The role of empathy in trolley problems and variants: A systematic review and meta-analysis.

[en] The role of empathy in morality is a subject of ongoing scientific debate due to the lack of systematic reviews and meta-analyses on this topic. To address this gap, we conducted a PRISMA-based systematic quantitative review to investigate the role of empathy in moral judgements, decision-making, and inclinations using trolley problems and variants, which are popular types of moral dilemmas that explore utilitarianism and deontology. We searched for articles in four databases (PsycINFO, Pubmed, WorldWideScience, and Scopus) and performed citation searches. Out of 661 records, we selected 34 that studied the associations between empathy and moral judgements, moral decision-making, and/or moral inclinations. Six meta-analyses and systematic reviews of these records consistently showed small to moderate associations between affective empathy and these moral parameters, particularly in personal moral dilemmas involving intentional harm (although some approaches highlighted more complex associations between these parameters). Regarding other empathy domains, most studies found limited or insignificant links between cognitive empathy domains and moral judgements, decision-making, and inclinations. We discuss the nuances and implications of these results.

Disciplines :

Social, industrial & organizational psychology

Author, co-author :

Nasello, Julian ; Université de Liège - ULiège > Unités de recherche interfacultaires > Research Unit for a life-Course perspective on Health and Education (RUCHE) ; Psychiatric Day Hospital "La Clé", Liège, Belgium

Triffaux, Jean-Marc ; Centre Hospitalier Universitaire de Liège - CHU > > Service de psychiatrie ; Psychiatric Day Hospital "La Clé", Liège, Belgium

Language :

English

Title :

The role of empathy in trolley problems and variants: A systematic review and meta-analysis.

Publication date :

14 June 2023

Journal title :

British Journal of Social Psychology

ISSN :

0144-6665

eISSN :

2044-8309

Publisher :

Wiley, England

Peer reviewed :

Peer Reviewed verified by ORBi

Additional URL :

https://doi.org/10.1111/bjso.12654

Available on ORBi :

since 15 June 2023

Statistics

Number of views

90 (28 by ULiège)

Number of downloads

2 (1 by ULiège)

More statistics

Scopus citations^®

Scopus citations^®
without self-citations

OpenCitations

OpenAlex citations

Bibliography

Aron, A., Aron, E. N., & Smollan, D. (1992). Inclusion of other in the self scale and the structure of interpersonal closeness. Journal of Personality and Social Psychology, 63(4), 596–612. https://doi.org/10.1037/0022-3514.63.4.596
Baez, S., Flichtentrei, D., Prats, M., Mastandueno, R., García, A. M., Cetkovich, M., & Ibáñez, A. (2017). Men, women… who cares? A population-based study on sex differences and gender roles in empathy and moral cognition. PLoS One, 12(6), e0179336. https://doi.org/10.1371/journal.pone.0179336
Bagby, R. M., Parker, J. D., & Taylor, G. J. (1994). The twenty-item Toronto Alexithymia Scale-I. Item selection and cross-validation of the factor structure. Journal of Psychosomatic Research, 38, 23–32. https://doi.org/10.1016/0022-3999(94)90005-1
Baheti, A. D., & Nayak, P. (2022). Covid-19 in India: Oxygen shortages and a real world trolley problem. BMJ, 376, o369. https://doi.org/10.1136/bmj.o369
Baron-Cohen, S., & Wheelwright, S. (2004). The empathy quotient: An investigation of adults with Asperger syndrome or high functioning autism, and normal sex differences. Journal of Autism and Developmental Disorders, 34(2), 163–175. https://doi.org/10.1023/B:JADD.0000022607.19833.00
Bartels, D. M., & Pizarro, D. A. (2011). The mismeasure of morals: Antisocial personality traits predict utilitarian responses to moral dilemmas. Cognition, 121(1), 154–161. https://doi.org/10.1016/j.cognition.2011.05.010
Baston, C. D. (2012). The empathy-altruism hypothesis: Issues and implication. In J. Decety (Ed.), Empathy: From bench to bedside. MIT Press.
Behnke, A., Strobel, A., & Armbruster, D. (2020). When the killing has been done: Exploring associations of personality with third-party judgment and punishment of homicides in moral dilemma scenarios. PLoS One, 15(6), e0235253. https://doi.org/10.1371/journal.pone.0235253
Benlahcene, A., Zainuddin, R. B., Syakiran, N., & Ismail, A. B. (2018). A narrative review of ethics theories: Teleological & deontological ethics. Journal of Humanities and Social Science (IOSR-JHSS), 23(1), 31–32. https://doi.org/10.9790/0837-2307063138
Bentham, J. (1789). Introduction to the principles of morals and legislation. Payne.
Bermond, B., Oosterveld, P., & Vorst, H. C. M. (1994). Bermond-Vorst Alexithymia Questionnaire; construction, reliability, validity and uni-dimensionality. Internal Report. University of Amsterdam: Faculty of Psychology, Department of Psychological Methods.
Bostyn, D. H., Sevenhant, S., & Roets, A. (2018). Of mice, men, and trolleys: Hypothetical judgment versus real-life behavior in trolley-style moral dilemmas. Psychological Science, 29(7), 1084–1093. https://doi.org/10.1177/0956797617752640
Bryant, B. K. (1982). An index of empathy for children and adolescents. Child Development, 53(2), 413–425. https://doi.org/10.2307/1128984
Burghart, M., & Mier, D. (2022). No feelings for me, no feelings for you: A meta-analysis on alexithymia and empathy in psychopathy. Personality and Individual Differences, 194, 111658. https://doi.org/10.1016/j.paid.2022.111658
Caviola, L., Kahane, G., Everett, J. A., Teperman, E., Savulescu, J., & Faber, N. S. (2021). Utilitarianism for animals, Kantianism for people? Harming animals and humans for the greater good. Journal of Experimental Psychology: General, 150(5), 1008–1039. https://psycnet.apa.org/doi/10.1037/xge0000988
Cecchetto, C., Korb, S., Rumiati, R. I., & Aiello, M. (2018). Emotional reactions in moral decision-making are influenced by empathy and alexithymia. Social Neuroscience, 13(2), 226–240. https://doi.org/10.1080/17470919.2017.1288656
Conway, P., & Gawronski, B. (2013). Deontological and utilitarian inclinations in moral decision making: A process dissociation approach. Journal of Personality and Social Psychology, 104(2), 216–235. https://psycnet.apa.org/doi/10.1037/a0031021
Conway, P., Goldstein-Greenwood, J., Polacek, D., & Greene, J. D. (2018). Sacrificial utilitarian judgments do reflect concern for the greater good: Clarification via process dissociation and the judgments of philosophers. Cognition, 179, 241–265. https://doi.org/10.1016/j.cognition.2018.04.018
Côté, S., Piff, P. K., & Willer, R. (2013). For whom do the ends justify the means? Social class and utilitarian moral judgment. Journal of Personality and Social Psychology, 104(3), 490–503. https://psycnet.apa.org/doi/10.1037/a0030931
Craig, S. C., McCarthy, A. F., & Gainous, J. (2022). Question wording and attitudinal ambivalence: COVID, the economy, and Americans' response to a real-life trolley problem. Social Science Quarterly, 103(1), 18–30. https://doi.org/10.1111/ssqu.13102
Cuff, B. M., Brown, S. J., Taylor, L., & Howat, D. J. (2016). Empathy: A review of the concept. Emotion Review, 8(2), 144–153. https://doi.org/10.1177/2F1754073914558466
Davis, M. H. (1980). A multidimensional approach to individual differences in empathy. JSAS Catalogue of Selected Documents in Psychology, 10, 85.
Davis, M. H. (1983). Measuring individual differences in empathy: Evidence for a multidimensional approach. Journal of Personality and Social Psychology, 44(1), 113–126. https://psycnet.apa.org/doi/10.1037/0022-3514.44.1.113
de Waal, F., Macedo, S. E., & Ober, J. E. (2006). Primates and philosophers: How morality evolved. Princeton University Press.
Decety, J. (2021). Why empathy is not a reliable source of information in moral decision making. Current Directions in Psychological Science, 30(5), 425–430. https://doi.org/10.1177/2F09637214211031943
Decety, J., & Cowell, J. M. (2014). Friends or foes: Is empathy necessary for moral behavior? Perspectives on Psychological Science, 9(5), 525–537. https://doi.org/10.1177/1745691614545130
Decety, J., & Cowell, J. M. (2015). Empathy, justice, and moral behavior. AJOB Neuroscience, 6(3), 3–14. https://doi.org/10.1080/21507740.2015.1047055
Dinić, B. M., Milosavljević, M., & Mandarić, J. (2021). Effects of Dark Tetrad traits on utilitarian moral judgement: The role of personal involvement and familiarity with the victim. Asian Journal of Social Psychology, 24(1), 48–58. https://doi.org/10.1111/ajsp.12422
Eklund, J. H., & Meranius, M. S. (2021). Toward a consensus on the nature of empathy: A review of reviews. Patient Education and Counseling, 104(2), 300–307. https://doi.org/10.1016/j.pec.2020.08.022
Foot, P. (1967). The problem of abortion and the doctrine of the double effect. In P. Foot (Ed.), (1977) Virtues and vices and other essays in moral philosophy (pp. 19–32). Basil Blackwell.
Gawronski, B., Armstrong, J., Conway, P., Friesdorf, R., & Hütter, M. (2017). Consequences, norms, and generalized inaction in moral dilemmas: The CNI model of moral decision-making. Journal of Personality and Social Psychology, 113(3), 343–376. https://doi.org/10.1037/pspa0000086
Gleichgerrcht, E., Torralva, T., Rattazzi, A., Marenco, V., Roca, M., & Manes, F. (2013). Selective impairment of cognitive empathy for moral judgment in adults with high functioning autism. Social Cognitive and Affective Neuroscience, 8(7), 780–788. https://doi.org/10.1093/scan/nss067
Gleichgerrcht, E., & Young, L. (2013). Low levels of empathic concern predict utilitarian moral judgment. PLoS One, 8(4), e60418. https://doi.org/10.1371/journal.pone.0060418
Greene, J., & Haidt, J. (2002). How (and where) does moral judgment work? Trends in Cognitive Sciences, 6(12), 517–523. https://doi.org/10.1016/S1364-6613(02)02011-9
Greene, J. D. (2007). Why are VMPFC patients more utilitarian? A dual-process theory of moral judgment explains. Trends in Cognitive Sciences, 11(8), 322–323. https://doi.org/10.1016/j.tics.2007.06.004
Greene, J. D., Nystrom, L. E., Engell, A. D., Darley, J. M., & Cohen, J. D. (2004). The neural bases of cognitive conflict and control in moral judgment. Neuron, 44(2), 389–400. https://doi.org/10.1016/j.neuron.2004.09.027
Greene, J. D., Sommerville, R. B., Nystrom, L. E., Darley, J. M., & Cohen, J. D. (2001). An fMRI investigation of emotional engagement in moral judgment. Science, 293(5537), 2105–2108. https://doi.org/10.1126/science.1062872
Haidt, J. (2001). The emotional dog and its rational tail: A social intuitionist approach to moral judgment. Psychological Review, 108, 814–834. https://doi.org/10.1037/0033-295X.108.4.814
Haidt, J. (2003). The Moral Emotions. In R. J. Davidson, K. R. Scherer, & H. H. Goldsmith (Eds.), Handbook of affective sciences. Oxford University Press.
Hannikainen, I. R., Machery, E., & Cushman, F. A. (2018). Is utilitarian sacrifice becoming more morally permissible? Cognition, 170, 95–101. https://doi.org/10.1016/j.cognition.2017.09.013
Hepper, E. G., Hart, C. M., & Sedikides, C. (2014). Moving Narcissus: Can narcissists be empathic? Personality and Social Psychology Bulletin, 40(9), 1079–1091. https://doi.org/10.1177/0146167214
Hogan, R. (1969). Development of an empathy scale. Journal of Consulting and Clinical Psychology, 33, 307–316. https://psycnet.apa.org/doi/10.1037/h0027580
Horne, Z., & Powell, D. (2016). How large is the role of emotion in judgments of moral dilemmas? PLoS One, 11(7), e0154780. https://doi.org/10.1371/journal.pone.0154780
Jolliffe, D., & Farrington, D. P. (2006). Development and validation of the basic empathy scale. Journal of Adolescence, 29, 589–611. https://doi.org/10.1016/j.adolescence.2005.08.010
Kahane, G. (2015). Sidetracked by trolleys: Why sacrificial moral dilemmas tell us little (or nothing) about utilitarian judgment. Social Neuroscience, 10(5), 551–560. https://doi.org/10.1080/17470919.2015.1023400
Kahane, G., Everett, J. A., Earp, B. D., Caviola, L., Faber, N. S., Crockett, M. J., & Savulescu, J. (2018). Beyond sacrificial harm: A two-dimensional model of utilitarian psychology. Psychological Review, 125(2), 131–164. https://doi.org/10.1037/rev0000093
Kahane, G., Everett, J. A., Earp, B. D., Farias, M., & Savulescu, J. (2015). Utilitarian’ judgments in sacrificial moral dilemmas do not reflect impartial concern for the greater good. Cognition, 134, 193–209. https://doi.org/10.1016/j.cognition.2014.10.005
Kahane, G., Wiech, K., Shackel, N., Farias, M., Savulescu, J., & Tracey, I. (2012). The neural basis of intuitive and counterintuitive moral judgment. Social Cognitive and Affective Neuroscience, 7(4), 393–402. https://doi.org/10.1093/scan/nsr005
Kant, I. (1785). Grundlegung zur Metaphysik der Sitten. Johann Friedrich Hartknoch.
Kogut, T., & Ritov, I. (2005). The “identified victim” effect: An identified group, or just a single individual? Journal of Behavioral Decision Making, 18(3), 157–167. https://doi.org/10.1002/bdm.492
Maranges, H. M., Chen, S. K., & Conway, P. (2022). Insecure and insensitive: Avoidant and anxious attachment predict less concern for others in sacrificial moral dilemmas. Personality and Individual Differences, 185, 111274. https://doi.org/10.1016/j.paid.2021.111274
Maranges, H. M., Hasty, C. R., Maner, J. K., & Conway, P. (2021). The behavioral ecology of moral dilemmas: Childhood unpredictability, but not harshness, predicts less deontological and utilitarian responding. Journal of Personality and Social Psychology, 120(6), 1696–1719. https://doi.org/10.1037/pspp0000368
May, J. (2018). The limits of emotion in moral. In K. Jones & F. Schroeter (Eds.), The many moral rationalisms (pp. 286–306). Oxford University Press.
Mendez, M. F., Anderson, E., & Shapira, J. S. (2005). An investigation of moral judgement in frontotemporal dementia. Cognitive and Behavioral Neurology, 18(4), 193–197. https://psycnet.apa.org/doi/10.1097/01.wnn.0000191292.17964.bb
Mill, J. S. (1861). Utilitarianism. In J. M. Robson (Ed.), The collected works of John Stuart Mill. Essays on ethics, religion and society (Vol. X, pp. 203–259). University of Toronto Press.
Mitchell, M. B., & Attipoe, G. M. (2020). Revisiting the “Trolley Problem” in COVID-19 pandemic. Hektoen International: A Journal of Medical Humanities. https://hekint.org/2020/10/15/revisiting-the-trolley-problem-in-the-covid-19-pandemic/
Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., Altman, D., & the PRISMA Group. (2009). Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. Annals of Internal Medicine, 151, 264–269. https://doi.org/10.7326/0003-4819-151-4-200908180-00135
Moore, A. B., Clark, B. A., & Kane, M. J. (2008). Who shalt not kill? Individual differences in working memory capacity, executive control, and moral judgment. Psychological Science, 19(6), 549–557. https://doi.org/10.1111/j.1467-9280.2008.02122.x
Nakamura, H., Ito, Y., Honma, Y., Mori, T., & Kawaguchi, J. (2014). Cold-hearted or cool-headed: Physical coldness promotes utilitarian moral judgment. Frontiers in Psychology, 5, 1086. https://doi.org/10.3389/fpsyg.2014.01086
Nasello, J. A., Dardenne, B., Blavier, A., & Triffaux, J. M. (2021). Does empathy predict decision-making in everyday trolley-like problems? Current Psychology, 1-14, 2966–2979. https://doi.org/10.1007/s12144-021-01566-1
Nasello, J. A., Dardenne, B., Hansenne, M., Blavier, A., & Triffaux, J.-M. (2023). Moral decision-making in trolley problems and variants: how do participants' perspectives, borderline personality traits, and empathy predict choices? The Journal of Psychology: Interdisciplinary and Applied, 1–21. https://doi.org/10.1080/00223980.2023.2206604
Nemiah, J. C. (1976). Alexithymia: A view of the psychosomatic process. Modern Trends in Psychosomatic Medicine, 3, 430–439.
Oudman, E., van Stigt Thans, S., Montoya, E. R., & Postma, A. (2021). Moral reasoning, moral decision-making, and empathy in Korsakoff's syndrome. Journal of Neuropsychology, 15(3), 462–476. https://doi.org/10.1111/jnp.12233
Oveis, C., Horberg, E. J., & Keltner, D. (2010). Compassion, pride, and social intuitions of self-other similarity. Journal of Personality and Social Psychology, 98(4), 618–630. https://psycnet.apa.org/doi/10.1037/a0017628
Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., Chou, R., Glanville, J., Grimshaw, J. M., Hróbjartsson, A., Lalu, M. M., Li, T., Loder, E. W., Mayo-Wilson, E., McDonald, S., … Moher, D. (2021). The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMC Systematic Reviews, 10, 89. https://doi.org/10.1186/s13643-021-01626-4
Park, G., Kappes, A., Rho, Y., & Van Bavel, J. J. (2016). At the heart of morality lies neuro-visceral integration: Lower cardiac vagal tone predicts utilitarian moral judgment. Social Cognitive and Affective Neuroscience, 11(10), 1588–1596. https://doi.org/10.1093/scan/nsw077
Patil, I., Larsen, E. M., Kichic, R., & Gleichgerrcht, E. (2021). Moral cognition about harm in anxiety disorders: The importance of experienced emotion. Psychological Reports, 124(6), 2501–2523. https://doi.org/10.1177/0033294120964134
Patil, I., Melsbach, J., Hennig-Fast, K., & Silani, G. (2016). Divergent roles of autistic and alexithymic traits in utilitarian moral judgments in adults with autism. Scientific Reports, 6(1), 1–15. https://doi.org/10.1038/srep23637
Patil, I., & Silani, G. (2014). Reduced empathic concern leads to utilitarian moral judgments in trait alexithymia. Frontiers in Psychology, 5, 501. https://doi.org/10.3389/fpsyg.2014.00501
Paul, E. S. (2000). Empathy with animals and with humans: Are they linked? Anthrozoös, 13(4), 194–202. https://doi.org/10.2752/089279300786999699
Rifkin, J. (2009). The empathic civilization: The race to global consciousness in a world in crisis. Penguin Group.
Romero-Rivas, C., López-Benítez, R., & Rodríguez-Cuadrado, S. (2022). Would you sacrifice yourself to save five lives? Processing a foreign language increases the odds of self-sacrifice in moral dilemmas. Psychological Reports, 125(1), 498–516. https://doi.org/10.1038/srep23637
Rosas, A., Viciana, H., Caviedes, E., & Arciniegas, A. (2019). Hot utilitarianism and cold deontology: Insights from a response patterns approach to sacrificial and real world dilemmas. Social Neuroscience, 14(2), 125–135. https://doi.org/10.1080/17470919.2018.1464945
Rota, G., Palumbo, S., Lattanzi, N., Manfrinati, A., Sarlo, M., Lotto, L., Pietrini, P., Rumiati, R., & Pellegrini, S. (2016). Harm aversion explains utilitarian choices in moral decision-making in males but not in females. Archives Italiennes de Biologie, 154, 50–58. https://doi.org/10.12871/000398292
Santamaría-García, H., Baez, S., García, A. M., Flichtentrei, D., Prats, M., Mastandueno, R., Sigman, M., Matallana, D., Cetkovich, M., & Ibáñez, A. (2017). Empathy for others' suffering and its mediators in mental health professionals. Scientific Reports, 7(1), 1–13. https://doi.org/10.1038/s41598-017-06775-y
Sarlo, M., Lotto, L., Rumiati, R., & Palomba, D. (2014). If it makes you feel bad, don't do it! Egoistic rather than altruistic empathy modulates neural and behavioral responses in moral dilemmas. Physiology & Behavior, 130, 127–134. https://doi.org/10.1016/j.physbeh.2014.04.002
Shao, C. (2020). The COVID trolley dilemma. The American Journal of Surgery, 220(3), 545–549. 10.1016%2Fj.amjsurg.2020.05.012
Sidgwick, H. (1874). The methods of ethics. Macmillan.
Smillie, L. D., Katic, M., & Laham, S. M. (2020). Personality and moral judgment: Curious consequentialists and polite deontologists. Journal of Personality, 89(3), 549–564. https://doi.org/10.1111/jopy.12598
Takamatsu, R. (2018). Turning off the empathy switch: Lower empathic concern for the victim leads to utilitarian choices of action. PLoS One, 13(9), e0203826. https://doi.org/10.1371/journal.pone.0203826
Takamatsu, R. (2019). Personality correlates and utilitarian judgments in the everyday context: Psychopathic traits and differential effects of empathy, social dominance orientation, and dehumanization beliefs. Personality and Individual Differences, 146, 1–8. https://doi.org/10.1016/j.paid.2019.03.029
Takamatsu, R., & Takai, J. (2019). With or without empathy: Primary psychopathy and difficulty in identifying feelings predict utilitarian judgment in sacrificial dilemmas. Ethics & Behavior, 29(1), 71–85. https://doi.org/10.1080/10508422.2017.1367684
Underwood, L. G., & Teresi, J. A. (2002). The daily spiritual experience scale: Development, theoretical description, reliability, exploratory factor analysis, and preliminary construct validity using health-related data. Annals of Behavioral Medicine, 24(1), 22–33. https://doi.org/10.1207/S15324796ABM2401_04
Vachon, D. D., & Lynam, D. R. (2016). Fixing the problem with empathy: Development and validation of the affective and cognitive measure of empathy. Assessment, 23(2), 135–149. https://doi.org/10.1177/10731911145
Vyas, K., Jameel, L., Bellesi, G., Crawford, S., & Channon, S. (2017). Derailing the trolley: Everyday utilitarian judgments in groups high versus low in psychopathic traits or autistic traits. Psychiatry Research, 250, 84–91. https://doi.org/10.1016/j.psychres.2017.01.054
Yu, C. L., & Chou, T. L. (2018). A dual route model of empathy: A neurobiological prospective. Frontiers in Psychology, 9, 2212. https://doi.org/10.3389/fpsyg.2018.02212
Zhang, X., Wu, Z., Li, S., Lai, J., Han, M., Chen, X., Liu, C., & Ding, D. (2020). Why people with high alexithymia make more utilitarian judgments: The role of empathic concern and deontological inclinations. Experimental Psychology, 67(1), 23–30. https://doi.org/10.1027/1618-3169/a000474
Zhou, X., Wildschut, T., Sedikides, C., Shi, K., & Feng, C. (2012). Nostalgia: The gift that keeps on giving. Journal of Consumer Research, 39(1), 39–50. https://doi.org/10.1086/662199