Neurointerventions in crime prevention: an ethical analysis
Interventions that act directly on the brain, or ‘neurointerventions’, are increasingly being used or advocated for crime prevention. For instance, drugs that attenuate sexual desire are sometimes used to prevent recidivism in sex offenders, while drug-based treatments for substance abuse have been used to reduce addiction-related offending. Recent scientific developments suggest that the range of neurointerventions capable of preventing criminal offending may eventually expand to include, for example, drugs capable of reducing aggression or enhancing empathy.
In this Wellcome Trust-funded project, we are investigating ethical questions raised by the use of such interventions to prevent criminal offending, focusing particularly on cases where they are imposed on convicted offenders as part of a criminal sentence or as a condition of parole. On the one hand, there seems to be at least some reason to support the use of neurointerventions in this way, since there is a clear need for new means of preventing crime. Traditional means of crime prevention, such as incarceration, are frequently ineffective and can have serious negative side-effects; neurointervention may increasingly seem, and sometimes be, a more effective and humane alternative.
On the other hand, neurointerventions can be highly intrusive and may threaten fundamental human values, such as bodily integrity and freedom of thought. In addition, humanity has a track record of misguided and unwarrantedly coercive use of psychosurgery and other neurotechnological 'solutions' to criminality.
We are deploying philosophical methods and recent thinking on autonomy, coercion, mental integrity and moral liability to answer two over-arching questions
We plan also to examine how our answers to these questions bear on the use of neurointerventions to prevent offending in individuals who have not previously offended, but are thought to be at high risk of doing so.
Thomas Douglas trained in medicine (BMedSc MB ChB, Otago) and philosophy (BA DPhil, Oxford) and is currently a Senior Research Fellow based in the Oxford Uehiro Centre for Practical Ethics and the Faculty of Philosophy, University of Oxford. His research lies in practical and normative ethics and currently focuses on the moral desirability of using medical interventions for non-medical purposes such as cognitive enhancement, behaviour modification, criminal rehabilitation and moral improvement. He has also written on moral worth, compensatory justice, moral status, and reproductive ethics.
David Birks is a Senior Research Fellow in Legal and Political Philosophy at the University of Kiel, and an Early Career Research Fellow at the Oxford Research Centre for the Humanities (TORCH). He previously worked on the Neurointerventions in Crime Prevention project, while he was a Junior Fellow in Legal and Political Philosophy at the University of Oxford and a Junior Research Fellow at Kellogg College.
Jonathan Pugh is a Research Fellow in Applied Moral Philosophy. After finishing his DPhil in 2014, he worked on the Neurointerventions in Crime Prevention project until late 2016. His research interests lie primarily in issues concerning personal autonomy in practical ethics, particularly topics pertaining to informed consent. He has also written on the ethics of stem cell research, genetic modification, and conservatism in value theory. In Feb 2017 he began a Wellcome Trust funded project on the ethics of Deep Brain Stimulation.
Hazem Zohny is a Research Fellow in Bioethics and Bioprediction at the Oxford Uehiro Centre for Practical Ethics. His current work focuses on the bioprediction of behaviour and the use of neurointerventions in crime prevention efforts. He has a PhD in Bioethics from the University of Otago, where he worked on ethical and conceptual issues related to human enhancement. His research interests also include moral responsibility, well-being, and global justice.
Lisa Forsberg is a Research Assistant on the project ‘Neurointerventions in Crime Prevention: An Ethical Analysis’. Her work has mainly examined different legal regimes under which anti-libidinal interventions may be provided to sex offenders. Lisa is also a doctoral student at the Centre of Medical Law and Ethics, King’s College London, working on a project entitled ‘Determining the Lawfulness of Procedures at the Margins of Medicine: Treatment, Enhancement, and the Power of Professional Judgement’. Lisa’s general research interests lie at the intersection of practical philosophy and medical and criminal law. She is particularly interested in issues relating to autonomy/consent and medical decision-making, controversial medical procedures, and organ transplantation.
Areti Theofilopoulou is a Research and Administrative Assistant working on the Wellcome-Trust funded project 'Neurointerventions in Crime Prevention: An Ethical Analysis'. She is also a DPhil student in Philosophy, affiliated with the Oxford Uehiro Centre for Practical Ethics. Her doctoral research, supervised by Thomas Sinclair and Dominic Wilkinson, is on Issues of Exclusion in Rawlsian Contractualism. Prior to that, Areti had completed a BA in Philosophy, Politics, and Economics at the University of Warwick, and an MSc in Political Theory at London School of Economics and Political Science.
Douglas T, 'Enhancement & Desert', Politics, Philosophy & Economics (forthcoming).
Theofilopoulou A, 'Punishment as Moral Fortification and Non-Consensual Neurointerventions', Law and Philosophy (forthcoming).
Douglas T, Zohny H, ‘The Negative Effects of Neurointerventions: Confusing Constitution and Causation’, AJOB Neuroscience (forthcoming).
Douglas T, ‘Going Above and Beneath the Call of Duty: The Luck Egalitarian Claims of Healthcare Heroes, and the Accommodation of Professionally-Motivated Treatment-Refusal’, Journal of Medical Ethics 2017; 43(12): 801-802.
D’Hotman D, Pugh J, Douglas T, ‘When Is Coercive Methadone Therapy Justified?’, Bioethics 2018; 32(7): 405-413.
Birks D, 'How Wrong Is Paternalism?', Journal of Moral Philosophy 2018; 15(2): 136-163.
Pugh J, 'Moral Bio-Enhancement, Freedom, Value and the Parity Principle', Topoi (forthcoming in print).
Birks D, Douglas T, ‘Two Ways to Frustrate a Desire’, Journal of Value Inquiry 2017; 51(3): 417-434.
Douglas T, Pugh J, Singh I, Savulescu J, Fazel S, 'Risk Assessment Tools in Criminal Justice and Forensic Psychiatry: The Need for Better Data', European Psychiatry 2017; 42: 134-137. [available online]
Douglas T, 'Neural and Environmental Modulation of Motivation: What's the Moral Difference?', in D Birks and T Douglas (eds.) Treatment for Crime (Oxford University Press, forthcoming). [publisher website]
D'Hotman D, Pugh J, Douglas T, The Case Against Forced Methadone Detox in US Prisons, Public Health Ethics (forthcoming in print). [available online]
Douglas T, Refusing to Treat Sexual Dysfunction in Sex Offenders, Cambridge Quarterly of Healthcare Ethics 2017; 26(1): 143-158. [journal version]
Forsberg L, Douglas T Anti-libidinal intervention in Sex Offenders: Medical or Correctional?, Medical Law Review 2017; 24(4): 453-473.
Pugh J, Maslen H, "'Drugs That Make You Feel Bad’? Remorse-Based Mitigation and Neurointerventions", Criminal Law and Philosophy 2017; 11(3):499-522. Discussed by The Hon. Mrs Justice Cheema-Grubb DBE in the Annual Borderlands Lecture, section 70.
Pugh J, Douglas T, Justifications for Non-Consensual Medical Intervention: From Infectious Disease Control to Criminal Rehabilitation, Criminal Justice Ethics 2016; 35(3): 205-229. [journal version]
Pugh J, Douglas T, Neurointerventions as Criminal Rehabilitation: An Ethical Review, in J J Jacobs and J Jackson (eds) Routledge Handbook of Criminal Justice (Routledge, 2016). [publisher website]
D'Hotman D, Pugh J, Douglas T, Methadone for Prisoners, The Lancet 2016; 387: 224.
Phillips EA, Rajender A, Brandon AF, Douglas T, Munarriz R, Sex Offenders Seeking Treatment for Sexual Dysfunction—Ethics, Medicine, and the Law, Journal of Sexual Medicine 2015; 12: 1591–1600.
Douglas T, Criminal Rehabilitation through Medical Intervention: Moral Liability and the Right to Bodily Integrity, Journal of Ethics 2014; 18(2): 101-122.
Douglas T, Bonte P, Focquaert F, Devolder K, Sterckx S, Coercion, Incarceration and Chemical Castration: An Argument from Autonomy, Journal of Bioethical Inquiry 2013; 10(3): 395-405.
Douglas T, Enhancing Moral Conformity and Enhancing Moral Worth, Neuroethics 2014; 7(1): 75-91.
Pugh J, Autonomy, Natality and Freedom: A Liberal Re-Examination of Habermas in the Enhancement Debate, Bioethics 2014; 29(3):145-152.
Douglas T, Enhancement, Biomedical, in H LaFollette (ed.) International Encyclopedia of Ethics (Wiley-Blackwell, 2013).
Pugh, J, G Kahane, and J Savulescu, Cohen’s Conservatism and Human Enhancement, The Journal of Ethics 2013; 17(4): 331–54.
Douglas T, Moral Enhancement, Journal of Applied Philosophy 2008; 25(3): 228-245.
Bomann-Larsen L, Voluntary Rehabilitation? On Neurotechnological Behavioural Treatment, Valid Consent and (In)appropriate Offers, Neuroethics 2013; 6 (1): 65–77.
Bublitz J C, Merkel R, 2014, Crimes Against Minds: On Mental Manipulations, Harms and a Human Right to Mental Self-Determination, Criminal Law and Philosophy 2014; 8(1): 51–77.
Bublitz J C, Merkel R, Autonomy and Authenticity of Enhanced Personality Traits, Bioethics 2009; 23(6): 360–74.
Caplan A, Ethical Issues Surrounding Forced, Mandated, or Coerced Treatment, Journal of Substance Abuse Treatment 2006; 31(2): 117–20.
Crockett M, Clark L, Hauser M, Robbins T, Serotonin Selectively Influences Moral Judgment and Behavior through Effects on Harm Aversion, Proceedings of the National Academy of Sciences 2010; 107(40): 17433–38.
Crockett M, Clark L, Tabibnia G, Lieberman M, Robbins T, Serotonin Modulates Behavioral Reactions to Unfairness, Science 2008; 320(5884): 1739–1739.
Greely H, Neuroscience and Criminal Justice: Not Responsibility but Treatment, University of Kansas Law Review 2008; 56(5): 1103–38.
McMillan J, The Kindest Cut? Surgical Castration, Sex Offenders and Coercive Offers, Journal of Medical Ethics 2013; 40(9): 583-590.
Rosati C, A Study of Internal Punishment, Wisconsin Law Review 1994; 123: 123-170.
Ryberg J, Is Coercive Treatment of Offenders Morally Acceptable? On the Deficiency of the Debate, Criminal Law and Philosophy 2015; 9(4): 619-631.
Ryberg J, Punishment, Pharmacological Treatment, and Early Release, International Journal of Applied Philosophy 2012; 26(2): 231–44.
Ryberg J, and T Petersen, Neurotechnological Behavioural Treatment of Criminal Offenders—A Comment on Bomann-Larsen, Neuroethics 2013; 6(1): 79–83.
Shaw, E, Direct Brain Interventions and Responsibility Enhancement, Criminal Law and Philosophy 2014; 8(1): 1–20.
Vincent N, Restoring Responsibility: Promoting Justice, Therapy and Reform Through Direct Brain Interventions, Criminal Law and Philosophy 2014; 8(1): 21–42.
Pugh J, Why Is Chemical Castration Being Used on Sex Offenders in Some Countries?, The Conversation 2016; available online.
Douglas T, Taking drugs to help others, Practical Ethics: Ethics in the News 2011.
Douglas T, Compulsory chemical castration for sex offenders, Practical Ethics: Ethics in the News 2008.
Douglas T, Interviewed on the ethics of neurointerventions in crime prevention, ‘Nine to Noon’, Radio New Zealand National, aired 19 January 2015.
Douglas T, ‘The Ethics of Morality Altering Drugs’, Radio Interview, CBC Radio (Canada), 21 April 2011.
Douglas T, Refusing to Treat Sexual Dysfunction in Sex Offenders, podcast from the Conscience and Conscientious Objection in Healthcare Conference, 24 November 2015.
Pugh, J, Justifications for Non-Consensual Medical Treatments: From Infectious Disease Control to Criminal Rehabilitation - St Cross Special Ethics Seminar, 12th November 2015.
Douglas T, Dr Tom Douglas defends the chemical castration of sex offenders, video interview on the Practical Ethics YouTube channel, 24 April 2018.
Ballantyne A, Card R, Clarke S, Devolder K, Douglas T, Giubilini A, Kennett J, Milnes S, Minerva F, Mori M, Munthe C, Oakley J, Persson I, Savulescu J, Wilkinson D, Consensus Statement on Conscientious Objection in Healthcare, Practical Ethics: Ethics in the News 2016.