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Dispatch: “Neuro-interventions and the Law” Conference

Dr. Ekaterina Pivovarova

Dr. Ekaterina Pivovarova

On September 12-14, 2014, the Atlanta Neuroethics Consortium was held at Georgia State University. The topic, Neuro-Interventions and the Law: Regulating Human Mental Capacity, brought together leading scholars on philosophy, neuroscience, law, cognitive and clinical psychology, psychiatry, and bioethics. The participants included Judge Andre Davis, Nita Farahany, Stephen Morse, Francis Shen, Walter Sinnot-Armstrong, Nicole Vincent, and Paul Root Wolpe. The conference panels, talks, and keynotes addressed pressing issues about managing and appropriately utilizing novel neuroscientific technologies as they relate to legal issues.

Dr. Ekaterina Pivovarova, a research fellow at CLBB, was a discussant on two panels. The first, “Making People Sane Enough for Release,” examined the use of neuro-interventions, specifically chemical castration, for management of sex-offenders post release.  Justice David Nahmias of the Supreme Court of Georgia described the difficulties judges face in managing risk of re-offense and the potential harm to public safety with that of respecting civil liberties of the defendants. Chris Ryan, a psychiatrist from the University of Sydney, reported on the effectiveness of chemical castration, mostly through the use of androgen therapy. He noted that there is no empirical support for the use of chemical castration in reducing recidivism. Dr. Pivovarova addressed the importance of developing comprehensive post-release management plans, rather than relying solely on reducing sexual drives. Additionally, Dr. Pivovarova stressed the need for individualized treatment guided by understanding criminogenic needs and personality factors that drive re-offending.

The second panel, on “Making People Sane Enough for Trial” examined use of neuro-interventions (i.e., medication) to restore competence. The panelists discussed the case of Jared Lee Loughner, who killed six people and injured thirteen, in a Tucson, Arizona. The discussion centered on the defendant’s treatment of medication over objection during incarceration, which was pursued by medical staff to manage his dangerousness. The treatment invariably resulted in restoration of competency to stand trial, an outcome argued against by the defense. Judge Davis spoke about the courts’ reliance on medical opinions about providing necessary treatments to manage safety of defendants and existing safeguards to protect the rights of the defendant. Nicole Vincent of Georgia State explored philosophical conundrums of medicating an individual, which inherently changes the self, and then prosecuting an individual whose mindset is distinct from the person who committed the crimes. Dr. Pivovarova stressed the responsibility of the state and medical authorities to safely manage all defendants under their care and highlighted the phenomenological experiences of individuals in the throws of psychosis.

The panels stimulated debate about ethical obligations, philosophical conundrums, legal and clinical practicalities, and need for establishing guidelines as neuroscientific realities become increasingly more available in our society. In his keynote address, Dr. Stephen Morse provided a legal perspective on various competencies, including controversies surrounding restoration of competency to be executed. He noted that despite objections that many have to this practice, while this policy exists in the United States, establishing safety guidelines may help to minimize harm to the defendants. Nita Farahany’s keynote addressed the rights to privacy amidst existing technological tools. She spoke about constitutional rights that protect certain activities and ethical conundrums that will need to be resolved with technological progress.

Dr. Pivovarova reported on research with CLBB faculty member Joshua Buckholtz, PhD in using transcranial Direct Current Stimuliation (tDCS) to modulating impulsive behaviors. She spoke about the potential, but distant, application of novel treatment to forensic populations. Dr. Pivovarova cautioned about early translation of such work to real-life settings, especially to vulnerable populations. Additionally, Sarah Izzo, a CLBB summer extern, under the tutelage of Dr. Pivovarova, presented a poster about generalizability issues with fMRI lie detection techniques.

In all, the conference excelled at offering a truly interdisciplinary take on ethical issues associated with neuro-interventions and the law. For additional information, please see the conference website.