Is it okay to neuro-rehabilitate?

Traditional rehabilitative programs such as anger management and behavioral therapy often aim both at enhancing an offenders’ reasoning processes and diminishing dispositions to act in a harmful way. For example, anger management therapy may train an offender to stop and count slowly to ten before acting upon a feeling of anger. This encourages the use of practical reason before acting. Another tool commonly used by therapists who do cognitive behavioral theory is called “systematic desensitization.” The technique exposes a person to stimuli to which he tends to have a very strong emotional reaction, with instructions on how to better manage and reduce that reaction over repeated exposures to the stimuli.

Other rehabilitative programs focus on changing situational factors that encourage destructive dispositions, such as educational programming or job training. By providing an offender with an education or job prospects, the programs attempt to remove an environmental factor that is linked to criminal behavior (joblessness) and place the offender in an environment where following the law is an easier choice. Similarly, treatment of addiction or other psychological disorders attempt to either diminish the strength of certain dispositions (in the case of addiction) or improve reasoning (in the case of many psychological disorders). Drug rehabilitation can work to try to decrease the strength of the disposition to administer the drug via pharmaceutical and situational means. In the former case, drugs may be given that lessen cravings or even make the addict sick when they administer the drug they are addicted to. Drug rehabilitative programs also attempt to increase the addict’s ability to make a reasoned choice not to take the drug via cognitive behavioral therapy.

Emerging technology and neuroscientific data may offer criminal courts new rehabilitative possibilities. We may, for example, develop an aggression reducing drug. Or, we might develop a neurosurgery that can remove the portion of the brain that produces strongly aggressive behavior.

Initially, these possibilities seem pretty exciting. They could be cheap (in comparison to paying for an offender to spend his life in prison) and make communities safer.

The problem is that administration of aggression-reducing drugs or aggression-elimination surgery will not just alter an offender’s disposition to respond aggressively to insults by a rival gang member, or the sight of his girlfriend kissing another man, but his dispositions to respond aggressively in every situation. And one can easily imagine a scenario where responding aggressively would constitute a virtuous act. If rehabilitated offender sees a little girl being beaten by a gang of boys, responding with the appropriate amount of aggression would constitute the virtues of courage and good Samaritanism. The development of good behavior, or virtue (in philosophical speak), is like development of expertise in a craft. This expertise allows one to make very specific, detailed decisions regarding virtuous action given a particular situation. Because the anti-aggression drug or surgery would affect an offender’s psychology in such a coarse, broad way, he would be unable to develop many virtues associated with the considered practice of aggression, including courage. In this way the drug or surgery would undermine his moral development. And in the case of neurosurgery, the impacts are permanent: the possibility of virtuous aggression is removed forever.

Contrast this result with the administration of medication to diminish an offender’s cravings for illegal drugs. This direct intervention does not interfere with dispositions that might be virtuous: such medicines tend to suppress withdrawal symptoms, relieve cravings, or block the effects of certain drugs so the motivation to take them is removed. When such a drug is given in concert with therapy, it may assist moral development. Similarly, a drug that decreased a person with schizophrenia’s hallucinations or delusions would not inhibit moral development. Instead, the medicine would seem to enhance moral agency.

I feel strongly that ethicists should be on the lookout for rehabilitative programming, fueled by technological advances in neuroscience and pharmacology, that are not respectful of an offender’s moral character and its potential development. Chemical castration programs in place in several US states and European nations (such as this one in Louisiana) fall afoul of this requirement. An offender sentenced to chemical castration is given weekly injections that eliminate his ability to have an erection. Such an offender has no possibility of developing virtue with regard to sexual choices.

It may be acceptable to incapacitate dangerous sexual predators in prison, but it is unethical to treat them as less than moral agents.

 

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