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Brain Scanning In A Mobile MRI

On a crystal clear June morning at Albuquerque’s Youth Diagnostic and Development Center, juveniles who have been convicted of violent offenses march by, craning their necks as a huge trailer drives through the gates. This is Kiehl’s prize — a $2 million mobile MRI provided by the Mind Research Network at the University of New Mexico. Kiehl transports the mobile MRI to maximum-security prisons around the state, and over the past few years, he has scanned the brains of more than 1,100 inmates, about 20 percent of whom are psychopaths.

For ethical reasons, Kiehl could not allow me to watch an inmate’s brain being scanned, so he asked his researchers to demonstrate.

After a few minutes of preparation, researcher Kevin Bache settles into the brain scanner, where he can look up and see a screen. On the screen flashes three types of pictures. One kind depicts a moral violation: He sees several hooded Klansmen setting a cross on fire. Another type is emotional but morally ambiguous: a car that is on fire but you don’t know why. Another type of photo is neutral: for example, students standing around a Bunsen burner.

The subjects rate whether the picture is a moral violation on a scale of 1 to 5. Kiehl says most psychopaths do not differ from normal subjects in the way they rate the photos: Both psychopaths and the average person rank the KKK with a burning cross as a moral violation. But there’s a key difference: Psychopaths’ brains behave differently from that of a nonpsychopathic person. When a normal person sees a morally objectionable photo, his limbic system lights up. This is what Kiehl calls the “emotional circuit,” involving the orbital cortex above the eyes and the amygdala deep in the brain. But Kiehl says when psychopaths like Dugan see the KKK picture, their emotional circuit does not engage in the same way.

“We have a lot of data that shows psychopaths do tend to process this information differently,” Kiehl says. “And Brian looked like he was processing it like the other individuals we’ve studied with psychopathy.”

Kiehl says the emotional circuit may be what stops a person from breaking into that house or killing that girl. But in psychopaths like Dugan, the brakes don’t work. Kiehl says psychopaths are a little like people with very low IQs who are not fully responsible for their actions. The courts treat people with low IQs differently. For example, they can’t get the death penalty.

“What if I told you that a psychopath has an emotional IQ that’s like a 5-year-old?” Kiehl asks. “Well, if that was the case, we’d make the same argument for individuals with low emotional IQ — that maybe they’re not as deserving of punishment, not as deserving of culpability, etc.”

Implications Of The Diagnosis

And that’s exactly what Dugan’s lawyers argued at trial last November. Attorney Steven Greenberg said that Dugan was not criminally insane. He knew right from wrong. But he was incapable of making the right choices.

“Someone shouldn’t be executed for a condition that they were born with, because it’s not their fault,” Greenberg says. “The crime is their fault, and he wasn’t saying it wasn’t his fault, and he wasn’t saying, give [me] a free pass. But he was saying, don’t kill me because it’s not my fault that I was born this way.”

This argument troubles Steven Erickson, a forensic psychologist and legal scholar at Widener University School of Law. He notes that alcoholics have brain abnormalities. Do we give them a pass if they kill someone while driving drunk?

“What about folks who suffer from depression? They have brain abnormalities, too. Should they be entitled to [an] excuse under the law?” he asks. “I think the key idea here is the law is not interested in brain abnormalities. The law is interested in whether or not someone at the time that the criminal act occurred understood the difference between right and wrong.”

At trial, Jonathan Brodie, a psychiatrist at NYU Medical School who was the prosecution’s expert witness, went further. Even if Dugan’s brain is abnormal, he testified, the brain does not dictate behavior.

“There may be many, many people who also have psychopathic tendencies and have similar scans, who don’t do antisocial behavior, who don’t rape and kill,” Brodie says.

Moreover, Brodie told the jury, Dugan’s brain scan in 2009 says nothing about what his brain was like when he killed Jeanine Nicarico.

“I don’t know with Brian Dugan what was going on in his brain” when he committed his crime, Brodie says. “And I certainly don’t know what was going on from a brain scan that was taken 24 years later.”

The jury seemed to zero in on the science, asking to reread all the testimony about the neuroscience during 10 hours of deliberation. But in the end, they sentenced Dugan to death. Dugan is appealing the sentence.

In the meantime, this case signals the beginning of a revolution in the courtroom, Kiehl says.

“Neuroscience and neuroimaging is going to change the whole philosophy about how we punish and how we decide who to incapacitate and how we decide how to deal with people,” he says, echoing comments of a growing number of leading scholars across the country, including Princeton and Harvard.

Just like DNA, he believes brain scans will eventually be standard fare. And that, he and others say, could upend our notions of culpability, crime and punishment.