Should dementia sufferers be punished for past crimes?

<p>This paper examines whether we ought to prosecute historic offences committed by people who have subsequently developed dementia. Currently, a person with dementia might avoid conviction on the basis of their currently diminished capacity. They may be unfit to plead, for example. The problem is that advanced dementia may undermine persistence of personal identity. Once someone develops dementia, they may no longer be the person who committed the crime. If so, they would not need to be excused for their offending. They would simply not be liable. If we think persistence of personal identity is based on psychological factors – as most of us do – a person with advanced dementia will not be the same person as the one who committed the crime. They will not deserve prosecution, never mind punishment. This issue has been overlooked by legal theorists. Although much has been written on the legal significance of dementia, it has been primarily in the context of advance directives or decision-making capacity. I will argue that advanced dementia is a challenge to criminal responsibility.</p>

Should dementia sufferers be punished for past crimes?

<p>This paper examines whether we ought to prosecute historic offences committed by people who have subsequently developed dementia. Currently, a person with dementia might avoid conviction on the basis of their currently diminished capacity. They may be unfit to plead, for example. The problem is that advanced dementia may undermine persistence of personal identity. Once someone develops dementia, they may no longer be the person who committed the crime. If so, they would not need to be excused for their offending. They would simply not be liable. If we think persistence of personal identity is based on psychological factors – as most of us do – a person with advanced dementia will not be the same person as the one who committed the crime. They will not deserve prosecution, never mind punishment. This issue has been overlooked by legal theorists. Although much has been written on the legal significance of dementia, it has been primarily in the context of advance directives or decision-making capacity. I will argue that advanced dementia is a challenge to criminal responsibility.</p>

Research in Adults with Diminished Capacity

Informed consent is often identified as a condition of ethical research. Therefore, ethical challenges arise when conducting research with adults who lack the capacity to provide informed consent. In this chapter, the authors consider these challenges using two principal cases: adults with dementia and adults with acute, emergent health conditions. As this pair of cases shows, decisional capacity can be “diminished” in many ways, and a number of strategies are available to address diminished capacity. In this chapter, the authors highlight surrogate consent and the partial-involvement strategies of assent and dissent and note additional protections afforded to these vulnerable populations.

Trial by Triad: substituted judgment, mental illness and the right to die

Substituted judgment has increasingly become the accepted standard for rendering decisions for incapacitated adults in the USA. A broad exception exists with regard to patients with diminished capacity secondary to depressive disorders, as such patients’ previous wishes are generally not honoured when seeking to turn down life-preserving care or pursue aid-in-dying. The result is that physicians often force involuntary treatment on patients with poor medical prognoses and/or low quality of life (PMP/LQL) as a result of their depressive symptoms when similarly situated incapacitated patients without such depressive symptoms would have their previous wishes honoured via substituted judgment. This commentary argues for reconsidering this approach and for using a substituted judgment standard for a subset of EMP/LQL patients seeking death.

Deal-Making Capacity of a Citizen: Criteria for Forensic Psychological Assessment

A psychological examination of 88 men and 42 women aged between 26 and 88 (116 of them had mental disorders, and 14 were mentally healthy) has been carried out while they were undergoing the complex forensic psychological and psychiatric examination for purposes of assessment a person's deal-making ability at the time of the transaction and diminished capacity. In respect of 46 persons, forensic experts took the decision that the persons ‘were unable to understand the meaning of their actions, regulate and control them at the time of the transaction’; 48 persons were found to be ‘able to understand the meaning of their actions, regulate and control them at the time of the transaction’; and 26 persons were found to be ‘able to understand the meaning of their actions, regulate and control them only if assisted by others’. In respect of 10 persons, the questions posed to forensic experts failed to be definitively resolved. 57 indicators, reflecting the disturbances of cognitive processes, individual psychological peculiarities, and data on socialization had been diagnosed for each of the examinees. Factor analysis made it possible to identify the pathopsychological symptom complexes that are relatively specific for persons who either have or lack the deal-making ability at the time of the transaction (Article 177 of the Civil Code of the Russian Federation), as well as for persons with diminished capacity due to mental disorder (Para. 2 of Article 30 of the Civil Code of the Russian Federation).

Predictive Validity of Operationalized Criteria for the Assessment of Criminal Responsibility of Sexual Offenders With Paraphilic Disorders—A Randomized Control Trial With Mental Health and Legal Professionals

The prevention of sexual violence is a major goal of sexual health. In cases of accused sexual offenders, the assessment of diminished criminal responsibility of the accused is one of the most important procedures undertaken by experts in the German legal system. This assessment follows a two-stage method assessing first the severity of a paraphilic disorder and then second criteria for or against diminished capacity. The present study examines the predictive validity of two different sets of criteria for the assessment of criminal responsibility in the context of paraphilic disorders combined with sexual offending. Two exemplary case vignettes of two suspected sexual offenders were developed to assess the criteria. For each participant, one of the two exemplary case vignettes was randomly presented. The presentation of the two different sets of criteria was also randomized, so that each participant was assigned only one of the two criteria sets to rate one of the presented cases. N = 349 participants from different professional backgrounds (mental health and legal professionals) completed their assessments and were included in the data analysis. The data were evaluated using logistic regression. Results show that the more recently published criteria set (Briken and Müller, 2014) predicts both the severity of the disorder as well as the diminished capacity twice as good as the older criteria set of Boetticher et al. (2005) currently used regularly for forensic court reports. In preliminary conclusion, the new criteria of Briken and Müller (2014) form an empirically based assessment of criminal responsibility. However, the proposed criteria cannot replace an extensive exploration of the accused person and a careful file analysis. Validity and reliability of the results are also limited due to the methodical choice of a vignette study.

The Frankfurt Discussion

This chapter recalls Theodor W. Adorno and Martin Heidegger's reputation as archenemies because of their political antagonism and Adorno's unanswered polemics against Heidegger after World War II. It examines Adorno and Heidegger's emphasis on the philosophical significance of art and their concern over the allegedly diminished capacity of moderns to experience the world beyond the technical domination of nature. It also investigates the role played by Heidegger in the emergence of Adorno's critical theory between the publication of Being and Time in 1927 and Heidegger's Nazi turn in 1933. The chapter reconstructs the Frankfurt discussion between Adorno and his Heideggerian opponents in the University of Frankfurt from 1929 to 1933. It elaborates that Frankfurt discussion was a debate over the significance of Heidegger's revolutionary philosophy and its implicit diagnosis of the crisis of modernity.

‘Range’: A gain and dynamic range independent quantification of spread aiding in panel design

In flow cytometers, ideally each detector receives photons from one specific fluorochrome. However, photons usually end up in different detectors too (fluorescence spillover). ‘Compensation’ is a process that removes this extra signal from all detectors other than the primary detector dedicated to that fluorochrome. Post ‘compensation’, the measurement error of spillover signals become evident as spreading of the data. Spillover reduces the ability to resolve single positive from double positive cell populations. For successful multi-color panel design, it is important to know the expected spillover. The Spillover Spread Matrix (SSM) can be used to estimate the spillover spread, but the outcome is heavily influenced by detector sensitivity. In short, the same single stained control sample produces different spillover spread values when detector sensitivity are altered. Many researchers unknowingly use this artifact to “reduce” the spread by decreasing detector sensitivity. This can result in reduced sensitivity and diminished capacity to resolve cell populations. In this article, we introduce ‘Range’ as an alternative tool that can predict the spillover independent of detector sensitivity. ‘Range’ is also independent of dynamic range, that allows to compare spread values between different types of instruments, something not possible using SSM.