Lawrence Altman’s thoughtful piece on Svensson in The New York Times casts the case as a matter of medical ethics, with Altman––and the majority of online commentators––arguing that medicine and murder don’t mix, and that a killer cannot be trusted in an asymmetrical relationship such as that of doctor/patient. (While the thought of a murderer-turned-physician is admittedly perverse, I can’t think of any profession that would welcome ex-cons into their ranks).

But this is not just a professional conundrum, it's a basic moral quandary, one that confronts anyone struggling with the question of criminal rehabilitation. To ask if Karl Svensson deserves to become a doctor is to invoke what psychologist Philip Tetlock calls a taboo trade-off. The trade-off pits a sacred value––killing is immoral and murderers should be punished––against a secular one––individuals who meet rigorous intellectual requirements should be allowed to study medicine. For many people, it is taboo to even suggest that a “secular” value deserves consideration. In my highly unscientific scan of Times’ readers’ input, this certainly seems to be the case, with fewer than one in 10 arguing that Svensson should be allowed to earn a degree. But interestingly, Svensson’s fellow Karolinska students were evenly divided on the question of whether he should be expelled. And Altman observed that while Swedes overwhelmingly endorsed the idea that a convicted criminal deserves a shot at med school, they revised their opinion when told that the criminal in question was the notorious Svensson.

Tetlock has found that even though people feel compelled to trumpet their moral outrage at the prospect of a taboo trade-off, they’ll reconsider when the trade-off is presented as necessary or inevitable. In one study, he found that while people expressed near universal outrage at the prospect of selling body organs, forty percent changed their tune when informed that the practice might be the only way to save lives. In other words, constraints force people to reconsider their “sacred” values.

It’s easy to argue that if a situation is dire enough, skills matter more than baggage. In a roadside accident, you’re not going to agonize over the credentials of a doctor who happens on the scene; if you’re on trial for a capital crime, you might not care about your lawyer’s background, as long as he can get you off the hook. (And if you’re John Gotti, you probably consider sociopathy on your legal team a plus).

Personally, I’m torn over the Svensson case. My moral instinct tells me this man should be banned forever from medicine––and certainly from dealing interpersonally with patients. But an instrumental impulse whispers that since the crime cannot be undone, he’s more valuable to society as a medical professional than he is as a parolee.

So here’s an idea that just might work in a socialist country like Sweden: Let the murderer get his medical license, on condition that he must work in a prison infirmary…. and live on the premises.