Brain Disease and Criminality

Neuroskeptic has the fascinating story of a man whose recurrent seizures were traced to a tumor in his right temporal lobe. The offending tissue was removed and the seizures eased, but the man later developed a condition known as Klüver-Bucy Syndrome that is associated with damage to the temporal lobes. The symptoms of the syndrome include hyperorality (constantly putting things in your mouth) and hypersexuality. He reported:

My appetite for food and sex increased dramatically. I had greater mood swings. I wanted sex constantly. Every day. I was very easily stimulated and began to touch myself regularly. I began to request sex daily from my wife. If I wasn’t having sex with my wife, I masturbated. This behavior increased over time. I became more emotionally labile, obsessive–compulsive... I become distracted so easily that I can’t get anything started or done.

Among other things he began compulsively downloading pornographic images from the internet, including some of pre-pubescent girls.

In 2006, he was arrested. A psychiatrist prescribed an antipsychotic, quetiapine, and an antidepressant, sertraline. His sexual obsessions disappeared, and according to his wife, "he became much warmer and loving but the medications shut off his libido... sex became non-existent." The patient was subsequently charged with 'knowingly and wilfully possessing material which contained at least three images of child pornography'. He plead guilty.

A judge gave him the most lenient sentence available under the sentencing guidelines, 26 months in prison and 25 months of home confinement.

The man's doctors, who include Oliver Sacks, have written an article arguing that he should not have been punished at all, since his condition was clearly caused by damage to his brain.

At the risk of glossing over some really hard questions about responsibility, I mostly agree with the doctors. The question I always ask about judicial punishment is, what good will it do to punish this person? It seems to me that the patient's hypersexuality might well have posed a threat to people around him -- see this story for some examples of the crazy things people with KBS have done -- but that problem was solved by medication. Wouldn't supervised mental health care, with mandatory medication, have worked as well in this case as imprisonment? What is gained by our spending $100,000 a year to keep this man in prison?