One day in February 2017, Michel Cadotte, 58, walked into his wife’s room at the long-term care institution where she was living to feed her lunch, a daily ritual for him. Jocelyne Lizotte, 60, his wife of 19 years, had battled Alzheimer’s disease for the past decade.

But that day, as Globalnews.ca wrote:

He cried as he struggled to feed her lunch and then placed a pillow under her head. Cadotte said he couldn’t explain what happened, but after a couple of attempts, he placed the pillow over her face and smothered her.

The dates of Lizotte’s birth and death were posted to Cadotte’s Facebook page, followed by a post saying he “cracked” and “gave in to her demand for help dying.”

Cadotte had looked into securing medically assisted suicide in 2014 for his wife, (medical aid in dying is legal in Quebec), but was informed she was not eligible on the grounds that she was unable to consent and her death was not imminent.

A jury found Cadotte guilty of manslaughter in the killing. He was sentenced to two years in prison.

Cadotte has stated he killed Lizotte because he couldn’t stand seeing her suffer anymore. But during sentencing arguments, as members of the couple’s families testified, they described the painful emotional impacts of Cadotte’s action, and a different picture was painted.

We usually take it for granted that empathy leads to altruistic actions, but what is happening in a case like this?

Empathic Dissonance

Across cultures and even in other species, individuals have been found to give priority to the well-being of close others.

Research on empathy has typically considered cases in which changes to others’ experience and existence move in tandem or are otherwise compatible. For example, rescuing drowning children. It is on the basis of situations like these that closeness and empathy are generally understood to motivate promoting others’ welfare.

When reducing suffering can be accomplished by conventional forms of helping, empathy seems to promote those conventional forms of helping. In contrast, little is known about the consequences of closeness, and the empathy associated with it, when actions that would promote different aspects of another person’s welfare are misaligned, a situation that could be called empathic dissonance.

Disease, Pain And Death

To take a closer look at these aspects of empathy, Adrianna Jenkins of the University of Pennsylvania designed three experiments in which saving a person’s life was incompatible with extinguishing the person’s suffering[1].

[caption id=“attachment_100919” align=“aligncenter” width=“700”] Results of Experiment 1.

Credit: Jenkins AC CC-BY[/caption]

There are, she points out, two categories of a person’s welfare

“1. those which promote a person’s subjective, psychological experience (quality of life) by reducing pain and suffering or increasing pleasure and happiness

those which promote a person’s objective, physical existence (duration of life), by increasing physical health or longevity."

Her work involved 203 participants were asked to read a brief story about someone in a life-threatening and extremely painful accident.

For example:

“Imagine that about a year ago, you learned that CC was diagnosed with a serious disease. After several tense discussions with doctors, CC told you that the disease was terminal; she didn’t know exactly how long she had to live. Since that time, CC’s condition has deteriorated rapidly, and she is in now constant, excruciating pain.

Imagine that it is the middle of the night, and an electrical fire has broken out in CC’s apartment. CC’s sheets have caught fire, and she is unable to move to escape. CC writhes helplessly in pain as the flames spread over her, severely burning her skin. The smoke begins to engulf her, and around her, she sees parts of the building begin to collapse. All things considered, would it be better if (A) CC is carried out of the building alive by the responding fire fighters or (B) CC is killed instantly by falling debris before the fire department arrives?”

In the first experiment, participants expressed greater preference to end the lives of friends than strangers.

In the second, they gave preference to those whose perspectives they had taken than those whom they considered from afar, and in experiment number 3, greater preference to end the lives of those who remained alert and actively suffering than those whose injuries had rendered them unconscious.

The findings call to mind studies that report our brains process the experience of empathy in a similar way to the experience of physical pain.

So is having extremely high levels of empathy with someone good or bad? And good or bad for whom? Perhaps Cadotte was able to see things the Lizotte’s family could not[2].

Or perhaps he was too close to see what they could.

“These findings demonstrate that empathizing with another person can have detrimental effects on aspects of that same person’s welfare, joining other findings that empathizing with one person can have detrimental effects on the welfare of other people…At the extreme, the current results suggest that empathy sometimes increases preferences for ending a person’s life,”

Jenkins writes.

[1] Jenkins AC (2019) Empathy affects tradeoffs between life’s quality and duration. PLoS ONE 14(10): e0221652. https://doi.org/10.1371/journal.pone.0221652

[2] Zaki J, Cikara M. Addressing Empathic Failures. Curr Dir Psychol Sci. 2015;24: 471–476.

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