Criminal Behavior & Brain Damage: Who is Responsible?

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There are many things we do not fully understand about the human brain, including links between criminal behavior and brain damage. The frontal lobe of the brain, for example, is known to be involved in important functions like judgment, impulse control, and social and sexual behavior, and damage or impairment to the frontal lobe can drastically alter an individual’s behavior. As these changes do not necessarily happen all the time, however, it is difficult to understand how accountable patients with frontal lobe damage can be over their behaviors. We asked doctors:

If a patient has been diagnosed with an impairment to their frontal lobe but is lucid some of the time, do you believe they should be legally held responsible for what they do when they’re not lucid?

Over 2,200 doctors from 20+ countries weighed-in on the debate, considering how much accountability someone with shifting consciousness should have. Globally, 65 percent of doctors stated that a patient with frontal lobe impairments should not be held legally responsible for their actions when they’re not lucid:

“The frontal lobe integrates the executive functions, the functions that allow the expression of the personality. A frontal, tumoral, traumatic or degenerative lobe pathology will bring with it a wide range of behavioral alterations. The consequences of the behavioral expression is not part of the intention or purpose of the patient, it is simply something that can not regulate… It should be understood that a person with frontal lobe syndrome will not have 100% lucid periods.” – Venezuela, Neurology

“If you have the diagnosis of impairment to your frontal lobe, even if you commit the greatest crime, an experienced criminal lawyer will declare you were not responsible . How can one ensure the state of consciousness in an unstable patient.” – Argentina, Gastroenterology

To legally hold an individual responsible for their actions in court means proving a guilty mind – an especially difficult task in the mentally impaired.

“The problem is how to verify that a person is not lucid during a certain act, that if it is a dangerous person?” – Venezuela, General Practice

“There is no right answer …we do not know enough about the cerebral functioning (organic lesions and biology, neurotransmitters …) to respond.” – France, General Practice

On the other hand, some doctors argued that if an individual is aware of their condition and of their risk of falling into a “non-lucid” state, they are responsible for taking appropriate preventative steps:

“Legally a person is not responsible for acts committed outside a state of mental clarity of justified cause. Obviously, if a person during their moments of lucidity is aware of their condition, he may well refrain from activities that endanger others or themselves, such as driving vehicles, performing surgeries, etc.” – Venezuela, General Practice

“I believe that if you are to be held responsible for your actions as long as you are under regular medical supervision by psychiatry and neurology. Why then should he suppose that an act of homicide in a crisis of aggressiveness frees him from responsibility and imprisonment?” – Venezuela, Pediatrics 

“I believe that having this limitation does not relieve him of responsibility for inappropriate behavior, since he must know what his limitations are because he does not know when he loses his lucidity, of course he must be in medical control, but I still do not think I should Be rid of their responsibilities.” – Venezuela, Pediatrics

The poll was fielded in July of 2017. 2253 physicians responded to the poll. The margin of error for the global poll was ±2%. More information about SERMO polling methodology can be found here.

Are you a physician? Log into SERMO to discuss ethical questions with other doctors from around the world.

 

 

 

 

 

 

 

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