Tuesday, December 9, 2014

An overview of Neurointerventions and the Law: Regulating Human Capacity (Lawyers, Neuroscientists, Philosophers, and Psychologists in Conversation)

During the weekend of September 12th, Georgia State University was home to fascinating conversations between prominent lawyers, neuroscientists, philosophers, and psychologists. The challenging, thought-provoking, and interdisciplinary nature of this forum was condensed within its title: Neurointerventions and the Law: Regulating Human Mental Capacity.

Image from AJOB Neuroscience

Organized by the Atlanta Neuroethics Consortium (ANEC), the conference sought debate on the legal implications of using modern neuro-interventions. Some of the questions that were raised included, but were not limited to:
  • What mental capacities does one need in order to be eligible for trial? For punishment? For release? For cognitive enhancement?
  • What policies should be in place to control such neuro-interventions?
  • What are the current neuro-interventions used in the courts, and how are they regulated?
  • How should we view the relationship between mental capacity and both moral and legal responsibility? 

Image from Knowing Neurons

The conference gathered many prominent members of the MacArthur Foundation Research Network on Law and Neuroscience. Some of the participants were Senior Judge Andre Davis (U.S. Court of Appeals for the Fourth Circuit), Nita Farahany (Duke University), Walter Glannon (University of Calgary, Stephen Morse (University of Pennsylvania Law School), Justice David Nahmias (Supreme Court of Georgia), and Paul Root Wolpe (Emory Center for Ethics).

The conference schedule was structured around four panels, each followed by “parallel streams” of three 30 to 40 minute long related talks given by panelists or conference attendees. Panels were released under the form of case studies that raised valuable questions about the use of neuro-interventions in a legal context. The format of the panel discussions was dynamic and interactive. First, each panelist presented his or her own views on the topic, then the chairs opened discussion among panelists by pointing out specific arguments, converging or diverging positions, and follow-up questions prompted by the panelists’ points. Finally, audiences had ample time to ask questions.

Image from The Jury Expert

More detailed information about each panel is available here, but following is a summary of each panel. To better frame the general course of a panel, I will discuss the first panel in more detail.

Panel 1: Making People Sane Enough for Release

The case discussed was that of State of New South Wales v Williamson. In 1990, a then 20-year old Williamson was sentenced to 24 years of imprisonment on account of violent sexual assault. He was released after 22 years on supervised parole on the condition of continuing treatment with the testosterone inhibitor cyprotene in the hopes of reducing the uncontrolled sexual urges of the offender. The ensuing questions was, “Should a neurointervention be a condition of release from prison for sex offenders?”.

Chris Ryan, a psychiatrist at the University of Sydney, and Katrina Sifferd, a philosopher from Elmhurst College, chaired the first panel. The panelists included a justice on the Supreme Court of Georgia, two neuroscientists, and two philosophers – testimony to the interdisciplinary nature of the conference. After the case was presented, Justice Nahmias remarked – to my surprise – that neuro-interventions such as drug administration and counseling in Georgia courts are pervasive, and designed to keep as offenders out of the prisons. Philosopher Farah Focquart then pointed out that even though testosterone inhibitors may reduce sexual thoughts, there is no evidence that they also remove aberrant sexual behaviors in sex offenders.

The conversation took an interesting spin when the panelists started questioning the divide between a sexual offender and a sexual offender with a sex disorder: how does introducing self-control in the equation change the grounds of culpability? Can we prevent sexual offenses from happening by finding a way to increase self-control, rather than decreasing sexual urges? Ultimately, the panel discussion arrived to a new, yet equally pertinent larger question: Is all bad behavior pathological? Can categories that were previously restricted to the legal sphere undergo medicalization, and how would that affect legal responsibility and accountability? All these are intriguing questions that require interdisciplinary evaluation as that promoted by the Neurointerventions and the Law conference.

Panel 2: Making People Sane Enough for Punishment

This panel focused on the case of Scott Panetti, a man suffering from delusional disorder, schizophrenia, bipolar disorder, and alcohol and drug abuse, who was sentenced to death after murdering two people. The question raised by this panel was whether neuro-interventions can and should be used to restore an inmate’s eligibility for punishment. Follow-up questions included what exactly constitutes eligibility for execution, and whether federal resources should be invested in rehabilitating offenders just in order to be able to subject them to punishment.

Scott Panetti : Image from The Austin Article

Panel 3: Making People Sane Enough for Trial

The third panel attacked the highly controversial question of who should diagnose whether an offender has the mental capacities to withstand trial, and whether psychosis is always a proof of incompetency. The role and reliability of science in the courts was evaluated, and panelists concluded that the consideration of scientific insights within a court of law needs to satisfy three distinct tiers of reliability: of the method, of the method with respect to the case in question, and of the person doing the expert testimony. Interesting corollary discussions explored the reliability of eye-witness testimony, which has historically been shown to be limited, particularly for cases in cross-racial cases. From a more neuroscientific perspective, the panelists evaluated the various methods of neuro-rehabilitation for schizophrenia such as memory enhancement drugs, cholinesterase inhibitors, and electroshock therapy.

Two points made during this panel particularly stood out to me. First, in providing a legal perspective on this question, Judge Davis made the stimulating remark that the law is not concerned with our philosophical lives. Second, in discussing the possible application of fMRI techniques to detect brain activation typical to lying during testimony (that is, if imaging techniques ever become advanced enough to reach reliability standards), how could the courts account for a case in which a particular false event memory is true for the testifier?

Panel 4: Cognitive Enhancement

The last panel was of particular interest to me. As a current college student, I am witnessing some of my peers’ desperate and constant search to obtain prescription medications such as Adderall and Ritalin in order to improve their academic performance. The use of such drugs, by virtue of providing users with increased mental abilities, may confer them an unfair academic advantage; therefore, institutions such as Duke University have categorized the use of cognitive enhancement drugs as a breach of academic honesty. The panelists discussed the necessity of policies such as that instituted by Duke and other ethical implications of cognitive enhancement.

Image from The Chronicle
Parallel Streams

There were eight distinct sessions of parallel streams, each consisting of three talks related in one way or another to the topic of the panel discussion. Since the audience of these talks was generally much smaller than that of the panel discussions, these panels were a great way to further conversations and allow more ample time for audience questions. Sometimes, however, it was difficult to choose one stream in lieu of another.

Poster Session

The conference integrated a poster session that attracted students from various disciplines and institutions. Some of the titles were “Enhancing Brain Activity Through Cognitive Entrainment”, “Coffee and Cognition”, and “Neuroscience and its Mind Altering Potential for Marketing”.

Closing thoughts

I was personally captivated by the interdisciplinary conversations I witnessed at the conference. As a neuroscience student, I am much more familiar with the specific tools of neuroscience and their applications than I am with Georgia’s code of laws, for instance. In that respect, I learned quite a bit about the legal perspective on mental illness and cognitive enhancement. Furthermore, I have always been interested in how a fixed code of laws can address individuals fairly, and Neuro-interventions and the Law directed my questions towards new directions: Does justice mean judging an individual against a fixed code applied broadly, or should it take into consideration, for example, the effects of early childhood trauma on neurodevelopment? Where should the line be set on this matter so that justice is upheld?

ANEC’s mission statement is to “bring together individuals and institutions who are concerned with the ethical, legal, and social implications of emerging neuroscience research and technology, and the neuroscientific foundations of moral behavior”. The Neurointerventions and the Law conference was a commendable effort to endorse the function of the new group, and a standing proof to the need of engaging in interdisciplinary conversation to advance both neuroscience research and the effectiveness of the legal process. It is only natural to engage multiple fields: we can only know what is just if we form an idea of what it means to be human, and philosophy, psychology, and neuroscience all bring different information towards constructing a more complete answer.

Want to cite this post?

Lucaciu, I. (2014). An overview of Neurointerventions and the Law: Regulating Human Capacity (Lawyers, Neuroscientists, Philosophers, and Psychologists in Conversation). The Neuroethics Blog. Retrieved on , from http://www.theneuroethicsblog.com/2014/12/an-overview-of-neurointerventions-and.html

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