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This is a tough issue. If a person is not mentally competent to stand trial without drugs in his system, he does not, by default, meet the legal requirements for sanity at the time of his crime. On the other hand, he did seem to have some sense that what he had done was illegal, at least in more lucid moments, but is that the same thing as knowing right from wrong?
Legally, the issue comes down to this:
Should prosecutors wage a legal war to force Loughner to take medicines that will render him mentally “competent” to stand trial and possibly be sentenced to death? And should Clarke fight for him to live off meds with his paralyzing mental illness indefinitely in order to spare him a trial and keep him alive?
It's pretty obvious that the prosecutors want him on meds so that he can be convicted of murdering six people and the attempted murder of a dozen more, including Congresswoman Gabrielle Giffords.
What are the ethics of medicating someone who clearly is not sane (schizophrenic or not, and I think not) simply so that the State can convict and execute him? The Daily Beast has a lengthy article on this issue.
A fierce court battle is raging over whether Jared Loughner, diagnosed as schizophrenic but not wishing to be medicated, should be restored to mental competency for an Arizona shooting trial—and face execution.
Nearly three months after he allegedly killed six people and injured Rep. Gabrielle Giffords and 12 others during a January shooting rampage in Tucson, Jared Lee Loughner sat in a Tucson courtroom, where his mental competency to stand trial was being evaluated. Gone were the shaved head and leering smile from his mug shot released after the shootings. Now Loughner wouldn’t stand out in a crowd—he’d grown a full head of brown hair, sideburns, and a goatee. He appeared benign.
And then, unexpectedly, he yelled at the judge: “Thank you for the free kill. She died in front of me. Your Cheesiness.”
The 22-year-old unemployed community-college dropout, who had just been diagnosed with schizophrenia, was later deemed mentally incompetent to stand trial. He was whisked back to a federal Bureau of Prisons medical facility in Springfield, Mo. Since then, he’s been at the center of a vicious court battle over whether he should be forced to take psychotropic medicines.
In the past few weeks, courts have ordered Loughner, who does not want to be medicated, to be put on meds, then taken off meds, then put on meds again, as lawyers prepare for yet another appellate-court hearing in late August over his forced medication.
The intense legal fight between Loughner’s defense team, led by star San Diego lawyer Judy Clarke, and federal prosecutors raises serious medical and ethical questions. Should prosecutors wage a legal war to force Loughner to take medicines that will render him mentally “competent” to stand trial and possibly be sentenced to death? And should Clarke fight for him to live off meds with his paralyzing mental illness indefinitely in order to spare him a trial and keep him alive?
Attorney Judy Clarke; inset: Jared Loughner, AP Photo
There’s no easy answer, Harvard Law professor Alan Dershowitz tells The Daily Beast, but clearly medications should not be “strategically advantageous,” either to prosecutors or to defense attorneys.
And although there’s a pressing need for the medical and legal professions to figure out how to “disincentivize” the use of medicine as a legal strategy, no one is doing much to fix the problem, notes Dershowitz. Some defendants can be so drugged up by psychotropic meds, he adds, that they exhibit a flat affect in the courtroom, persuading the jury to convict because the accused shows “no remorse.”
The purpose of medicating defendants, Dershowitz repeats, is to “heal, not give legal advantages.”
The purpose of medicating defendants, Dershowitz repeats, is to “heal, not give legal advantages.”
Prosecutors for the Loughner case declined to be interviewed for this story; Clarke did not return a phone call seeking comment.
Loughner was first forced to take Risperidone, a psychotropic drug used to treat schizophrenics, in mid-June, after he’d spent nearly six months in custody without medications.
In court records, prosecutors say it was necessary to give him Risperidone because he threw chairs, spat, swore, tried to disarm a video camera with a roll of wet toilet paper, and barricaded himself behind his bed to avoid a mental-health hearing.
Clarke, who is known for her compassion for her mentally ill clients as much as for her legal skills, in court records says other inmates have exhibited more bizarre behavior, such as hurling feces and urine at their jailers, without being forcibly medicated. Yet Loughner, who did neither, was considered a “danger to himself and others,” she says.
The defense attorney called the prosecutors’ “dangerousness” excuse an “end run”—prosecutors with a keen interest in restoring Loughner’s mental competency managed to get him on just the right meds without a so-called Wells hearing mandated by the Supreme Court. In such a hearing, forcible medication of a defendant is ordered only after a judge carefully weighs the prisoner’s constitutional rights against the government’s right to take a defendant to trial.
So far, though, the courts have mostly sided with prosecutors, who cited a different Supreme Court case that allows forced medication of prison inmates without judicial review if they are a danger to themselves or others.
Clarke had a brief victory when Loughner was taken off Risperidone by court order in early July.
But an appellate panel ordered him back on the drug after prison officials reported that he had deteriorated without the Risperidone. Prison officials said Loughner exhibited disturbing behavior that included constant weeping, feeling hopeless, expressing regret for the “circumstance that led to his arrest,” pacing so much he injured his ankle, “keeping his hands in his underwear and touching himself sexually,” and asking for a lethal injection.
Steve Pitt, a forensic psychiatrist based in Scottsdale, Ariz., says “starting and abruptly stopping” a psychotropic medication like Risperidone is generally “ill advised.”
In the Loughner case, he says, “when you have someone who is reportedly showing signs of clinical improvement while on medication and then deteriorates when off the medication, you don’t need to be a psychiatrist to know that he has benefited from the medication and needs to resume taking it.”
For doctors “to stand by and not do anything” as a patient “destabilizes” in a “clinical emergency,” says Richard J. Bonnie, the director of the Institute of Law, Psychiatry, & Public Policy at the University of Virginia, would be unethical. Bonnie, who opposes the death penalty in most cases, says it is entirely ethical for the prosecution to seek to restore a mentally ill defendant competent to stand trial. He also says a defense lawyer representing a seriously mentally ill patient often must work hard to establish trust, and establishing trust could include advocating for the client’s wish not to take medications.
Elizabeth Kelley, a Cleveland defense attorney who chairs a mental-health committee for the National Association of Criminal Defense Lawyers—of which Judy Clarke is a past president—says medicating someone against his will is not often appropriate. She calls forced medication of Loughner a “perversity” and a “way to perhaps execute him.”
Kelley doesn’t fault Clarke for asking the court to take away Loughner’s meds, because he never wanted to be medicated in the first place. And she wonders whether Loughner, whom she calls “profoundly mentally ill,” could ever truly be “restored” to competency to stand trial.
The only one who hasn’t weighed in on the matter, beyond expressing a wish not to be medicated, is Loughner himself, who sits in a Missouri prison cell. He’s on Risperidone now, but he may not be taking the drug for long. Clarke is preparing for an Aug. 31 Ninth Circuit Court of Appeals hearing on his forced medication. “She has a huge up-road battle,” says former federal prosecutor Kurt Altman, who has successfully prosecuted a federal death-penalty case.
“Her job,” he says, “is to keep Loughner off death row.”
If you don't know of Kristin Neff, you should. And if you do, you'll no doubt want to know more. Why? Because Neff, the world's leading self-compassion researcher, has developed a mind-altering prescription that just might change your life.
Neff, who conducts her compassion research at the University of Texas in Austin, would never indulge in such hyperbole. Neither would I, except the compassionate researcher's inspirational remedy changed my life -- no exaggeration. I was minding my own business -- practicing psychotherapy, teaching, writing articles -- and soon after finding Neff's heart-opening findings, I was not only going easier on myself, I was realizing my life's dream.
Turns out, Neff began researching self-compassion after her own life-changing experience. Before I go farther, it's worth pointing out that she and I are so similar there are even some points of confusion. We both blog for The Huffington Post, and we've both written books on the same subject with similar titles. Neff's new book "Self-Compassion" (not to be confused with my own, "The Self-Compassion Diet") reveals her personal and professional discoveries for all manner of positive change. If you're interested in changing for good, be sure to read this book and try each chapter's tried-and-tested compassion-enhancing exercises.
So Neff and I have a few things in common, but we've never met. Nor had we spoken until one thing recently led to another, and we got to chatting long distance about her and her new book. What follows are eight things you should know about Neff:
1. Self-compassion changed Neff's life almost immediately. Neff first learned about self-compassion in the late 90s, when she enrolled in a meditation class to deal with a deep sense of shame and self-loathing. "I was going through a nasty divorce and was a bit of mess," she says. "I had never considered that having compassion for yourself might be as important as having compassion for others." Long story short, the new divorcee found self-compassion to be so transformative, she did more than just make it her life's work: she and her now husband vowed to be compassionate 'til death do they part.
2. Before she dove into self-compassion research, Neff studied self-esteem. But after training with the leading self-esteem expert, the newly-minted Ph.D. concluded that the field of psychology had fallen out of love with self-esteem. "I realized that self-compassion was the perfect alternative to the relentless pursuit of self-esteem," she says. "Why? Because [self-compassion] steps in when self-esteem falls down, when you blow it, when you fail. That's precisely when self-compassion can help you: when self-esteem deserts you." On a wise professor's advice to pursue her passion for self-compassion and make the world a better place, Neff took a leap of faith. "I was unsure if it would be career suicide to study a field that no one in academia had ever studied, but I took his advice. He was right!"
3. She's not just a respected researcher, she's a real-life movie star. Neff believes the number of hats she wears on any given day is unremarkable, and yet, not all that long ago, this researcher, professor, writer, wife and mother took a professional timeout to star in a remarkable film chronicling her family's personal journey with autism (her nine-year-old son, Rowan, is autistic). Most remarkably, Neff is more than multi-talented, she's ever so humble.
4. She hates going to the gym, loves dining out with friends and maintains a healthy weight. Neff may look like a magazine cover girl in her book-jacket photo, but she's one of those rare women who maintains her weight without slavishly dieting and exercising. "I don't know any woman who's totally happy with her body," she says, "but I do try to appreciate what's good about mine." Health, not appearance, is what motivates this natural beauty to go for a walk, get enough sleep and generally take good care of herself. "I'm certainly not perfect," she adds, "but I feel fine with who I am."
5. She doesn't always practice what she preaches.Neff doesn't pretend to be perfectly compassionate. In fact, she's refreshingly honest about her all-too-human imperfections, like picking on her husband when she's irritable. But for Neff, self-compassion is always a life-saver, especially in dealing with her greatest challenge: raising a son who has autism. "Self-compassion helped me steer clear of anger and self-pity, allowing me to remain patient and loving toward Rowan despite the feelings of despair and frustration that would inevitably arise," she explains. "I'm not saying that I didn't have times when I lost it. I had many. But in those times I still had my practice of self-compassion to fall back on."
6. Practice makes ... bearable. When the going gets tough, Neff automatically gets a self-compassionate mindset going. When, for example, Rowan would throw a tantrum in a crowded airplane, the feel-good mother would automatically call to mind phrases from her favorite informal practice: "This is really hard. This is a moment of suffering. May I be kind to myself in this moment. May I give myself the compassion I need." For Neff, rehearsing kinder, gentler thoughts doesn't make an unbearable situation instantly better, but it makes it bearable.
7. Hate mail is all in a day's work. Expecting positive or neutral book reviews, Neff was initially surprised by the Amazon.com reviewer who threw her book in the trash. And yet, that one-star review and the singular piece of hate mail she's received reminded Neff that her message of self-love flies in the face of America's stiff upper lip culture. It's especially threatening, she's learned, to those who have, for whatever reason, shut themselves down emotionally. "Opening their heart and letting in all the fear they've kept out for so long is the last thing they want to do." Neff has to deal with the vocal minority who doesn't understand her book, but the overwhelming majority gives Neff's book five stars.
8. She can't think of a downside to self-compassion, but there are times when its downright impractical. "If you're a soldier in the middle of a battle, you aren't going to stop and tell yourself, 'This is hard,' and give yourself a hug." If there's a problem, she admits, it's that people get really excited about self-compassion then berate themselves for not being self-compassionate enough. Neff's best advice: "Don't beat yourself for beating yourself up."
Jean Fain is a Harvard Medical School-affiliated psychotherapist specializing in eating issues, and the author of "The Self-Compassion Diet." For more information, see www.jeanfain.com. Got a thing or two to say about any of the above? Please share in the comments section.
Depending on who we listen to, the internet is either destroying us, ruining our minds and social connections, or expanding us, acting as part of our extended mind, connecting us in ways never before possible.
I tend to feel the later is more true, at least in my experience.
The advent of the Internet, with sophisticated algorithmic search engines, has made accessing information as easy as lifting a finger. No longer do we have to make costly efforts to find the things we want. We can “Google” the old classmate, find articles online, or look up the actor who was on the tip of our tongue. The results of four studies suggest that when faced with difficult questions, people are primed to think about computers and that when people expect to have future access to information, they have lower rates of recall of the information itself and enhanced recall instead for where to access it. The Internet has become a primary form of external or transactive memory, where information is stored collectively outside ourselves.
I'll be posting the first bit or so of each one, so follow the links to read the whole article.
At the end, there is an NPR story about how children who have grown up with the internet have brains that function differently - they do not so much multitask as easily move back and forth between tasks very rapidly.
TOTAL RECALL?: The advent of the Internet and near-ubiquitous information at our fingertips makes it less critical for us to commit items to memory. Using the Internet as a mental crutch is not necessarily a bad thing, according to researchers.
Has the Internet dumbed down society or simply become an external storage unit that enhances the human brain's memory capacity? With Google, Internet Movie Database and Wikipedia at our beck and call via smart phones, tablets and laptops, the once essential function of committing facts to memory has become little more than a flashback to flash cards. This shift is not necessarily a bad thing, nor is it irreversible, according to a team of researchers whose study on search engines and learning appears in the July 15 issue of Science.
Led by Columbia University psychologist Betsy Sparrow, the researchers conducted a series of experiments whose results suggest that when people are faced with difficult questions, they are likely to think that the Internet will help them find the answers. In fact, those who expect to able to search for answers to difficult questions online are less likely to commit the information to memory. People tend to memorize answers if they believe that it is the only way they will have access to that information in the future. Regardless of whether they remember the facts, however, people tend to recall the Web sites that hold the answers they seek.
In this way, the Internet has become a primary form of external or "transactive" memory (a term coined by Sparrow's one-time academic advisor, social psychologist Daniel Wegner), where information is stored collectively outside the brain. This is not so different from the pre-Internet past, when people relied on books, libraries and one another—such as using a "lifeline" on the game show Who Wants to be a Millionaire?—for information. Now, however, besides oral and printed sources of information, a lion's share of our collective and institutional knowledge bases reside online and in data storage.
Last year's annual question posed by Edge was "How is the Internet changing the way you think?" Several psychologists answered that it was becoming an extension of their minds. "The Internet is a kind of collective memory,’ wrote Stephen Kosslyn (Harvard University). "When I write with a browser open in the background, it feels like the browser is an extension of myself."
A research team led by Betsy Sparrow has now tested the idea that the Internet really has become a kind of memory prosthesis. First they showed that difficult questions prompted dozens of undergrad participants to think automatically of computers and search engines. Participants tackled either easy or difficult trivia questions and then completed a version of the classic Stroop task: they had to look at a series of words and say what colour ink they were written in. After difficult questions, participants were extra slow at naming the colour of words like "Google". This is a sign that the search engine concept was salient in their minds and therefore interfered more with the process of colour naming.
Next, a group of dozens more undergrad participants read 40 trivia statements and then typed them into a computer. Half the participants were told that the computer would save their entry, the others were told the entries would be deleted. Participants in the "saved" condition performed worse at a subsequent recall test of the statements, as if they'd relied on the computer as an external memory store. Half the participants in both conditions had been instructed explicitly to try to remember the statements, but this made no difference to their memory performance. "Participants were more impacted by the cue that information would or would not be available to them, regardless of whether they thought they would be tested on it," the researchers said.
By now, you’ve probably heard about this smart study showing that Google is making you stupid, led by Betsy Sparrow at Columbia. The scientists demonstrated that the availability of the internet is changing the nature of what we remember, making us more likely to recall where the facts are rather than the facts themselves. Patricia Cohen of the Times summarizes the results:
Dr. Sparrow and her collaborators, Daniel M. Wegner of Harvard and Jenny Liu of the University of Wisconsin, Madison, staged four different memory experiments. In one, participants typed 40 bits of trivia — for example, “an ostrich’s eye is bigger than its brain” — into a computer. Half of the subjects believed the information would be saved in the computer; the other half believed the items they typed would be erased.
The subjects were significantly more likely to remember information if they thought they would not be able to find it later. “Participants did not make the effort to remember when they thought they could later look up the trivia statement they had read,” the authors write.
A second experiment was aimed at determining whether computer accessibility affects precisely what we remember. “If asked the question whether there are any countries with only one color in their flag, for example,” the researchers wrote, “do we think about flags — or immediately think to go online to find out?”
In this case, participants were asked to remember both the trivia statement itself and which of five computer folders it was saved in. The researchers were surprised to find that people seemed better able to recall the folder.
The headlines are already emphasizing the amnesiac effects of the internet, as if Google were a pox on the hippocampus. The scientists themselves are mostly sanguine about the data, noting that humans have been relying on “transactive memory” ever since the invention of language. It’s just that, for most of human history, the only other reliable sources of information were other people. What these experiments reveal is that we treat the search engine like a particularly clever friend, a buddy with a gift for factoids and trivia.
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Here is an interview with Betsy Sparrow, one of the researchers from the study being discussed above. The PBS video can't be embedded, so follow the link - it's short.
Columbia University Psychologist Betsy Sparrow discusses her newest research that examines the effect living in a search engine rich society has on the way we think. Her new paper, which she complete with the help of Jenny Liu and Daniel Wegner is titled, "Google Effects on Memory: Cognitive Consequences of Having Information at Our Fingertips"
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In this NPR story from Talk of the Nation, the topic switches to children who have never known anything but the internet infused world. Their brains seem to function differently, and that fact may require that we change the way we do education.
Author Don Tapscott says it's time for universities to adjust to students digital habits — not the other way around.
Few will argue about America's colleges and universities being critical to our economic and intellectual future. And by many measures, that future looks promising: Competition for places in the country's top schools is fiercer than ever, more families are willing to pay higher tuition, and employers are putting a greater premium on a college degree.
But Don Tapscott, co-author of Macrowikinomics: Rebooting Business And The World, argues that universities are woefully behind the times.
Tapscott — who has studied the digital revolution — tells NPR's Neal Conan that the traditional lecture model in American universities is no longer appropriate for a generation that has grown up making, changing and learning from digital communities.
"My generation — the boomers — grew up watching 24 hours a week of TV per kid," Tapscott says. But, he adds, today's young people have had a very different experience.
"This new generation comes home and they turn on their computer and they're in three different windows and they've got three magazines open and they're listening to iTunes and they're texting with their friends," he says, "and they're doing their homework."
With such a networked approach to work and leisure time, Tapscott says the traditional university classroom is starting to feel less appropriate.
A Harvard student studying the corporate management expert Peter Drucker once summed up his disillusionment with what Tapscott calls the "broadcast model" of learning: "Why would I sit there and listen to a [teaching assistant] talking to 300 of us," Tapscott recalls him saying, "when I can go online and interact with a real-time Peter Drucker?"
"The big thing is to get an 'A' without having ever gone to the lecture," Tapscott says. "All these kids that have grown up collaborating and thinking differently walk into a university and they're asked to sit there and passively listen to someone talking."
He says that if someone from 100 years ago miraculously came back and found a modern engineer designing a bridge, it would be clear how much technology had changed things. But if that same person walked into a university lecture hall today, it would be entirely familiar.
"We need to move toward a collaborative model of learning that's student focused, [that's] highly customized and that is a model appropriate for a new generation that learns differently," says Tapscott. He warns that universities are ignoring the changing needs and desires of young people — and they're doing so at their own peril.
"When you have the cream of the crop of an entire generation thinking that the model of pedagogy is deeply flawed," he says, "well, the writing's on the wall."
Psychopaths or mentally ill? I have issues with the psychopath diagnosis, and I think it's probably a good thing we do not use it in the States. I tend to believe that no one is born is evil (excluding severe brain damage), so if a person becomes a mass killer there was some serious physical, emotional, and environmental trauma that short-circuited the normal human ability to empathize or feel compassion.
But all of that is another discussion.
Alan Saunders, host of the Philosphers Zone podcast (from ABC Radio National in Australia), speaks with ethics Professor Walter Sinnott-Armstrong on the moral judgment of psychopaths - everything you think you know about psychopaths may be wrong.
Our guest this week says psychopaths are rarely high functioning corporate executives with a taste for downsizing. More often, they are low functioning and far more prone than to violent crime than the rest of the population. Today we explore moral judgement, neuroscience, psychopathy and the criminal justice system with ethics Professor Walter Sinnott-Armstrong from Duke University in the United States.
Walter Sinnott-Armstrong Chauncey Stillman Professor in Practical Ethics Department of Philosophy and The Kenan Institute for Ethics Duke University United States
Title: Conscious Will and Responsibility:A Tribute to Benjamin Libet, Author: Edited by Walter Sinnott-Armstrong and Lynn Nadel Publisher: Oxford University Press (2011) (Oxford Series in Neuroscience, Law and Philosophy)
Title: Morality Without God? Author: Walter Sinnott-Armstrong Publisher: Oxford University Press (2009)
