To bridge or not to bridge: Moral Judgement in Cocaine Use Disorders, a case-control study on human morality

ABSTRACT

Background

In the “Dual-Process theory”, morality is characterized by the interaction between an automatic-emotional process, mediated by the Anterior Cingulate Cortex (ACC) and linked to personal-deontological decisions, and a rational-conscious one, mediated by the Dorso-Lateral Prefrontal Cortex (DLPFC) and linked to impersonal-utilitarian decisions. These areas are altered by chronic use of cocaine, with a possible impact on moral decision-making.

Objective

To evaluate the difference between a group of Cocaine Use Disorder (CUD) patients and a control group in moral decision-making.

Methods

Subjects with CUD were compared to an equal-sized healthy group regarding their moral decision-making. Trolley and Footbridge Moral Dilemmas were administered to each group. The quality of the answer (yes or no) and the time needed to answer were recorded.

Results

The recruited group includes 72 subjects, 36 with CUD and 36 healthy subjects (average age of 39.51 ± 9.89). In the Trolley dilemma, almost all the subjects (97.3%) answered “yes”, while in the Footbridge dilemma CUD subjects answered “yes” more often (52.7%) than the healthy group (19.4%).

Conclusion

For strong emotional dilemmas (Footbridge), cocaine users answered “yes” with a higher frequency compared to healthy subjects, highlighting a wider utilitarian tendency in decision-making and a poor emotional participation.

KEYWORDS:

• Substance use disorder
• cocaine use disorders
• morality
• addiction
• moral decision-making

Acknowledgements

Thanks to Federico Capone and Antonio Arrè for their help with data collection.

Author contributions

AM, AMi, GMn conceived the idea of this paper; data were extracted by AM, AMi, GMn, GS and ADP, whilst SC, MP, GB, GM, supervised all stages of the process and were consulted to resolve any possible disagreement. AM, AMi, GMn, GS, AP and SC drafted the first version and revised it after contributions from GB, GDP, MP, and GM. All authors approved the final version.

Disclosure statement

GM has been a consultant and/or a speaker and/or has received research grants from Angelini, Doc Generici, Janssen-Cilag, Lundbeck, Otsuka, Pfizer, Servier, Recordati.

AM, AMi, GMn, SC, GS, ADP, GB, GDP, MP: nothing to be declared.

Supplementary data

Supplemental data for this article can be accessed online at https://doi.org/10.1080/17470919.2023.2242096

Additional information

Funding

GM received funds from the European Project entitled ‘Analysis, Knowledge dissemination, Justice implementation and Special Testing of Novel Synthetic Opioids’ – JUST-2017-AG-DRUG. The other authors received no specific funding for this work.