US criminal courts have recently moved toward seeing juveniles as inherently less culpable than their adult counterparts, influenced by a growing mass of neuroscientific and psychological evidence. In support of this trend, this chapter argues that the criminal law’s notion of responsible agency requires both the cognitive capacity to understand one’s actions and the volitional control to conform one’s actions to legal standards. These capacities require, among other things, a minimal working set of executive functions—a suite of mental processes, mainly (...) realized in the prefrontal cortex, such as planning and inhibition—which remain in significant states of immaturity through late adolescence, and in some cases beyond. Drawing on scientific evidence of how these cognitive and volitional capacities develop in the maturing brain, the authors sketch a scalar structure of juvenile responsibility, and suggest some possible directions for reforming the juvenile justice system to reflect this scalar structure. (shrink)

Many commentators agree that the trend to try juveniles as adults fails to recognize that there should be an asymmetry in our treatment of juvenile and adult crime such that all else being equal juvenile crime deserves less punishment than does adult crime. This essay explores different rationales for this asymmetry. A political rationale claims that the disenfranchisement of juveniles compromises the state’s democratic authority to punish juveniles in the same way it is permitted to punish adults. A (...) developmental rationale claims that juveniles deserve to be punished less than adults because their immaturity makes them less responsible and, hence, less culpable for their wrongdoing. Gideon Yaffe’s new book The Age of Culpability expresses skepticism about the developmental rationale and defends a version of the political rationale. By contrast, this essay finds important limits to the political rationale and defends a qualified version of the developmental rationale. In the process, it argues against treating the asymmetry between juvenile and adult crime as a categorical one. (shrink)

The aim of this study is to identify the typical psychological, demographic, socio-economical, educational, health, and criminological characteristics of juvenile delinquents who tend to continue in their criminal career to adulthood and therefore obstruct the possibility of successful, non-offending integration to society. Subjects of research were young male prisoners jailed in the Juvenile imprisonment house that completed the test battery. By ex-post analysis after a period of five years, the differences between offenders and non-offenders were identified. Results show (...) significant differences in the age of prisoners, length of imprisonment, presence of violent offence in the criminal history, number of previous offences recorded, differences in factors i, h, and q1 from the Sixteen Personality Factor Questionnaire, responses within the Hand test characteristic, and in several signs of the drawings in a Draw-A-Person test. The importance and influence of listed factors is discussed. (shrink)

Genomic and neuro-scientific research into the causes and course of antisocial behaviour triggers bioethical debate. Often, these new developments are met with reservation, and possible drawbacks and negative side-effects are pointed out. This article reflects on these scientific developments and the bioethical debate by means of an exploration of the perspectives of one important stakeholder group: juveniles convicted of a serious crime who stay in a juvenile justice institution. The views of juveniles are particularly interesting, as possible applications of (...) current and future scientific findings are considered to be most effective if applied early in life. Based on their statements we come to the following provisional conclusions. Concerns about labelling and stigmatization are recognized and widely shared. Possible effects on one's identity are acknowledged too. Yet, a possible biological underpinning of one's antisocial behaviour is not considered to result in the development of a criminal identity. Nonetheless, psychopharmacological interventions are experienced as endangering one's current self. Concerns regarding the refusal of responsibility and the blaming of one's genes or brain can be put into perspective. Instead, participants emphasize the motive of own choice as underlying their criminal behaviour. Moreover, bioethical debate should pay attention to the role of parents of children at risk and the parent-child relationship in families at-risk. We argue that the short-term and long-term interests of children at risk, as well as their interests and those of society at large, may conflict. In order to deal appropriately with newly arising dilemmas, a normative framework needs to be developed. (shrink)

Statistics from both South Africa and the United States of America indicate that the phenomenon of violence amongst youths is increasing. This implies that a larger number of youths are being exposed to the experience of violence and thus present with the complex and multi-dimensional effects of such an experience. Past research has centred mostly on the causative factors that can be statistically represented, with little focus being paid to the juveniles’ in-depth, subjective experience of the phenomenon. For the male (...) adolescent, the experience of the phenomenon of violence is complex, diverse and may span across many aspects of his life, including physical, psychological, personal and social dimensions. Three participants were sourced from the Leeuwkop Juvenile Correctional Facility in Johannesburg and interviewed for the purpose of this study. The participants were selected based on their age (between 13 and 19 years of age) and the type of crime that they had committed (assault with intent to do grievous bodily harm, common assault or indecent assault). In accordance with the phenomenological approach, open-ended interviews were used as a research method in order to allow for the participants’ unique and subjective experience of the phenomenon to emerge. The researchers found that the phenomenon of violence is characterised by the juveniles’ experience of external events that provoke a certain response manifesting itself in violent behaviour. The responses described by the participants were mostly emotional in nature and included emotions such as anger, rage and fury. The experience of violence also holds certain consequences for the male juvenile offender. The most common consequence experienced by all three participants was their subsequent arrest and incarceration in a correctional facility. Indo-Pacific Journal of Phenomenology , Volume 11, Edition 1 May 2011, iii-v. (shrink)

Background: Individuals with psychopathic traits demonstrate an attenuated emotional response to aversive stimuli. However, recent evidence suggests heterogeneity in emotional reactivity among individuals with psychopathic or callous-unemotional (CU) traits, the emotional detachment dimension of psychopathy. We hypothesize that primary variants of psychopathy will respond with blunted affect to negatively valenced stimuli, whereas individuals marked with histories of childhood trauma/maltreatment exposure, known as secondary variants, will display heightened emotional reactivity. To test this hypothesis, the present study examined fear-potentiated startle between psychopathy (...) variants while viewing aversive, pleasant, and neutral scenes. Method: 238 incarcerated adolescent (M age = 16.8, SD = 1.11 years) boys completed a picture-startle paradigm and self-report questionnaires assessing CU traits, antisocial-aggressive behavior, and maltreatment. Results: Latent profile analyses identified four classes; primary variants (high CU traits, high aggression, low maltreatment; n = 46), secondary variants (high CU traits, high aggression, high maltreatment; n = 42), and two nonpsychopathic groups differentiated on maltreatment experience (n = 148). Findings from an ANOVA comparing identified groups on startle amplitude difference scores (i.e., aversive-neutral) suggested a main effect for group, F(3,196)=8.91, p<.001, η2 = .12. Primary variants of juvenile psychopathy displayed reduced startle potentiation to aversive images (threat and victim scenes), whereas secondary variants distinguished by high levels of childhood maltreatment did not. Conclusions: Findings add to a rapidly growing body of literature supporting the possibility of multiple developmental pathways to psychopathy (i.e., equifinality), and extend it by finding support for divergent potential biomarkers between primary and secondary psychopathy variants. (shrink)

This paper proposes and analyzes the psychometric properties of the PREVI-A scale. It describes the process of item development, the factorial structure of the scale, reliability, evidence of validity and diagnostic performance with regard to recidivism risk in juvenile offenders. The sample was made up of 212 juvenile offenders held at detention centers run by the Madrid Agency for Reeducation and Reintegration of Juvenile Offenders, a regional government body. Statistical analyses were used to corroborate the theoretical factorial (...) structure of the PREVI-A, which consists of six risk/protection dimensions based on the Risk-Needs-Responsivity Model, and to obtain empirical support for the reliability and validity of PREVI-A as a tool to assess the risk of recidivism by juvenile offenders in Spain. (shrink)

The justice of criminal punishment depends in part on the possibility of holding people accountable for their choices. There is a wide variation between nations on the age at which juveniles can be prosecuted in adult criminal courts. This variation reflects disagreement about the underlying logic of responsibility. This paper examines the philosophical difference between adults and children as agents. The paper argues that the moral status of children is importantly distinct from adults, specifically with respect to how (...) class='Hi'>responsibility should be mitigated. The paper explains this in terms of the developmental aspect of childhood. By considering empirical evidence from psychology and neuroscience we can understand the mistakes that juveniles make as a form of developmental impairment. The paper shows why these findings lead to the conclusion that the practice of trying children as adults is immoral and should be eliminated. (shrink)

Several states in the United States of America and countries in Europe punish parents when their minor child commits a crime. When parents are being punished for the crimes committed by their children, it should be presumed that parents might be held responsible for the deeds of their children. This article addresses the question whether or not this presumption can be sustained. We argue that parents can be blamed for the crimes of their children, not because they have the duty (...) to control their children as is often maintained, but because they have the duty to assist their child to develop in such a way that s/he becomes a morally competent agent. (shrink)

Neil Levy argues that the degree to which psychopaths ought to be held blameworthy for their actions depends on the extent to which they are capable of mental time travel—episodic memory and episodic foresight. Levy claims that deficits in mental time travel prevent psychopaths from fully appreciating what it is to be a person, and, without this understanding, we can at best hold psychopaths blameworthy for harming non-persons. In this paper, I build upon and clarify various aspects of Levy’s view. (...) Specifically, I begin by outlining the neurobiological data on mental time travel, and I argue that psychopaths, or at least some psychopaths, appear to have the deficits Levy ascribes to them. I then expand upon the legal implications of his argument by using an analogy between juveniles and psychopaths to argue that the penological justification for retributive punishment against psychopaths ought to be substantially diminished. (shrink)

At the end of Section III of “Freedom and Resentment,” just after he has drawn our attention to the reactive attitudes, P. F. Strawson remarks, “The object of these commonplaces is to try to keep before our minds something it is easy to forget when we are engaged in philosophy, especially in our cool, contemporary style, viz., what it is actually like to be involved in ordinary inter-personal relationships, ranging from the most intimate to the most casual.” It is striking, (...) then, that the proponent of so thoroughly naturalistic an account of moral responsibility seems himself largely to ignore the fact that moral agents do not spring into existence ab initio. The adult moral agent, who is the central character of normative theory and of accounts of moral responsibility, was once a child. Our juvenile selves get a mention in Strawson’s paper, but only as examples of creatures who are paradigmatically not responsible or who inhabit “a borderline, penumbral area ” with respect to responsibility. Thus it remains a mystery, on Strawson’s account, how we become the morally responsible creatures he takes us to be. (shrink)

Several states in the United States of America and countries in Europe punish parents when their minor child commits a crime. When parents are being punished for the crimes committed by their children, it should be presumed that parents might be held responsible for the deeds of their children. This article addresses the question whether or not this presumption can be sustained. We argue that parents can be blamed for the crimes of their children, not because they have the duty (...) to control their children as is often maintained, but because they have the duty to assist their child to develop in such a way that s/he becomes a morally competent agent. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Psychopathy, Other-Regarding Moral Beliefs, and ResponsibilityLloyd Fields (bio)AbstractIn this paper I seek to show that at least one kind of psychopath is incapable of forming other-regarding moral beliefs; hence that they cannot act for other-regarding moral reasons; and hence that they are not appropriate subjects for the assessment of either moral or legal responsibility. Various attempts to characterize psychopaths are considered and rejected, in particular the widely held (...) view that psychopaths are, in general, incapable of understanding moral concepts. The particular disability proposed here, the incapacity to form other-regarding moral beliefs, is then derived from an analysis of what is required for someone to be a responsible agent. This is illustrated with a detailed case history. A defect of this kind is shown to vitiate moral responsibility, because it renders the psychopath irresponsive to the social pressures which normally ensure respect for moral norms. It is also shown that the psychopath is not a suitable subject for the assessment of legal responsibility, because he lacks the capacity to act from common prudence to avoid sanctions. I conclude that the attempt to characterize particular defects from among the heterogeneity of psychopathic subjects, could lead to better targeted, and hence to more effective, management of particular cases.KeywordsCriminality, mental illness, personality disorder, blame, liability, moral beliefs, guilt, social moralityIntroductionThe term “psychopath” has been used with a wide variety of different meanings and, no doubt, covers a heterogeneous group of subjects (Criminal behaviour and mental health 1992). My aim in this paper is to argue that at least a subgroup of those subjects are characterized by an inability to form other-regarding moral beliefs—and hence, for this particular reason, are not morally responsible agents—and that they also lack the capacity for prudence, and hence are not legally responsible agents.I begin by distinguishing the particular sense in which I will be using the term “psychopathy.” I then consider some suggestions in the literature regarding the defect by which psychopaths might be characterized—that they are mentally ill, or incapable of understanding moral concepts. In rejecting these, I come to the suggestion that the relevant defect is an inability to form other-regarding moral beliefs, a defect which is graphically illustrated by a case report from the literature. I explore the implication of this kind of defect for [End Page 261] moral responsibility as a socially-embedded notion, and the implication of the psychopath’s inability to exercise prudence in relation to legal liability.Nothing in this paper should be taken to suggest that psychopaths are irredeemable. On the contrary, as I argue in an endnote, correctly characterizing the defect from which they suffer leads directly to forms of treatment whose effectiveness has acquired a measure of empirical support.The Nature of PsychopathyPsychopathy is not a homogeneous concept; there are different types of psychopaths. For example, Henderson identified a type of psychopath who he classified as “Predominantly Creative,” exemplified by such figures as T. E. Lawrence and Joan of Arc. In people of this type genius is associated with heightened sensitivity, psychosexual immaturity and emotional instability (Henderson 1939, 108–20; Henderson and Gillespie 1969, 317). Predominantly creative psychopaths do not come within my purview.By “psychopathy” I shall mean the specific form of personality disorder described by Cleckley in his book, The Mask of Sanity (Cleckley 1964). Cleckley’s description forms the basis of Hare’s Revised (20-item) Psychopathy Checklist. The Checklist includes the following personality traits and deviant behaviors:1. Glibness/superficial charm.2. Grandiose sense of self-worth.3. Need for stimulation/proneness to boredom.4. Pathological lying.5. Conning/manipulative.6. Lack of remorse or guilt.7. Shallow affect.8. Callous/lack of empathy.9. Parasitic lifestyle.10. Poor behavioral controls.11. Promiscuous sexual behavior.12. Early behavior problems.13. Lack of realistic, long-term plans.14. Impulsivity.15. Irresponsibility.16. Failure to accept responsibility for own actions.17. Many short-term marital relationships.18. Juvenile delinquency.19. Revocation of conditional release.20. Criminal versatility (Hare 1986, 18). 1This conceptualization resembles in many respects the category of Antisocial Personality Disorder as described in the American Psychiatric... (shrink)

At present, many countries have lowered the minimum age of criminal responsibility to deal with the trend of juvenile crime. In practical terms, whether countries advocate for lowering the age of criminal responsibility along with early puberty, or regulating the minimum age of juvenile criminal responsibility through their policies, their deep-rooted hypothesis is that age is tied to adolescents’ psychological growth, and, with the rise in age, the capacity for dialectical thinking, self-control, and empathy gradually (...) improves. With this study, we aimed to test whether this hypothesis is valid. The participants were 3,208 students from junior high school, senior high school, and freshman in the S province of the People’s Republic of China. We subjected the gathered materials to independent-samples t-tests, one-way analysis of variance, linear regression analysis, and Bonferroni post hoc test. The influence of the age variable upon dialectical thinking, self-control, and empathy was significant, but only empathy was positively correlated with age variable ; dialectical thinking ability, and self-control ability were negatively correlated with the age variable. Bonferroni post hoc test confirmed these findings. Therefore, we concluded the following: Juvenile criminal responsibility, based on the capacity for dialectical thinking, self-control, and empathy, is not positively correlated with age. Age is not the only basis on which to judge a juvenile’s criminal responsibility. More research that directly links age differences in brain structure and function to age differences in legally relevant capacities and capabilities is needed. Political countries should appropriately raise the minimum age of criminal responsibility and adopt the doli incapax principle in the judicial process. (shrink)

In this paper we attempt to reply to the thoughtful comments made on our book, Responsible Brains, by a stellar group of scholars. Our reply focuses on two topics discussed in the commenting papers: first, the issue of responsibility for negligent behavior; and second, the broad claim that facts about brain function are normatively inert. In response to worries that our theory lacks normative implications, we will concentrate on an area where our theory has clear relevance to law and (...) legal policy: juvenile responsibility. (shrink)

Acerca de la imagen de tapa: Ritmos Primarios, la Subversión del Alma, de Hugo Aveta, 2013.

In his comments, Daniel Nicholls succeeds in saying more than a few things that I had scarcely realized about the ways in which I write and, therefore, of what I tend to take for granted. He sees in what I write a capacity ‘to utilize the “obvious” whilst at the same time saying something about it.’ Not every philosopher would take that as a compliment. Many philosophers and philosophies have quite other pretensions – to transcend the illusions of common thought (...) and perception towards a higher plane of metaphysical philosophy – or of physics and mathematics. I find that Nicholls’s remark both compliments and complements my work, however. The use of everyday language and example to disturb that everyday world to ‘bring it into high relief’ as Nicholls puts it – is a significant part of philosophical method. To juxtapose the esoteric language of metaphysics (being-in-itself, being-for-itself, being-for-others) with the everyday (what there is, living for oneself, living for others) is to haunt the everyday with a metaphysical imagination even as it reveals what metaphysics had erased from the coinage of common words. (I am thinking, of course, of Derrida’s remarks about Anatole France’s satirical view of philosophical language as coinage from which all marking has been erased). (shrink)

In this article I argue that Part II of the Family LawAct 1996 gives expression to a new form ofresponsibility. I begin by suggesting thatresponsible behaviour has shifted from prohibiting orrequiring particular actions: we now exhibitresponsibility by our attitude towards our actions. I then examine where this new conception ofresponsibility has come from. Through an examinationof the work of post-liberal theorists, principallyMichael Sandel, I argue that a changing view ofpersonhood within post-liberal theory has led to aquestioning of the possibility of (...) choice, and that theabsence of choice necessitates a shift in thedefinition of responsible behaviour. If we are createdby our decisions then we cannot be held to account forour decisions, but only for the care we have takenover them. Responsibility is therefore measured notby our level of self-control but by our level ofself-awareness. Finally I examine the consequences ofthis shift in the meaning of responsibility. Withinthis framework autonomy is illusory thereforedecisions do not need to be respected. This explainswhy the implementation of Part II of the Family LawAct 1996 has been called into question. Within thisframework responsibility is relative therefore itextends indefinitely. This enables the Family Law Actto be uniquely intrusive and judgmental: everydivorcing couple, on being held up to scrutiny, isfound lacking. (shrink)

Acerca de la imagen de tapa: El Negro Matapacos, por Caiozzama. Noviembre 2019, Santiago de Chile.

Self-control has gained enormous attention in recent years both in philosophy and the mind sciences, for it has profound implications on so many aspects of human life. Overcoming temptation, improving cognitive functioning, making life-altering decisions, and numerous other challenges all depend upon self-control. But recent developments in the philosophy of mind and in action theory, as well as in psychology, are now testing some of the assumptions about the nature of self-control previously held on purely a priori grounds. New essays (...) in this volume offer fresh insights from a variety of angles: neuroscience; social, cognitive, and developmental psychology; decision theory; and philosophy. While much of the literature on self-control is spread across distinct disciplines and journals, this volume presents for the first time a thorough and truly interdisciplinary exploration of the topic. The essays address four central topics: what self-control is and how it works; temptation and goal pursuit; self-control, morality, and law; and extending self-control. They take up an array of complex and important questions. What is self-control? How is self-control related to willpower? How does inhibitory control work? What are the cultural and developmental origins of beliefs about self-control? How are attempts at self-control hindered or helped by emotions? How do our beliefs about our own ability to deal with temptation influence our behavior? What does the ability to avoid temptation depend on? How should juvenile responsibility be understood, and how should the juvenile justice system be reformed? Can an account of self-control help us understand free will? Combining the most recent scientific research with new frontiers in the philosophy of mind, this volume offers the most definitive guide to self-control to date. (shrink)

When laws or legal principles mention mental states such as intentions to form a contract, knowledge of risk, or purposely causing a death, what parts of the brain are they speaking about? We argue here that these principles are tacitly directed at our prefrontal executive processes. Our current best theories of consciousness portray it as a workspace in which executive processes operate, but what is important to the law is what is done with the workspace content rather than the content (...) itself. This makes executive processes more important to the law than consciousness, since they are responsible for channeling conscious decision-making into intentions and actions, or inhibiting action.We provide a summary of the current state of our knowledge about executive processes, which consists primarily of information about which portions of the prefrontal lobes perform which executive processes. Then we describe several examples in which legal principles can be understood as tacitly singling out executive processes, including principles regarding defendants’ intentions or plans to commit crimes and their awareness that certain facts are the case, as well as excusatory principles which result in lesser responsibility for those who are juveniles, mentally ill, sleepwalking, hypnotized, or who suffer from psychopathy. (shrink)

Impaired emotional capacity in antisocial populations is a well-known reality. Taking the dimensional approach to the study of emotion, emotions are perceived as a disposition to action; they emerge from arousal of the appetitive or aversive system, and result in subjective, behavioral, and physiological responses that are modulated by the dimensions of valence, arousal, and dominance. This study uses the International Affective Picture System (IAPS) to study the interaction between the type of picture presented (pleasant, neutral, or unpleasant) and group (...) (adolescents under custody in juvenile justice centers, adolescents under non-custodial measures, and secondary school students) in the emotional assessment of these dimensions. The interaction between the study variables was statistically significant. Statistically significant differences were found between the three types of pictures presented, in the ratings of unpleasant pictures between the custody group and the group of secondary students in regular schooling in valence, and in the ratings of unpleasant, neutral, and pleasant pictures in arousal, between the custody group and all groups. Discriminant analyses of each affective dimension indicate that the unpleasant pictures with violent and/or aggressive content tend to be in the functions that most differentiate the antisocial groups. (shrink)

Juvenile offenders are sometimes transferred to a criminal court where they may stand trial as adults. The rationale for this current trend cannot be justified based on evidence from developmental psychology, the evidence of consistent positive effects for particular intervention strategies, and ethical arguments for justification of punishment. The rationale in actuality reflects the selective manipulation of the alternative conceptions of young people as dependent and vulnerable or as autonomous and responsible to continue to justify policies that entail cultural (...) and racial discrimination. Discretionary decisions at various stages of the justice process amplify racial disparities as minority youths proceed through the system and result in more severe dispositions that for comparable White youths. (shrink)

Explains what lying is and why people do it; then discusses trust, living responsibly, and the value of telling the truth.

This article is an attempt to understand ethical theory not just as a set of well-developed philosophical perspectives but as a range of moral capacities that human beings more or less grow into over the course of their lives. To this end, we explore the connection between formal ethical theories and stage developmental psychologies, showing how individuals mature morally, regarding their duties, responsibilities, ideals, goals, values, and interests. The primary method is to extract from the writings of Kohlberg and his (...) students the cues that help to flesh out a developmental picture of a wide range of ethical perspectives. Thus, developmental psychology benefits from gaining a broader understanding of “morality” and “ethics,” and ethical theory benefits from a richer understanding of how moral maturity arises from youthful beginnings in juvenile and adolescent thinking. Results of this study offer insight into the difficulty of teaching ethics and a refined ability to assess moral maturity in business activity. (shrink)

Cross-cultural sex differences in mobility and harm avoidance have been widely reported, often emphasizing fitness benefits of long-distance travel for males and high costs for females. Data emerging from adults in small-scale societies, however, are challenging the assumption that female mobility is restricted during reproduction. Such findings warrant further exploration of the ontogeny of mobility. Here, using a combination of machine-learning, mixed-effects linear regression, and GIS mapping, we analyze range size, daily distance traveled, and harm avoidance among Hadza foragers during (...) middle childhood and adolescence. Distance traveled increased with age and, while male adolescents had the longest daily ranges, average daily distance traveled by each sex was similar. We found few age- or sex-related patterns in harm-avoidant responses and a high degree of individual variation. When queried on the same issues, children and their parents were often in alignment as to expectations pertaining to harm avoidance, and siblings tended to behave in similar ways. To the extent that sex differences in mobility did emerge, they were associated with ecological differences in physical threats associated with sex-specific foraging behaviors. Further, we found no strong association between harm avoidance and mobility. Young Hadza foragers of both sexes are highly mobile, regardless of how harm avoidant they are. Taken together, our findings indicate that the causal arrows between harm avoidance and mobility must be evaluated in ecologically specific frameworks where cultural expectations of juvenile mobility can be contextualized. (shrink)

The theory of neoteny assumes that adult animals that are higher on the phylogenetic scale retain juvenile characteristics for greater periods of their lifetime. This hypothesis would account for the continuation of curiosity, learning and playfulness in humans and other higher primates in contrast to less evolved mammals. The failure of the neoteny process could result in humans that have lost these juvenile characteristics and lack motivation, curiosity and the capacity to learn freely. These features are indicative of (...) the negative symptoms of dementia praecox, a chronic mental illness that strikes individuals as they become adults.It is postulated that a possible mechanism in the etiology of dementia praecox is the failure of regulator genes to program structural genes to produce enzymes necessary for neoteny. Positive symptoms of the disorder may be conceptualized as the organisms aberrant response to this activation failure. The role of regulator genes in chronic illness may prove a significant avenue for further investigation. (shrink)

Moral and legal notions engaged in clinical ethics should not only possess analytic clarity but a sound basis in empirical findings. The latter condition brings into question the expansion of the mature minor exception. The mature minor exception in the healthcare law of the United States has served to enable those under the legal age to consent to medical treatment. Although originally developed primarily for minors in emergency or quasi-emergency need for health care, it was expanded especially from the 1970s (...) in order to cover unemancipated minors older than 14 years. This expansion initially appeared plausible, given psychological data that showed the intellectual capacity of minors over 14 to recognize the causal connection between their choices and the consequences of their choices. However, subsequent psychological studies have shown that minors generally fail to have realistic affective and evaluative appreciations of the consequences of their decisions, because they tend to over-emphasize short-term benefits and underestimate long-term risks. Also, unlike most decisionmakers over 21, the decisions of minors are more often marked by the lack of adequate impulse control, all of which is reflected in the far higher involvement of adolescents in acts of violence, intentional injury, and serious automobile accidents. These effects are more evident in circumstances that elicit elevated affective responses. The advent of brain imaging has allowed the actual visualization of qualitative differences between how minors versus persons over the age of 21 generally assess risks and benefits and make decisions. In the case of most under the age of 21, subcortical systems fail adequately to be checked by the prefrontal systems that are involved in adult executive decisions. The neuroanatomical and psychological model developed by Casey, Jones, and Summerville offers an empirical insight into the qualitative differences in the neuroanatomical and neuropsychological bases of adolescent versus adult decision making. These and other data, as well as developing law bearing on the culpability of juvenile criminal offenders, argue for critically re-evaluating the expansion of the mature minor exception with regard to medical decision making, as well as in support of a rebuttable presumption in favor of treating minors as immature decisionmakers. The clinical ethics of adolescent medical decision making will need foundationally to be reconsidered. (shrink)

The War Inside is a groundbreaking history of the contribution of British psychoanalysis to the making of social democracy, childhood, and the family during World War II and the postwar reconstruction. Psychoanalysts informed understandings not only of individuals, but also of broader political questions. By asserting a link between a real 'war outside' and an emotional 'war inside', psychoanalysts contributed to an increased state responsibility for citizens' mental health. They made understanding children and the mother-child relationship key to the (...) successful creation of a democratic citizenry. Using rich archival sources, the book revises the common view of psychoanalysis as an elite discipline by taking it out of the clinic and into the war nursery, the juvenile court, the state welfare committee, and the children's hospital. It traces the work of the second generation of psychoanalysts after Freud in response to total war and explores its broad postwar effects on British society. (shrink)