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Can crimes and crashes be blamed on bad genes?
On Friday, Nature reported details of an Italian case in which a court, for the first time in Europe, reduced a criminal sentence based on a genetic theory of behavior. According to the report:
Pietro Pietrini, a molecular neuroscientist at Italy's University of Pisa, and Giuseppe Sartori, a cognitive neuroscientist at the University of Padova, conducted a series of tests [on the defendant] and found abnormalities in brain-imaging scans and in five genes that have been linked to violent behaviour—including the gene encoding the neurotransmitter-metabolizing enzyme monoamine oxidase A (MAOA). A 2002 study ... had found low levels of MAOA expression to be associated with aggressiveness and criminal conduct of young boys raised in abusive environments. In the report, Pietrini and Sartori concluded that [the defendant's] genes would make him more prone to behaving violently if provoked. ... On the basis of the genetic tests, Judge Reinotti docked a further year off the defendant's sentence, arguing that the defendant's genes "would make him particularly aggressive in stressful situations". Giving his verdict, Reinotti said he had found the MAOA evidence particularly compelling.
Scientists interviewed by Nature say this kind of genetic determinism is too crude and tenuous to justify sentence reductions. Genes operate in relation to each other, not independently, and they produce different effects depending on environmental factors and population differences such as ethnicity. My colleague Dan Engber, who alerted me to the Nature report, has made similar points about brain scans and neuro-determinism. I'm highly sympathetic to his indictment of the field.
Despite these criticisms and the skepticism of judges, Nature reports that according to a database maintained by Nita Farahany of Vanderbilt law school,
in the past five years there have been at least 200 [U.S.] cases where lawyers have attempted to use genetic evidence to support the idea their clients' were predisposed to violent behaviour, depression or drug or alcohol abuse. In Britain, there have been at least 20 such cases in the past five years.
And don't be surprised if the next target of genetic determinists is car crashes. Neuroscientists from the University of California at Irvine have just laid out the case in a paper in Cerebral Cortex, accompanied by a catchy press release. The release is titled, "Bad driving may have genetic basis, UCI study finds." It reports:
People with a particular gene variant performed more than 20 percent worse on a driving test than people without it—and a follow-up test a few days later yielded similar results. About 30 percent of Americans have the variant. ... The driving test was taken by 29 people-22 without the gene variant and seven with it. They were asked to drive 15 laps on a simulator that required them to learn the nuances of a track programmed to have difficult curves and turns. Researchers recorded how well they stayed on the course over time. Four days later, the test was repeated. Results showed that people with the variant did worse on both tests than the other participants, and they remembered less the second time.
The release explains how the gene works:
This gene variant limits the availability of a protein called brain-derived neurotrophic factor during activity. BDNF keeps memory strong by supporting communication among brain cells and keeping them functioning optimally. When a person is engaged in a particular task, BDNF is secreted in the brain area connected with that activity to help the body respond.
The study, funded by the National Institutes of Health, will surely become fodder for defense attorneys in civil and criminal cases involving crashes or dangerous driving. And these lawyers won't be alone in their interest. In the press release, Steven Cramer, the neuroscientist who led the study, says, "I'd be curious to know the genetics of people who get into car crashes. I wonder if the accident rate is higher for drivers with the variant."
I bet every auto insurer would like to know the same thing.
I'm counting on Engber to pick apart the study and the press release. Let's hope the authors are oversimplifying the impact of genes on behavior. Because if the link between genes and driving performance is solid enough to justify reduced sentences and damage awards, it's hard to see why insurances shouldn't be allowed to test and charge you accordingly.
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Everywhere you look, fat people are being charged extra. More for plane seats. More for health insurance. More, in the form of reduced incentive payouts, under proposals for Medicare and Medicaid.
Now, more for ambulance service.
We've talked about ambulances before. Along with toilets and coffins, they're part of a global size upgrade for bigger bodies. And it's expensive. Heather Hollingsworth of the Associated Press does the math:
Transporting extremely heavy people costs about 2 1/2 times as much as normal-weight patients. It takes more time to move them and requires three to four times more crew members, who often must use expensive specialty equipment. ... [One] unit in Topeka recently spent about $10,000 to retrofit an ambulance with equipment that accommodates patients weighing up to 1,600 pounds. Ambulance services with helicopters also are creating larger patient compartments and adding stronger gurneys. Sales of specialized lift systems nationwide are expected to reach $193 million by 2012, up from $75 million in 2004, according to EMS Insider, an industry newsletter. The sale of specialized stretchers is expected to nearly double to $50 million in 2012.
Now there's a movement to pass on the costs. Hollingsworth reports:
Ambulance companies say it's time for insurance providers, Medicaid and Medicare, or patients themselves to begin paying the added costs, which are cutting into their razor-thin profit margins. In the past, ambulance companies often absorbed the extra expense of serving the obese. Now they are adding charges similar to those already imposed on intensive-care patients, people requiring multiple medications and patients on ventilators.
The surcharge is significant. In several cities, ambulance services are billing nearly double for anyone over 500 pounds. In raw numbers, that's around $500 to $700. Fat-rights activists say the extra fees are discriminatory. The president of one group tells Hollingsworth, "Ambulance services are a critical public service and should accommodate the needs of all of those who require them at a fair cost."
I don't have a quick answer to this problem, but maybe we can start to think it through. First, we need to decide whether privately operated ambulances are, as the fat-rights spokesman says, a public service. It seems pretty clear, for example, that private airlines can make you pay double if you don't fit in a seat. Do ambulances have to play by nicer rules because medical services are inherently public? If so, shouldn't the public reimburse them?
Second, to the extent that fat is an issue of personal responsibility, does that really apply to ambulance service? Nobody's going to lose weight so they can save $700 on their next ambulance trip. To the extent that motivation can overcome obesity, the reason people are going to lose weight is to stay out of the hospital altogether.
Third, if you think fat people should bear the extra cost of transporting them, what does that say about your overall views on insurance for preexisting conditions? The health-care reforms being debated in Congress would bar insurers from excluding people with pre-existing conditions. The argument is that people aren't responsible for such conditions and shouldn't be priced out of the insurance market on account of them. Therefore, we would socialize their extra cost. Is that OK with you? If so, to the extent that obesity is genetically or environmentally induced, shouldn't we treat it the same way?
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When the government tells insurers what they can or can't do, it's easy to restrict outcome-based incentives for weight loss. Why let those nasty, greedy companies charge people more for being fat? But the public sector is a different ballgame. When taxpayers fund wellness incentives, they're entitled to see results. So don't expect the government to protect fat people from outcome-based incentives while footing the bill for health care. The more it pays, the more results it will demand.
More here.
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In other words, boys don't have to get vaccinated against HPV for the same reason they don't have to wash dishes, do laundry, buy birth control, or think about other people in general: Girls will do it for them.
More here.
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Last week, when Ross Douthat made a case for "regulating abortion," I asked him and other pro-lifers how far we should go. The Partial Birth Abortion Ban Act has a maximum jail sentence of two years for doctors who perform the forbidden procedure. Is that the kind of regulation we should apply to abortions? Would the country stand for it?
Today, let's turn the tables on those of us who oppose abortion regulation. How far should we go? Would you oppose regulation even of abortions aimed at preventing the births of girls? Because there's increasing evidence that such abortions, which take place by the millions in Asia, are now being done by the thousands in the United States as well.
Let's start with the data noted here last year, when
economists Douglas Almond and Lena Edlund published an article in Proceedings of the National Academy of Sciences examining the ratio of male to female births in "U.S.-born children of Chinese, Korean, and Asian Indian parents." Among whites, the boy-girl ratio was essentially constant, regardless of the number of kids in a family or how many of them were girls. In the Asian-American sample, the boy-girl ratio started out at the same norm: 1.05 to 1. But among families whose first child was a girl, the boy-girl ratio among second kids went up to 1.17 to 1. And if the first two kids were girls, the boy-girl ratio among third kids went up to 1.5 to 1. This 50 percent increase in male probability is directly contrary to the trend among whites, who tend to produce a child of the same sex as the previous child.
A recent paper by economist Jason Abrevaya adds:
The evidence from the California natality data is particularly striking for Indian births between 1991 and 2005: second-born children are 0.9 percentage points more likely to be boys, third-born children 6.6 percentage points more likely, and fourth-born children 8.1 percentage points more likely. Moreover, Indian parents are significantly more likely to have a boy (and a terminated pregnancy since last birth) if they have had only daughters previously. The simple framework of Section 4.5 suggests that the unusually high boy percentages among third- and fourth-born Indian children in California would be consistent with gender-selective abortion rates of around 10%. ...
Using census data, Abreveya estimates that from 1991 to 2004, U.S. families of Chinese or Indian descent aborted more than 2,200 fetuses just for being girls. (For the data, see Table 13 of his paper; he explains his calculations on Pages 23-24.)
Researchers had expected sex selection among Asians to decline as they became Americans. But in today's New York Times, Sam Roberts reports:
Demographers say the statistical deviation among Asian-American families is significant, and they believe it reflects not only a preference for male children, but a growing tendency for these families to embrace sex-selection techniques, like in vitro fertilization and sperm sorting, or abortion. ... [A] number of experts expressed surprise to see evidence that the preference for sons among Asian-Americans has been so significantly carried over to this country.
Roberts quotes one woman who got pregnant with a boy after having two girls. The woman says flatly: "If the third one was going to be a girl, then I would say probably I would have terminated."
Should that abortion be allowed? And if legal intervention in such cases is unwise, should we do something short of that? Should schools teach that aborting girls is wrong? Should doctors counsel couples not to do it? Should community leaders speak out against it? The last president called for a culture of life. Should this president call for a culture of respect for women?
What about purveyors of sex selection? Roberts notes that at least one assisted reproduction provider, the Fertility Institutes, offers sex selection and "has unabashedly advertised its services in Indian- and Chinese-language newspapers in the United States." (The company has also promoted and withdrawn an offer to select embryos for "eye color, hair color and complexion.") This form of sex selection takes place when the offspring are tiny, dish-bound embryos, not fetuses. The clinic's medical director, Dr. Jeffrey Steinberg, says the practice is "not harming anyone." Is he right? Should he be allowed to continue peddling sex selection (as he does in this video) to Asian-Americans? And if it's fine to advertise this service at the embryonic stage, why not at the fetal stage?
Absolutists on both sides need to think carefully. If you're pro-life, how far are you willing to go in regulating abortion? If you're pro-choice, how far are you willing to go in leaving it unregulated?
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Banning abortions isn't just a statement of "respect for human life," as many pro-lifers imagine. It's a commitment to investigate, prosecute, and punish.
I'm all for morality, custom, compromise, and common sense. These elements of society have plenty to say about abortion, and they're saying it. But criminal law? Do we really want to go that far?
More here.
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Look out, fat folks. As we learn more about the intractability of your condition, the good news is that people may stop expecting you to diet or exercise your way to a thinner body. The bad news is, they may start expecting you to go under the knife.
More here.
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Good news in the fight against teen pregnancy: The FDA is making to it easier for young people to get morning-after pills.
Here's the FDA's announcement:
On March 23, 2009, a federal court issued an order directing the FDA, within 30 days, to permit the Plan B drug sponsor to make Plan B available to women 17 and older without a prescription. The government will not appeal this decision. In accordance with the court's order, and consistent with the scientific findings made in 2005 by the Center for Drug Evaluation and Research, FDA notified the manufacturer of Plan B informing the company that it may, upon submission and approval of an appropriate application, market Plan B without a prescription to women 17 years of age and older.
The New York Times warns that Plan B won't solve the problem:
Contraception advocates have pushed for easy access to Plan B for girls and women of all ages because the longer a woman delays in taking the medicine after unprotected sex, the more likely she will become pregnant. Eliminating doctors from the transactions, it was hoped, would lead to far fewer pregnancies and abortions. Indeed, advocates once predicted that widespread and easy access to emergency contraceptives would cut the number of induced abortions in half and slash teenage birth rates. But young people in the United States have so much unprotected sex—one in three girls under the age of 20 will get pregnant, with 80 percent of the pregnancies unplanned—that Plan B has been little more than a sandbag on an overtopped flood wall. Even women who are given the medicine free often fail to take it after having unprotected sex. "This is not going to be a cheap cure to the unintended pregnancy epidemic in this country," said James Trussell, director of the Office of Population Research at Princeton University.
Trussell has made the same point before: Emergency contraception has
not reduced unintended pregnancies in America or anywhere else that has introduced it. There is so much unprotected sex you would have to use so much emergency contraception to make a dent. ... It is not a magic bullet. If you want to seriously reduce unintended pregnancies in the UK you can only do [that] with implants and IUDs.
Why implants and IUDs? Because you don't have to think about them. They bypass the most common cause of what we erroneously call contraceptive failure: our own failure to use contraceptives properly and consistently.
I agree that using implants to bypass human failure is the most effective way to prevent unintended pregnancies. But that's no excuse for tolerating our failure in the first place. Emergency contraception, taken promptly after sex, can be (though you shouldn't rely on it) a magic bullet. But bullets don't work unless you fire them. Technology requires human agency.
Cecile Richards, president of the Planned Parenthood Federation of America, makes precisely this point about the FDA's decision: "Providing birth control, including emergency birth control, to young women helps them make responsible decisions and avoid unintended pregnancy."
The FDA hasn't solved the problem of unintended pregnancy. It has given you one more means to solve it. Go get your emergency contraception, now. And while you're at it, ask about an implant, so you won't have to count on a last-minute pill to bail you out. The responsibility is yours.
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Can a drug cure the urge to steal?
It looks that way. In the April 1 issue of Biological Psychiatry, scientists from the University of Minnesota School of Medicine report:
An 8-week, double-blind, placebo-controlled trial was conducted to evaluate the safety and efficacy of oral naltrexone for kleptomania. Twenty-five individuals with DSM-IV kleptomania were randomized to naltrexone (dosing ranging from 50 mg/day to 150 mg/day) or placebo. ... Subjects assigned to naltrexone had significantly greater reductions in ... stealing urges (p = .032), and stealing behavior (p < .001) compared with subjects on placebo. Subjects assigned to naltrexone also had greater improvement in overall kleptomania severity ... Naltrexone demonstrated statistically significant reductions in stealing urges and behavior in kleptomania.
It sounds like an April Fools' joke. But it isn't. In an interview with Reuters, the study's lead author explains that naltrexone "gets rid of that rush and desire" to steal.
Naltrexone is better known as a drug for alcohol or drug addiction. Many of us, while accepting these addictions as diseases, continue to regard theft as a matter of personal responsibility. Should we rethink that distinction? If the same drug relieves both conditions, should we take kleptomania more seriously as an illness?
The floor's open.
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Under a Georgia bill, if you're 39, your doctor is forbidden to fertilize more than two of your eggs per treatment cycle. Take all the hormones you can stand, make all the eggs you want, but you get two shots at creating a viable embryo, and that's it.
How does this restriction "protect the mother" and "reduce the risk of complications" for her? It doesn't. ... So why limit the number of embryos created per cycle? Because the bill's chief purpose isn't really to help women. It's to establish legal rights for embryos.
More here.
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Ross Douthat is such a sensible and honest guy, I really ought to be able to sell him on the idea that contraception can significantly lower the abortion rate.
I pontificate; he demurs. I throw data; he remains unconvinced. I feel like a shingle salesman standing in the rain at the front door of a house that has holes in its roof and 2 inches of water inside. The owner's standing there, listening, his arms folded. How am I not making this sale?
Ross and his Atlantic colleague, Megan McArdle, have persuasively challenged what I used to believe: that birth-control availability was the key to reducing abortions. Three years ago, in a careful analysis, McArdle made a case that "the monetary cost of contraception is, at best, a small contributing factor to unwanted pregnancy in this country." A friend who works in reproductive health has impressed a similar lesson on me from her own research: Use, not access, is the missing ingredient.
The data back her up. So, last Sunday, I conceded the point:
Eight years ago, the Alan Guttmacher Institute surveyed over 10,000 American women who had abortions. Nearly half said they hadn't used birth control in the month they conceived. When asked why not, 8 percent cited financial problems, and 2 percent said they didn't know where to get it. By comparison, 28 percent said they had thought they wouldn't get pregnant, 26 percent said they hadn't expected to have sex and 23 percent said they had never thought about using birth control, had never gotten around to it or had stopped using it. Ten percent said their partners had objected to it. Three percent said they had thought it would make sex less fun.
This isn't a shortage of pills or condoms. It's a shortage of cultural and personal responsibility. It's a failure to teach, understand, admit or care that unprotected sex can lead to the creation—and the subsequent killing, through abortion—of a developing human being.
Ross listened thoughtfully, as he always does. But he didn't budge:
I remain unconvinced that [Saletan's] preferred method for such reductions—a dramatic new push, whether political or cultural, to expand the use of contraception in the United States—would produce anything like the results that he envisions. Consider, for instance, the idea that the government should dramatically expand eligibility for free contraception through Medicaid. ... [T]he universalization of this program, according to its supporters, might reduce the national abortion rate by somewhere between 1 and 2 percent. That's not nothing, obviously, but it's not a whole lot ...
Whoa, there. That's the old debate: access. What I'm talking about now is the other part of the equation: use. Access is important, but pills and condoms don't work unless people use them.
There's nothing fancy about this idea. I don't have a brilliant program in mind. All I have is process of elimination: If most people in this country, including me, aren't willing to ban abortions (check), and if you can't stop people from having sex (check), and if contraception is the only other way to prevent pregnancy (check), and if providing access to contraception hasn't solved the problem (check), then the remaining factor is human failure to use the contraception. Target that problem. I don't care whether it's through the federal government, states, clinics, schools, churches, or Conan O'Brien. All that matters is sending a forceful message that if you're not prepared to become a parent, you must either avoid vaginal intercourse or use birth control religiously.
If sex-ed programs aren't getting this message across, come up with better sex-ed programs. Or go through churches, doctors, parents, Facebook, Webkinz—whatever. Keep trying until you find something that works.
On this point, I should mention an equally sincere critique from the other side. One of my proposals for getting the message across was that "reproductive-health counselors must speak bluntly to women who are having unprotected sex." (I recommended the same message for men.) Jodi Jacobson, a longtime pro-choice activist and editor at RH Reality Check, says counselors are already doing this:
[W]omen's rights advocates and reproductive health providers have always put these two issues together. It's called "prevention" and it is the core of reproductive health services that include efforts to prevent unintended pregnancies, prevent infections, assist people who wish to get pregnant, offer pre-natal and maternal care, and much more.
What exactly does Mr. Saletan think reproductive health counselors do, but guide people toward protected sex, help them find the methods they need and which will work best for them, and counsel them on correct and consistent use?
Most counseling matches this tone. It's deferential, technical, and service-oriented. I understand the need to gain and hold each patient's confidence. But plainly, the message isn't getting across. This should be obvious from the fact that half the women getting abortions in this country are coming back for their second or third termination.
I've sat and talked with people who staff and supervise clinics. One recounted an internal staff debate over whether a woman who came in for an abortion and wasn't using birth control should be encouraged to use it next time—or whether this was too morally presumptuous. Another described moral differences between American and European clinics. In many European facilities, she explained, if you come back for a repeat abortion, the counselors will demand to know whether you were using birth control and if not, why not.
I admire everyone who works in family planning and reproductive health. But we need to do a better job of getting the message across. One measure of our failure is the national abortion rate. And if you don't accept that as a moral challenge, take it as a political one. Because if you can't do something to dry up the demand for abortions, Ross Douthat and others will be happy to target the supply.
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From today's piece:
I remember the day my first child was born. He lay sleeping, swaddled, in a plastic bin at the hospital. That's when I finally understood what it meant to be a parent. "If we leave this hospital without this baby," I told my wife, "we'll be arrested."
It was a joke, but it was also true. You arrive at the hospital as two people, and you leave as three. You can't just make a baby and walk away. It's yours forever.
Unless, that is, you make a baby through in vitro fertilization. In that case, you can put the embryo away in a freezer and decide what to do about it later. Or never. ...
More here.
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Chalk up another victory for the gambling-addiction defense.
Yesterday, attorneys for Tim Donaghy, the former NBA referee who admitted to betting on basketball games he officiated, filed a psychological "evaluation" that blames his crimes on compulsive gambling. The author is Stephen Block, a gambling treatment counselor. Sample quotes from the evaluation, as reported by the Associated Press: 1) "In my professional opinion, Mr. Donaghy would never have committed these offenses if he was not a pathological gambler." 2) "His gambling history demonstrates the need to gamble to fulfill the underlying need for 'action.' " 3) "He could not stop himself from gambling." The Washington Post supplies one more: 4) "His judgment and insight were impaired by his gambling behavior."
The plea worked. Today, Donaghy was sentenced to 15 months in prison instead of the 27 to 33 months that had been expected. According to the Post, the judge "said she took Donaghy's gambling addiction into account, as well as his cooperation with the government's investigation." Reuters quotes the judge on Donaghy's gambling addiction: "Although it contributed to his criminal conduct, it does not excuse it." No excuse, but a nice contribution: His sentence gets halved.
I'm not going to sit here and claim that compulsive gambling doesn't exist. But disorders that are powerful and real for some people have a way of being diagnosed in other people who don't share many of the symptoms but just happen to need a legal excuse. In this case, all we have is an evaluation solicited and supplied by the defendant's attorneys.
More to the point—and this is the crazy part—in this case, the crime is gambling. If you plug that information into the evaluation, here's what it boils down to: "Mr. Donaghy would never have committed this gambling if he was not a pathological gambler." No kidding! He committed gambling because "he could not stop himself from gambling," because "his judgment and insight were impaired by his gambling." How do we know his gambling is compulsive? Because of his "gambling history." The circularity is shameless.
And don't even get me started on the idea that Donaghy had a "need to gamble to fulfill the underlying need for 'action.'" An "underlying need for action" pretty well describes the motivation for half the world's crimes.
If you really believe Donaghy's gambling was addictive, don't just make it a mitigating factor in sentencing for the crime of gambling. Abolish the crime. Because a crime can't excuse itself.
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In Sunday's Washington Post, Rick Weiss detailed an important and underreported trend: the increasing role of genetics in legal disputes. His reporting illustrates how the march of science and the evolution of law are changing the way we think of ourselves. In South Carolina, the state's highest court overturned a murder conviction based on evidence that the killer acted out of genetically based depression. In Tennessee, a murder defendant blamed his conduct on inherited mental illness. In Georgia, lawyers in a murder case sought tests to determine whether their client had a gene associated with violence. In Arizona, a convicted killer argued on appeal that his attorney should have told the court about a similar gene-based propensity.
How did we get here? Weiss's research suggests a confluence of two trends. One is the habituation of courts to DNA. The growing familiarity of this kind of evidence masks the evolving purposes to which it has been put. First came DNA as identification, basic CSI stuff. Then came DNA as evidence of harm: Plaintiffs sued companies over toxic damage, but their DNA failed to show the toxin's expected effects. Then there's DNA as a cause of disease: In pollution and malpractice cases, courts have tested plaintiffs' DNA to check out the argument that genes, not products or procedures, sickened them. And if DNA explains the past, why not use it to predict the future? HIV tests have already been court-ordered to project victims' longevity and thereby calculate lifelong damages. Genetic longevity tests will be next. In a custody case, one parent successfully demanded that the other be tested for the deadly Huntington's gene. Apparently, the point was to challenge the second parent's fitness.
So, we're already in the business of testing for genes to predict fitness. That brings us to the second trend: the increasing use of biology to assess criminal responsibility. U.S. case law has traditionally discounted perpetrators' culpability in the event of sleepwalking, epileptic seizures, insanity, retardation, or "diminished capacity." Three years ago, the Supreme Court struck down death sentences for teenagers, citing evidence of their "underdeveloped sense of responsibility." Every month, scientists find new correlations between genes and traits such as aggression or mental illness. Just two weeks ago, the Human Nature News roundup flagged a study showing a genetic correlate of ruthlessness. As the cost of genetic testing declines, the temptation to test defendants increases. The persuasiveness of some genes increases as well: The allele cited in the Georgia murder case has subsequently been connected to violence in additional studies.
Put the two trends together, and you're looking at a gradual invasion of personal responsibility by genetic determinism. It's a conceptual shift from thinking of people as subjects to thinking of them as objects. The shift helps defense lawyers who need excuses for their clients' behavior. But it comes at a price: If your client is an object, why should we treat him like a subject?
As Weiss points out, courts already use unscientific evidence of "future dangerousness" to decide which killers should be executed. Genes could hardly do worse at predicting such risks. Weiss cites an Idaho case in which the defendant's genetic "propensity to commit murder" became a justification for executing him. A judge in the Arizona murder case drew the same conclusion about the appellant's "alleged genetic predisposition for violence." If your client's genes made him kill, they'll do it again. So don't expect us to let him live.
Nor should you expect us to protect his DNA from scrutiny under the Fourth or Fifth Amendment. If he's the product of his genes, as opposed to their manager, why should we treat them as his possession? He's their possession. Ditto for self-incrimination: If mental states are products of genes, we don't need his testimony; we just need his DNA. We can't make him open his mouth to testify, but we can make him open it for a swab, which could tell us plenty about his mind.
Are we more than our programming? Ladies and gentlemen of the jury, I leave that question in your hands.