by Zachary Shapiro
In the course of my year-long project with Petrie-Flom, I am studying the potential impact of neuroimaging techniques on criminal law. During the course of my research, I found a story of an individual whose case presents difficult questions for our conceptions of criminal guilt and responsibility.  While this may be a bit longer than a normal entry, I want to share this story with you.
In 2000, a 40 year-old man, “Mr. Oft”, found himself developing an increasing, and nearly uncontrollable, interest in child pornography. Mr. Oft began collecting pornographic material, while making efforts to conceal his behavior from his family, and from those who knew him. Collecting pornography gave way to soliciting prostitution at “massage parlors,” and while Mr. Oft at first made careful attempts to conceal his actions, his aberrant behavior continued, and soon Mr. Oft was obsessively collecting and downloading child pornography, both at work and at home. Before long, Mr. Oft began making subtle sexual advances toward his prepubescent stepdaughter. After several weeks, his stepdaughter informed his wife of this behavior, leading to the discovery of his newly collected child pornography.
After his wife reported him, Oft was found guilty of child molestation and was ordered to either undergo inpatient rehabilitation in a 12-step program for sexual addiction or go to jail. Despite Oft’s strong and clear desire to avoid prison, he found himself unable to resist soliciting sexual favors from staff and other clients at the rehabilitation center. The center expelled him, and Mr. Oft prepared to go to jail. However, the night before his sentence was to begin, Oft was admitted to the University of Virginia Hospital emergency department complaining of severe headaches. In the course of his neurological examination, Oft made numerous sexual advances towards the hospital staff, and appeared totally unconcerned after urinating on himself. This behavior, combined with his seemingly unsteady gait, caused doctors to undertake a full neurological evaluation, eventually ordering an MRI scan of his brain.
The scan revealed that Oft had a large orbitofrontal brain tumor. The tumor was growing in the part of the brain thought to be involved in regulation of social behavior. While abnormalities in this area of the brain have been associated with both impulse control problems, and antisocial conduct, disease in the orbitofrontal cortex is not associated with defects in moral reasoning, and Oft admitted knowing that his actions were “wrong.”
After the tumor was surgically removed, Oft found his pedophilic urges gone. While he was able to complete his treatment, and avoid jail time, about a year later, Oft once again began having headaches, and secretly resumed collecting child pornography. A subsequent MRI found that the tumor had regrown, necessitating further surgery, which was successful.
Mr. Oft’s case raises questions not easily answered by our current model of criminal justice. On one hand, Mr. Oft clearly and repeatedly, broke the law. Furthermore, he knew that his crimes were morally and legally wrong, as his own admissions, as well as attempts at concealing his actions, attest. On the other hand, Mr. Oft’s behavior seems to have a very clear causal link to his brain tumor.
There is no simple answer to the complicated questions raised by this case. With an offense seemingly so linked to a brain-based disorder, is Oft deserving of leniency? Is it proper to argue that Oft has diminished responsibility for his behavior, despite the harm he caused others? Furthermore, since arguably all behavior is caused by one’s brain, does Oft’s tumor simply offer a more tangible explanation, but not an excuse, for his behavior? As neuroscience better elucidates the brain-based mechanisms responsible for all human action, the following question arises: could these new discoveries change notions of criminal responsibility, both for individuals like Mr. Oft, as well as for those without such a clear neurological factor underlying their antisocial behavior.
My project will investigate whether we can utilize the latest techniques of neuroimaging in order to better deal with criminal cases like Mr. Oft’s. But I am really curious what you readers think of the ethical questions raised by a case like this. Please take a moment to comment below!
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