Neuro-Enhancement: repairing the criminal brain? Insights gained from daily practice in a mental health clinic

MLE (Mutual Learning Event) organized at Museum het Dolhuys in Haarlem, the Netherlands on 6 February 2015

The event focused on practical experience with the application of neuro-enhancement technologies. Therefore, the audience consisted of students from different universities in the Netherlands, employees from mental health institutions, and people in one way or another involved in mental health care. The moderator of the evening was Carine Neefjes (Museum het Dolhuys). The event was organized by Anna Meijknecht (Tilburg University) and Winnie Toonders (Radboud University) in cooperation with Museum het Dolhuys in Haarlem.

The speakers were:

- Dr Farah Focquaert (Bioethicist, Leuven University). Her presentation was titled: Direct intervention in the criminal brain – ethical dilemma's.

- Jelle Troelstra (psychiatrist, Van der Hoeven clinic). His presentation was titled: Chemical castration of sexual criminals Experience and insights from daily practice in a mental health clinic (TBS kliniek).

 

The event took place in a 13th century madhouse (Dolhuys), now a museum, where they have an exhibition titled: Dissecting the criminal brain. The MLE took place in the room of this exhibition. 

During the MLE a short questionnaire was distributed to the audience consisting of approx. 25 people (age: between 20-60; mix of students, mental health practitioners and others. 14 participants returned the questionnaire). An impression of the outcomes of this questionnaire:

 

  • As regards the questions whether experience and insight gained with regard to chemical castration of delinquents committing sexual offences are relevant for the discussion regarding the application of DBS and other NE techniques on criminals: 11 out of 14 persons agreed that it provides information on, for instance, the continuation or change of therapy. 1 person considered it only relevant for the discussion on autonomy and consent. Not as regards therapeutical aspects. 2 persons did not agree.
  • Reactions on the statement that ‘the application of DBS on criminals contributes to the realization  of an ideal society’ were as follows: 2 out of 14  answered ‘yes, that is wonderful’; 4 persons considered this  a scary idea;  6 persons had other ideas such as: ‘What is  an ''ideal society'', and according to whom?’, ‘An ideal society  is a too broad notion, but DBS  could reduce criminal behavior’,  ‘there will never be an ideal society’, ‘only if side-effects can be excluded’, ‘biologically speaking such  ‘improvement’ will not improve the next generation.’ 2 persons had no idea.
  • DBS should be applicable to: 1) improvement of the cognitive capacity of students and juveniles (1 person, out of 14, but ‘only if available for everyone’); 2) increase the  labor capacity (1 person); 3) peoples with compulsive neuroses (10 persons); 4) elderly people with Parkinson (10 persons); 5) people suffering from a mental depression (10 persons); 6) the treatment of criminals (9 persons); 7) military with PTSS (4 persons); 8) drug addicts (8 persons); 9) Otherwise (5 persons): ‘everyone who wants it’, ‘as long as unpredictable side-effects: very restrictive application’, ‘only if available and accessible of everyone and  without side-effects’, ‘anxiety disorder.’
  • Regarding autonomy: 10 persons out of 14 thought criminals are sufficiently able to give their informed consent to the application of DBS in their head. 10 persons out of 14 considered that DBS, being an effective treatment, should be applied on criminals, if necessary even under force. However, the following additional conditions were mentioned: ‘lifelong enclosure should remain available as an alternative’, ‘it is upon the judge to decide’, ‘only when side- effects can be excluded’, ‘only as a last resort’. 2 persons had no idea.
  • When asked who decides on the application of DBS to  a person with an 'criminal'  brain, the answers were as follows:  a) the judge (4 persons out of 14); b) the parents of a child with a 'criminal' brain  (2 persons);  c) the person with a 'criminal' brain  him/herself  (6 persons);  d) the victim of the person with the 'criminal' brain (1 person); e) the medical doctor (7 persons);  Otherwise 4/14: ‘all abovementioned persons should decide in cooperation’ and:  ‘there is not enough knowledge available to take a balanced decision.’ 
  • As regards   further legislation and regulation: 8 out of 14 persons stated that there is a need for new legislation/regulation with regard to DBS. 1 person thought that the existing legislation/regulation suffices. Others (5/14) thought that ‘every case is different’, that ‘the technology is not yet  perfect’, admitted that he/she does ‘not know enough about current legal framework’, considered it ‘impossible to draft  general rules’.