A supplement for empathy?

Nov. 21, 2016
In his 1972 novel Breakfast of Champions, the American writer Kurt Vonnegut, Jr. (1922-2007), wrote, “I tend to think of human beings as huge, rubbery test tubes, with chemical reactions seething inside.” Vonnegut was speaking ironically; he didn’t really think of human beings that way: if there is one over-arching theme in his body of work, it is the question of how we remain human in an increasingly technological world. But he was making a serious point about how chemical influences affect psychological states, and I think he would have been interested in a news release that recently crossed my desk.

The release described research conducted at the University of Cardiff (Wales) and presented at the Society of Endocrinology annual conference. It concerned a study that indicated that people with low levels of the hormone oxytocin exhibit reduced empathy. That is, in the study, people suffering medical conditions causing low levels of oxytocin performed worse on empathy tasks. The research suggests that hormone replacement could improve the psychological well-being of those living with the low levels.

Oxytocin, which has sometimes been called “the love hormone,” has a role in sexual arousal, recognition, trust, anxiety, and mother-infant bonding. It is produced by the hypothalamus and stored in the pituitary gland.

The researchers investigated empathic behavior in people whom they suspected of having reduced oxytocin levels due to one of two medical conditions caused in response to pituitary surgery. The study assessed 20 people with cranial diabetes insipidus (CDI). In CDI, the body has reduced levels of ADH, a chemical also produced in the hypothalamus and structurally very similar to oxytocin. They also assessed 15 people with hypopituitarism (HP), a condition in which the pituitary gland does not release enough hormones. These two patient groups were compared to a group of 20 healthy controls.

The researchers gave all participants two tasks designed to test empathy, both relating to the recognition of emotional expression. Both tasks required participants to identify which emotion or feeling best described a series of images of human faces.

The scientists measured each group’s oxytocin levels and found that the 35 CDI and HP participants had slightly lower oxytocin compared to the healthy controls. They also saw that the CDI and HP groups performed significantly worse on empathy tasks, compared to controls. In particular, CDI participants’ ability to identify expressions was predicted by their oxytocin levels:  those with the lowest levels of oxytocin produced the worst performances.

“This study looks at low oxytocin as a result of medical, as opposed to psychological, disorders,” said Katie Daughters, lead researcher. “The results from our patient groups suggest it is also important to consider medical conditions carrying a risk of low oxytocin levels.”

“Patients who have undergone pituitary surgery, and in particular those who have acquired CDI as a consequence, may present with lower oxytocin levels. This could impact their emotional behavior, and in turn affect their psychological well-being. Perhaps we should be considering the introduction of oxytocin level checks in these cases.”

Perhaps. But empathy is subjective, and how much of it someone should have is a matter of opinion; the ethical questions that might be raised by the idea of giving patients who have not presented with psychological problems supplements to make them, well, nicer, need to be addressed. And if one extends the implications of the study further—to the idea of giving supplements to patients who seem to lack the optimal amount of empathy for any reason—that could be a slippery slope, at least.

Now, ethical questions can have ethical answers, and science should not fear to tread on the edges of them. But one lesson to learn from this research is that clinicians should be very careful when dealing with the “huge, rubbery test tubes” that they treat. Kurt Vonnegut, Jr., would agree.