tag:theconversation.com,2011:/global/topics/biology-and-blame-10799/articlesBiology and Blame – The Conversation2014-06-15T20:35:17Ztag:theconversation.com,2011:article/274632014-06-15T20:35:17Z2014-06-15T20:35:17ZPut down the smart drugs – cognitive enhancement is ethically risky business<figure><img src="https://images.theconversation.com/files/51017/original/z44cvp7x-1402627753.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Cognitive enhancers could join coffee, pain killers and antibiotics as an accepted – and expected – mode of self-improvement.</span> <span class="attribution"><a class="source" href="https://www.flickr.com/photos/cosmoflash/2392022758">Flickr/cosmo flash</a>, <a class="license" href="http://creativecommons.org/licenses/by-sa/4.0/">CC BY-SA</a></span></figcaption></figure><p><em>Cognitive performance enhancers promise to deliver a better version of ourselves: smarter, more alert and more mentally agile. But what if such enhancement was no longer a personal choice but a socially and legally enforced responsibility? In the final instalment of <a href="https://theconversation.com/topics/biology-and-blame">Biology and Blame</a>, Nicole A Vincent and Emma A. Jane explore the risks of normalising this emerging trend.</em></p>
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<p>In Australia and all around the world, students, academics and professionals of various stripes are increasingly <a href="http://www.ncbi.nlm.nih.gov/pubmed/23702522">experimenting with</a> new cognitive enhancement technologies to boost their memory, attention, reflexes, clarity of thought and ability to function well with little sleep.</p>
<p>In many cases, this involves the repurposing of medications that have previously been used to help the sick become “normal”, rather than to boost the well into some sort of superhuman sphere. These include controlled drugs such as <a href="http://www.betterhealth.vic.gov.au/bhcv2/bhcmed.nsf/pages/nvcrtlor/$File/nvcrtlor.pdf">Ritalin</a> (a central nervous system stimulant usually prescribed for hyperactivity and impulse control), <a href="http://www.nlm.nih.gov/medlineplus/druginfo/meds/a602016.html">modafinil</a> (a medication used for increasing wakefulness in patients with conditions such as narcolepsy) and <a href="http://www.patient.co.uk/medicine/donepezil-aricept">donepezil</a> (used to treat dementia). </p>
<p>Interest is also growing in <a href="http://www.hopkinsmedicine.org/psychiatry/specialty_areas/brain_stimulation/tdcs.html">transcranial direct current stimulation</a> (tDCS) devices, which stimulate the brain using electricity drawn from nine-volt batteries. These largely unregulated and under-tested devices <a href="https://theconversation.com/its-electrifying-non-invasive-brain-stimulation-17873">are said to sort out</a> everything from depression to poor sports performance. But there are <a href="http://blogs.law.stanford.edu/lawandbiosciences/2013/10/24/electroceutical-ads-are-here-what-will-regulators-say/">concerns</a> that the DIY use of such “electroceuticals” may result in at-home users zapping their brains in ways that harm rather than help.</p>
<p>Because these techniques and technologies are new – or at least are being put to novel use – the issues that tend to get most attention in academia and in the media relate to their effectiveness and safety. </p>
<p>The jury is still out on which of these techniques and technologies work, for whom they work, and how and how well they work. There is also breathtaking disagreement about such fundamental issues as: what percentage of people are using them; whether their effects are best described as “enhancement” or only as “treatment”; and what side effects they might produce. </p>
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<img alt="" src="https://images.theconversation.com/files/51027/original/t94r7t93-1402632279.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/51027/original/t94r7t93-1402632279.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=906&fit=crop&dpr=1 600w, https://images.theconversation.com/files/51027/original/t94r7t93-1402632279.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=906&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/51027/original/t94r7t93-1402632279.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=906&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/51027/original/t94r7t93-1402632279.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1139&fit=crop&dpr=1 754w, https://images.theconversation.com/files/51027/original/t94r7t93-1402632279.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1139&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/51027/original/t94r7t93-1402632279.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1139&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">The jury is still out on whether, or how well, cognitive enhancement works.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/62807512@N05/6957782012">Julia Shore</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc-nd/4.0/">CC BY-NC-ND</a></span>
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<p>Several recent studies report around a 30% improvement in language learning by <a href="http://www.ncbi.nlm.nih.gov/pubmed/24485800">subjects who used modafinil</a> or <a href="http://www.ncbi.nlm.nih.gov/pubmed/23988131">tDCS</a> over those who did not.</p>
<p>Other researchers, however, <a href="https://theconversation.com/smart-pills-magic-bullets-or-benign-slugs-7628">warn that the hype</a> surrounding cognitive enhancement is unhelpful and possibly even dangerous. This, they say, adds to the pressure people already feel to use these technologies, even though claims about their effectiveness and safety are at least premature if not overstated and even outright misleading.</p>
<p>But while safety and effectiveness are indeed important concerns, some ethico-legal issues are even more critical. Let’s imagine, for instance, that modafinil and tDCS turn out to be as effective and safe as the optimistic studies suggest; that they are as relatively inexpensive, innocuous and helpful as all those other prosaic props that regularly help us get through the day (coffee, painkillers and post-work flutes of prosecco, as just three examples). </p>
<p>Despite the benefits, we think there is good reason not to embrace these new technologies: namely, to ensure that cognitive enhancement does not become the new “normal”. Put another way, we don’t want to find ourselves in a scenario where mildly electrifying our brains is no longer considered a personal choice but is instead a socially and legally enforced responsibility. Yet, right now, concerns about effectiveness and safety are all that stands between us and that scenario.</p>
<h2>The new ‘normal’</h2>
<p>To understand this situation, consider two examples one of us <a href="https://www.youtube.com/watch?v=0z7QJgUeGqk">discussed recently</a> at TEDxSydney.</p>
<p>In a clever article written for Limelight Magazine last year, the very talented and accomplished Sydney-based concert pianist Simon Tedeschi <a href="http://www.limelightmagazine.com.au/Article/329982,simon-says-i-admit-to-doping.aspx">writes about</a> how a significant portion of concert musicians nowadays use or feel pressured to use medications called <a href="http://www.mayoclinic.org/diseases-conditions/high-blood-pressure/in-depth/beta-blockers/art-20044522">beta blockers</a>. This is to calm their nerves before recitals for jobs, and on stage to deliver the superior performances we have come to expect of them. </p>
<p>Off-label uses of beta blockers began quietly in classical music circles in the late 1970s when small numbers of performers began using these cardiac medications <a href="http://www.nytimes.com/2004/10/17/arts/music/17tind.html?_r=4&">to prevent crippling performance anxiety</a> such as slippery palms, thumping hearts and flute-unfriendly lip quivers. </p>
<p>But, as time passed, increasing numbers of musicians turned to these medications to the point where this practice is becoming a new “normal”. Other concert musicians are increasingly wondering whether they too should start using beta blockers simply to keep up and remain competitive with those who already use them. </p>
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<img alt="" src="https://images.theconversation.com/files/51021/original/jf2myvmt-1402631663.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/51021/original/jf2myvmt-1402631663.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=401&fit=crop&dpr=1 600w, https://images.theconversation.com/files/51021/original/jf2myvmt-1402631663.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=401&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/51021/original/jf2myvmt-1402631663.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=401&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/51021/original/jf2myvmt-1402631663.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=504&fit=crop&dpr=1 754w, https://images.theconversation.com/files/51021/original/jf2myvmt-1402631663.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=504&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/51021/original/jf2myvmt-1402631663.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=504&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Musicians are increasingly using beta blockers to calm their nerves before concerts.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/gigitaly/2600694064">Gigi Tagliapietra</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc/4.0/">CC BY-NC</a></span>
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<p>What was once a choice for a few disadvantaged people is becoming a de facto necessity for all. And this did not occur because anybody intended it to be this way, but simply because of the way in which competition (and audience expectations) works.</p>
<p>A second example comes from three years ago, when members of a Jetstar cabin crew <a href="http://www.abc.net.au/lateline/content/2011/s3279602.htm">complained to the media</a> that their employer, a Thai company based in Bangkok called Tour East Thailand, was increasingly expecting them to work 20-hour shifts. The crew members were concerned that in the event of an emergency they would be too tired to be able to respond effectively and passengers’ safety could be compromised. </p>
<p>Imagine, though, what might happen in scenarios like this if enhancers such as modafinil turn out to be effective and safe health-wise. Given the enormous pressure on workers to achieve ever-rising levels of productivity, there is a risk that employers might make it a condition of employment that cabin crew use such medications to remain alert for the duration of their shifts.</p>
<p>This would be an industrial relations nightmare: nobody should be expected to enhance themselves just to do their job. </p>
<p>When the debate focuses on effectiveness and safety, it’s too easy to overlook myriad social, political and ethical reasons to say “no” to cognitive enhancement right now. This risks dystopic scenarios where corporations use such medications to save money by demanding superhuman efforts from workers rather than simply employing more staff. </p>
<p>At present, social attitudes towards cognitive enhancement range from fanatical enthusiasm to dismissive scepticism and frightened resistance. But these polarised reactions are likely to disappear once safety, effectiveness and equity of access can be assured. </p>
<p>Our worry is that – at precisely that point – cognitive enhancement will join coffee, painkillers, antibiotics and even smart phones in becoming the commonsensical and expected choice. The burden of proof will have shifted such that everyone will be expected to enhance themselves; justifications will have to be given to explain why we should not comply.</p>
<h2>Enhancement as a responsibility</h2>
<p>Here is another way to see this point.</p>
<p>Imagine you’re a surgeon about to perform a delicate, difficult, lengthy and ultimately risky operation, and that you could substantially improve your patient’s chances of survival by safely taking a pill that would increase your wakefulness, mental acuity, perceptiveness and ability to stay focused. </p>
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<img alt="" src="https://images.theconversation.com/files/51025/original/xcqfkmy6-1402632146.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/51025/original/xcqfkmy6-1402632146.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/51025/original/xcqfkmy6-1402632146.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/51025/original/xcqfkmy6-1402632146.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/51025/original/xcqfkmy6-1402632146.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/51025/original/xcqfkmy6-1402632146.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/51025/original/xcqfkmy6-1402632146.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Judges are not likely to recognise a duty for surgeons to enhance themselves any time soon.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/ale_era/3681831618">Aleera/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by-nd/4.0/">CC BY-ND</a></span>
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<p>If the pill really were that effective, and if it really had so few side effects, would it be a <em>fait accompli</em> that you should take it? Should you now <em>have</em> to take this pill to give your patients the best chance of recovery and survival? And would you be negligent – perhaps even reckless – if you didn’t take it? </p>
<p>When we are asked about whether we <em>ought</em> to enhance ourselves – and whether we would be responsible for any bad consequences and held responsible under the law if we don’t – it’s much less obvious that the answer should automatically be “yes”. </p>
<p>What we’re concerned about is the slippery slope that might lead from enhancement being a <em>choice</em> to it being a <em>responsibility</em> — that what’s initially freely chosen as a way of bettering ourselves, accomplishing more, or just making life easier and keeping up, may eventually become expected and even required. Sound unlikely? Consider <a href="http://www.health.qld.gov.au/hrpolicies/other/FRMS_web.pdf">hints by Queensland Health</a> that medical staff might have a duty to fight fatigue by, among other forms of cognitive enhancement, consuming the equivalent of five to six cups of coffee a night. </p>
<p>Despite these sort of caffeine-friendly suggestions, <a href="http://onlinelibrary.wiley.com/doi/10.1111/1468-2230.12056/abstract">judges are not likely</a> to recognise a duty for surgeons to enhance themselves any time soon. This is a good thing. What’s more, though, if we wish things to stay this way, we may need to resist the temptation to pop pills to enhance ourselves — even if the immediate benefits seem attractive. The long-term consequences may be distinctly unattractive.</p>
<h2>Exercising restraint</h2>
<p>Advances in science and technology subtly shape our lives by gradually, and often imperceptibly, changing the moral, legal and social landscape. What we expect of ourselves and of one another also changes with the times. It changes with what we think people are capable of doing and what we think is reasonable to expect people to be capable of doing. </p>
<p>If we wish to retain our choice, we may need to resist the temptation to use even safe and effective enhancers. </p>
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<img alt="" src="https://images.theconversation.com/files/51028/original/8txc3q4z-1402632605.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/51028/original/8txc3q4z-1402632605.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=398&fit=crop&dpr=1 600w, https://images.theconversation.com/files/51028/original/8txc3q4z-1402632605.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=398&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/51028/original/8txc3q4z-1402632605.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=398&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/51028/original/8txc3q4z-1402632605.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=501&fit=crop&dpr=1 754w, https://images.theconversation.com/files/51028/original/8txc3q4z-1402632605.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=501&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/51028/original/8txc3q4z-1402632605.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=501&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Despite the benefits, there is a persuasive reason not to embrace cognitive-enhancing technologies.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/worldbank/5321246556">World Bank Photo Collection</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc-nd/4.0/">CC BY-NC-ND</a></span>
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<p>Or, at least, if the benefits of cognitive enhancement are ultimately worth it, we should keep the conversation going about how to ensure that cognitive enhancement does not just become the new “normal”. We must not allow our expectations to creep upwards and ultimately coerce us collectively into having to enhance ourselves. </p>
<p>This will require intelligent regulation of these exciting – but ethically challenging – new technologies in a way that transcends the current dominance of discussions about effectiveness and safety.</p>
<p><br></p>
<p><em>This is the seventh and final article in our series <a href="https://theconversation.com/topics/biology-and-blame">Biology and Blame</a>. Click on the links below to read other pieces:</em></p>
<p><strong>Part one – <a href="https://theconversation.com/genes-made-me-do-it-genetics-responsibility-and-criminal-law-27395">Genes made me do it: genetics, responsibility and criminal law</a></strong></p>
<p><strong>Part two – <a href="https://theconversation.com/irresponsible-brains-the-role-of-consciousness-in-guilt-27432">Irresponsible brains? The role of consciousness in guilt</a></strong></p>
<p><strong>Part three – <a href="https://theconversation.com/psychiatrys-fight-for-a-place-in-defining-criminal-responsibility-27514">Psychiatry’s fight for a place in defining criminal responsibility</a></strong></p>
<p><strong>Part four – <a href="https://theconversation.com/looking-for-psychopaths-in-all-the-wrong-places-fmri-in-court-27591">Looking for psychopaths in all the wrong places: fMRI in court</a></strong></p>
<p><strong>Part five - <a href="https://theconversation.com/why-shouldnt-addiction-be-a-defence-to-low-level-crime-27520">Why shouldn’t addiction be a defence to low-level crime?</a></strong></p>
<p><strong>Part six – <a href="https://theconversation.com/natural-born-killers-brain-shape-behaviour-and-the-history-of-phrenology-27518">Natural born killers: brain shape, behaviour and the history of phrenology</a></strong></p><img src="https://counter.theconversation.com/content/27463/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Nicole A Vincent also works for Technische Universiteit Delft in The Netherlands, as Chief Investigator of the "Enhancing Responsibility" research project funded by the Netherlands Organisation for Scientific Research (NWO).</span></em></p><p class="fine-print"><em><span>Emma A. Jane does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Cognitive performance enhancers promise to deliver a better version of ourselves: smarter, more alert and more mentally agile. But what if such enhancement was no longer a personal choice but a socially…Nicole A Vincent, Associate Professor of Philosophy, Law, and Neuroscience, Georgia State UniversityEmma A. Jane, Senior Lecturer in Media, Journalism and Communication, UNSW SydneyLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/275182014-06-12T20:33:59Z2014-06-12T20:33:59ZNatural born killers: brain shape, behaviour and the history of phrenology<figure><img src="https://images.theconversation.com/files/50808/original/tnqdc8tw-1402466207.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Phrenologists believed the shape of the brain offered a clear-cut explanation for behaviour.</span> <span class="attribution"><a class="source" href="https://www.flickr.com/photos/hey__paul/6418553349">Hey Paul Studios/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by-sa/4.0/">CC BY-SA</a></span></figcaption></figure><p><em>Long before neuroscience, phrenology claimed to have the power to determine who was afflicted with badness and who was suffering from madness.</em></p>
<p><em>In the second-last article in our series <strong><a href="https://theconversation.com/topics/biology-and-blame">Biology and Blame</a></strong>, James Bradley details some interesting facts about this pseudo-science.</em></p>
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<p>At 8am on Monday October 24, 1853, Patrick O’Connor and Henry Bradley were hanged together outside the Melbourne Gaol in front of a large crowd. </p>
<p>Bradley and O'Connor were responsible for one of the lesser known, but more spectacular outbreaks of bushranging in the early period of the Gold Rushes, and paid the ultimate penalty for their violent crimes.</p>
<p>Having murdered a man in cold blood, they piratically seized a boat in northern Tasmania, and crossed the Bass Strait, landing somewhere near <a href="http://en.wikipedia.org/wiki/Western_Port">Western Port</a>. They then stole horses, held up travellers, and shot anyone who got in their way. </p>
<p>No one died, but that was through luck rather than judgement.</p>
<h2>A different judgement</h2>
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<a href="https://images.theconversation.com/files/50811/original/n5w73bdh-1402467022.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/50811/original/n5w73bdh-1402467022.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/50811/original/n5w73bdh-1402467022.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=587&fit=crop&dpr=1 600w, https://images.theconversation.com/files/50811/original/n5w73bdh-1402467022.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=587&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/50811/original/n5w73bdh-1402467022.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=587&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/50811/original/n5w73bdh-1402467022.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=738&fit=crop&dpr=1 754w, https://images.theconversation.com/files/50811/original/n5w73bdh-1402467022.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=738&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/50811/original/n5w73bdh-1402467022.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=738&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">A phrenology chart.</span>
<span class="attribution"><a class="source" href="http://commons.wikimedia.org/wiki/File:Phrenologychart.png">Heida Maria via Wikimedia Commons</a></span>
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<p>After the execution, medical men descended on the corpses. They paid particular attention to the malefactors’ skulls, and the following day’s <a href="http://trove.nla.gov.au/ndp/del/title/13">The Argus</a> explained how “cerebral physiology” had revealed that both were, in effect, natural born killers.</p>
<p>O’Connor’s skull revealed that:</p>
<blockquote>
<p>even if blessed by the controlling influence of a most powerful intellect instead of a very weak one, this would still have been a violent, murderous man.</p>
</blockquote>
<p>Bradley’s case was worse:</p>
<blockquote>
<p>Here … we have a person with all the passions and appetites of full-grown man, and controlling intellect of an average child — in fact a criminal idiot.</p>
</blockquote>
<p>The newspaper concluded that the “pirate bushrangers”, as they had become known, “had not powers of self-control.” They were, in fact, “not so much <em>criminals</em> as <em>state patients</em>.” </p>
<p>“Their destination should have been the asylum not the gallows.” </p>
<p>In other words, they should have been treated rather than punished.</p>
<h2>Phrenology’s heart</h2>
<p>“Cerebral physiology” was a euphemism for phrenology, a now-discredited pseudo-science. But make no mistake: in its day, phrenology was on the cutting edge of brain science. </p>
<p>During the first half of the 19th century, and arguably beyond, it offered a clear-cut explanation for why people behaved the way they did. And it was hailed by many as an extraordinarily effective explanatory tool. </p>
<p>Two ideas lay at the heart of phrenology’s seductive power. First, different areas of the brain were associated with different mental capacities or faculties. And, as the brain developed, it shaped the skull. </p>
<figure class="align-left zoomable">
<a href="https://images.theconversation.com/files/50810/original/55v8c7k8-1402466479.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/50810/original/55v8c7k8-1402466479.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/50810/original/55v8c7k8-1402466479.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=1014&fit=crop&dpr=1 600w, https://images.theconversation.com/files/50810/original/55v8c7k8-1402466479.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=1014&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/50810/original/55v8c7k8-1402466479.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=1014&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/50810/original/55v8c7k8-1402466479.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1274&fit=crop&dpr=1 754w, https://images.theconversation.com/files/50810/original/55v8c7k8-1402466479.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1274&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/50810/original/55v8c7k8-1402466479.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1274&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">An illustration and definition of ‘phrenology’ from Webster’s Dictionary circa 1900.</span>
<span class="attribution"><a class="source" href="http://upload.wikimedia.org/wikipedia/commons/1/17/1895-Dictionary-Phrenolog.png">Quasipalm via Wikimedia Commons</a></span>
</figcaption>
</figure>
<p>An underdeveloped faculty might result in a depression of the skull then, while an overdeveloped faculty would result in a bump or protuberance. </p>
<p>A skilled (usually medical) observer could detect either.</p>
<p>But what phrenology also offered was the potential to sort the wheat from the chaff — most phrenologists agreed that some criminals were born bad, while others were made bad by life circumstances.</p>
<h2>Some scepticism</h2>
<p>This was the position of the doyen of British phrenology, George Combe, who, in his <a href="http://www.historyofphrenology.org.uk/constindex.html">The Constitution of Man in Relation to External Objects</a> (1828), wrote that “certain individuals were unfortunate at birth”.</p>
<p>This line was reiterated by Scottish geologist George S. Mackenzie in 1836 when he petitioned the Secretary of State for the Colonies. Spurred by “recent atrocities that have occurred in New South Wales”, Mackenzie argued the selection of convicts to be transported to that colony was too haphazard. </p>
<p>Instead, their “individual history and characters should be inquired into”, and only the redeemable sent. And, of course, the best way to achieve this was by using phrenology, which would be “an engine of unlimited power” in shaping the reform of criminals.</p>
<p>Mackenzie’s petition was accompanied by a plethora of supporting testimonials provided by eminent scientists and medical men. </p>
<p>But the Secretary of State was unmoved by phrenology’s claims. And so too was the legal profession as a whole.</p>
<h2>Impact in the colonies</h2>
<p>Indeed, the legal profession would soon seek to <a href="https://theconversation.com/psychiatrys-fight-for-a-place-in-defining-criminal-responsibility-27514">purge the courts of the insanity plea</a> in favour of whether the criminal, sane or not, knew that he or she was committing a crime. </p>
<p>With this most phrenologists concurred: however underdeveloped a mental organ was, the criminal still possessed the ability to make a moral decision.</p>
<p>But just because phrenology failed to make an impact on the courts, doesn’t mean it had no impact upon penal policy in general. Alexander Maconochie, who, for a short time, was the progressive governor of the Norfolk Island penal colony, was deeply influenced by the discipline.</p>
<p>So too were the medical men who dissected the bodies of executed criminals. Like Bradley and O’Connor’s, dissections involved a minute examination of the internal structures of the brain, combined with a more general analysis of the bumps and depressions of the skull; all as part of the search to establish brain-based criminality.</p>
<p>Phrenology cast an extraordinarily long shadow over the 19th and early 20th centuries. Its public face may have become a tool for mesmerists and other quacks. But the project to locate criminal culpability in the brains and bodies of criminals continued apace.</p>
<h2>Criminal tattoos</h2>
<p>We see its inheritance in psychiatrist and anthropologist Cesare Lombroso’s 1876 <a href="http://books.google.com.au/books/about/Criminal_Man.html?id=yyRaEG-V_70C&redir_esc=y">L’Uomo Delinquente</a> (Criminal Man), although by now there was no talk of specific faculties or organs. </p>
<figure class="align-left ">
<img alt="" src="https://images.theconversation.com/files/50819/original/3fbh3vkg-1402468509.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/50819/original/3fbh3vkg-1402468509.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=594&fit=crop&dpr=1 600w, https://images.theconversation.com/files/50819/original/3fbh3vkg-1402468509.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=594&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/50819/original/3fbh3vkg-1402468509.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=594&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/50819/original/3fbh3vkg-1402468509.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=747&fit=crop&dpr=1 754w, https://images.theconversation.com/files/50819/original/3fbh3vkg-1402468509.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=747&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/50819/original/3fbh3vkg-1402468509.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=747&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Lombroso’s work was deeply influential.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/ivanlositattoos/8248958735">ivan losi/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc-sa/4.0/">CC BY-NC-SA</a></span>
</figcaption>
</figure>
<p>For Lombroso, the criminal was the product of a vitiated nervous system. Both the brains and skulls of criminals demonstrated evidence of atavism; in other words, criminals were evolutionary throwbacks, no less, and their skulls and faces bore the signs of degeneration. </p>
<p>It was for this reason that Lombroso made tattoos a dominant symptom of the pathological criminal (the striking illustrations in L’Uomo Delinquente are an abundant resource for the historian of tattooing). Only a person with a degenerated brain and nervous system would be able to subject him or herself to the pain of the tattooist’s needle!</p>
<p>But this notion of the biologically hard-wired criminal was one view among many. To be sure, it was deeply influential, particularly within the emergent discourse of eugenics. But it also vied with other ideas.</p>
<p>The celebrated French criminologist Alexandre Lacassagne, for instance, had a different take to Lombroso on the matter of tattoos. For him, they were “speaking scars” that talked of the life and culture of the tattooed individual. In the same way, the criminal was made by social circumstances rather than biological inheritance.</p>
<h2>Echoes of the past</h2>
<figure class="align-right ">
<img alt="" src="https://images.theconversation.com/files/50812/original/jcyhyw8k-1402467421.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/50812/original/jcyhyw8k-1402467421.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=605&fit=crop&dpr=1 600w, https://images.theconversation.com/files/50812/original/jcyhyw8k-1402467421.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=605&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/50812/original/jcyhyw8k-1402467421.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=605&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/50812/original/jcyhyw8k-1402467421.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=760&fit=crop&dpr=1 754w, https://images.theconversation.com/files/50812/original/jcyhyw8k-1402467421.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=760&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/50812/original/jcyhyw8k-1402467421.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=760&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Neuro-culpability: the modern-day phrenology?</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/jonolave/3565473585/in/photolist-6r4Z5v-sUk8Y-DWwGq-6SCgsW-7fhqq4-36fL9x-6SCgyS-DNJBS-mEuJm-5ab3s-7TyLXR-36fLaX-6Dht52-36fL7r-5cSyC-5cSzd-5cSzy-NtjN-DNJyY-5VnsDf-36koWS-ousHF-p17xW-4MwMCt-NtjP-4XUGF1-4MFAHb-4yuCEY-4MBprk-oyuYN-4NCiwq-92G4KQ-5byCf-5fbHci-36koXQ-36koYL-KvtyF-dz135E-5Vi6FV-h75wwe-e8anXe-5Vnsx3-3Td6p-5N63kr-czTdAU-5Nai9Q-5Naikq-7ebjQt-cKnD2-9mRza3">Jon Olav Eikenes/Flickr (resized)</a>, <a class="license" href="http://creativecommons.org/licenses/by-sa/4.0/">CC BY-SA</a></span>
</figcaption>
</figure>
<p>However alien phrenology looks, and however much it appears to modern eyes as a pseudo-science, we would do well to remember that, like contemporary neuroscience, it was once believed to possess the power to determine who was afflicted with badness and who was suffering from madness.</p>
<p>Indeed, this gives us reason to exercise some scepticism about contemporary neuroscience’s claims. The eminent historian of forensic psychiatry Joel Eigen has noted that neuroscience is “the latest but not the final chapter” in the story of identifying the pathological criminal.</p>
<p>Phrenology, which once spoke so loudly about the human condition, has gone the way of all things. Is it possible that the same fate awaits our contemporary understanding of neuro-culpability? </p>
<p>It is not impossible that today’s neuroscience will end up looking like yesterday’s phrenology. And only time will reveal the next instalment of the fraught dialogue between criminology and biological determinism. </p>
<p><br></p>
<p><em>This is the sixth article in our series <strong><a href="https://theconversation.com/topics/biology-and-blame">Biology and Blame</a></strong>. Click on the links below to read other pieces:</em></p>
<p><strong>Part one – <a href="https://theconversation.com/genes-made-me-do-it-genetics-responsibility-and-criminal-law-27395">Genes made me do it: genetics, responsibility and criminal law</a></strong></p>
<p><strong>Part two – <a href="https://theconversation.com/irresponsible-brains-the-role-of-consciousness-in-guilt-27432">Irresponsible brains? The role of consciousness in guilt</a></strong></p>
<p><strong>Part three - <a href="https://theconversation.com/psychiatrys-fight-for-a-place-in-defining-criminal-responsibility-27514">Psychiatry’s fight for a place in defining criminal responsibility</a></strong></p>
<p><strong>Part four – <a href="https://theconversation.com/looking-for-psychopaths-in-all-the-wrong-places-fmri-in-court-27591">Looking for psychopaths in all the wrong places: fMRI in court</a></strong></p>
<p><strong>Part five - <a href="https://theconversation.com/why-shouldnt-addiction-be-a-defence-to-low-level-crime-27520">Why shouldn’t addiction be a defence to low-level crime?</a></strong></p>
<p><strong>Part seven - <a href="https://theconversation.com/put-down-the-smart-drugs-cognitive-enhancement-is-ethically-risky-business-27463">Put down the smart drugs – cognitive enhancement is ethically risky business</a></strong></p><img src="https://counter.theconversation.com/content/27518/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>James Bradley does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Long before neuroscience, phrenology claimed to have the power to determine who was afflicted with badness and who was suffering from madness. In the second-last article in our series Biology and Blame…James Bradley, Lecturer in History of Medicine/Life Science, The University of MelbourneLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/275202014-06-11T20:32:22Z2014-06-11T20:32:22ZWhy shouldn’t addiction be a defence to low-level crime?<figure><img src="https://images.theconversation.com/files/50780/original/tgdrxhgg-1402450441.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Although addiction is often characterised as a disease and not a crime, it is criminal to possess and use certain drugs.</span> <span class="attribution"><a class="source" href="https://www.flickr.com/photos/e_monk/5831180626">e_monk/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc-sa/4.0/">CC BY-NC-SA</a></span></figcaption></figure><p><em>In today’s article in our series <strong><a href="https://theconversation.com/topics/biology-and-blame">Biology and Blame</a></strong>, Jeanette Kennett considers an inconsistency in the law’s approach to compulsion – addicts are responsible but others compelled to harmful behaviours are not.</em></p>
<hr>
<p>Addiction is not a crime. Indeed, it’s often characterised as a disease. But although it’s not a crime to be addicted, it is criminal to possess and use certain drugs. And many addicts commit other crimes, such as selling drugs or low-level property offences, to service their addiction. </p>
<p>Should addiction, then, be a mitigating factor that lessens the responsibility for such crimes? And should the issue of whether or not addiction is a disease make any difference to that judgement? </p>
<p>In broad terms, it’s agreed that those suffering from what the Diagnostic and Statistical Manual of Mental Disorders (DSM) calls severe substance use disorder experience a cluster of symptoms, including impaired control over drug use, despite often very severe negative consequences and repeated attempts to cut down or stop use.</p>
<h2>The affliction of addiction</h2>
<p>In <a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3782756/">an ongoing study</a> I’m involved in, for instance, many respondents report using drugs even in the face of pain, ill-health and the very real prospect of death: </p>
<blockquote>
<p>I think now I have kidney or liver problems, […] because certain drinks… the pain is just … I can’t stand up, I have to lay down and it … yeah, like I literally can’t get up, it passes after about 45 minutes … but it’s really intense pain… <strong>Respondent 4</strong></p>
<p>[T]here’s 12 of us started out together. And I think two are in institutions and the rest are dead, and I’m here. .. Any time that could have been me. <strong>Respondent 39</strong></p>
<p>You’ve always got that in the back of your mind you’re going to have a seizure, or you may not wake up. <strong>Respondent 25</strong></p>
</blockquote>
<p>Clearly, if the prospect of death doesn’t deter this group, legal punishment is unlikely to be effective. Most of our subjects report little pleasure from drug use and want to be free of their addiction. For them addiction is an affliction, like a disease. </p>
<p>As one of our respondents said:</p>
<blockquote>
<p>If a disease is something you don’t want that you’ve got and that ruins your life, you know it [addiction] is in a way. <strong>Respondent 67</strong></p>
</blockquote>
<h2>A fundamental inconsistency</h2>
<p>But Australian courts have often taken the view that addiction does not normally lessen criminal responsibility. The general principle was stated forcefully by <a href="http://www.judicialcollege.vic.edu.au/eManuals/VSM/index.htm#6186.htm">the judge in a 1988 case</a>: </p>
<blockquote>
<p>It is no mitigation whatever that a crime is committed to feed an addiction… If anyone hitherto has been labouring under the misapprehension that it was mitigation, then the sooner and more firmly they are disabused of it the better.</p>
</blockquote>
<p>A UK <a href="http://philosophy.sas.ac.uk/about/news/mental-capacities-and-legal-responsibilities-7-8-april">researcher has pointed out</a> the inconsistency in the approach of courts where compulsion is an issue. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/50781/original/ffhts4jr-1402451206.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/50781/original/ffhts4jr-1402451206.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=450&fit=crop&dpr=1 600w, https://images.theconversation.com/files/50781/original/ffhts4jr-1402451206.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=450&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/50781/original/ffhts4jr-1402451206.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=450&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/50781/original/ffhts4jr-1402451206.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=566&fit=crop&dpr=1 754w, https://images.theconversation.com/files/50781/original/ffhts4jr-1402451206.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=566&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/50781/original/ffhts4jr-1402451206.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=566&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Many addicts commit low-level property offences to service their addiction.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/ryteclick/1452217063">Twanda Baker/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by-sa/4.0/">CC BY-SA</a></span>
</figcaption>
</figure>
<p>In a number of decisions, British courts have held that an <a href="https://theconversation.com/force-feeding-anorexic-patient-curbs-freedom-of-choice-7815">anorexia sufferer’s refusal of food</a> is compelled and that this affects their competence to refuse treatment. </p>
<p>The finding that one patient, known as W, lacked the mental capacity to refuse treatment was based on the understanding that she had an “addictive illness” which “creates a compulsion to refuse treatment or to accept treatment that is likely to be ineffective”. </p>
<p>This is consistent with the accounts of patients who say they would like to be free of anorexia but cannot just choose to eat.</p>
<p>Why is “addictive illness” and “compulsion” recognised as impairing responsibility and treated sympathetically in one area of the law but not the other? </p>
<h2>Futile blame and punishment</h2>
<p>Perhaps it is because addiction, but not anorexia, is seen as a disorder for which the sufferer is responsible. In a 1999 armed robbery case, <a href="http://www.judicialcollege.vic.edu.au/eManuals/VSM/index.htm#6189.htm">the judge said:</a>:</p>
<blockquote>
<p>[S]elf-induced addiction at an age of rational choice establishes moral culpability for the predictable consequences of that choice.</p>
</blockquote>
<p>But most people in Western societies use addictive drugs recreationally at some stage in their lives, and most people don’t become addicted. No one intends to become an addict. </p>
<p>What’s more, those who do become addicts may have taken no more moral risks than many of those who condemn them, including some who sit on the bench and in the jury room. </p>
<p>Indeed, we must often go so far back in time to find the initial faulty actions leading to addiction that it stretches credulity to suggest the reason why this person is <em>now</em> blameworthy is because they should have foreseen this outcome all those years ago. </p>
<p>If addicts ought not to be held responsible for current offences on the basis of decisions made long ago, and if they are now genuinely impaired, then we must question why we so often engage in futile blame and punishment. </p>
<p>Surely, our focus should be on instituting measures that can help support and restore the capacities that underpin responsibility. </p>
<p><br></p>
<p><em>This is the fifth article in our series <strong><a href="https://theconversation.com/topics/biology-and-blame">Biology and Blame</a></strong>. Click on the links below to read other pieces:</em></p>
<p><strong>Part one – <a href="https://theconversation.com/genes-made-me-do-it-genetics-responsibility-and-criminal-law-27395">Genes made me do it: genetics, responsibility and criminal law</a></strong></p>
<p><strong>Part two – <a href="https://theconversation.com/irresponsible-brains-the-role-of-consciousness-in-guilt-27432">Irresponsible brains? The role of consciousness in guilt</a></strong></p>
<p><strong>Part three - <a href="https://theconversation.com/psychiatrys-fight-for-a-place-in-defining-criminal-responsibility-27514">Psychiatry’s fight for a place in defining criminal responsibility</a></strong></p>
<p><strong>Part four – <a href="https://theconversation.com/looking-for-psychopaths-in-all-the-wrong-places-fmri-in-court-27591">Looking for psychopaths in all the wrong places: fMRI in court</a></strong></p>
<p><strong>Part six – <a href="https://theconversation.com/natural-born-killers-brain-shape-behaviour-and-the-history-of-phrenology-27518">Natural born killers: brain shape, behaviour and the history of phrenology</a></strong></p>
<p><strong>Part seven - <a href="https://theconversation.com/put-down-the-smart-drugs-cognitive-enhancement-is-ethically-risky-business-27463">Put down the smart drugs – cognitive enhancement is ethically risky business</a></strong></p><img src="https://counter.theconversation.com/content/27520/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Jeanette Kennett receives funding from The Australian Research Council.</span></em></p>In today’s article in our series Biology and Blame, Jeanette Kennett considers an inconsistency in the law’s approach to compulsion – addicts are responsible but others compelled to harmful behaviours…Jeanette Kennett, Professor of Philosophy, Macquarie UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/275912014-06-10T20:28:53Z2014-06-10T20:28:53ZLooking for psychopaths in all the wrong places: fMRI in court<figure><img src="https://images.theconversation.com/files/50677/original/sw9jzpdw-1402381846.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">People are becoming more likely to believe that high-tech visualising techniques might allow us to see psychopathy in the actual physiology of the brain.</span> <span class="attribution"><a class="source" href="https://www.flickr.com/photos/jetheriot/6186786217/in/photolist-aqGTZT-niwG-sUk8Y-5kpAF6-6SCgyS-2ZKyJ-88vUCB-7A2f5q-96kggg-5DFXnV-4J6pL9-5uFETL-7qPG4L-kjAshW-5vuQhg-3MYT-5U2AQc-e4CcRp-3MZj-8v8DYZ-7zQwgc-aXr9yn-7iG2pk-4PTLMq-5Rjfht-5TMrYz-5Mchw8-5G4EHt-5MxeE7-5GsB5B-36fL9x-5yxm2W-5Nz4pi-4rdZ9E-7si8jt-ShC9j-7N5Pot-61DQLB-4wVAX1-kWfuq-4KH9B2-dLSKTQ-7x6RJG-fzT9Xx-9Xsr6X-6oi5aB-bPbME2-4wjQDd-tmJ6c-5yiug4">JE Theriot/Flickr (resized)</a>, <a class="license" href="http://creativecommons.org/licenses/by-sa/4.0/">CC BY-SA</a></span></figcaption></figure><p><em>In the latest instalment of our series <strong><a href="https://theconversation.com/topics/biology-and-blame">Biology and Blame</a></strong> Micol Seigel poses some important questions about the assumptions behind the legal use of fMRI.</em></p>
<hr>
<p>Of the current uses of psychiatry in legal settings, the claim that psychopaths can be identified through <a href="https://theconversation.com/the-science-of-medical-imaging-magnetic-resonance-imaging-mri-15030">functional magnetic resonance imaging</a> (fMRI) is among the most worrisome. </p>
<p>Psychiatrists who make this claim present their polychrome powerpoints, which, to the rest of us, look like Jackson Pollock in a sunshiney mood, and point to this or <a href="https://theconversation.com/adventures-in-blobology-20-years-of-fmri-brain-scanning-4095">that stripe or blip as proof</a> of a physiological predisposition to carry out dastardly deeds.</p>
<p>No matter that psychopathy is only glancingly referred to in the American Psychiatric Association’s <a href="https://theconversation.com/explainer-what-is-the-dsm-14127">Diagnostic and Statistical Manual of Mental Disorders</a>. (Rumours that the fifth edition, which came out earlier this year, would embrace the terminology explicitly, turn out to have been exaggerated.) </p>
<p>And no matter that the interpretation of such images are in a stage we might generously term “developmental.”</p>
<h2>Two broken tools equal?</h2>
<p>The scientists offering fMRI images admit their data is unconvincing on its own. Their solution is to cross the scans with results from a diagnostic tool based on personal interviews using the <a href="http://en.wikipedia.org/wiki/Hare_Psychopathy_Checklist">Psychopathy Check List-Revised</a>.</p>
<p>As an analytic instrument, the <a href="http://www.jonronson.com/psycho.html">Check List is not much better</a> than the brain scan. It suffers from a lack of specificity, tabulating a series of rather common characteristics – egocentricity, lack of realistic long-term goals, manipulation, dishonesty, impulsivity, grandiose self-righteousness, narcissism, dependence, irresponsibility, bullying, boredom, and promiscuity. </p>
<p>The blurriness of these profiling points can reveal them everywhere or nowhere.</p>
<p>So, take one inconclusive diagnostic test, cross it with another inconclusive diagnostic test, and … honest science would agree you have nothing at all. </p>
<p>As <a href="http://www.jstor.org/discover/10.2307/25619824?uid=3737536&uid=2&uid=4&sid=21104133560837">one group of researchers puts it</a>:</p>
<blockquote>
<p>the medical and psychological understanding of psychopathy itself is an empty vessel, a characterization of behaviors without stable symptoms, a disease without a cause.</p>
</blockquote>
<p>Yet the champions of fMRI diagnosis continue to forge ahead, and in an era in which neuroscientific explanations are offered <a href="http://www.nytimes.com/2012/11/25/opinion/sunday/neuroscience-under-attack.html">for every arena of human experience</a> (success in business, for instance, political leanings, and sexuality), their arguments are gaining ground. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/50673/original/xyxm5q8y-1402380937.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/50673/original/xyxm5q8y-1402380937.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/50673/original/xyxm5q8y-1402380937.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/50673/original/xyxm5q8y-1402380937.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/50673/original/xyxm5q8y-1402380937.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/50673/original/xyxm5q8y-1402380937.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/50673/original/xyxm5q8y-1402380937.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Psychopathy researchers assume people in prison did heinous things and that most heinous things land their agents in prison.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/thomashawk/10490113913">Thomas Hawk/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc/4.0/">CC BY-NC</a></span>
</figcaption>
</figure>
<p>People are more and more likely to believe that psychopathy is a disorder inscribed upon the body. And that high-tech visualising techniques might allow us to see psychopathy in the actual physiology of the brain.</p>
<h2>An alarming similarity</h2>
<p>To a historian such as myself, this claim sends off little alarm bells, recalling 19th-century criminal anthropologists such as Italian legal scholar <a href="http://en.wikipedia.org/wiki/Cesare_Lombroso">Cesare Lombroso</a>, who conducted research in prisons and mental asylums to determine the physical characteristics of criminal types. Mapping cranial shapes and sizes, he claimed to find congenital, hereditary, and unavoidable evidence of criminality.</p>
<p>Lombroso has long been in ill-repute thanks to the overly-biological focus of his assumptions and the circularity of his research design: he studied prisoners to draw conclusions about crime. </p>
<p>So even if there had been clear patterns of bumps and bones of the skull, his science could not determine whether they were evidence of criminal types, or traits of the poor and working people in the district of the jail — or even qualities acquired inside, as adaptations to imprisonment itself.</p>
<p>Interestingly, the problem of research location is something modern psychopathy research shares with its 19th-century precedents: proponents of psychopathy as a coherent diagnosis have all researched in prisons or focus on incarcerated subjects. </p>
<p>This is a methodological misstep, to put it mildly. Researchers assume psychopaths are concentrated in prisons, run experiments in prisons, and then conclude that psychopaths are concentrated in prisons. </p>
<h2>A tautological definition</h2>
<p>Indeed, <a href="http://www.newyorker.com/reporting/2008/11/10/081110fa_fact_seabrook?currentPage=all">one of the most-cited definitions</a> of psychopathy is actually:</p>
<blockquote>
<p>the condition of moral emptiness that affects between fifteen to twenty-five per cent of the North American prison population… </p>
</blockquote>
<p>This is what logicians call a tautology – a circular proof, a statement that substitutes premise for conclusion.</p>
<p>Again, some scientists recognise this problem. <a href="http://www.hare.org/scales/pclr.html">Robert Hare</a>, the author of the famous checklist, for example, wrote a book called <a href="http://www.snakesinsuits.com/">Snakes in Suits</a> about psychopaths in corporate boardrooms. But many researchers continue merrily to scan those ever-available brains behind bars.</p>
<p>Using the prison as site for research, psychopathy researchers embrace and ignore one overwhelmingly distracting, toxic assumption: that the criminal justice system works. </p>
<p>Their research assumes people in prison did heinous things (that they are guilty) and that most heinous things land their agents in prison (that the balance of miscreants are caught). </p>
<p>What if prisons actually mainly house the poor, the mentally ill, the addicted, and over-policed black and brown youth? What if the majority of prisoners is in for crimes of poverty or as casualties of the drug war – or both? </p>
<p>If the truly evil are not in prison, why is neuropsychiatry looking for them there? And can we trust its conclusions in a court of law?</p>
<p><br></p>
<p><em>This is the fourth article in our series <strong><a href="https://theconversation.com/topics/biology-and-blame">Biology and Blame</a></strong>. Click on the links below to read other pieces:</em></p>
<p><strong>Part one – <a href="https://theconversation.com/genes-made-me-do-it-genetics-responsibility-and-criminal-law-27395">Genes made me do it: genetics, responsibility and criminal law</a></strong></p>
<p><strong>Part two – <a href="https://theconversation.com/irresponsible-brains-the-role-of-consciousness-in-guilt-27432">Irresponsible brains? The role of consciousness in guilt</a></strong></p>
<p><strong>Part three - <a href="https://theconversation.com/psychiatrys-fight-for-a-place-in-defining-criminal-responsibility-27514">Psychiatry’s fight for a place in defining criminal responsibility</a></strong></p>
<p><strong>Part five - <a href="https://theconversation.com/why-shouldnt-addiction-be-a-defence-to-low-level-crime-27520">Why shouldn’t addiction be a defence to low-level crime?</a></strong></p>
<p><strong>Part six – <a href="https://theconversation.com/natural-born-killers-brain-shape-behaviour-and-the-history-of-phrenology-27518">Natural born killers: brain shape, behaviour and the history of phrenology</a></strong></p>
<p><strong>Part seven - <a href="https://theconversation.com/put-down-the-smart-drugs-cognitive-enhancement-is-ethically-risky-business-27463">Put down the smart drugs – cognitive enhancement is ethically risky business</a></strong></p><img src="https://counter.theconversation.com/content/27591/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Micol is a member of Decarcerate Monroe County, a local prison activist group, and the national grassroots abolitionist organization Critical Resistance.</span></em></p>In the latest instalment of our series Biology and Blame Micol Seigel poses some important questions about the assumptions behind the legal use of fMRI. Of the current uses of psychiatry in legal settings…Micol Seigel, Associate Professor in American Studies & History, IUPUILicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/275142014-06-09T20:38:36Z2014-06-09T20:38:36ZPsychiatry’s fight for a place in defining criminal responsibility<figure><img src="https://images.theconversation.com/files/50477/original/dcrcy7zx-1402036682.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Psychiatrists wanted people found 'not guilty by reason of insanity' to be dispatched to places like the Asylum for Criminal Lunatics Broadmoor.</span> <span class="attribution"><a class="source" href="http://commons.wikimedia.org/wiki/File%3AAsylum_for_Criminal_Lunatics%2C_Broadmoor.jpg">Illustrated London News, 1867/ Public domain, Wikimedia Commons</a></span></figcaption></figure><p><em>Are people with “diseases of the mind” responsible for their criminal acts?</em></p>
<p><em>In the latest article in our series <strong><a href="https://theconversation.com/topics/biology-and-blame">Biology and Blame</a></strong>, Ivan Crozier looks back at how psychiatrists tried to carve out a role for their profession in determining criminal responsibility.</em></p>
<hr>
<p>Prior to 1760, medical opinion was not used in insanity defences; rather, the use of psychiatric evidence in court was the result of a long struggle between the relative authorities of lawyers and psychiatrists, in which the law held a dominant position and was slow to change. </p>
<p>Following the 1843 trial of Daniel M’Naghten for killing Edward Drummond, <a href="http://hansard.millbanksystems.com/lords/1843/mar/13/insanity-and-crime#S3V0067P0_18430313_HOL_16">debate in the House of Lords</a> held that:</p>
<blockquote>
<p>to establish a defence on the ground of insanity, it must be clearly proved that, at the time of the committing of the act, the party accused was labouring under such a defect of reason, from disease of the mind, as not to know the nature and quality of the act he was doing; or, if he did know it, that he did not know he was doing what was wrong.</p>
</blockquote>
<p>This ruling has remained the basis for understanding criminal responsibility in many jurisdictions since. Establishing responsibility is one of the basic principles of the law, so the role of psychiatric expertise in assessing “disease of the mind” became fundamental.</p>
<p>The M’Naghten Rules were far from the first legal pronouncement on <a href="http://www.nejm.org/doi/full/10.1056/NEJM199508173330721">criminal responsibility</a>, but for the growing field of psychiatry, the ill-defined phrase “disease of the mind” was a subject over which it felt it had some authority. </p>
<p>At almost every opportunity (giving expert testimony, for instance, or reporting on crime in psychiatric journals or theorising about legal insanity), psychiatrists criticised the emphasis on the cognitive limb of the Rules (that the defendant knew what they were doing, and that it was wrong). </p>
<p>They maintained this cognitive understanding of mental incapacity was far too narrow when contrasted with the growing psychiatric concepts of “diseases of the mind”. </p>
<p>Indeed, most psychiatrists believed <em>they</em> should be in the position to define the mental illness under which the defendant was labouring, rather than adhere to a legal definition they thought irrelevant.</p>
<h2>The law prevails</h2>
<figure class="align-right ">
<img alt="" src="https://images.theconversation.com/files/50468/original/my8txswj-1402033804.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/50468/original/my8txswj-1402033804.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=882&fit=crop&dpr=1 600w, https://images.theconversation.com/files/50468/original/my8txswj-1402033804.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=882&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/50468/original/my8txswj-1402033804.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=882&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/50468/original/my8txswj-1402033804.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1109&fit=crop&dpr=1 754w, https://images.theconversation.com/files/50468/original/my8txswj-1402033804.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1109&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/50468/original/my8txswj-1402033804.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1109&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Artist sketch of Daniel M'Naughtan and an engraving of his signature dated March 4 1843, from the Scottish Reformer s Gazette.</span>
<span class="attribution"><a class="source" href="http://commons.wikimedia.org/wiki/File%3AScottish_Reformer's_Gazette_1.jpg">Public domain/Wikimedia Commons</a></span>
</figcaption>
</figure>
<p>But not being responsible for one’s actions was (and remains) strictly <a href="http://ukcatalogue.oup.com/product/9780199698592.do">a legal, not medical, problem</a>. And the law had only to satisfy itself that the defendant would not be executed without understanding their crime. </p>
<p>The burden of proof of non-responsibility lies with the defence. The role of psychiatric evidence might be assumed to carry much weight in this but, in practice, the law maintains its powerful position because it defines the acceptable terms of evidence. </p>
<p>To have evidence about a defendant’s responsibility accepted, psychiatrists had not only to establish that he or she was insane, but also that the insanity met narrow legal requirements. The profession pushed itself into legal debates, criticising legal judgements on insanity and giving evidence that fitted the defendant to the M'Naghten Rules by explaining their conduct as a product of a “disease of the mind”. </p>
<p>And there was significant agitation to bring the law into line with biological understandings of mental incapacity. Brain damage, epilepsy, “lesions of the will”, “degeneration”, irresistible impulses and other psychiatric concepts were (not always successfully) enrolled to explain a defendant’s non-responsibility. </p>
<p>Rather than being sent to the gallows, psychiatrists wanted those found “not guilty by reason of insanity” to be dispatched to new, specialised criminal lunatic asylums, such as Broadmoor (opened 1863).</p>
<h2>Gaining ground</h2>
<p>The efforts began to pay off; increasingly, judges listened to psychiatric evidence. In 1883, Victorian England’s premier legal theorist, James Fitzjames Stephen, held that:</p>
<blockquote>
<p>If it is not, it ought to be the <a href="https://archive.org/details/historyofcrimina03step">law of England</a> that no act is a crime if the person who does it is at the time prevented either by defective mental power or by any disease affecting his mind from controlling his own conduct, unless the absence of the power of control has been produced by his own default.</p>
</blockquote>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/50471/original/zb8jwm3n-1402034503.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/50471/original/zb8jwm3n-1402034503.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=478&fit=crop&dpr=1 600w, https://images.theconversation.com/files/50471/original/zb8jwm3n-1402034503.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=478&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/50471/original/zb8jwm3n-1402034503.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=478&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/50471/original/zb8jwm3n-1402034503.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=601&fit=crop&dpr=1 754w, https://images.theconversation.com/files/50471/original/zb8jwm3n-1402034503.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=601&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/50471/original/zb8jwm3n-1402034503.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=601&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Outfits used for people in criminal lunatic asylums.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/curiousexpeditions/557454194">Curious Expeditions/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc-sa/4.0/">CC BY-NC-SA</a></span>
</figcaption>
</figure>
<p>Although welcomed by psychiatrists, Stephen’s pronouncement did not enter the English law until its <a href="http://www98.griffith.edu.au/dspace/bitstream/handle/10072/49437/84022_1.pdf;jsessionid=CF58C910299096ACA6832535AC651AFB?sequence=1">modified introduction</a> in the Homicide Act of 1957.</p>
<p>In 1896, as part of psychiatry’s challenge to the Rules, a committee of the Medico-Psychological Association (later the Royal College of Psychiatrists), recommended that in trials where the defendant’s mental condition might play a role, judges ask juries to question: </p>
<blockquote>
<p>a) Did the prisoner commit he act alleged? b) If he did, was he insane at the time? c) If he was insane, has it nevertheless been proved to the satisfaction of the jury that his crime was unrelated to his mental disorder?</p>
</blockquote>
<p>Unsurprisingly, the proposal favoured the weight of psychiatrists’ expert evidence about defendants’ mental state. In a (delayed) response to these recommendations, the British Medical Association formed the <a href="http://pubmedcentralcanada.ca/picrender.cgi?artid=759042&blobtype=pdf">medico-political sub-committee on crime and punishment</a> in 1913.</p>
<p>The subcommittee held the M’Naghten Rules should be kept in substance, but that Stephen’s 1883 clause concerning “irresistible impulse” be added, so that a person shouldn’t be held to be responsible if prevented by a disease of the mind from controlling their behaviour unless the lack of control is their own fault.</p>
<figure class="align-left ">
<img alt="" src="https://images.theconversation.com/files/50469/original/wx68dwpf-1402034040.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/50469/original/wx68dwpf-1402034040.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=894&fit=crop&dpr=1 600w, https://images.theconversation.com/files/50469/original/wx68dwpf-1402034040.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=894&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/50469/original/wx68dwpf-1402034040.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=894&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/50469/original/wx68dwpf-1402034040.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1123&fit=crop&dpr=1 754w, https://images.theconversation.com/files/50469/original/wx68dwpf-1402034040.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1123&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/50469/original/wx68dwpf-1402034040.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1123&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">James Fitzjames Stephen in 1886.</span>
<span class="attribution"><a class="source" href="http://commons.wikimedia.org/wiki/File%3AJames_Fitzjames_Stephen.jpg">Bassano/Public domain via Wikimedia Commons</a></span>
</figcaption>
</figure>
<h2>Close but…</h2>
<p>The government’s response to these medical challenges was to found the Atkin Committee to report on Insanity and Criminal Responsibility after the high-profile trial of Ronald True (1922). The Committee rejected the Medico-Psychological Association position, but it agreed with psychiatrists that mental disorders progressively erode the capacity for self control. </p>
<p>It also agreed that M’Naghten didn’t always produce the just response to insanity. Essentially, it accepted mental disease excused guilt but was loath to turn this into a psychiatric decision. It noted:</p>
<blockquote>
<p>the difficulty of distinguishing some of such cases [where the act is not voluntary] from cases where there is no mental disease, such as criminal acts of violence or sexual offences where the impulse at the time is not merely uncontrolled, but uncontrollable. The suggested rule, however, postulates mental disease, and we think that it should be made clear that the law does recognise irresponsibility on the ground of insanity where the act was committed under an impulse which the prisoner was, by mental disease, in substance, deprived of any power to resist. </p>
</blockquote>
<p>So, following Stephen, the Atkin Committee sided with the BMA and recommended the introduction of an irresistible impulse clause to the laws of criminal responsibility. </p>
<p>But a report doesn’t make the law, and a reformist judge’s 1923 attempt to raise a bill reflecting the Atkin Committee’s recommendations before the House of Lords failed. The opportunity to bring the laws of criminal responsibility into line with the medical and psychiatric opinion of the day was lost as the Lords held that will and cognition, rather than a psychiatric understanding of “disease of the mind”, remained central to responsibility.</p>
<p>Although much of the urgency for dealing with mentally ill defendants decreased after the removal of the death penalty, M'Naghten still frames much of the legal understanding of the effects of diseases of the mind.</p>
<p><br></p>
<p><em>This is the third article in our series <strong><a href="https://theconversation.com/topics/biology-and-blame">Biology and Blame</a></strong>. Click on the links below to read other pieces:</em></p>
<p><strong>Part one – <a href="https://theconversation.com/genes-made-me-do-it-genetics-responsibility-and-criminal-law-27395">Genes made me do it: genetics, responsibility and criminal law</a></strong></p>
<p><strong>Part two – <a href="https://theconversation.com/irresponsible-brains-the-role-of-consciousness-in-guilt-27432">Irresponsible brains? The role of consciousness in guilt</a></strong></p>
<p><strong>Part four – <a href="https://theconversation.com/looking-for-psychopaths-in-all-the-wrong-places-fmri-in-court-27591">Looking for psychopaths in all the wrong places: fMRI in court</a></strong></p>
<p><strong>Part five - <a href="https://theconversation.com/why-shouldnt-addiction-be-a-defence-to-low-level-crime-27520">Why shouldn’t addiction be a defence to low-level crime?</a></strong></p>
<p><strong>Part six – <a href="https://theconversation.com/natural-born-killers-brain-shape-behaviour-and-the-history-of-phrenology-27518">Natural born killers: brain shape, behaviour and the history of phrenology</a></strong></p>
<p><strong>Part seven - <a href="https://theconversation.com/put-down-the-smart-drugs-cognitive-enhancement-is-ethically-risky-business-27463">Put down the smart drugs – cognitive enhancement is ethically risky business</a></strong></p><img src="https://counter.theconversation.com/content/27514/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Ivan Crozier currently receives funding from the ARC. Previous research on this topic was funded by the University of Edinburgh.</span></em></p>Are people with “diseases of the mind” responsible for their criminal acts? In the latest article in our series Biology and Blame, Ivan Crozier looks back at how psychiatrists tried to carve out a role…Ivan Crozier, ARC Future Fellow, University of SydneyLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/274322014-06-05T20:36:48Z2014-06-05T20:36:48ZIrresponsible brains? The role of consciousness in guilt<figure><img src="https://images.theconversation.com/files/50197/original/8f3d2fmx-1401856759.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Philosophers argue that people are not over and above the systems involved in information processing –we are our brains, plus some other, equally physical stuff. </span> <span class="attribution"><a class="source" href="https://www.flickr.com/photos/tjblackwell/4679548147">Tom Blackwell/Flickr (reszied)</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc/4.0/">CC BY-NC</a></span></figcaption></figure><p><em>In the second instalment of <strong><a href="https://theconversation.com/topics/biology-and-blame">Biology and Blame</a></strong>, Neil Levy considers how neuroscience can affect legal judgements.</em></p>
<hr>
<p>Can human beings still be held responsible in the age of neuroscience? </p>
<p><a href="http://www.amazon.com/Free-Will-Sam-Harris/dp/1451683405/ref=sr_1_4?ie=UTF8&qid=1401671704&sr=8-4&keywords=sam+harris">Some people say no</a>: they say once we understand how the brain processes information and thereby causes behaviour, there’s nothing left over for the <em>person</em> to do. </p>
<p>This argument has not impressed philosophers, who say there doesn’t need to be anything left for the person to do in order to be responsible. People are not anything over and above the causal systems involved in information processing, we are our brains (plus some other, equally physical stuff). </p>
<p>We are responsible if our information processing systems are suitably attuned to reasons, most philosophers think.</p>
<p>There are big philosophical <a href="http://plato.stanford.edu/entries/moral-responsibility/">debates</a> concerning what it takes to be suitably attuned to reasons, and whether this is really enough for responsibility. But I want to set those debates aside here. </p>
<p>It’s more interesting to ask what we can learn from neuroscience about the nature of responsibility and about when we’re responsible. Even if neuroscience doesn’t tell us that no one is ever responsible, it might be able to tell us if particular people are responsible for particular actions.</p>
<h2>A worthy case study</h2>
<p>Consider a case like this: early one morning in 1987, a Canadian man named <a href="http://www.worldsciencefestival.com/2011/10/the_curious_case_of_kenneth_parks/">Ken Parks</a> got up from the sofa where he had fallen asleep and drove to his parents’-in-law house. </p>
<figure class="align-right ">
<img alt="" src="https://images.theconversation.com/files/50201/original/85wvzr5g-1401857520.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/50201/original/85wvzr5g-1401857520.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=600&fit=crop&dpr=1 600w, https://images.theconversation.com/files/50201/original/85wvzr5g-1401857520.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=600&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/50201/original/85wvzr5g-1401857520.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=600&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/50201/original/85wvzr5g-1401857520.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=754&fit=crop&dpr=1 754w, https://images.theconversation.com/files/50201/original/85wvzr5g-1401857520.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=754&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/50201/original/85wvzr5g-1401857520.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=754&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Some argue that once we understand how the brain causes behaviour, there’s nothing left over for the person to do.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/reighleblanc/1372176177">Reigh LeBlanc/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc/4.0/">CC BY-NC</a></span>
</figcaption>
</figure>
<p>There he stabbed them both before driving to the police station, where he told police he thought he had killed someone. He had: his mother-in-law died from her injuries. </p>
<p>Parks had no discernible motive for his crime and no history of violence. He claimed he was sleepwalking throughout the whole thing. Should we believe him? </p>
<p>We can’t go back in time and get direct evidence concerning whether he was sleepwalking. But there’s plenty of indirect evidence available. </p>
<p>The fact the action was out of character for Parks is one piece of evidence. He also had a childhood history of sleepwalking. Other pieces of evidence came from science: two separate <a href="http://en.wikipedia.org/wiki/Polysomnogram">polysomnograms</a> (a test used for study and diagnosis in sleep medicine) indicated sleep abnormalities.</p>
<p>Assuming we believe him, why should sleepwalking excuse murder? A first attempt at an answer might be that sleepwalkers don’t know what they’re doing. Maybe that answer is right, but we need to take care in assessing it. </p>
<p>Sleepwalkers don’t act randomly or blindly, nor are their actions mere reflexes. Instead, they act intelligently. </p>
<p>Ken Parks drove 23 kilometres through suburban streets: that doesn’t happen by accident. Rather it indicates an impressive degree of control over his behaviour. </p>
<p>Parks responded to information in ways that made sense, turning the steering wheel to follow the road, braking and accelerating to avoid obstacles, and so on. So why not think he’s responsible for his actions?</p>
<h2>Guilty or not?</h2>
<p>Here neuroscience is relevant once again. There’s a <a href="http://cogweb.ucla.edu/CogSci/Baars-update_03.html">great</a> <a href="http://www.cs.helsinki.fi/u/ahyvarin/teaching/niseminar4/Dehaene_GlobalNeuronalWorkspace.pdf">deal</a> of <a href="http://www.pnas.org/content/95/24/14529.full">evidence</a> that consciousness, which is greatly diminished in sleepwalking, plays an important role in integrating information. </p>
<figure class="align-left ">
<img alt="" src="https://images.theconversation.com/files/50207/original/nyk7kjh6-1401857712.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/50207/original/nyk7kjh6-1401857712.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=402&fit=crop&dpr=1 600w, https://images.theconversation.com/files/50207/original/nyk7kjh6-1401857712.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=402&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/50207/original/nyk7kjh6-1401857712.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=402&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/50207/original/nyk7kjh6-1401857712.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=505&fit=crop&dpr=1 754w, https://images.theconversation.com/files/50207/original/nyk7kjh6-1401857712.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=505&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/50207/original/nyk7kjh6-1401857712.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=505&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">The brain actually doesn’t work like this.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/djking/3609802638">Dave King/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc-sa/4.0/">CC BY-NC-SA</a></span>
</figcaption>
</figure>
<p>When we are conscious of what we’re doing, the information is simultaneously available to a wide range of different brain regions involved in behaviour. When we’re less conscious, the information is only available to a small number of these regions.</p>
<p>When information is available to only a small number of brain regions, we can still respond to it in a habitual kind of way. That’s why Ken Parks was able to drive his car: he (like most of us) had acquired driving habits. </p>
<p>It’s because of these habits we’re able to drive while daydreaming or singing along with the radio, hardly aware of what we’re doing.</p>
<p>But the information concerning what he was doing was not broadly available to his mind. That’s important, because he wasn’t able to control his behaviour in the light of all his beliefs. He responded automatically, without being able to ask himself whether he valued what he was doing. </p>
<p>A whole range of information which would normally have stopped him (screams, the sight of blood, his mother-in-law’s terrified face) couldn’t interact with the mechanisms causing his actions.</p>
<p>The Canadian court found Parks <a href="http://en.wikipedia.org/wiki/R._v._Parks">not guilty on the charge of murder</a> (an acquittal later upheld by the Supreme Court). I think they were right to do so. </p>
<p>Neuroscience provides evidence that in the absence of consciousness, we can’t control our behaviour in the light of our values. And that’s a good reason to excuse us.</p>
<p><br></p>
<p><em>This is the second article in our series <strong><a href="https://theconversation.com/topics/biology-and-blame">Biology and Blame</a></strong>. Click on the links below to read other pieces:</em></p>
<p><strong>Part one – <a href="https://theconversation.com/genes-made-me-do-it-genetics-responsibility-and-criminal-law-27395">Genes made me do it: genetics, responsibility and criminal law</a></strong></p>
<p><strong>Part three - <a href="https://theconversation.com/psychiatrys-fight-for-a-place-in-defining-criminal-responsibility-27514">Psychiatry’s fight for a place in defining criminal responsibility</a></strong></p>
<p><strong>Part four – <a href="https://theconversation.com/looking-for-psychopaths-in-all-the-wrong-places-fmri-in-court-27591">Looking for psychopaths in all the wrong places: fMRI in court</a></strong></p>
<p><strong>Part five - <a href="https://theconversation.com/why-shouldnt-addiction-be-a-defence-to-low-level-crime-27520">Why shouldn’t addiction be a defence to low-level crime?</a></strong></p>
<p><strong>Part six – <a href="https://theconversation.com/natural-born-killers-brain-shape-behaviour-and-the-history-of-phrenology-27518">Natural born killers: brain shape, behaviour and the history of phrenology</a></strong></p>
<p><strong>Part seven - <a href="https://theconversation.com/put-down-the-smart-drugs-cognitive-enhancement-is-ethically-risky-business-27463">Put down the smart drugs – cognitive enhancement is ethically risky business</a></strong></p><img src="https://counter.theconversation.com/content/27432/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Neil Levy receives funding from the Australian Research Council. He has previously received funding from the Templeton Foundation and the Wellcome Trust.</span></em></p>In the second instalment of Biology and Blame, Neil Levy considers how neuroscience can affect legal judgements. Can human beings still be held responsible in the age of neuroscience? Some people say no…Neil Levy, Head of Neuroethics, Florey Institute of Neuroscience and Mental HealthLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/273952014-06-04T20:34:27Z2014-06-04T20:34:27ZGenes made me do it: genetics, responsibility and criminal law<figure><img src="https://images.theconversation.com/files/50173/original/dx5qy96n-1401847793.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Genetics is just the latest specialist knowledge threatening to take the question of criminal responsibility away from law and hand it over to science. </span> <span class="attribution"><a class="source" href="https://www.flickr.com/photos/photograham/630904128/in/photostream/">Graham/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc-sa/4.0/">CC BY-NC-SA</a></span></figcaption></figure><p><em>Welcome to <strong><a href="https://theconversation.com/topics/biology-and-blame">Biology and Blame</a></strong>, a series of articles examining historical and current influences on the notion of criminal responsibility.</em></p>
<p><em>Today, Arlie Loughnan considers the challenge to the legal system posed by genetic science.</em></p>
<hr>
<p>It’s not much of an exaggeration to say we’re in the midst of a crisis in criminal responsibility. </p>
<p>Society is becoming more aware of what causes people to commit crime. The range of causes includes addiction, a history of sexual or physical abuse, and “rotten social backgrounds”, as they say in the United States. </p>
<p>How, then, under these conditions, can we still call people to account for their actions in court, on the basis they acted freely and voluntarily when they committed an offence? Do we have to throw away ideas of responsibility for crime?</p>
<h2>The heart of the law</h2>
<p>Criminal responsibility is the conceptual core of criminal laws: it allows us to hold a person accountable for his or her conduct, and justifies punishment if they’re convicted. </p>
<p>Criminal responsibility is different to criminal liability, which concerns the outcome of a trial. Rather, it relates to whether a person is properly recognised as a subject of the law, or put another way, whether it’s appropriate that he or she is held to the moral standard of behaviour criminal laws encode.</p>
<p>Our notion of criminal responsibility centres on a person’s mental state – what the accused knew, thought or perceived. We construct the defendant as an abstract, rational entity – made up of a set of capacities or exercising a set of choices – and abstracted from his or her social and political context. </p>
<figure class="align-left ">
<img alt="" src="https://images.theconversation.com/files/50181/original/myfktjhv-1401849065.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/50181/original/myfktjhv-1401849065.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=452&fit=crop&dpr=1 600w, https://images.theconversation.com/files/50181/original/myfktjhv-1401849065.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=452&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/50181/original/myfktjhv-1401849065.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=452&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/50181/original/myfktjhv-1401849065.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=568&fit=crop&dpr=1 754w, https://images.theconversation.com/files/50181/original/myfktjhv-1401849065.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=568&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/50181/original/myfktjhv-1401849065.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=568&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Genetic science is threatening ideas about criminal responsibility.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/edyson/38312588">Esther Dyson/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc/4.0/">CC BY-NC</a></span>
</figcaption>
</figure>
<p>This approach <a href="http://ukcatalogue.oup.com/product/9780199698592.do">reflects the influence of psychology</a> on the historical development of the principles and practices of criminal law.</p>
<p>Now, genetic science – in this context, the influence of genes on human behaviour – is threatening or promising (depending on your perspective) to render criminal responsibility – and the ideas about blameworthiness or culpability at its heart – null and void. </p>
<p>Research suggests <a href="http://link.springer.com/article/10.1007%2Fs10519-011-9463-4">genetic as well as shared environmental influences</a> are important factors in persistent antisocial behaviour. On the face of it, such research appears incompatible with beliefs about individual choice on which criminal law rests.</p>
<p>Genetic science does indeed pose a challenge for criminal law. It’s not possible or desirable to ignore developments in scientific knowledge, for the legitimacy of criminal law practices if nothing else. But genetic science isn’t yet living up to its promise – or threat – to overwhelm current practices. </p>
<p>Evidence from the United States, where the effect of genetics on crime has been hotly debated, indicates <a href="http://papers.ssrn.com/sol3/papers.cfm?abstract_id=1909958">limited use</a>. In particular, “gene evidence” appears to be brought into the courtroom by defence counsel, rather than prosecution, and to be <a href="http://www.cell.com/neuron/abstract/S0896-6273(14)00441-3">used for mitigation at sentencing</a>, rather than at the point of conviction. </p>
<p>As this suggests, the impact of this evidence is modest, and it’s being integrated into existing criminal practices.</p>
<h2>A deeper understanding</h2>
<p>It should also be remembered that genetics is the latest in a long line of specialist scientific knowledges that have promised or threatened to take the question of criminal responsibility away from law and hand it over to science. </p>
<p>Neuroscience, with its ability to produce a picture of the living brain, and cognitive psychology, with its insights into higher mental processes, have also claimed some territory. </p>
<figure class="align-right ">
<img alt="" src="https://images.theconversation.com/files/50178/original/gnwzy5h9-1401848590.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/50178/original/gnwzy5h9-1401848590.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=600&fit=crop&dpr=1 600w, https://images.theconversation.com/files/50178/original/gnwzy5h9-1401848590.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=600&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/50178/original/gnwzy5h9-1401848590.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=600&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/50178/original/gnwzy5h9-1401848590.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=754&fit=crop&dpr=1 754w, https://images.theconversation.com/files/50178/original/gnwzy5h9-1401848590.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=754&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/50178/original/gnwzy5h9-1401848590.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=754&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Whether a particular genetic disease or condition impacts responsibility for crime is an entirely separate issue to having the genes.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/liebe_gaby/11614991503">Gabriela Ferreira/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc-sa/4.0/">CC BY-NC-SA</a></span>
</figcaption>
</figure>
<p><a href="https://nyupress.org/books/book-details.aspx?bookId=1517">And older ideas</a> drawn from eugenics (about the degeneracy of particular families and whole populations) and phrenology (famous for its focus on the size and shape of the heads of criminals), for instance, were once thought to have all the answers to the problem of crime.</p>
<p>What’s all too easily lost in this perennial debate about science and criminal responsibility is an appreciation that legal evaluation of responsibility for alleged criminal conduct is not merely a mechanical exercise. Ideas of causation are not the same in law as in science. </p>
<p>A particular configuration of genes (or, more accurately, the interaction of those genes and the environment) may cause a particular disease, for instance, but whether the disease impacts responsibility for crime is an entirely separate issue. </p>
<p>Criminal responsibility is about factors such as someone’s appreciation of wrongfulness of their behaviour rather than genetic predisposition or tendency. And appreciation of wrongfulness doesn’t readily reduce to the configuration of genes.</p>
<p>Assessing responsibility for crime is a moral-evaluative task, one in which lots of different types of evidence – scientific and non-scientific – is taken into account. </p>
<p>At the end of the day, where the individual faces a serious charge, this evaluation is undertaken by a jury of lay people whose role is precisely to weigh all the evidence – and apply their (not expert) knowledge in evaluating an individual. </p>
<p><br></p>
<p><em>This is the first article in our series <strong><a href="https://theconversation.com/topics/biology-and-blame">Biology and Blame</a></strong>. Click on the links below to read other pieces:</em></p>
<p><strong>Part two – <a href="https://theconversation.com/irresponsible-brains-the-role-of-consciousness-in-guilt-27432">Irresponsible brains? The role of consciousness in guilt</a></strong></p>
<p><strong>Part three - <a href="https://theconversation.com/psychiatrys-fight-for-a-place-in-defining-criminal-responsibility-27514">Psychiatry’s fight for a place in defining criminal responsibility</a></strong></p>
<p><strong>Part four – <a href="https://theconversation.com/looking-for-psychopaths-in-all-the-wrong-places-fmri-in-court-27591">Looking for psychopaths in all the wrong places: fMRI in court</a></strong></p>
<p><strong>Part five - <a href="https://theconversation.com/why-shouldnt-addiction-be-a-defence-to-low-level-crime-27520">Why shouldn’t addiction be a defence to low-level crime?</a></strong></p>
<p><strong>Part six – <a href="https://theconversation.com/natural-born-killers-brain-shape-behaviour-and-the-history-of-phrenology-27518">Natural born killers: brain shape, behaviour and the history of phrenology</a></strong></p>
<p><strong>Part seven - <a href="https://theconversation.com/put-down-the-smart-drugs-cognitive-enhancement-is-ethically-risky-business-27463">Put down the smart drugs – cognitive enhancement is ethically risky business</a></strong></p><img src="https://counter.theconversation.com/content/27395/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Dr Loughnan’s research on responsibility in criminal law is supported by the Australian Research Council (ARC) (No. DE130100418).</span></em></p>Welcome to Biology and Blame, a series of articles examining historical and current influences on the notion of criminal responsibility. Today, Arlie Loughnan considers the challenge to the legal system…Arlie Loughnan, Associate Professor in Law, University of SydneyLicensed as Creative Commons – attribution, no derivatives.