Clean Hands

Scrupulosity is a form of OCD that raises philosophical puzzles because of its superficial similarities to morally extreme, non-pathological motivation. Cases of Scrupulosity are first presented, then Scrupulosity is characterized as a form of obsessive-compulsive disorder (OCD) because of its moral or religious obsessions and/or compulsions and its underlying anxiety. Scrupulosity is specifically characterized by perfectionism, chronic doubt and intolerance of uncertainty, and moral thought-action fusion. It is a mental illness and not simply religious devotion, moral virtue, or strength of character. Scrupulous moral judgments differ from genuine moral judgments because their underlying anxiety leads to systematic distortions and leads those with Scrupulosity to act in a way that primarily soothes their anxiety instead of responding to the morally relevant features of the situation. People with Scrupulosity are likely less accountable for harms they cause, which can be explained by reasons-responsiveness theories of responsibility. There is justification for treating Scrupulosity over moral objection without imposing the therapist’s own moral standards.