We cannot yet divine a person’s sexual proclivities by examining his or her brain, but researchers just got a lot closer. A group of scientists affiliated with Georg August University in Germany have described a novel way to analyze fMRI brain scans of in order to pinpoint images individuals find sexually interesting. The study does not describe, but does suggest a means of identifying pedophiles using currently available technology. That sort of process might, theoretically, screen kids for signs of future sexual deviance and allow businesses that hire for childcare to avoid individuals that present a higher risk. Still, the implementation or adoption of any such screening process doesn’t just present a solution, it presents myriad profound moral challenges.
“It seems to me that you have a number of interesting, tough ethical and legal questions here,” Arthur L. Caplan, professor of medical ethics at New York University, told Fatherly. “None of which are anywhere close to being resolved right now.”
On the one hand, Caplan says, it’s understandable that parents might want to strap every creepy adult to an fMRI before letting them near their kids. But that doesn’t mean it’s ethical to do so. “I can imagine parents saying to babysitters, ‘Bring your brain scan before I hire you’,” Caplan says. “To me, it’s not ethical unless the tests are highly accurate, and unless we have a full understanding, as a society, of how many people with the increased risk actually do anything.”
Although this recent fMRI study has thrown the spotlight onto neuroethics, the question of what our society would do with technology that could help us read minds and suss out intentions is nothing new. It’s, in one form or another, the subject of a handful of dystopian novels, including Minority Report. And Caplan has been tracking the slow march of “precognition” technologies toward reality for at least 15 years. In 2003, Caplan wrote that a technique known as brain fingerprinting could eventually be used in a murder investigation to scan suspects’ brain. He even mentioned fMRI. He was aware of the potential.
“It was pretty predictable,” Caplan laughs.
Indeed, fMRI scans (which measure brain activity by detecting how blood flows to specific regions of the brain) have already appeared in court, making the ethical dilemma a more immediate puzzle.
For Caplan, the first question is when to test a patient for a particular proclivity. Should we start by screening children for sexual deviance? “Presumably, general screening would only be allowed with consent,” he says. “But even so what’s the intervention?” As with genetic screenings, Caplan says, it wouldn’t necessarily be ethical to test children for a disease that we cannot treat. “I can test children to see whether they’re going to get Alzheimer’s or Huntington’s disease, but I can’t fix any of those things,” he says. “So a lot of people, including me, would argue there’s no point in testing them until they’re old enough to decide if they want to know.”
In 2013, the American Psychiatric Association updated the Diagnostic and Statistical Manual of Mental Disorders to remove pedophiles who do not act on their impulses. Pedophilia is, the group conclude, a sexual orientation. Naturally, there was a caveat. The DSM says that in order for a pedophile to be diagnosed with a mental disorder, they must “Feel personal distress about their interest, not merely distress resulting from society’s disapproval” and “Have a sexual desire or behavior that involves another person’s psychological distress, injury, or death, or a desire for sexual behaviors involving unwilling persons or persons unable to give legal consent.”
At around that same time, the “Virtuous Pedophiles” movement started to gain momentum online, spurring some pedophiles to out themselves and profess a genuine concern with their impulses and a deeply held desire to protect children even at the cost of their personal reputations. In going public with their desires, these men addressed the same issue as a screening process might, but without the invasiveness.
Many people threatened and ostracized the “out” pedophiles.
Which is all to say that a test would still be unethical unless it was fairly accurate and the results could be translated easily into real risk figures based on other mental characteristics. After all, temptation is not a crime. Unfortunately, predictions are typically derived from large data sets and there aren’t any good figures on the phenomenon. What we know is this: Studies suggest as much as one percent of the adult population is sexually attracted to children. Obviously, the vast majority never act on it.
In the right hands, an accurate test could direct at-risk adults to seek help. In the wrong hands, the same test could cause undue damage to a lot of people who never would have hurt anyone.
There’s also a concern about misuse. Could tests fall into the wrong hands? Others already have–if you take a wide view of what that means. Caplan recalls how direct-to-consumer genetic tests such as 23andMe have made it possible for anyone to learn about his or her DNA without possessing an understanding of how to interpret the results. In some cases, the results of these tests can lead to workplace and insurance discrimination—companies and insurers deciding they’d rather not work with someone who has an increased risk of cancer or neurodegenerative diseases. Despite the fact that, when the results are put into context, whatever increased risk such tests reveal tends to be minimal.
Caplan envisions a similar commercial takeover (and rampant misuse and misinterpretation) of fMRI scans. “Is a company going to say ‘Is your kid going to be a pervert? Come into our brain scan facility, get a head picture, and see what risks you have’?” Caplan asks. “I can easily imagine that happening. DTC advertising has been horrible in genetics—scaring people, not counseling them in how to understand the results. My hunch is most brain scans will show that you’ll become an ax murderer or sex offender, but just because there’s an increased risk doesn’t mean it’s going to happen. The information will be hard to understand, for most people.”
But what about scanning suspects in a murder trial, or convicted criminals to determine if they’ve truly been rehabilitated? Would it be ethical to scan the brains of sex offenders and, if the scan shows they’re no longer attracted to children, let them off the hook? How about new employees at a daycare center? Should we screen anyone who plans on working with kids?
All of these questions will likely be irrelevant. Because once brain scans are capable of detecting our proclivities with even a modicum of accuracy. “There will be no real logic,” Caplan says.
All employers will want to test all employees because nobody wants to hire a pedophile in potentia, even if he or she will never touch a child. Caplan also imagines that visas could one day be accepted or denied based on fMRI results. “Sex trafficking is a huge problem,” he says. “Someone might say, before you can come to Thailand or the Philippines, you have to submit a brain scan as part of your visa application.”
Whether we should brain scan our babysitters or whether the government has a right to demand an fMRI before we travel, however, is an ethical question that hinges on information that does not yet exist. Although the preliminary studies are in, we still have little notion of how accurate these scans are likely to be—and that’s where the ethics are likely to pivot. Not that it really matters. “Whether it’s ethical or not, people would love to get a feeling of security by invoking these tests, and there’s a lot of money to be made here,” Caplan says. “We’d better get ready for swimming in a sea of business and profit around brain scanning.”
“It may overwhelm the ethics,” he says.
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