Blame the Brain?

19 November 2014
Presented by Hannah Critchlow.

Putting the brain on trial: did your brain make you do it? Neuroscience in the courtroom exposed. Plus the dark side of new neurotechnologies and do we have free will or are our actions pre-determined?

In this episode

02:40 - The future of neuroscience research

How will brain findings shape future societies? Will we all become part machine? Is there a dark side to brain research?

The future of neuroscience research
with Geoff Ling, Defense Advanced Research Projects Agency, George Koob, National Institute on Alcohol Abuse and Alcoholism, Tom Insel, National Institute of Mental Health.

How will brain findings shape future societies? Will we all become part machine?Alzheimer's brain Is there a dark side to brain research?

We explore in this special Neuroethics series...

Hannah - Hello. I'm Hannah Critchlow reporting from Washington DC for this special Naked neuroscience podcast in partnership with the International Neuroethics Society and the Wellcome Trust where we'll be taking a journey into the future to explore how brain research could shape our future society. In the last two episodes, we welcomed in the era of the brain. We discussed the colossal cash injections, including the human brain initiative and the human brain project, that hopes that we can peer into the human as never before. And we started to discuss how as a society, we should best use the data that comes out. Plus, we met the robots that may be caring for our increasingly elderly populations in the future. In this episode, we explore how the US defence agency who are involved in creating the internet are also involved in producing these new human brain imaging techniques and we get their take on how it might be used.

Geoffrey - When any new technology comes about, there will be somebody who's going to think of good things to do with it and there are going to be other folks who think of bad things to do with it. And you can't let that limit you in terms of proceeding forward on the technology because in the advancement of technology, we may in fact find the solutions to those bad uses.

Hannah - And we discuss if we really have free will or can we simply state that our brains force us to act the way that we do?

George - You can equate free will with self-control and that self-control or self-regulation is where our conscious brain can direct our unconscious impulses.

Hannah - Plus the brain isn't fully developed until the mid-20s, making teenagers more likely to take risks, have poor decision making and be more susceptible to peer pressure. We explore the ramifications of these findings in the court room.

Nita - Seems to actually be gaining a lot of traction in the US. It seems that judges and courts, and policy makers find that to be an appealing reason to try to be less harsh, less long-term in the way we treat juveniles and to try to have more compassionate decision-making with respect to them. Understanding that their brains are likely to get better over time, that they're likely to exercise better judgment over time.

Hannah - All to come! One of the sessions at the International Neuroethics Society was centred on the future of neuroscience research and it's ethical implications. I met with the panellists to discuss the issues raised.

Geoffrey - Name is Geoffrey Ling, I'm at the Defence Research Projects Agency. I'm the director of the biological technologies office. So, the internet, clearly one of the major advances of the last century. The program was initiated and involved DARPA. The scientists working there realized the internet had great potential but as he pursued forward I doubt very much that he actually thought some of the negative consequences. Such as that there'd be maleficents around using it for child pornography. But even if he had known that, it was not a good reason not to proceed forward with the technology.

Hannah - So even though now we have the dark web where there's lots of child pornography and also drugs being sold, and people being trafficked, and also people being murdered, for example, via the dark web. Even though there are lots of negatives associated with the internet there's also lots of positives and President Obama sees neuroscience as, potentially, a similar scenario.

Geoffrey - I agree. With everything good, there's always the bad. And when any new technology comes about,  there will be somebody who's going to think of good things to do with it and there are going to be other folks who think of bad things to do with it.

And you can't let that limit you in terms of proceeding forward on the technology because in the advancement of technology, we may in fact find the solutions to those bad uses. So, for example, in the dark web, we find that the internet as we know it for most people they're able to monitor that activity and have some level of control over.

So, there has to be a parallel one developed for this other one but then as technology will advance even further we'll find ways in fact to manage that. So, what I'm saying to you is that many times the solutions for some of these problems can be found within the technology itself.

Hannah - What kind of technology and what kind of neuroscience research are DARPA funding?

Geoffrey - So, at DARPA, we're really looking at neuro-technology as much as the President mandated in the Brain Initiative which is brain research advancement through innovative neuro technologies. Focus is to build neuro-technology such that these technologies will, in fact, be enabling to the neuroscientific community at large.

So, a particular technology in the hands of one neuroscientist, may have one function in the hands of another neuroscientist, may have another, but there lies the beauty of it. A hammer is a classic example of a very useful, broadly applied technology. A hammer in the hands of a sculptor will create art, in the hands of an orthopaedic surgeon will repair a hip, and a hammer in the hands of a carpenter will build a house. We view the same thing for neuro-technologies. The ability to look at functional data, potentially at anatomical data at different scales will in fact, be transformative as well informative to the neuroscientific community and those where we're focused at.

Hannah - And currently, neuroscientists are using quite dated techniques in order to peer into the brain and so that's why President Obama is really interested in investing in new technologies that will revolutionize the way that we can look at the human brain and see how we behave?

Geoffrey - That is indeed true. If you think about it, the ability to then find these breakthroughs that will after very desperate diseases such as epilepsy, stroke, Parkinson's disease, and other neuro-degenerative disorders such as Alzheimer's. It's going to be the tools that enable the neuroscientist to work with the neuroclinicians to make these advances, but we are working with very old technologies.

MRI has been around clinically since the 80s. EEGs are clinically since the 1920s, and so if you think about that, I mean they really have not kept pace with the other technologies that these clinicians such as the computer, for example, an iPad, an iPhone, this sort of thing. So, in fact we really are at a point where we desperately need these new technologies.

Hannah - And you mentioned today about the case of a pilot who unfortunately had lost the use of some of her limbs, and she was able to control a plane by thought alone. There was a question raised from this by one of the audience members which was, "Will humanity somehow lose itself as we become more in of a relationship with machine and with robots."

Geoffrey - So, I'll make it clear that that woman was not a pilot. That was the amazing thing. Was that she was just a regular person who had become quadriplegic due to a disease process and in fact when we were able to do this interface, she was able to show that she was able to fly or control, well I should say, a simulated aircraft as well as a seasoned pilot which is really quite extraordinary. It tells you the opportunity space for some of these neuro-technologies.

As far as losing one's self-identity in these interfaces, we're not there yet and we may be a long, long ways away from that 'cause what these technologies do is they measure simple signals and they translate them into motor activity. That's a far cry from being integrated within a machine or a substance that actually has a self-awareness and a self-consciousness, and before machines actually get to that point, it's going to take quite a bit of advances to do that. Will it happen one day? I may. I don't know though. That one is worthy of a very in depth discussion and what is the definition of self-consciousness, self-awareness, and so I think we're far away from that.

Hannah - And George, you mentioned consciousness, and the issue, the big issue of free will of today's meeting.

George - George Koob and I'm director of the National Institute on Alcohol Abuse and Alcoholism.

Well, basically I raise the argument of free will versus my brain made me do it, and you can take that argument from philosophers who would argue that there is no such thing as free will. Because basically they argue that these false assumptions about that we could behave differently than we did and that most of our conscious activity is in the present, things that we select. And so, we've learned a lot about how the brain makes selections and we know that habits can be formed in some basic parts of our brain. We know our stress responses and some basic parts of our brain that even reptiles have but in the end, I kind of fall on the zone of Patricia Churchland who argues that you can equate free will with self-control, and that self-control or self-regulation is where our conscious brain can direct our unconscious impulses. A key part of that is the frontal cortex and a key part of that frontal cortex is the ventral part of the frontal cortex, and then you get into a neuroethical question as to what happens when you have damage to that part of the ventral pre-frontal cortex whether it's through developmental issues or whether it's through excessive alcohol use as an adult. And I think that's a question that remains out there to be solved in neuroethics is that when is it really true that your brain made you do it?

Hannah - So, as we're finding out more and more through neuroscience on how the brain of an alcoholic, for example, may look. You might say that they have brain damage and that is causing them to impulsively and compulsively go towards alcohol?

George - Exactly right. You can make that argument but you can also the converse argument that that brain has the capability to recover that dysfunction and we know that to be the case in alcoholism because individuals do recover and they use a much diffuse pathways in their brain in that recovery process. So, I think it's kind of a cup half-empty, cup half-full position while you're engage in excessive drug taking behaviour, you may have a dysfunctional brain. But the brain, when it goes obstinate, has the capability to recover normal function. That would be the way I look at it.

Hannah - And talking about treatments. Tom, you made the point that although we're at a precursor to one of the largest neuroscience conferences in the world where over 40,000 neuroscientists are converging this weekend in Washington. You made the argument that although neuroscience is finding out lots of things about basic brain function and there are more and more neuroscientists being employed, we haven't actually made huge leap or huge translation for patients in the clinic or homeless people on the streets, for example.

Tom - I'm Tom Insel, I'm the director of the National Institute of Mental Health. That's the case, so the public health data speak for themselves. When you look at measures of morbidity and mortality, what's striking is the lack of change that we have seen remarkable improvements in life expectancy and we've seen reductions, really profound reductions, in some areas for mortality whether it's in heart disease or acute lymphoblastic leukaemia, or certain forms of stroke. We've done really very well.

When you look at suicide, it's striking that over 20 years, there's not really not even a hint of a reduction in the numbers and the numbers are very unsettling - 39,000 suicides this year in the United States expected. At least based on the historical trends and that's double the number of homicides. So, we're talking about very large numbers. There was a time in this country when homicides outnumbered suicides. Those are down about 50%. Suicide hasn't budged. Suicide 90% of the time is related to a mental illness or some form of brain disorder. That's inexcusable that we haven't been able to deliver to begin save lives when the actual numbers demonstrate just how prevalent this is.

Hannah - And so, bear in mind that we're about to have a big celebration of neuroscience at the conference. How on Earth do we try and translate some these of these findings to help patients that have mental health issues?

Tom - Well. There's sort of two sides to it, I think you do need the deep dive on the brain and you need to understand much, much more than we understand today about how the brain works.

The imaging is spectacular that we're seeing but to be fair, what we can do in mice for imaging as well as for diagnostics and therapeutics is way, way beyond where we are for humans. And that's really the challenge for us as a neuroscience community. How do we get to the point where we can take the kind of molecular cellular systems understanding that we have and some of the tools that seem to be working so well for simple organisms and take them to be able to study the human brain. Developing a human neuroscience and then to use that to actually make a difference for people with brain disorders.

Hannah - And one of the audience members today, we were discussing some of the ethics raised by how this research might be used. So, research is coming out of peering into the human brain. This audience member made the point that as a neuroscience community, maybe we have to see ourselves as part ethicist and start to tackle these issues individually as neuroscientists. Do you agree with that? Or do you think that it's the job of the policy makers and the ethicists? George.

George - Well. When you submit a grant application, you are more importantly a training application in the United States, you are required to take a course in ethics that's administered by your institution. It wouldn't be too much of a stretch that that was also included some neuroethics for people who are involved in training for the nurse sciences. So, for example, post docs at the Scripps Research Institute have to take this course and it's required of all post-doctoral fellows and it has to be put on the application or the studies sections that are reviewing the application will find fault with the application. So, that's one parochial take on it but this could be expanded in such a way and maybe will be based on our discussions today.

Hannah - And Tom.

Tom - I am not sure that I really understand that proposal. I don't what it would mean to expect all neuroscientists to begin to incorporate neuroethics or ethics. I think I'd have to understand what the neuroscience area is about and I'd have to understand what that practically means. I have to say that today there are so many requirements for someone who wants to do science. I'm a little bit cautious about increasing the demands or the requirements that will create a speed bump. I'm okay on the guard rails and I'm okay on the idea that we could use those flashing yellow lights at times, but we know so little and the needs are so urgent. I want to make sure that we're not getting in the way of progress by asking too much of people.

Hannah - And Geoff.

Geoffrey - I've nothing more to add to that.

Hannah - And so, very final question. What do you think might be the dark sides that may emerge from the Brain Initiative and the Human Brain Project, for example? Can you foresee? Can you look into the future and say that there might be some dark internet-type analogies that might come out of the data. Starting with you, Tom.

Tom - One of the biggest concerns I have about the Brain Initiative is that it won't be able to accomplish the dream, either positive or negative of what could be done here. There is no question that the challenge is great and the need is even greater. But whether there will be funding, whether there will be a right amount of fundamental knowledge, and whether we'll get lucky with the technology to do what we want to do is a huge, huge question for me still. So, I have to confess that, yes there are days when I think about what could be the negative consequences of great progress in this area but at this stage in the process, most of all what I'm worried about is that we won't make the progress we need to have a positive impact.

Hannah - George.

George - I would think that my dark side would be the issue about neuroethics. When we get to the point where you can tell that someone has a small dysfunction in, say, the connection between the insula and amygdala. Does that really mean that they have a mental disorder or that they have an impulse control disorder, let's say, and then do we pay for treatment of that even though there is no manifestation, and there's going to be a huge ethical  concern about the cost of doing super sophisticated diagnosis and who's going to pay for it and is it really necessary, and who's going to have access to it. So, all of the questions that we always have about health care are going to be expanded and it's the way I would argue.

Hannah - Particularly relevant for America where you didn't have the National Health Service. And lastly, Geoff.

Geoffrey - Well. I would say that the thing I worry most about on the dark side is in fact what I would say is an exaggerated concern because a lot of these things in the near-term certainly just about all of the things in the near-term are really meant to improve the human condition. And one of the problems you have in any of these things as you're improve the human condition is that you do worry very much about the downsides, the negative or untoward consequences as it were. So, to put it very bluntly, I believe that there's things called the one-third rule. The one-third rule is one-third of the work and the effort goes into the basic research, one-third is just getting through regulation, and one-third is getting through the commercial hurdles before you actually see any of these things making it out into the patient and into the bed side. So, when you think about that, that means only one-third of it is actually the research. The other two-thirds are actually hurdles to get through to getting into the bed side and that to me is really the darkest side right now as far as I can see it.

Hannah - Thanks to Geoff Lang from the US Defence Advanced Research Projects Agency. George Koob from the National Institute on Alcohol Abuse and Alcoholism, and Tom Insel from the National Institute of Mental Health.

18:33 - Putting neuroscience on trial

How brain findings are being used to help convict, or acquit, individuals in the courts of law.

Putting neuroscience on trial
with Professors Lisa Claydon, Manchester University, Nita Farahany, Duke University, Jennifer Chandler, Ottawa University, Paul Catley, Open University, Katy deKogel, Dutch Ministry of Justice, Calvin Ho, National University of Singapore

How brain findings are being used to help convict, or acquit, individuals in the Old Bailey Justicecourts of law.

Next we'll examine neuroscience being used in the court room. We put the brain on trial by looking at international case studies with our panel of experts.

Nita - Nita Farahany from Duke University. So when we're talking about neuroscience in the court room in this context, we're talking about a criminal defendant making use of it to say my brain made me do it. The controversy in the criminal court room for adults is that the kind of neuroscientific evidence that's being used is a population level data, meaning the science tells us only us about differences across the population, not about why any particular person behaves the way that they did. And so when an adult criminal comes into the courtroom and says my brain made me do it and here's the brain scan that proves that that's true. It's problematic because the science support that kind of individualized assessment.

Hannah - So, for example, that would be a psychiatrist holy grail, wouldn't it? If someone could have a brain scan and then the psychiatrist would be able to say, "Oh yes, you have Schizophrenia," or "You have psychopathy," and then they can start treating immediately based on that brain scan result. The science just isn't there yet. You're finding something very different though in terms of the use of neuroscience in the youth criminal justice system in America.

Nita - Yeah. So, with juveniles who come into the court room, the kind of argument that they are making isn't so much about what their individual brain is that's different from the population. It's actually, their brain is just like every other juvenile but that every other juvenile has a category is different in kind than an adult and that's because the juvenile brain is still developing. The frontal lobe region of the brain which is essential for executive decision making, for planning, and pre-meditation, the kinds of myelination of neurons which are critical to kind of decreasing the noise in the brain and enabling us to make good judgments and good decisions. Those are still all in development in juveniles, and so when they come in they're not saying, "My brain. My abnormal brain made me do it. Instead, it's my juvenile brain made me do and you should treat juveniles as a class or as a category differently than you treat adults."

That kind of claim seems to actually be gaining a lot of traction in the US. It seems that judges and courts, and policy makers find that to be an appealing reason to try to be less harsh, less long-term in the way we treat juveniles and to try to have more compassionate decision making with respect to them understanding that their brains are likely get better over time. That they're likely to exercise better judgment over time.

Hannah - So it's not the case that young people who may commit crimes in their teens would then be incarcerated for a hundred years say with no chance of appeal? They would be able to say my brain wasn't in a certain state as they were a teenager which would fit with the neuroscientific data as we understand it now and then rehabilitation and processes might be able to be incurred.

You've have some really results in Canada in terms of the way the justice system looks at different individuals very differently based on the risk and the neuroscience data. Can you tell us a little bit about the cases now?

Jennifer - Certainly. Yes. Hello. I'm Jennifer Chandler, I'm an associate professor at the Faculty of Law University of Ottawa, Canada. I was comparing two cases involving 14-year old offenders in Canada. Both whom were able to claim that they had immature brains and so that should be taken into consideration, and indeed the Canadian law explicitly does that in the statute.

In addition, they had another cause of disability which was brain damage due to prenatal alcohol exposure and so what we saw was perhaps a willingness to take into consideration that their brain was immature and that they might get better, but that was constrained by the sense that they permanent serious brain damage due to foetal alcohol exposure and they would not get better.

So, it produced very different results in these two offenders, one of whose brain damage was more severe than the other and while we might have said, well he had more diminishment of his capacity and so is less morally blame-worthy, he ended up with a much longer sentence because of concern that he would be very difficult to rehabilitate.

Hannah - Isn't that the case that really anyone who commits a crime might have some kind of brain damage or some altered brain function which allows them to act in a way that isn't in keeping with our society and our legal system. So, in that case, couldn't you say that any criminal has diminished responsibility.

Lisa - Hi. I'm Lisa Claydon. I'm a senior lecturer in law at the Open University. You aren't in a criminal case going to look at that as an issue unless the defendant wants to raise it and clearly most of the time it wouldn't be to his advantage to raise it because we've already heard that actually saying, I could potentially be less in control of myself, might not be a good legal argument for a defendant to make. So, I think that the simple answer is that a defendant really has to have a reason to bring forward information that relates his brain state at the time of the crime and usually that reason will be that he hopes to make a plea which will diminish the charge or mitigate sentence.

Hannah - There's a case that in the UK at least, over 80% of youths that are convicted in the criminal system will go on to reoffend which indicates that the current rehabilitation system isn't successful. If, for example, there was a school or a hospital that was failing at over an 80% rate, then it would probably be shut down. So, is there any way that we can use neuroscience understanding to help improve the rehabilitation system for those people that are convicted?

Lisa - Yeah. There is quite some interesting research in the way neuroscience could be used to improve behavioural interventions. For instance, to predict for whom they work and for whom not, and behavioural interventions play a large role in the prison system. For instance, in the Netherlands, a lot of them have been bought in the 90s. For instance, aggression regulation therapy, and they work for about 10 to 50 percent of the offenders.

Hannah - And what does the aggression regulation therapy entail?

Lisa - It's a cognitive behavioural intervention. So, it teaches you different attitudes towards aggression and it aims at teaching you to control yourself better for instance, and that's all with the ultimate aim of reducing criminal behaviour.

Hannah - And in the States, I believe there's also some evidence that you can have a look at those children that have been exposed to quite violent traumatic events in their early life and then also pair that up with genetic data to then predict whether they might be likely to kind of repeat that circle of violence themselves in their own life, and go and commit vicious crimes.

Lisa - So, the same problem that we have with the adults system is the problem we have with any particular juvenile again. So, even if you are able to tell through genetic testing and environmental impulses, or environmental influences that an individual fits within a category that is more likely to be violent.

That doesn't tell us a particular youth is more likely to be violent, only that people generally with those types of early exposure are more likely to be violent.

And so, what I wouldn't want the evidence to be used for is to do brain scanning or genetic scanning of children and then label or stigmatize a child and say that this person is much more likely than some somebody who doesn't have this environmental influence, genetic influence, or neurological influence to be a violent offender as an adult.

What I would hope is that by looking at this information across the population, we have very good reason to intervene early across to decrease childhood violence, to try to make available treatments that address the kind of predispositions that we're seeing at group levels.

Hannah - So that they hopefully wouldn't then go on to commit a crime themselves. They would actually be rehabilitated or have some prevention treatment before they commit a crime.

Lisa - That's right. And again, it would be preventive treatment, right? Which is ways to prevent people from ending up in the prison system, in the criminal system, ending up as offenders. So it's trying to have early childhood intervention that increases the chances that all of our youth will have the best possibility of not ending up on a life and a path of crime.

Hannah - And Paul, you're findings of case studies in the UK.

Paul - Hi. I'm Paul Catley. I'm a senior lecturer in law at the Open University. We've been looking at a range of cases and what we found is that there's increasing numbers of cases that have been used both to argue that someone should not have convicted or alternatively, that the sentence is unjust and excessive.

One case which we found particularly interesting because of the extent of the neuroscientific evidence that was being brought in was a case where a 15-year old was assaulted. There was no dispute there that he'd been assaulted but the question was about the seriousness of the injuries that he sustained and the family were claiming that he'd suffered serious brain injury. Quite a number of years later, he and a lot of members of his family were charged with conspiracy to defraud. At that trial, one of the big issues was - was he malingering? Was he just pretending to be unable follow things? Or was there some real genuine medical problem? He  was convicted but when he appealed some time later, at that point there were later MRI scans which were able to support the argument that actually, yes, there was a degenerative brain disorder there which had probably been there at the time of trial. And so, supported his argument that he hadn't been fit to stand trial initially and led to his conviction being quashed.

Hannah - So that neuroscience data came eleven years after the initial case was brought to court and he'd already been sentenced and served three years in prison at that point.

Paul - Yes. So in that sense, you know, it's fairly unsatisfactory outcome. I guess, you know, from his viewpoint and his family's viewpoint, he is cleared, his conviction is quashed, he doesn't have the criminal record, but as you say, you know, it came very late. And this was the individual for whom prison was probably an awful experience. Someone with a severe brain disorder from an ethnic minority, coping in a prison situation when he'd also got failing eye sight. So, it must have been a very difficult three years for him.

Hannah - And findings from Singapore.

Calvin - Hello. My name is Calvin Ho. I'm from the Centre for Biomedical Ethics at the Yong Loo Lin School of Medicine - National University of Singapore. Yeah, I think neuroscience evidence has been very helpful in the way that courts have come to understand their role. So, for instance, in relation to a diagnosis of Kleptomania, courts are prepared to recognize that perhaps the accused is deserving less of a blame given the particular condition.

However, I think the court has also emphasized that the court may be somewhat lenient in terms of whether you are to be blamed for shoplifting is quite a different situation in keeping to a particular plan. So, the courts saw its role as ensuring that some of these young people who have been diagnosed with Kleptomania keep to particular treatment plan, rather than to punish them for a particular condition that I think it is prepared to recognize that these young people have no control over.

Hannah - And then last point really. Do you think that neuroscientists need to be trained, communicating their work to lawyers so that they can actually provide evidence in a court setting?

Lisa - Yes. I think that would be a very good thing. To make clear of which tests are ready for use and which aren't. That would be very important I think.

Jennifer - I would agree. I don't know whether Nita would agree with that.

Nita - Absolutely. One of the problems right now is the mismatch between neuroscientific understandings and legal understandings of some basic concepts like what does it mean to engage in a voluntary action, what is a mental state, and the miscommunication that occurs between the two right now is causing a lot of problems on both sides in terms of understanding and appropriate use of neuroscience in a legal setting. So, I think neuroscientists need to be better trained to communicate with public policy makers and legal decision makers, and legal decision makers need to be better trained to understand and appropriately incorporate neuroscience, and to not incorporate where it's inappropriate to do so.

Calvin - Yeah. I think that it's really important because it's interesting that courts in Singapore and Malaysia have asked Council to introduce neurological evidence, so I think there's receptivity there. And of course we should recognize that neuroscience is a very important decision making tool because they seem to attribute a certain level of objectivity.

Hannah - Thanks to Anita Farahany, Elisa Claydon, Jennifer Chandler, Paul Catley, Katy deKogel, and Calvin Ho. Well, unfortunately that's all we have for in this special series of Naked neuroscience. I'm Hannah Critchlow and I've been reporting from the International Neuroethics 2014 meeting hosted at the AAAS, so the American Association for the Advancement of Science at Washington DC. Thanks to all those who took part in the program, and to the Wellcome Trust for their generous support. In the next episode, I'll be reporting from Calcutta where I'll be meeting the president of India who is opening a brand-new neuroscience hospital and research facility there. So, hopefully see you next month to open our minds.

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