Veil-of-ignorance reasoning affects moral judgment and cognitive flexibility in people with obsessive-compulsive disorder

Individuals with obsessive-compulsive disorder (OCD) have rigid moral judgments compared to healthy people. They tend to prefer deontological options when they face moral dilemmas. Recent research has indicated that activating the Veil-of-Ignorance (VOI) reasoning changes moral judgment in healthy participants, leading them to favor utilitarian choices. However, the effect of VOI reasoning on OC patients' moral judgment has not been studied. The present research aimed to investigate the effect of VOI reasoning on moral judgment and cognitive flexibility of OC patients across two studies (N = 336). In study 1, we recruited 80 OCD participants and 80 healthy participants via convenience sampling and assigned them randomly to either the VOI or non-VOI group. Participants in the VOI group read the VOI versions of the footbridge (personal dilemma) and trolley (impersonal dilemma) dilemmas prior to answering the standard scenarios. In the control group, participants only responded to the standard versions of the dilemmas. In study 2, 88 OCD participants and 88 healthy participants were recruited and followed the same procedure as the first study except that they responded to the bioethical personal and impersonal dilemmas. At the end of each experiment, participants answered the cognitive flexibility test. Results indicated that OCD participants who engaged in VOI reasoning subsequently made more utilitarian choices in response to impersonal dilemmas compared to the OCD participants in the non-VOI condition. However, VOI reasoning did not change their choices in response to personal dilemmas. On the other hand, healthy participants favored utilitarian options in response to personal dilemmas. Both healthy and OC participants performed better on the cognitive flexibility test after engaging in VOI reasoning.