Uehiro Centre for Practical Ethics, University of Oxford, Oxford, UK.
Bioethics. 2022 Sep;36(7):774-782. doi: 10.1111/bioe.13043. Epub 2022 May 19.
Neurointerventions-interventions that cause direct physical, chemical or biological effects on the brain-are sometimes administered to criminal offenders for the purpose of reducing their recidivism risk and promoting their rehabilitation more generally. Ethical debate on this practice (henceforth called 'neurocorrection') has focused on the issue of consent, with some authors defending a consent requirement in neurocorrection and others rejecting this. In this paper, I align with the view that consent might not always be necessary for permissible neurocorrective use, but introduce a qualification I argue ought to inform our ethical and legal analysis of neurocorrection if we are to administer neurocorrectives nonconsensually. I maintain our use of nonconsensual neurocorrection should be constrained by a beneficence requirement-that it should be limited to neurocorrectives that can be expected to benefit those required to undergo them; and my argument is that a beneficence requirement is necessary in order to safeguard against offender abuse. I highlight how we afford a heightened protective role to beneficence in other instances of biomedical intervention where consent is absent or in doubt; and I argue a beneficence requirement is also necessary in the correctional context because alternative candidate protections would provide insufficiently strong safeguards on their own. I then consider whether requiring beneficence in nonconsensual neurocorrection would (a) be incompatible with penal theory, (b) be objectionably paternalistic, or (c) foreclose many fruitful avenues of crime control. I argue in each case that it would not.
神经干预——对大脑直接产生物理、化学或生物学影响的干预——有时会被用于犯罪者,目的是降低他们的累犯风险,更普遍地促进他们的康复。关于这种做法(以下简称“神经矫正”)的伦理争论集中在同意问题上,一些作者主张在神经矫正中需要同意,而另一些作者则反对这一观点。在本文中,我认为,在可允许的神经矫正使用中,同意不一定总是必要的,但我提出了一个条件,如果我们要非自愿地进行神经矫正,我认为这个条件应该告知我们对神经矫正的伦理和法律分析。我主张,我们对非自愿性神经矫正的使用应该受到仁慈要求的限制——它应该仅限于那些可以预期对需要接受治疗的人有益的神经矫正;我的论点是,为了防止罪犯滥用,仁慈要求是必要的。我强调了在其他没有同意或同意存在疑问的情况下,我们如何在生物医学干预中给予仁慈更高的保护作用;我认为,在矫正背景下,仁慈要求也是必要的,因为替代的候选保护措施本身提供的保护措施不够强大。然后,我考虑了在非自愿性神经矫正中要求仁慈(a)是否与刑法理论不一致,(b)是否具有明显的家长式作风,或(c)是否会排除许多富有成效的犯罪控制途径。我在每种情况下都认为,事实并非如此。