Högskolan i Skövde

The ventromedial prefrontal cortex (vmPFC) is a specific area in the brain that regulates emotions during decision-making. When this area is damaged, moral reasoning will be affected, and this is seen in individuals with lesions in the vmPFC. This systematic review investigated how vmPFC lesions affect moral reasoning by analyzing six studies comparing patients with vmPFC lesions and healthy controls. The tasks in the different studies involved hypothetical moral dilemmas and economic decision-making games (e.g., the Ultimatum game). The vmPFC patients in the hypothetical moral dilemma studies consistently showed a greater tendency to make utilitarian moral judgments, especially in emotionally charged high-conflict scenarios. However, in social-economic tasks, vmPFC patients showed emotion-based behavior, such as rejecting unfair offers even at a personal cost. These findings suggest a diminished emotional influence on moral reasoning in vmPFC patients compared to healthy controls, leading to decisions where outcomes are prioritized over social and moral norms. However, the complexity of vmPFC damage may not eliminate emotional responses entirely but rather impair the ability to regulate specific emotions depending on the context. In conclusion, the evidence supports that vmPFC does have a role in balancing emotion and logic during moral decision-making.