How is my statement implying that people (adults, at least) will be forced to do anything?
We screen children for autism not just so they can have a diagnostic label, but so their challenges can be addressed effectively.
In the case of sociopathy, we could screen children to identify those who have a high likelihood of sociopathy so that such individuals can be properly treated. No, they wouldn’t have much of a choice inasmuch as they are children and few children are given a choice when it comes to medical treatment. Big whoop. And if early interventions fail and they indeed become monsters, we will have solid justification for isolating them in a residential facility rather than sending them to church camp for the summer and hoping Jesus will save them. Coercion only would come in when it is clear that we are dealing with a very harmful individual. Very harmful people shouldn’t have a lot of rights, sorry.
If you are a mass shooter and you just killed 20 people in cold blooded murder, you forfeit your right to decide what kind of prison sentence you get and whether you get X kind of rehab or Y kind. And I am not going to be upset if a judge offers such a person an opportunity for a lighter sentence in exchange for following a medical regimen that has a proven record in reducing sociopathic behavior. That is coercive too, but I think most people would say it is neither cruel nor unusual punishment.
There are two possible points of coercion: forcing people to be screened, and forcing people to be treated/isolated. I think it is realistic to assume sociopaths will largely refuse voluntary screening and refuse treatment/isolation. If they wanted to behave like normal people, they wouldn’t need the screening, would they?
And if the subject is a child, as AHunter3 pointed out, if the kid is at risk of developing schizophrenia chances are the parents sexually abuse their child, and will refuse to send the kid in for screening.
Either the parents consent to the screening or things get so bad that the government overrides their nonconsent.
Right, the parents have that choice. And I am pointing out that parents of schizophreniacs likely abuse their children sexually and will therefore object to screenings that might expose their abuse. If what AHunter3 says is true, it would seem that the first screening should be for sexual abuse, not sociopathy.
If the person committed a crime, you lose the advantage of a pre-emptive screening because the deed is already done. Court-ordered psychological examinations are already commonplace and future biometric tools, if helpful in making a diagnosis, will just become a regular part of the examination.
Color me skeptical, considering the existing difficulty in compelling already known mentally ill people to comply with medications, etc… against their will, both because they don’t like it, and because the courts won’t uphold it.
I’d think something similar for *potential * sociopaths would be impossible to actually push through any legislatures.
And this is the crux of the free will discussion. Only free willers believe that wanting to be good is sufficient to be good. They think sociopaths have a failure of “want” rather than a failure of cognition. Determinists such as myself think this a load of bunk.
Why would a sociopath choose to get screened? Maybe they are tired of prison life. Maybe CPS is threatening to take away their kids unless they can stop verbally abusing them. Maybe they have to get tested to get security clearance for a dream job. Maybe–despite what we have been led to believe–some sociopaths actually do have remorse. It is just that remorse isn’t enough to stop their bad behavior (alcoholics and overeaters should be able to sympathize).
Um…this is nuts, sorry. I really don’t know what you are communicating with this. We shouldn’t screen children for mental illness because their mentally ill parents will then rape them? Does that really make sense to you?
If a bad-ass kid is tormenting the community and his parents refuse to get him tested and possibly treated, why shouldn’t the government step in? How does it benefit him or the community to let him tear shit up just because people are afraid of governmental overreach? There is always the risk of governmental overreach. This is why we have safeguards and watchdogs.
Schizophrenia and socipathy are not the same thing. This argument is so bizarre I don’t know what to do with it, other than to remind you that bad parents are always going to exist. Screening tools or not. If parents don’t want to get their bad-behaving kids screened, OK. But then when their kids become the next mass shooter, they need to be prepared to be called monsters too.
If a 13-year kid who is convicted of assault and battery can receive medical treatment to deal with his physical aggression and low empathy, maybe he won’t grow up to be a mass shooter. Maybe instead of spending a million dollars keeping him incarcerated for the next ten years, we only have to spend $40,000–the cost of two years of therapy and medicine.
There is a difference between court-ordered screening and court-ordered treatment. If you object to the latter because BAD THINGS MIGHT HAPPEN!!, then there is no point of the former.
To be honest, the total impracticality and the lack of an ethical foundation means this is just going to be misused.
Once we start testing, even on extremely spurious science, then other conditions will be dragged in, until we decide that certain people will be defined as undesirable, the idea of aborting fetuses is an alarming idea.
What we are really discussing here is eugenics, which of course has as its bedfellow racism.
I will add one other thing, having worked many years with offenders it is striking just how selfish and sociopaths they are, the ones who are drug addicts are the worst - drug taking strips all empathy from even a reasonably decent person because the next hit is the only thing in the world that matters - so what are you going to do, the war on crime isn’t going all that well, do we lock up all drug users forever? What about the dealers? Good luck on paying for all that.
Your presumptive test simply will not work because it will predate any drug taking activity and it means that you must test everyone periodically - can you imagine how well that’d go down, especially with a 10% false positive on the general population in order to whittle out maybe 1% of sociopaths. Monstro, I notice huge numbers of conditionals which would lead to decision making agencies, these would need to be driven by various standards, appeals processes and legal process - all of these are flawed and in the end we are actually discussing the stigmatisation and punishments of large numbers of individuals for no other reason than the purported attempt at creating some sort of Utopia.
You use anecdotes, and your versions of examples - what you do not use is any reference to ethics, data or facts.
To me this actually reveals that your utopia is actually built upon your own sociopaths ideals of how you can control and force a society to conform to your demands, anyone who argues in favour of such a scheme has to be revealing a little of their own sociopathy, so maybe you should take the test first and inform the rest of us about the effects upon you and your family
I guess we should cease all research that may lead us to discover why people behave the way they do. Because it is inevitable those discoveries will be misused. It is invitable there will be harmed. It is inevitable no one will be helped. It is inevitable that safeguards against overreach would fail. So let’s keep thumping our bibles and praying. That is working so much better than whatever medical science could come up with. Fuck science, amirite?
Because you have not provided a valid cite for declaring that percentage. How do YOU know that 90% of “sociopaths” display disruptive behavior? How are YOU defining that? Some people define “disruptive” as any child that doesn’t shut up and do as he’s told without question. Some people define “disruptive” as any girl that wants a career instead of devote all her time to a husband and children. Who gets to define “disruptive”? Are hyperactive children - who do tend to be disruptive - now also sociopaths?
You know, when the XYY karotype was discovered in the 1960’s it was initially linked to men with violence and criminal history. Then both science and everyone else “knew” that men with XYY were “likely” to be criminals. Then some new and better studies were done (ones that didn’t do all their subject selection from prisons and mental institutions but rather from newborns) and it turns out that, whoops, the vast majority of XYY men show no unusual symptoms (although greater than expected height along with learning disabilities might lead to screening) and it turns out that XYY men are no more likely than average to be aggressive or violent. WHOOPS! But, you know, when you pick your test subjects from a pool of men already pre-selected for violence and/or aggression you wind up with a false correlation.
So… we don’t know, for a fact, that your “sociopaths” (which, as has already been mentioned, is not a technical term in psychiatry) are all 90% inclined to be “disruptive”, much less criminal. Maybe if we defined the term, defined “disruptive”, and came up with a reliable test we’d find that genes only accounted for, say, 10% of a predisposition towards murder and mayhem and the rest was nurture. Or some other mix. You’re guessing. Which is OK if it’s just your life but you’re talking about other peoples’ lives.
You mean… like HIV testing has minimized the stigmatization of living with a positive HIV status?
As a general rule, people are not good at developing such programs so I have much doubt about it. And you’re talking about a test that, if you’re correct, will tell parents their children are 90% like to grow up to be criminals. Oh, nothing stigmatizing about *that…! * :rolleyes:
But… hypothetically… even if we could do that… what would be the purpose of the testing? Only if something positive could be done would it be worthwhile, and if something could be done but the expense was out of the reach of the average family testing would just be a sick joke, wouldn’t it? Hey, you’re kid is messed up but fixable… except you can’t afford to fix him. Have fun organizing spaghetti dinners for the cause!
So…
MAYBE acceptable, IF the test is…
Reliable
Useful
Affordable
AND
We can actually do something about the problem
Ordinary people can afford the treatment
20% error rate seems kind of high to me. Are those positive errors or negative errors? What are the consequences if someone is falsely identified as a “sociopath” - would the treatment required be harmful to people without the genetic variation? Side effects for anyone?
There you go again, assuming that the default sociopath is a murderer. Cite, please. Is there ANYTHING to substantiate that?
Because side effects can be icky. Hey, we cured your disease but the medication made you completely deaf! Gee, I’m glad to be alive but it still sucks my collection of tunes is now useless to me, I can no longer enjoy playing my oboe, and I’ll never hear my grandbabies say they love me. Or… hey, we saved you from Flesh Eating Disease but now you’re a quadruple amputee! Gee, I’m glad to be alive but it still sucks I no longer have hands or feet (goddammit, I still can’t play my oboe anymore!) and I have to have someone wipe my ass for me after I take a shit.
Not everybody is going to agree on what “acceptable” means here. And even if someone does think their situation is an improvement that doesn’t rule out sucky side effects from treatment.
The moment you take a genetic test to screen for disease you limit your estate planning options. Also your ability to insure yourself is going to take a major, major hit.
There’s been a test for Huntington’s Disease for quite some time now. A lot of people DON’T get tested even if they have relatives with the disease because nothing can be done. There is no treatment. Knowing doesn’t do jack for you. People who find out their status in regards to this gene sometimes commit suicide rather than continuing living with the knowledge they are doomed to get this disease.
Knowing you have a genetic disease is only useful if there is a TREATMENT for that disease.
Otherwise, you might be a lot happier NOT knowing.
Because right now there is ALWAYS a penalty for having a mental illness. It’s not as bad as it used to be, but there is still a stigma. Hell, there’s still a stigma just for having a relative who is “crazy”, much less being the affected person yourself.
I think what I find most disturbing in your viewpoint is that you are talking about modifying people not for the benefit of the patient but for the benefit of other people.
Now, there might be some people so awful that is justified from a public safety standpoint. A Jeffrey Dahmer, for example - we just can’t allow someone to go around raping and eating people after performing a DIY lobotomy. But Dahmer was such an outlier even among crooks and crazies that you just can’t set public policy based on him. But while there might be justification for forced treatment after someone does Something Horrible you’re talking about doing this before someone has done anything wrong at all.
The original question was on a binary identification. If you want to expand this to a spectrum of sociopathic behavior, you still have problems, especially in determining where the cutoff point is.
I didn’t say anything about forcing people to do anything, but false positives have costs. All the stuff you mention has costs. Who’s going to pay for it when we don’t even treat identified sociopaths? And what about the change in how someone is treated when they are misidentified? Are you sure that when they are called a problem they won’t become a problem to meet expectations? Remember the studies about what happens when a teacher is told that a kid in the class is either extra smart or a problem?
This kind of thing was mentioned all the time with AIDS testing. Testing everyone (not just those at risk) for AIDS was a terrible idea because the false positives would overwhelm the true positives. Breast cancer screening seems to have the same problem.
If the number of false positives was small it might be worth it, but I chose my example so that it wasn’t. What percentage of sociopaths are there in the population? How good is the test. I bet that this solution would cause way more problems than it solves.
You asserted I am assuming that all sociopaths are criminal. I come back with the response that I am assuming they are all disruptive. And now you are equating the two things. I think that is disingenuous.
Because it is a hypothetical. I don’t have to provide a cite for something that isn’t real.
Substitute “sociopath” for “individual with anti-social personality disorder”, if it pleases you. And then use the criteria outlined in the DMS-5 if you need some help figuring out what kind of person I am talking about
See above.
The same people who are tasked with diagnosing a person with APD would be tasked with flagging individuals who are sufficiently disruptive to be screened for sociopathy. So the kid with Tourettes who screams obscenities would likely not get a recommendation for screening, since his doctor would have a modicum of intelligence. Similarly, a doctor won’t recommend screening any girl with high self-esteem, because her doctor will likely have a modicum of intelligence. But if the little girl is constantly in and out of detention because she won’t stop bullying all the kids on the playground, maybe her doctor will be like, “Hey, this is worrisome. Let’s see what could be going on here.” Why will the doctor do this? Because he will likely have some intelligence. Not all the time, but the vast majority of the time. And for incompetent doctors, we have things like malpractice lawsuits and disciplinary boards to keep them in check.
Scientists aren’t perfect. Resarchers have historically made mistakes and so have practitioners. Humans gonna human. So…does that mean we shouldn’t do science? We shouldn’t use science, even in ways that have few downsides? I mean, if your little girl was a schoolyard bully, would you not take her to a therapist? Would you not consider whether a pill may help her with her aggression? If you would, I have no idea why you’re knee-jerking so hard here. Sure, medicine can always be used in scary ways. That is why we have medical ethics boards and regulations. I see no reason to assume those safeguards would be thrown out of the window.
You seem to be trying to score points on definitions rather than substance. I really am not a fan. If you don’t know what a sociopath is, substitute any clinical-sounding label you want for “shitty person”. Maybe it is a person who abuses their spouse or children. Maybe it is someone who kicks puppies in their spare time. Maybe it is a violent criminal. It doesn’t matter what I mean by “sociopath”. You know there are people who act like monsters because you are a smart person who has been around the block for a long enough time. Pretend we are talking about people who act like monsters. Now pretend we have a screening tool that allows us to identify such people before they can do much harm.
You’re overthinking this way too much if you can’t do this.
Do you think the benefits of HIV testing could possibly outweigh the stigma of living with HIV status? Benefits not just for the infected but for their partners and families?
Do you think the stigma has been reduced through the years BECAUSE testing is so prevalent?
Do you think the fact that there are for effective treatments for HIV has led to more testing and even less stigmatization?
Can you imagine how much worse the AIDS epidemic would be if people shied away from testing because “OMG the government will round people up and kill us!!” Or “OMG they don’t even know what HIV is!!” Or “OMG remember the Tuskeegee thing!!” If you can see how hysterical those arguments are, you can understand why I am frustrated by your arguments.
The purpose of course would be to prevent and treat, the same as any diagnostic tool. You have a toddler that is acting out? Well he could have a hundred things wrong with him. Maybe we would have individualized treatment plans for all these disorders. So if he just has the markers for sociopathy (however you want to define that), he gets prescribed brain stimulus treatments followed up with CBT. If that is too scary, here are some pills. If that is too scary, here is a dietary plan and some vitamin supplements. If that is too scary, well, I guess pray on it 'cuz science has run out of ideas for you. If I were a doctor and I had a patient who didn’t want to follow any of my recommendations because “OMG science gets things wrong sometimes!”, I would be wondering what the fuck they want me to do for them. Why did they come to me if they didn’t want me to use science to help them with their problems?
And re poor people, let’s have universal healthcare so cost isn’t even an issue. But how is this relevant to the discussion? Screening tools might be expensive and not covered by insurance right away. Does that mean no one should use them?
Effective treatment for Alzheimer’s will likely be available for the wealthy before the poor. That is sad, but that does not have any bearing on whether screening tools should be developed and implemented. That is more an indictment of the healthcare system than it is on the ethics of biomarker screening.
10% false positive and 10% false negative. This is a higher error rate than what is usually deemed acceptable for drug trials. But we aren’t talking about drug trials. We are talking about pinpointing “at risk” populations. And we are talking about interventions that have a low risk of harm outside of cost and convenience. If a kid doesn’t respond positively to a year of group therapy, OK. At least we tried something.
I am sure some Oscar the Grouch might complain about having to take vitamin D shots and wasting time practicing relaxation techniques. And maybe some person might get stuck with an incompetent therapist that does more harm than good. But the same can be said for any treatment. If the vast majority of cases are helped, then a person with a tragic outlier experience is just a sad anecdote. I think most people are willing to accept an occasional sad anecdote in exchange for not having to worry so much about monsters roaming the streets. But YMMV.
I have firsthand experience with mental illness and stigma and putting up with stigma (as well as horrible side effects) so I could get successful treatment. So I don’t need a lecture, sorry. And I also know that a lot of mental illness follows from trauma. Trauma caused by a childhood full of abuse. Or trauma caused by being a victim of violent crime. I think we are smart enough to find a way to thread the needle between minimizing the number of abusers out there without increasing the number of victims. Yes, we would have to ensure there are safeguards in place. All medical interventions require safeguards. Big whoop. Doesn’t mean we shouldn’t try.
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You misunderstand me. If a biometric screening test for sociopathy exists, if the existence of such a test is common knowledge, and if such a test is available, those potential sociopaths who want to behave like normal people will seek out the test on their own thus removing any ethical conundrum. You could say they would volunteer for a voluntary test.
Some forms of paranoia will also prevent people from consenting to a biometric test, including the somewhat reasonable paranoia about misuse of their biometric data.
If the only treatment is some horrifying procedure such as a lobotomy, the person might refuse treatment even if they are screened. Alternately if the treatment involves talking to a psychologist, and the patient has a problem talking to people, they might be unable to bring themselves to the office. Or if the psychologist prescribes a regimen (medical or behavioral), and the patient fails to keep the regimen, they may be unable to bring themselves back to face the doctor.
No, you have it backwards. The parents are already abusing the kids, that’s why the kids become sociopaths. If you ask the parents to send their kids to therapy, the parents of potential sociopaths are already abusing their kids and could get busted if the kids talk to a shrink. Why would abusive parents ever agree to send the kids off to therapy?
If he is “tormenting the community”, as in breaking the law, then the government can and should step in. But as I pointed out shortly after, you lose the advantage of a pre-emptive screening because the deed is already done. Unless the kid has a good excuse, he already meets the criteria for sociopathy.
Either psychosis is a subset of sociopathic disorders or (in my opinion) there are not and never will be biometric markers to identify sociopathy, with the possible exception of some future-tech invasive brain scan.
The point is that bad parents severely undermine the utility of any proposed sociopathy screening.
Don’t confuse psychological treatment with medical treatment, and don’t confuse the hypothetical existence of a sociopath-test with a sociopath-cure or treatment. In the worst case, we have the test but no cure and inconclusive treatment.
Also, it is possible that a kid’s first actionable encounter with law enforcement is after the shooting. There are constitutional limitations to overcome before the government can force the kid to do anything.
You wrote this with a sarcastic emoticon, but if said research involves or proposes involuntary changes to a person’s mental state, it deserves very high scrutiny.
I understand that part of the populace would be comfortable trusting the wisdom, good intentions, professionalism, etc, of doctors.
When the concern is patient self-determination, I am not among them. They have a spectacularly dismal track record, especially within the subfield of psychiatric medicine.
I’m skeptical, largely because I feel I was misdiagnosed with a minor psychiatric disorder and that the misdiagnosis was ultimately damaging to me. My story isn’t a crazy horror story, it’s just run of the mill disturbing.
First, this is going to sound ironic because of my screen name, but I picked my name because it was a play on the title of a cool sci-fi story. It never occurred to me that anyone would take it as anything but a play on words. And I’ve been too lazy to change it.
Anyway, I was once diagnosed with some sort of moderate depressive disorder. I did go to my doctor with depressive symptoms. I saw it as a situational thing. I had a fairy tale romance of 7 years crash and burn and shortly afterwards sister was killed in a horrific accident. I felt I needed a little help for a little while., maybe a few months. Which was what I told my doctor. But I did not, and still do not, feel I was experiencing anything abnormal. I think my reaction was totally normal for the situation.
I was not given any sort of biological test - I don’t believe one exists, but I was asked a series of questions that sounded like one of those women’s magazine quizzes. And based on that, I was diagnosed with depression. The diagnostic criteria did not seem to take into account the real world factors that had led me to feel the way I did. And my symptoms were lack of concentration, weight loss, inability to sleep. I want to note that I never felt any sort of lack of self-worth or urge to self-harm AT ALL.
So my doctor gave me a prescription for Paxil. She told me I wouldn’t feel anything at first but then I would start to feel gradually better. I took one 10mg pill.
The effect was immediate. It was like a gram of cocaine mixed with a micro dose of LSD, except the high lasted much longer. It was intensely euphoric. I was engaged with everything and everyone. People and things had auras around them. I couldn’t sleep except for a few hours of restless thrashing but I didn’t need to. My neck muscles were as stiff as board and I had electric shooting pains running up my jaw into the side of my neck. But I didn’t much care.
I dutifully reported all this to my doctor who encouraged me not to “give up” and to keep taking the drug. I think she gave me Valium to help me sleep.
But after a few weeks or so all this wore off and I felt worse than ever. So my doctor gave me another brand, which was good for a few weeks of euphoria. Zoloft. Lexapro, Prozac ( that one was intense, it gave me 6 weeks of manic euphoria). Rinse and repeat.
But eventually all the euphoric and manic effects stopped, and the medication did nothing but make me really sleepy all the time. Plus I had a new boyfriend and wanted to reverse that horrible sexual deadening. So I got switched to an SNRI.
That drug immediately turned me into a completed different person. A raging angry person with no capacity for joy or pleasure. I found out what the phrase “see red” really meant, which was something I had never experienced. I threw things and broke them. I yelled and screamed at people. And I got these weird oddly specific violent ideations. Not homicidal, I just wanted to give certain people a solid uppercut punch to their left jaw.
So I immediately stopped it, after my new boyfriend threatened to leave me if I didn’t. Which was about a week after I started taking that drug.
I stopped taking everything. I didn’t see any reason to continue. My grief had faded. I had a new boyfriend. And none of these drugs had worked the way they were supposed to, even though the euphoria was fun while it lasted.
But I got a lot of pushback for that decision, because apparently there was this perception that had a medical disorder that I was refusing to treat.
And even though I only took those drugs for about 6 months and at very low doses, I had a lot of trouble going off them. And the muscle stiffness NEVER went away completely, I still have issues with it almost 20 years later. And I feel I am somewhat more emotionally labile than I was before that 6 month chemistry experiment on my brain. And that week of being angry and violent left me with a lot of psychological debris.
I probably would have resisted taking them in the first place had it not been for the general perception aka “Listening to Prozac” ( this was in the year 2000 ) that they were mild and harmless and could make even normal people better than well.
But, based on my own experience, I cannot agree with the wholesale prescription of these drugs to young children. Or the idea of legally compelling anyone to take them.
I’ve seen the Voight-Kampff test in action and it seems effective, though dangerous for the tester. One question is:
You’re in a desert walking along in the sand when, all of a sudden, you look down and see a tortoise crawling toward you. You reach down and flip it over onto its back. The tortoise lies there, its belly baking in the hot sun, beating its legs, trying to turn itself over, but it cannot do so without your help. You are not helping. Why?
But seriously, I’m firmly in the Nurture camp and don’t believe that a test that could identify sociopathic tendencies could be useful after the age of, oh, ten, when the patient realizes he can game the test, like Rachael does later. Younger if he’s smarter, never if he’s dumb but carrying a trump card like Leon has. It is my belief–and without science to define it and identify it belief is all we have in this thread–that sociopaths, like everybody else, see that certain behaviors lead to their being rewarded. For sociopaths it’s behaviors that the rest of society sees as negative, but he got what he wanted.
Seriously, is sociopathy considered a genetic trait or is it learned behavior, typically from trauma or events experienced by people during formative times of their lives?
I disliked the Bladerunner version of that test because it started with “tell me one positive thing about your mother.” Now, even most people with terrible mothers could probably think of something positive, but it also wouldn’t be that weird to be human and also react with anger at that question. I know there was supposed to be other stuff about cameras seeing pupils, etc (though it would be pretty hard for any camera to see them while someone stood up and moved around the room), but the questions were a hard part of it.
Same as lie detector tests. They assume that someone is going to be more stressed when they’re lying. However, you’re also going to be more stressed when you’re talking about something that upsets you, or where you’re just not sure.
Monstro - you said to Broomstick “if you don’t know what a sociopath is…” But nobody knows. Psychiatrists don’t. It will never be possible to do a genetic test for something nobody can agree the definition of. And this thread was started off the back of *your *hypothetical that we could pre-screen for this.
You’re basically assuming we can pre-screen for evil and then, with a huge 10% failure rate, condemn loads of kids to forever be treated as evil. You talk about a failure of imagination, but it’s a huge failure of imagination to not think hmm, maybe treating kids as evil might make them give up on being good, or in the best case scenario, lead to them being hugely depressed due to guilt about thins they haven’t done yet.
There have sort of been real-world trials with this, too. If you grow up as part of a gangster family or a family with mental health problems you have a much greater chance of getting into trouble. There have been so many longitudinal studies going over this sort of labelling that I don’t want to go and seek them out. Because I don’t think any reasonable person actually needs to have cites that telling a kid they’re bad and always will be makes it more likely that they will be bad.
By labelling children as evil from birth you would, essentially, be making it much more likely that they turn out that way, including some kids who never even had the supposed tendency to begin with. Not a bad SF short story, but a terrible real world.
Um, it was a movie. Or a novella. Or a novelization. Or another movie, depending. Not intended to be taken seriously. Or it was, Dick being a bit nuts. I didn’t intend it seriously, except as a lead into my belief that this discussion is, at best, silly because a reliable test is impossible.
The test isn’t designed to elicit specific emotional responses, it’s desgned to provoke an emotional response which it can then gauge for being genuine or manufactured. The idea isn’t, “If this question makes them angry, they’re a replicant,” it’s, “Replicants won’t have genuine emotional responses to this question.” And, of course, there’s reasons why a human might fake an emotional response to a question like that, which is why there’s a lot of questions. A “real” person is going to have genuine emotional responses to most of them. A replicant, in theory, wouldn’t have a genuine emotional response to any of them.
That said, in my headcanon for the movie, the Voight-Kampala test is actually bullshit pseudoscience, like a lie detector.