Abstract

Dietmar Hübner and Lucie White question the ethical justification of employing risky neurosurgical interventions to treat imprisoned psychopaths. They argue that (1) such interventions would confer no medical benefit on the psychopath as there is no “subjective suffering” involved in psychopathy and (2) psychopaths could not voluntarily consent to such procedures because they could have no “internal motivation” for doing so. In the course of their discussion, the authors insightfully show that certain aspects of the psychopath’s personality structure are especially relevant to assessing the ethics of risky treatment options. As I argue, however, the particular conclusions that the authors draw are too strong. A deeper look at the psychopathic profile casts doubt on (1) and (2). In some cases, psychopaths can be plausibly construed as experiencing subjective suffering on account of their disorder and as appropriately motivated to voluntarily consent to neurosurgical treatment. After arguing for this view, I suggest that the psychopath’s consent to neurosurgical intervention might nonetheless be problematic, as their emotional incapacities might preclude their abilities to adequately appreciate the relevant risks.