Psychos in the C-Suite While they don’t seem to feel shame, they are preoccupied with being thought of as highly moral.

It is my impression we’re making more psychopaths. I can’t back this up with statistics because doctors don’t write “total psycho” on the diagnosis line. Psychopathy isn’t a diagnostic category and is largely viewed as part of a cluster of antisocial personality disorders. But doctors commonly use the term and it has defined characteristics. The American Psychological Association calls it a chronic disposition to disregard the rights of others. Manifestations include a tendency to exploit, to be deceitful, to disregard norms and laws, to be impulsive and reckless, and, most important, to lack guilt, remorse and empathy. The APA has reported 15% to 25% of prison inmates show characteristics of psychopathology, far more than in the general adult population.

But that’s where I see growth. Subtle psychopaths, the kind who don’t stab you, are often intelligent, charming and accomplished. I believe two are currently in the news. (I confine myself to the business sphere, leaving out the equally rich field of politics.)

American PsychoElizabeth Holmes was just sentenced to 11 years in federal prison for defrauding investors in her famous Theranos scam. People used to ask why she did it. By now that’s clear. She did it to be important. She wanted to be admired. She wished to be thought a genius, a pioneer. She no doubt wanted money, though part of her con was to live relatively modestly—she wore the same black turtleneck and trousers most days. She wanted status, then and now as Tom Wolfe said the great subject of American life. And she seemed to think she deserved these things—that she merited them, simply by walking in. One thing you pick up as you read John Carreyrou’s great reporting, in these pages and his book, is that she seemed not at all concerned with the negative effects of her actions on others. She didn’t seem to care that investors lost hundreds of millions, people lost jobs, the great men she invited on her board were humiliated.

Sam Bankman-Fried’s cryptocurrency-trading firm, FTX, collapsed last month. We’re still in the why-did-he-do-it phase—Was it deliberate deception? Untidy bookkeeping? Visionaries often leave the details to others! We make mysteries where there aren’t any. He had a great life while it worked! He made himself famous, rich, admired—friend of presidents and prime ministers, the darling of a major political party. To the Democrats he was the biggest thing since George Soros.

But somehow a valuation of $32 billion was, in a matter of weeks, turned into, or revealed as, nothing. FTX filed for bankruptcy on Nov. 11, and FTX’s new CEO, John Ray, said he believed gross negligence was involved and a “substantial portion” of FTX customers’ assets may be “missing or stolen.” Soon after, the crypto firm BlockFi filed for bankruptcy in New Jersey and Bermuda.

A peculiarity of subtle psychopaths is that while they don’t seem to feel shame, they are preoccupied with being thought of as highly moral. Ms. Holmes was simply trying to help sick people get their blood tested more easily. This was part of her origin myth—a relative’s illness made her sensitive to the needs of the suffering. Mr. Bankman-Fried gave away millions and became the public face of a movement called effective altruism. He was just trying to help the less fortunate live better lives! And he was so modest about it, eschewing material things, clad in rough sandals, a thin T-shirt, shorts. Like the young St. Francis, stripping himself naked that his robes might be sold for the poor.

I don’t know if Elon Musk fits in this category. I hope he’s an eccentric genius with a moral core and not a psychopath. We’ll find out! It’s good he’s in space. His buying Twitter has excited lots of people, frightened others. If he merely changes that public square from an entity of the left to an open entity, good. We’ll see how content moderation goes. But many conservatives see him as a kind of savior. Is he? Saviors by definition save others.

Does he strike you as preoccupied by the needs of other people? Evince an old-fashioned interest in the public weal? He offers to buy the site, changes his mind, tries to back out, is forced to honor his agreement, takes over. In the ensuing chaos he tweets out memes of a whore tempting a monk, to illustrate, strangely, his invitation to Donald Trump to rejoin the site. He tweets out photos of his bedside table—two life-size handgun replicas and scattered cans of Diet Coke. It looked as if a school shooter lived there.

“He stands for free speech.” Mr. Bankman-Fried stood for selflessness and “responsible” regulation of crypto. Ms. Holmes stood for thinking outside the box and breaking through false limits. They all believe in something.

My fear with Mr. Musk is that if a scientific paper came out saying eating baby parts will add half a century to your life, he’d tweet: We can grow the babies in discarded ship containers and eat them—for the squeamish, God didn’t make them, I did so there’s no soul or anything.

But again, most interesting in psychopaths is the lack of remorse. They don’t like being caught—that upsets them—but they don’t mind causing others harm. It’s their superpower. They’re not hemmed in by what limits you.

Which is a conscience. People often refer to their consciences—they say things like “My conscience is clear.” It’s not an unknown entity to them. But they seem to think it’s something they were born with, like a sense of smell. When actually a conscience has to be formed and developed or it doesn’t work.

Every major faith in the world has thoughts here. In Catholic teaching, says Father Roger Landry, Columbia University’s Catholic chaplain, the traditional definition of conscience is “a judgment of the practical reason applying moral principles to concrete circumstances leading to the conclusion to do or not do something.”

“Many people today confuse their conscience with their opinion or even with their feelings about what is the right thing to do or avoid,” he said in an email. “Many think that if their intentions were good, and they desired a good outcome, then the action would be morally fine. But, as is obvious, sometimes we will feel good about doing something wrong (‘I stole, but he was rich’; ‘I insulted her, but she deserved it.’)” A conscience must be informed “with the truth that comes from God—the Ten Commandments, the Beatitudes, corporal and spiritual works of mercy, other passages in Sacred Scripture, the moral teachings of the Church.” These things “illumine our eyes so that we may see things more clearly.”

“Conscience can make erroneous judgments, either because it identifies wrong principles (e.g., personal autonomy as the supreme value), or has the right principles in a disordered rank (prioritizing not hurting others’ feelings over helping the person give up drugs.)” But to form a conscience we have a duty “to tune into God’s frequency rather than our own echo chamber, or the confused noise that can come from culture.”

We need better consciences. If we got them, we’d have fewer psychopaths.