 years, the respective role of emotions and reason, their possible interaction, and their behavioural expression during moral evaluation remains an unresolved issue. A dualistic approach to moral evaluation proposes that the right dorsolateral prefrontal cortex (rDLPFc) controls emotional impulses. However, recent findings raise the possibility that the right DLPFc processes emotional information during moral decision making. We used repetitive transcranial magnetic stimulation (rTMS) to transiently disrupt rDLPFc activity before measuring decision making in the context of moral dilemmas. Results reveal an increase of the probability of utilitarian responses during objective evaluation of moral dilemmas in the rTMS group (compared to a SHAM one). This suggests that the right DLPFc function not only participates to a rational cognitive control process, but also integrates emotions generated by contextual information appraisal, which are decisive for response selection in moral judgements., (© The Author (2011). Published by Oxford University Press.)

Recently, cognitive neuroscience has shed new light on our understanding of the neural underpinning of humans' morality. These findings allow for a fundamental questioning and rethinking of the alleged dichotomy between reason and emotion, that has profoundly shaped both moral philosophy and moral psychology. Functional neuroimaging and neuropsychology studies have provided strong arguments favoring a dynamic and interdependent interaction between rational and emotional processes in the brain. Yet another fundamental issue remains largely unexplored: the dissociation between certain behaviours and the moral judgments that seem to precede them. The importance of this dissociation was highlighted in a study of psychopathic patients during which they preserved their moral judgments while frequently engaging in completely non moral behaviour. Such dissociation could result from the cognitive difference between an objective moral judgement with no personal consequence, and a subjective behavioural choice that has effective or potential personal consequences. Consequently, the results of moral dilemma experiments would differ widely depending whether they explore objective or subjective moral evaluations. That these evaluations involve two distinct neural processes should be taken into account when exploring the neural bases of human morality., (© 2011 médecine/sciences – Inserm / SRMS.)