Diagnosing blame: Responsibility and the psychopath

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28 Scopus citations


The diagnosis of psychopathy is controversial largely because of two notions: first, that because of their defects, psychopaths cannot understand morality, and second, that these defects should thus excuse psychopaths from moral responsibility for their actions. However, it is not clear just what is involved in understanding morality. The argument that the psychopath is ignorant of morality in the same way that one might be ignorant of facts is difficult to sustain. However, a closer examination of the psychopath’s peculiar deficiencies reveals that the psychopath’s understanding of morality might be impaired in other ways.

Original languageEnglish (US)
Pages (from-to)199-214
Number of pages16
JournalJournal of Medicine and Philosophy (United Kingdom)
Issue number2
StatePublished - Apr 1992
Externally publishedYes

Bibliographical note

Funding Information:
* Part of this paper was written at the University of Chicago Center for Clinical Medical Ethics, which is supported by grants from the Henry J. Kaiser Foundation, the Andrew Mellon Foundation and the Pew Charitable Trusts. I would like to acknowledge the valuable help that 1 received while writing this paper from Mary Mahowald, Marcia Baron, Grant Gillett, Rick Howard, Paul Mullen, Robin Downie and Elizabeth Telfer. 1 Because conceptions of psychopathy differ widely, I should state at the outset that I will be referring mainly to what is sometimes called the 'primary psychopath', the most well-known descriptions of which are found in the North American psychiatric literature. Probably the most influential work on this type of psychopath has been done by Hervey Cleckley and R. D. Hare. 2 Of course, there are criteria for the diagnosis of diabetes mellitus other than the patient's symptoms, such a blood glucose levels; the point here is that even we could diagnose it only by symptoms, 'diabetes mellitus' would still be an adequate explanation, upon which successful treatment of the disorder could be justifiably based. 3 Cleckley presents several ways in which the psychopath differs from the ordinary criminal. First, the criminal works consistently toward his own ends, while the psychopath does not work consistently at anything, and does not take advantage of what he gains. Second, the ends and purpose of the psychopath are much more difficult to understand. Third, the psychopath acts much more self-destructively. Fourth, the psychopath rarely commits murder or other major


  • Disease
  • Ethics
  • Philosophy
  • Psychiatry
  • Psychopathy
  • Responsibility


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