'Morality pills' may be the US's best shot at ending the coronavirus pandemic, according to one ethicist

COVID-19 is a collective risk. It threatens everyone, and we all must cooperate to lower the chance that the coronavirus harms any one individual. Among other things, that means keeping safe social distances and wearing masks^[1]. But many people choose not to do these things^[2], making spread of infection more likely.

When someone chooses not to follow public health guidelines around the coronavirus, they’re defecting from the public good. It’s the moral equivalent of the tragedy of the commons^[3]: If everyone shares the same pasture for their individual flocks, some people are going to graze their animals longer, or let them eat more than their fair share, ruining the commons in the process. Selfish and self-defeating behavior undermines the pursuit of something from which everyone can benefit.

Democratically enacted enforceable rules – mandating things like mask wearing and social distancing – might work, if defectors could be coerced into adhering to them. But not all states have opted to pass them^[4] or to enforce the rules^[5] that are in place.

My research in bioethics^[6] focuses on questions like how to induce those who are noncooperative to get on board with doing what’s best for the public good. To me, it seems the problem of coronavirus defectors could be solved by moral enhancement: like receiving a vaccine to beef up your immune system, people could take a substance to boost their cooperative, pro-social behavior. Could a psychoactive pill be the solution to the pandemic?

It’s a far-out proposal that’s bound to be controversial^[7], but one I believe is worth at least considering, given the importance of social cooperation in the struggle to get COVID-19 under control.

Public goods games show scale of the problem

Evidence from experimental economics shows that defections are common to situations in which people face collective risks. Economists use public goods games^[9] to measure how people behave in various scenarios to lower collective risks such as from climate change or a pandemic and to prevent the loss of public and private goods.

The evidence from these experiments is no cause for optimism. Usually everyone loses^[10] because people won’t cooperate. This research suggests it’s not surprising people aren’t wearing masks or social distancing – lots of people defect from groups when facing a collective risk. By the same token, I’d expect that, as a group, we will fail at addressing the collective risk of COVID-19, because groups usually fail. For more than 150,000 Americans so far^[11], this has meant losing everything there is to lose.

But don’t abandon all hope. In some of these experiments, the groups win and successfully prevent the losses associated with the collective risk. What makes winning more likely? Things like keeping a running tally of what others are contributing, observing others’ behaviors^[12], communication and coordination^[13] before and during play, and democratic implementation of an enforceable rule requiring contributions^[14].

For those of us in the United States, these conditions are out of reach when it comes to COVID-19. You can’t know what others are contributing to the fight against the coronavirus, especially if you socially distance yourself. It’s impossible to keep a running tally of what the other 328 million people in the U.S. are doing. And communication and coordination are not feasible outside of your own small group.

Even if these factors were achievable, they still require the very cooperative behavior that’s in short supply. The scale of the pandemic is simply too great for any of this to be possible.

Promoting cooperation with moral enhancement

It seems that the U.S. is not currently equipped to cooperatively lower the risk confronting us. Many are instead pinning their hopes on the rapid development and distribution of an enhancement to the immune system – a vaccine.

But I believe society may be better off, both in the short term as well as the long, by boosting not the body’s ability to fight off disease but the brain’s ability to cooperate with others. What if researchers developed and delivered a moral enhancer rather than an immunity enhancer?

Moral enhancement is the use of substances to make you more moral. The psychoactive substances act on your ability to reason about what the right thing to do is, or your ability to be empathetic or altruistic or cooperative.

[You need to understand the coronavirus pandemic, and we can help. Read The Conversation’s newsletter^[15].]

For example, oxytocin, the chemical that, among other things, can induce labor or increase the bond between mother and child, may cause a person to be more empathetic and altruistic^[16], more giving and generous^[17]. The same goes for psilocybin^[18], the active component of “magic mushrooms.” These substances have been shown to lower aggressive behavior in those with antisocial personality disorder^[19] and to improve the ability of sociopaths to recognize emotion in others^[20].

These substances interact directly with the psychological underpinnings of moral behavior; others that make you more rational could also help. Then, perhaps, the people who choose to go maskless or flout social distancing guidelines would better understand that everyone, including them, is better off when they contribute, and rationalize that the best thing to do is cooperate.

Moral enhancement as an alternative to vaccines

There are of course pitfalls to moral enhancement.

One is that the science isn’t developed enough. For example, while oxytocin may cause some people to be more pro-social, it also appears to encourage ethnocentrism^[22], and so is probably a bad candidate for a widely distributed moral enhancement. But this doesn’t mean that a morality pill is impossible. The solution to the underdeveloped science isn’t to quit on it, but to direct resources to related research in neuroscience, psychology or one of the behavioral sciences.

Another challenge is that the defectors who need moral enhancement are also the least likely to sign up for it. As some have argued, a solution would be to make moral enhancement compulsory^[23] or administer it secretly, perhaps via the water supply^[24]. These actions require weighing other values. Does the good of covertly dosing the public with a drug that would change people’s behavior outweigh individuals’ autonomy to choose whether to participate? Does the good associated with wearing a mask outweigh an individual’s autonomy to not wear one?

The scenario in which the government forces an immunity booster upon everyone is plausible. And the military has been forcing enhancements like vaccines or “uppers” upon soldiers^[25] for a long time. The scenario in which the government forces a morality booster upon everyone is far-fetched. But a strategy like this one could be a way out of this pandemic, a future outbreak or the suffering associated with climate change. That’s why we should be thinking of it now.

References

1. ^{^} keeping safe social distances and wearing masks (www.cdc.gov)
2. ^{^} many people choose not to do these things (www.pewresearch.org)
3. ^{^} tragedy of the commons (en.wikipedia.org)
4. ^{^} not all states have opted to pass them (www.aarp.org)
5. ^{^} to enforce the rules (www.clickondetroit.com)
6. ^{^} My research in bioethics (scholar.google.com)
7. ^{^} bound to be controversial (slate.com)
8. ^{^} Josh Edelson/AFP via Getty Images (www.gettyimages.com)
9. ^{^} public goods games (en.wikipedia.org)
10. ^{^} Usually everyone loses (doi.org)
11. ^{^} For more than 150,000 Americans so far (www.cdc.gov)
12. ^{^} observing others’ behaviors (doi.org)
13. ^{^} communication and coordination (doi.org)
14. ^{^} democratic implementation of an enforceable rule requiring contributions (doi.org)
15. ^{^} Read The Conversation’s newsletter (theconversation.com)
16. ^{^} altruistic (doi.org)
17. ^{^} more giving and generous (doi.org)
18. ^{^} The same goes for psilocybin (doi.org)
19. ^{^} lower aggressive behavior in those with antisocial personality disorder (doi.org)
20. ^{^} ability of sociopaths to recognize emotion in others (doi.org)
21. ^{^} Jeffrey Hamilton/DigitalVision via Getty Images (www.gettyimages.com)
22. ^{^} appears to encourage ethnocentrism (doi.org)
23. ^{^} make moral enhancement compulsory (global.oup.com)
24. ^{^} administer it secretly, perhaps via the water supply (doi.org)
25. ^{^} forcing enhancements like vaccines or “uppers” upon soldiers (www.theatlantic.com)