 Hi, I'm Sheila Loutman, associate director of the Health Law Institute, and it's my pleasure to introduce our speaker for today, Professor Jennifer Chandler. Professor Chandler earned her LLM from Harvard and joined the University of Ottawa Faculty of Law in 2002. Before that, she spent some time in practice and served as a clerk to then Supreme Court Justice, Johns Pinka. The courses she teaches include mental health law, neuroethics, medical-legal issues, also tort law, and a graduate course called Tecna Prudence that addresses technology and legal theory. Professor Chandler's research, like her teaching, is evidence of an extremely flexible and dynamic brain. The work places law and legal principles into deep engagement with a range of other disciplines, in particular neuroscience and psychiatry, and developments in philosophy, sociology, and ethics, reflecting on neuroscience and psychiatry, as well as technology. Much of her work has explored how new technologies are ways of knowing and shaping our minds and brains, interact with normative questions about the meaning of autonomy and respect for persons. She's contributed in important ways to public conversations about subtle and not-so-subtle coercion and the use of new technologies and neuropsychiatric interventions, conversations about the regulation of organ transplantation and the regulation of scientific inquiry, for instance, relating to stem cells and cloning, the criteria for determining death and other controversies arising at the end of life, and a range of questions relating to how judges think or are used to think about the brain. Today, Professor Chandler will share with us some of the fruits of her research under the title you see, brains on trial, neuroscientific evidence in Canadian criminal cases. With that, Professor Chandler. Thank you so much, Eli. I think that was one of the kindest introductions I've ever had. That was great. Thank you. I'm absolutely delighted to be here and thank all of you so much for coming. I was actually speaking on a similar topic last week at the International Neuro-Ethics Society in Washington, and on my way down from Ottawa to Washington, of course, you have to pass the dreaded American Immigration Customs, guys. And I was asked, what are you doing in the States with tones of deep suspicion? Well, I'm going to a conference. You are a wad on. And I told them, and I'm thinking, he's worried I'm going to get paid. I better reassure him there's no tax issue here. I said, and I'm not being paid. And he said, yes, but what? He said, yeah, yeah, I've got that. But what's it on? And I said, well, it's on brain neuroscientific evidence. And he said, talk English to me, lady. So I... So anyway, it was a poor start. And I managed finally to, eventually he suggested what my talk was on. And I said, you're right, that's it. And at that point, I was allowed to continue. So I'm going to try to, if it will go better today, I've had a practice run. So essentially, what have I done with this thing? My topic is the culmination of work I've been doing for a couple of years, which is to create a huge database, actually. We scan through thousands of Canadian criminal decisions over a particular period to try to track how Canadian criminal courts are using this evidence about the brain. And in particular, evidence about the brain of the criminal offender to make judgments about moral blameworthiness, about prognosis, about risk of recidivism, amenability, or not amenability, but likelihood of successful treatment and things like that. And it's a series of colleagues I have in other countries who've been doing a parallel thing, which has allowed us to do it comparatively. And that's quite interesting. But before I launched to telling you about the results of this study and some of the issues that it raises, I thought perhaps I would tell you just a little bit about this field of neuro law. This is something that has been taking off, I'd say in the last, I guess this book was one of the earliest ones around 2003, but much more recently in a bit of an explosion. And I think this parallels a deep interest generally about the brain. We hear that the 2000s were the decade of the brain. There's now a neuro marketing, a neuro aesthetics, a neuro economics, a neuro everything, including neuro law, neuro ethics. And I guess one way to think about this area is of a bi-directional flow of influence between law and neuroscience. Questions about how emerging cognitive and behavioral neuroscience are affecting legal procedures as well as legal concepts like responsibility and capacity. And then going the other direction, law affecting neuroscience, looking at how we want to regulate the application of novel neuroscientific or neurological interventions like deep brain stimulation as we expand those into the realm of psychiatric application. There's a whole history of psychosurgery which is a very controversial one in the middle part of last century, which is casting a shadow over the expansion of the use of deep brain stimulation for people suffering psychiatric illness. So many, many interesting issues and we're seeing also a lot of interest in understanding the neurology or neuropsychology of moral decision making, which might allow us to understand how people and judges feel and determine guilt, for example, make moral judgment. What is particularly interesting in this research is that application of particular interventions including commonly prescribed drugs like beta blockers appear to shift people's moral reasoning. So all of these are the kinds of themes that we talk about in this neuro law, neuro ethics area. So let me move now a little more specifically to the topic that I'm gonna address now, which is this issue of as we learn more about brains, about neurological, let's just call it abnormalities, differences that are correlated with particular problematic behaviors, what do we do with that information? We have to decide whether it has any legal or moral significance. And so one of just a quick example for you of something that's going on more generally, but more kind of in headline grabbing fashion here, this issue, are psychopaths mad or bad? Do we regard this kind of thing as an illness or do we regard this as something that's morally blame worthy and subject people who are psychopaths and commit crimes to criminal punishment motivated by a judgment of their moral blame worthiness. And what's very interesting about the research coming out of this area is from a range of psychological to neuro imaging studies, they're detecting systematic differences in the activity of the brains of psychopaths in particular domains, particularly in the area of the feeling or the expression of fear, the recognition of fear and emotional reactivity. And so this raises a big question, because if we go to the definition of mental disorder that we use in the criminal law to decide if someone is guilty or not, we ask whether the person is able to understand the nature and consequences of their act and to know whether it's wrong. Well, what does know whether it's wrong mean? Do we mean factually it's on the law books or do we require a deeper emotional sense of the moral wrongness of something? If the latter, then we might say perhaps psychopaths are disabled in a way from really knowing it's wrong. There's been a real kind of bias. We've always sort of preferred the rational mind over the emotional and been suspicious of the emotional, but really perhaps really knowing anything requires the two in appropriate balance. And this is what generates this kind of suggestion. Kent Keele is, I believe he is a Canadian. He studied with Robert Hare who did the psychopathy test in BC. He's now down in the US, but he neuroimages psychopaths. And this is just a quote from this little article where he was talking about a case that he, it was a death penalty case in the US where he was attempting to make this argument that Dugan was the last name of the man that accused and convicted was ill, not bad and should not be blamed such as to warrant capital punishment. He said, it's amazing, people have no empathy, not even know what it is, no visceral responses, no understanding of guilt. It's a real disorder. It's as profound as any other mental illness. So it's this interesting question. These are the kinds of problems that the criminal justice system has to wrestle with and start to decide how to incorporate these stories about how defective brains are producing behavior. How do we meld that up with moral judgment, moral blame? So that's a sort of in large measure sort of the general area in which this database that I've created falls. So we've seen this not just with brain imaging but also with genes. There's a little quote here from a news article a couple years ago. You may have heard of the warrior gene. It's been in the news a little bit. It's a particular gene that affects serotonin metabolism in the brain. And it exists in two forms, one high activity, one low activity form. And it appears that violent offending is elevated when you have that particular one version of that gene in combination with an abusive childhood generates a much elevated risk of being incarcerated for a criminal offense. Beautiful example of how it's not just the brain, not just the environment, but often the two together. But the courts take this information and say, well, what are we gonna do with that? Well, that you have used it in Italy to do a neuroscientific and genetic workup of offenders and say this person is less morally blame worthy, diminished capacity because she had a bad childhood, this is a woman in this case, bad childhood and she has the risky vulnerability gene. So why, what is the appeal of all this biological explanations of criminal offending? This is not new. People like Cesare Lombroso in the 19th century were measuring skulls and purporting to find bumps which said you were a criminal or would be a criminal. He was also interested in jaws and other aspects of measuring human beings and deducing particular psychological and mental properties from it. But there's been this desire to kind of try to get at behavior through biology. And I think there's a couple of reasons. One is we want to understand, we're looking for some sort of explanation because it promises to us a sense of predictability, targets to try to intervene on. And we like to understand things. So I think there's that going on, but there's also a very strong sense that when you can explain something biologically, you can push away moral blame. We see this in the context of trying to destigmatize mental illness, explaining that as biological disorder as opposed to the unfair kinds of judgments people make about lack of willpower and et cetera, et cetera. When we talk about addiction as a chronic brain disease as opposed to a weakness of the will, these are all efforts to push away the moral blameworthiness that would otherwise be applied to that behavior. And it's the same here, a sense that if we can explain criminal offending in biological terms, we are able to sort of, it gives us a sense we're doing something more humane and progressive here. We're not blaming, we're seeing illness and attempting to fix it. So that's one thing that's going on. And then a little more cynically and to distinguish between biological and environmental or social causes of crime, biological explanations might be more appealing because we as a society can focus less on inequality, childhood deprivation and abuse, various kinds of social factors, political factors that might explain criminal offending and say, no, no, the problem's within the offender. It's his biology or her biology. Not us, with our social structures, it's this guy. It's in him. So that allows sort of an explanation of responsibility and blame that's a little cheaper and easier. We don't have to do too much to change our social society if it's really a question of biology. And finally, who must bear the solution that flows from my last point? Fixing the one or two criminals cheaper than fixing the whole society to try to reduce the risk of criminal offending. So these are some of the reasons why we might have this interest in explaining criminal behavior biologically and including using the brain. So I just had to put this up, too. I'm going to be talking a lot about fetal alcohol spectrum and developmental damage to the brain. But I wanted to put this up, too, because it was published. It's a study from Ontario published in the summer, I believe. It's in the October. Anyway, it's this article here. The researchers went and did a random sampling of people incarcerated in four Ontario jails and found, this is all self-reported, but found a remarkable level of brain injury. History of blows to the brain causing unconsciousness. 40% amongst the female offenders, about 50 amongst the males. And especially telling in the female offenders was that the criminal offending was very likely to occur after the brain injury had occurred. The men, it was sometimes offending started, and then there was a brain injury, and it continued. Now, can we explain causality? I don't know, but it's rather an interesting statistic suggesting we should really be paying attention to brain injury as a driver of criminal offending. What we should do about it is something that I'll now talk about. So here's the database project. This is just a quick overview of the methods. This is the boring part, but I know be able to interpret the results that I'm about to tell you about. So our question was, how is this evidence being used in Canadian criminal cases? So I used a legal database that we were able to, we have access to, the broadest one possible of Canadian court cases, using a whole set of search strings meant to cast a very broad net. And then there was a filtering stage to find those that fit the inclusion criteria and to take out those that were in the exclusion criteria. I'll tell you what those are on the next slide. And then the resulting set of cases was entered into a database coding for a whole set of different bits of information that allow us to do something quantitative, to start to see patterns in the cases. Limitations, it's only a five-year period. I'm continuing to build it, and I think to be really confident in the data, I need a bigger set, but this will give you a sense at least at the beginning of where it's going. Only English, I'm afraid, at this point. And there's a whole bunch of limitations that flow from the way we report legal judgments and the way we construct databases. Namely, not all criminal proceedings generate reported reasons, so I'm unable to capture those. I don't even know how many I'm missing because we don't have good statistics on what gets reported and what doesn't. It excludes administrative and tribunal decisions, so there's whole steps of the criminal process that are excluded. And in addition, I'm only reading the judgments produced by judges. So there's a question of what evidence was actually provided to the judge, I don't know. All I see is what the judge sees fit to describe in the reasons, and I'm trapped by the extent to which the judge even understood the neuroscientific evidence. So these are all of my caveats and limitations. So which cases did I include? We scanned over 2,000 of them, found 279 that mention neuroscientific evidence as we defined it, and I kept 133 as cases in which there had been an impact of the evidence. And to be included, it had to be evidence related to brain structure or function that bared upon the accused's responsibility for the crime, so looking backwards in time. Trial is at time one, a crime occurred before that, so we're looking back. And also it could bear on the dangerousness or treatability, so looking to risk of recidivism, whether that risk can be reduced through treatment, and so forth. If it touched on one of those two things, it was kept. And I also included, I was very broad in terms of the evidence included, it was all the way from high tech neuroimaging down to simply taking a medical history and hearing someone had been hit on the head or so forth. Neuropsychological testing was also included, these are various tests, testing various aspects, various cognitive functions to see if in fact there's been some form of brain damage. Excluded drug induced changes, so intoxication and things like that, and I induced psychiatric conditions unless a brain-based cause was mentioned. So, first we can see that there's a slow steady increase in the cases, and as I keep going I'll move it backwards in time and see if this trend holds and keep it updated to see if it continues that way, which I think is interesting. The types of neuroscientific evidence that are mentioned, now here's where I'll have to give you a bit of my interpretation explanation of why we see this pattern. So you can see that a very large proportion of the cases, quick mention, we had 133 cases, 186 mentions of evidence because some cases mentioned several types of evidence, that's why we have a different number, but very commonly three kinds of evidence, reference to fetal alcohol spectrum disorder, neuropsychological testing or history of brain trauma. We didn't see a lot of high-tech use of functional magnetic resonance imaging and the cutting edge kinds of things here in Canada, although it has been used in the states, for example. Couple references to specific neurological disorders, but these are the big three. And I think one explanation for this is that essentially at sentencing, and you're about to see also that most of the data set are sentencing decisions, at sentencing we have a rule in Canada which flows from the Gladio case and or the criminal code as interpreted by the Gladio case that when an Aboriginal offender is before the court, the judge must, there must be the creation of a so-called Gladio report, which is looking into the background of the offender and gathering the kind of evidence about the Aboriginal offender that is relevant to the sentencing decision. And the reason for this is because of the overrepresentation of Aboriginal offenders in the criminal justice system, and this was a measure to attempt to get, bring before the courts the information that would be needed to assess guilt and punishment. And what essentially has happened, I think, to explain this is that we, in essence, it's like looking for the keys under the street lamp. We're shining a specific lamp in one location and therefore we find a lot of brain damage in that location. It doesn't mean that in fact there's not a lot of brain damage elsewhere. We're just not necessarily picking it up everywhere else. So I want to emphasize that these results, you don't suggest that brain damage is only occurring within one population of offenders and only one type. It's just, for legal reasons, what we seem to be pushing the courts to look for. So I think that's probably the explanation of this kind of pattern. Now, you can see that the stage of the criminal process is heavily weighted towards sentencing. And a quick word at sentencing. At the decision, the sentencing decision, the criminal code tells a court to consider a whole bunch of different factors. One is moral blame, what was the capacity, what was the degree of responsibility of the offender, but also to consider a whole bunch of other factors such as risk to the society, questions of deterrence, rehabilitation potential, which is related to risk. And all of these things are being considered at sentencing. At the dangerous offender or long-term offender stage, this is for a small group of repeat serious offenders. Moral blame is irrelevant. It's a focus entirely on can the risk be reduced. So we see the brain-based evidence being used a lot at that stage, much less for these other stages of the process. But to give you a little bit of an idea of what some of them are, the fitness question is an inquiry at the outset as to whether an offender is actually fit to send trial. So that's sometimes used there. Guilt would be situations where we're trying to determine if the person had the necessary guilty mind. So situations where someone was acting involuntarily, had a seizure, for example. Brain-based evidence would be brought to bear there to explain that they were not acting voluntarily and shouldn't be responsible. Not criminally responsible by reason of mental disorder. This was formerly called the insanity defense, but it's looking for evidence that there was a mental disorder of sufficiently high seriousness to call into question capacity for responsibility. And there's a mixture of other purposes, including things like assessing whether a plea is valid, whether a confession was risky. And sometimes we point, or the cases point to these brain problems to suggest the person was not really capable of registering a plea or their confession might have been coerced because if they were more vulnerable. But by and large, this is really a story about sentencing, which is lucky because it allows me to start to look a little bit at how courts are balancing questions of moral blame and free will and treatment and risk, the kinds of competing considerations that are the issue at that stage. So give you a sense of what was going on in these cases. Many of these cases involve multiple charges. So what I did was I selected the most serious charge in any case and coded that case as being about only that. And so you'll see that many of them deal with quite serious offenses, assault, homicide and sexual assault, robbery, and then an array of other smaller numbers of offenses. And so what was the impact of this evidence? How did it affect the reasoning in these cases? So if we look just at the sentencing cases in which were at the sentencing stage, what we see is a very mixed picture. We see that in some, in a large number of cases, there's a use of this brain-based evidence to talk about blame and moral blame more than us. And in some, it reduces moral blame. There's a sense this is a person with diminished capacity. We can't blame them as we would someone who didn't have these impairments. In a small number of cases, the judges said, don't care, you had brain damage. You did such a terrible thing. It doesn't reduce blame-worthiness. Judges would say that too, even in cases of fairly serious disability. And then in a lot of cases, there was a mixed reaction. Judges said, well, yeah, it's too bad. You have this brain damage through no fault of your own. It diminishes your capacity, but you know what? This brain damage you have really makes you a risky person. It can't be fixed. You have trouble controlling your impulses. You have cognitive deficits. You're difficult to treat. I think we are raising risk here. So there's a sort of a double-edged sword involved with this evidence. You can get with one hand a reduction in the blame at the same time condemned for being risky to society and unfixable. So that essentially is the nugget of how this evidence may affect offenders. And you can see that this treatment and risk being mentioned, this pessimism in some cases in this, oh yeah, well maybe we should try this for you, optimism in others. At the guilt stage, the focus was on whether the person was responsible or not, whether, as I said, had a seizure and acted involuntarily, or in fact had a mental disorder that made them incapable. And another interesting use of it is an attempt to use neuroscientific evidence in cases of accused drunk driving, for example, where there's a crash and the police show up and the driver is weaving around. And the argument is, I wasn't drunk, I just got hit on the head in the crash, that's why I look drunk. So we see that kind of attempt used as well. Fitness to stand trial, please in confessions for the other small categories that I mentioned. Now, what I'd like to do is focus on these sentencing decisions to show some sort of sub-patterns within that set of cases. So we might start to see where perhaps it might strategically be sensible to bring this evidence in, assuming one is a defense lawyer. So here's the breakdown. We can see that it's quite a few cases in which the evidence is mitigating, but it's actually outweighed by the number in which it's either, well, this is very similar, almost outweighed. There's an equal number where it's actually aggravating or simply does not reduce moral blame at all. So it's a little bit split. And we also see that the hopes for risk reduction via treatment are pretty much balanced as well. So in the next couple of slides, what I'm going to do is set out as a pattern that we see by ranking the charges in according to degree of seriousness. So on the left we'll have the most serious charges going down to, on the right, the least serious. And the way I've decided something is serious or not is I've looked at the median length of incarceration for that class of offense. Now this is very crude because within an offense like theft or assault, there's a broad range of seriousness, but one has to kind of simplify a little bit. So this is the way I've tried to set this up so that we can see whether there's a difference in the interpretation of the information at the serious end of the offense scale versus the not so serious. And I think we can see some things. I'm giving you all the caveats now, so you'll be able to interpret the slide in a moment. One caveat is in some offense types, there's a very small number of cases. Those are not very reliable things. There's too few cases to really judge what's going on, so we can ignore those. So in anticipating, what I think I'm going to show you or I'm going to try to show you is that on the serious end of the offense spectrum, there's much less willingness to mitigate. And in fact, there's express statements that is not mitigating. And similarly, there's more pessimism about treatment. And when you think about it, it kind of makes sense. Those very serious offenses are where the judges feel they can be less generous in terms of acknowledging the diminished mental capacity of offenders because they're more worried about public safety. And this is the pattern we see. So you can see organized by most serious in terms of length of sentence starting here and going that direction. And we can see that this gray bar are the cases where there's an explicit statement, there shall be no mitigation because of brain damage. And these are clustered here, with the exception of a couple in assault, but they're clustered at the serious end of the offenses, whereas the other mixed and mitigating is sort of spread around. So an unwillingness to reduce morally and worthiness seems to be clustered at the edge of homicide, robbery, and sexual assault. Now as for treatment, we can also see pessimism. Again, something weird going on with theft over there. Only n equals 9, so I propose we ignore that one. But if we look here, we can see this gray bar again of a clustering perhaps of pessimism about treatment on this end with a particularly high proportion in homicide and sexual assault. Whereas quite a lot of optimism for break and enter and drug offenses thinking well treatment will reduce risk adequately. So essentially, this is the pattern that we're seeing, which raises a question for defense counsel. When you're wanting to bring this kind of evidence forward, it might well depend the nature of the offense. And if it's a very serious offense, it's more likely that judges will be negatively struck by this evidence as suggesting the person's untreatable and risky. This, of course, depends upon the nature of the evidence. And I have a couple specific cases to try to bring this a little bit more to life for you. Here are two that we can compare. So these are two cases involving very similar young offenders. Both of them were 14. Both of them committed murder. In the first case, a 14-year-old girl smothered to death a three-year-old son of her foster parents. She was angry at people who were, she'd been moved from one home to another. And she left, she smeared the child with blood and left a note under his head saying, his last words were mom or something like that. So it was a very horrible case. In this case, a 14-year-old boy raped and murdered a support worker who was trying to help him. And both of them had a diagnosis of fetal alcohol spectrum disorder. They had cognitive deficits, difficulty with impulse control, memory, language, social interactions. And in the case of the girl, it was a moderate cognitive disability, but it was said to be permanent and she would require lifelong support. In the case of the boy, it was severe impairment that he had. And the evidence was treatments unlikely to succeed because of his cognitive deficits. There's an interesting interaction going on here because most legal systems recognize that adolescents have immature brains. They're still developing and they have a lower degree of impulse control, judgment, things like that. Stuff we all know, although it's interesting recently, all kinds of neuroimaging has been brought to bear to say, aha, see, the adolescent brain is different, which everyone says, yeah, yeah, we got that already. But anyway, so normally we regard youth as mitigating because we assume the young have diminished capacity. And this is why both of these offenders were before youth courts under the Youth Criminal Justice Act, but that statute allows for offenders to be transferred into adult court and exposed to a much heavier sentence, life imprisonment. If it's thought that the youth sentence, in this case, four years, seven years, would be insufficient to hold the offender accountable. So this accountability is expressly about moral blame. It's about a sense that accountability is trying to ensure that there's sort of an appropriately weighty punishment applied to match the blameworthiness of the action. And so these two cases were about whether these offenders should be transferred to adult court because the sentences were inadequate if they're under the Youth Act. And so that's the issue. And if you are looking at this, you're saying, okay, if we are trying to judge moral blameworthiness, and that's our criterion for exposing these 14-year-olds to life sentence, who's more blameworthy here? Looks like she is. She has more capacity than he does. They both murdered somebody. She has more cognitive ability, he's more impaired. We would say he's less to blame than she is. However, that's not what happened. What happened was the court said, well, we think she might improve a little bit, although she's constrained by her brain damage. She might be a little bit treatable, especially with an intensive rehabilitative custody and supervision order, which is kind of an order one can do for youth under the Act. He, on the other hand, you can see in the quote there, this young man through no fault of his own is likely beyond redemption. Protection of the public has to prevail. He went off to adult court and got a life sentence. She stayed in youth court and got four years plus a three-year supervision. So, and the other thing is the language is striking in the two. There's an emphasis that neither of them was at fault for the, quite clearly, for the damage they'd suffered prenatally. But this wasn't about moral blame anymore. This was about protection of the public at this point. So this is meant to demonstrate to you sort of vivid example of how this evidence can be used to, in ways that actually work against the particular offender. So, and this is what I think is kind of interesting paradox here because when we think about the motivations for criminal punishment, there's two main categories. There's what's called retributive purposes of punishment by which we want to punish because it's deserved. That's a sense. There's a, people ought to be punished in proportion to their dessert. And then there's the consequentialist functions of punishment such as deterrence, rehabilitation and so forth, where we're looking forward and trying to get something good, it's valuable out of the punishment. And we've often looked at retributive criminal justice as something ignoble. You know, it's all about vengeance and something is not very humane or progressive or recognizing the difficulties many offenders have had in their lives. But what I think is interesting about cases like this is if we stuck with retributivism, that he would have done much better than if we stuck with the consequentialist attempts to protect society. So it's an interesting question. Is retributivism sort of ultimately create better outcomes when we think of disability? Now, one response to me is, look, the problem is not, retributivism is no good. The problem is that we have no other alternatives for offenders other than jail. If we had somewhere else, then we should stick with retributivism. We should recognize those diminished capacity, but because of protectionally the public, we need a better alternative location to care for and supervise people with serious brain damage. Of course, that's the answer, but I'm going to show you a case in a moment which shows how very difficult that is. But before I go on to that, here's just another young offender case along similar lines in which a judge was actually looking at offenders who did not have brain damage, and this actually worked in their favor. So they have no brain damage, no neurological deficits. This is to be differentiated from people with fetal alcohol, brain damage, other intellectual deficits makes it difficult to control their impulses. This does not exist here. So it's not just the danger of showing brain damage. You want to actually say, hey, I don't have brain damage, therefore I can be treated and rehabilitated. But back to this point of if we have people who clearly, as both of them did, serious disabilities, so there's real questions about whether it's really, what is the society doing where you have a 14 year old with a mental disability who's going to be in jail for life? If we look at what is being done now about cases like this, there was a year ago a consensus statement on legal issues of fetal alcohol spectrum disorder saying, we really need to make sure this evidence about the brain and brain damages coming to the courts so that the courts can take it into consideration in making their decisions. But I think, from my perspective, I think for many cases this is true, it won't be mitigating, but there's going to be a lot of offenders for whom this is actually not a very helpful idea. Unless one puts in place alternative dispositions non-jail locations where people can live and receive proper care and supervision. So this push to, we've got to get more testing, more screening, more rigorous testing for FAS is the only part of the picture, I think. But there is last winter a bill, a private members bill, so I'm not quite sure how far this will go, but private members bill introduced in Parliament to essentially empower the judge to order an FAS assessment. Now it can be done if the defence or the prosecutor asked for it, but it can also be done by the judge on his or her own motion, whether the offender wants it. So I, again, because of the concern that this evidence might actually work against the accused, suggest to me that that may look good, but it may not be good for some. So here's the case which I'll end on, which shows where we are with the difficulty of having alternative placements for people with mental disability. So this case could lack, terrible case, a man, I think he was in his 30s, if I remember correctly, horrible childhood, abusive, chaotic childhood, foster homes, parents, both alcoholics, he had alcohol, fetal alcohol exposure problems as a result. He was repeated offender. He was, he'd been, I don't know, a record of 45 different charges of various kinds, and the particular charge that he was before the court for, in this case, was he'd wandered into a public library and groped a little child, and he seemed to have some pedophilic kind of interests. So his other specialty was breaking into houses and groping and assaulting women who were asleep. So this is not something the society can easily tolerate going on, so we have a real problem, and in the course of sentencing him, this crown also brought a dangerous offender application. If he becomes labeled a dangerous offender, he can be put, sent to jail for his offense, the public's library offense, but then just kept in jail for an indeterminate period. This is what is possible. It's kind of a preventative detention for people who are expected to be extremely high risk of reoffending, and at this point, what's critical to avoid being labeled a dangerous offender is to show that the risk can be managed in the community, at which point you become a long-term offender under a long supervision order, but you don't have to have indeterminate incarceration. And so this was the question here. Should he be a dangerous offender subject to indeterminate detention or not? And the expert evidence assessed him and said, you know, he's got serious cognitive deficits. He doesn't seem to really realize what's going on here, our attempts to treat in the past have made no headway. However, I think the risk could be manageable if he was in permanent for life, 24-7 supervision in a group home for developmentally-delayed sex offenders and not allowed any unaccompanied access to the community among a variety of other measures that were recommended. The correctional witness said, such a thing doesn't exist. We have group homes where there's supervision, but we don't have the capacity or resources to have one-on-one supervision wherever he goes to make sure he doesn't get out into the community. That's not the way these group homes work. There's sort of movement in and out of the facilities. And the crown said, look, if the supervision requirements that are ordered here or recommended by the expert replicate jail, then commit them to jail. And this has been said by other courts in other cases that if what we're describing is jail, he may as well put them in jail. And the defense made a very interesting point, I think. Defense said, you're interpreting a criminal code provision which asks, is his risk manageable? The expert has told you it is, has told you what's required. The fact that the state doesn't feel like funding that alternative supervisory arrangement, it's not the offenders' fault, his risk is manageable. And was arguing, you should not use the state's failure to put alternative measures in place as the lynchpin that sends people like this mentally disabled man into jail for the rest of his life because to be quite honest, he won't get out. The risk can't be reduced easily in his case was the evidence. So the judge says, well, he's a dangerous offender. I have to interpret the criminal code in light of what the actual resources are and the risk to the public. And the fact that he needs this treatment in perpetuity means we should go with an indeterminate sentence. And nothing can provide the 24 hour supervision that a penitentiary provides. This is kind of a sad conclusion, I think. So that gives you a little bit of a sense of what we're getting out of the cases and some of the problems that we're seeing. And I want to end it, I guess this is not really a humorous note, but it's an interesting note of a case from 2006 in which a judge was, I think the judge had seen one too many of these cases of mentally disabled offenders who were going back into jail and could be expected to come back before the judge very frequently. And he was speaking to Mr. Obed in this case, speaking to the sentence, saying this is what your sentence is going to be, and said five years, two years from now, maybe we'll know a whole lot of different things, maybe in a couple of years we can actually go inside the brain and reorganize things. This is, to me, raises a whole bunch of additional kind of questions, in addition to kind of a charming optimism. But the thing is we are, with deep brain stimulation, putting electrodes in people's heads to change their behavior, and it raises, and this is where I get into my advertisement for all these students out there wanting to do graduate studies, I'm looking for students wanting to work with me on this very topic, of what kinds of interventions are legitimate, can be legitimately put, both in legal and ethical terms, to offenders as an offer, take this treatment, and then we might regard you as lower risk and reduce your sentence. And there's all kinds of potential interventions on the horizon as we learn more and more about behavioral neuroscience and how to intervene in the brain. So these questions are coming up. So with that I will stop, and I'd love to hear your questions and comments. Yes, yes. Your study looks at what judges say about the neuroscience of the evidence, I think. So do you have a sense of whether the sentences are back mitigated when they state it as a mitigating factor? It's sometimes hard because it's sort of more of a gestalt kind of thing. So the judges will say, often will say, here's a list of mitigating factors and here's a list of aggravating factors and here's what the sentences were for roughly equivalent crimes and we distinguish up and down depending upon these different factors. So we can't really tell how much of a mitigating effect the evidence had or aggravating effect it had in any case. All we know is that the judge mentioned it as something that went into the cauldron of coming to the decision. Makes me think maybe it's just a pure factor set of discretion and then they bring together whatever exists to support their view. Yeah, that may well be. And some people, the legal realists, say every judgment is that. They come to the judge to get some gut kind of reaction and then searches for the justification for it. Yeah, it's possible. Yes? The prior example, Joe, that you mentioned, I think it's quite attention on the screen, the judge could order an assessment. Is that just the fetal alcohol section? Would everyone want to vote? It's focused specifically on fetal alcohol. Why that specific focus? I think it is a reflection of the attention that this particular form of brain damage has in our justice system. And I think it's because it flows from the overrepresentation of First Nations within the incarcerated population, the offender population. And there is fetal alcohol throughout Canadian society. There's certain demographics in which it's a little bit higher in rural communities as well as in some First Nations as well. And so I think that attention to that problem is something that's particularly Canadian because when I was talking to my colleagues from the UK, the US, Netherlands, Singapore, we were all doing these studies. I said, most of my cases are about fetal alcohol effects. And they said, no, we don't have any. I'm like, what? Of course you have it in your communities. It's everywhere. And it's just sort of, as I mentioned, we happen to be looking at this for particular historical, cultural reasons. Yeah. Yeah. That's a good point. Yes? Yeah. What fetal alcohol, is there any push to? Once he is people suggesting that every now and then and talking to my UK colleagues, there has been a suit brought against a mother there. I don't know where that is. I would suggest that's a relatively unlikely kind of case to take forward. In Canada, we have many cases which the Winnipeg versus DFG case, which you may know about, which was a glue sniffing case where there's an attempt by the state to intervene to force treatment on a woman. And it was said for a variety of policy reasons that couldn't be done. And similarly, in health law generally, where there's what they call maternal fetal conflict cases, where there's a desire to do a medical intervention on the woman for the benefit of the fetus, it's the woman's interests that are above the liberty interests of the woman. Yes? I'm very interested, although very nervous, about the implications of some of your latter slides, where you talked about the possibility of a course consent in the criminal sentencing process with a deep brain stimulation and psychosurgery. I mean, in an area where there's such a complex interrelationship between moral and sociological issues and criminal sentencing, that frankly scares the hell out of you. And among other reasons, let me just give you this example. Science has a way of thinking that understands much more than it does in reporting what appear to be advances. And I just spoke about it, I thought I was right, but it was in 1949 that the Portuguese neurologist Antonio Monez was spent. Nobel Prize? Nobel Prize for Lomonomy. Yeah. And to me, that kind of example of a gross violation of people's bodily and psychological integrity still gives them that level of comfort and distinction. Makes me extremely nervous. Yeah, and that's nuts. And I think it should all make us feel humbled when we start talking about physiological intuitions or more sociological reasons. Indeed. I mean, we can take an example. No one's doing, well, certainly not in Canada, doing psychosurgery for criminal offenders here. Although, in 2006, there were a couple of reports that there was brain surgery being done for addiction in Russia and China. Now, there's a bit of an outcry saying, hey, can we be totally confident that these were autonomous decisions that were being made? Do we want to go down this road? So it is burbling away in the background. And deep brain stimulation is sort of the latest version of that that I'm predicting is going to go in this direction, because DBS involves the implantation of an electrode and the stimulation of the brain, not the destruction of brain tissue as in the other forms of psychosurgery. And in theory, it's reversible. It's obviously very risky. But it is being explored for a variety of psychiatric conditions, including intractable aggression and addiction. These are kinds of things that come up in the criminal system. And I mean, we can look at one particular form of biological intervention that's being used commonly in Canada and around the world, which is anti-libidinal drugs for sex offenders. So these are colloquially called chemical castration. It involves drugs to suppress testosterone, which brings down sex drive as well. And this is quite common. You can read the cases where it's applied. We've even had one challenge by an offender to the court saying, this is contrary to my charter rights to be put in this position of having to consent to this bodily modification at the pain of this sentence. And the judge said, look, no one's forcing you to do anything. You choose. You are lawfully being convicted. And this is what your sentence would be. If we can reduce your risk, we're willing to lighten that sentence. Is that coercion? Now, I kind of think it is. But that doesn't necessarily mean that all coercion is bad. Some people in the theoretical area say there's no such thing as a coercive offer. If, by definition, all it does is give you some other alternative course of action, that's not harming you. I happen to think it can harm to give an option some options. And one case from the states that I was able to find which illustrates this, it was a case from the 80s from Georgia, I think it was. And it was a judge dealing with a serious sex offender and who came up with a very long sentence, I think 45, 47 years or something like that. And then sort of in an offhand comment said, yeah, now, if you were going to get physically castrated, we might reconsider that. And then he said, oh, wait a minute. I don't think I can say that. Whereupon, and this is how it got to trial, the offender sued to have that offer reinstated because the offender preferred the castration to the 47 years. So it's a very interesting problem. We can't rely upon the autonomous consent. By making the punishment awful enough, you can get people to desire whatever else you offer by way of alternative. Doesn't mean we should be doing that. So those are the themes that I'm inquiring into here. And we're going to be interviewing all kinds of different people to find out how do you determine what kinds of offers can be made? Which ones should we be really worried about? What are the characteristics of these kinds of interventions? Is it reversibility? Is it the sense that it's a mutilating kind of thing or an invisible thing? Are drugs OK, but surgery is not? Is the thing that bothers us the fact that it changes the identity, the characteristics of the person in a way that they're not really themselves anymore? Do we prefer kinds of treatments like talk therapies where the party is changed, but has some opportunity to be aware of it while it's happening and to reject or take on board aspects of that change? So these are all the various themes. But it is interesting. I mentioned the vaccines. There's a bunch of clinical trials now ongoing for vaccines against cocaine, actually nicotine as well, methamphetamine. And I can see that this kind of thing would be a very easy thing to integrate into criminal offending. But when you think about it from a quasi-Foucault perspective, it's very interesting what's being done here. You basically get the offender to want to do what you want him to do through this sentencing exercise. And notice what's being done. We just decide certain substances are prescribed. They're criminal. And rather than having to force the person, control the person by some sort of shackles, like physical constraints on the outside, we move the constraints into the body. We conscript the immune system of the offender as an arm of the state to control his behavior. And so I find that a rather interesting way to look at what this kind of treatment really does. Yes? In conventional medicine, there are some ideas around testing and treatment that are important. So to use a test, you should know something about its characteristics, the sensitivity, how often it detects a real problem, and specificity, how often it gives false alarm. In treatment, the essential idea is numbers needed to treat, numbers needed to harm. In your review of these legal cases, have any of the experts who've been giving opinions ever been asked about the tests where they compose either a biological explanation for behavior or some mitigating factor or some non-mitigating factor who may have ever been asked what's the specificity and sensitivity of what you suggest me? And alternatively, when they suggest these various treatments, do they ever get asked how many people are helped? How many people have these treatments? I suspect that this kind of evidence where it exists is provided. It doesn't make its way into the actual judgments. So I can imagine that forensic psychiatrist might say something like, well, the proportion of men having antilabinol therapy who go on to reoffend amongst my patients is X, for example. Yeah. Yeah. The literacy doesn't support that the knowledge actually exists. And I think when we accept somebody as an expert, maybe letting them get away with ideas that they wouldn't get away with if they were actually doing medical things. The other difficulty, though, is that the law is never looks for medical scientific levels of certainty. At the sentencing stage, it's always a very messy kind of, it's messy in two ways. It's messy in terms of trying to balance all kinds of competing objectives. So it's not all about, is he going to reoffend? It's also about deterrence of others. It's also about punishment, all kinds of things that are not even related to recidivism. So it's that mess. But there's also the fact that when you're judging risk and forensic risk assessment, it's you look at this large population and look at factors that characterize who offends and who doesn't. But it's always recognized you have one individual before you, and we don't know where they're going to fit within that distribution anyway. So the idea is that mess as well. So looking for a real kind of certainty is never really demanded by the courts. Yes? Have you made any comparison in terms of controlling? So have you taken cases similar to, roughly, or a very difficult task, you take roughly similar cases with roughly similar evidence except one has zero science evidence, and one doesn't, and see whether, ultimately, it can make any difference in terms of the outcome. Yeah, that would be a wonderful study to do. That would be so hard to control for all the various possible factors. One thing I could do, and to answer your question, I haven't done it, but what I could do is go back and actually order transcripts and copies of the evidence from cases that look very similar to me and then try to actually see exactly what kind of evidence was put forward. The difficulty is it may well be from different judges and different communities have different sorts of sensitivities, so I won't be able to control for that. But I think doing that a bit would help, I think. That's a good idea. Yeah, yes? You seem to be suggesting that the use of so-called chemical preservation, but there is no evidence to indicate that the people who accept that have a lower level of recidivism than the people who don't accept that with a similar background. And if there is no evidence at all of the position, I find that very disturbing. I didn't mean to say that. I don't know that to be true. I think, I don't know if the gentleman ahead of you was suggesting that, it was that... Well, I'd say that often the positions people accept are worried of experts, but sometimes you don't really know what we're talking about. Brian Dohmann had a thing about medical BS, the other day, and the courts sort of accept it. Fortunately for us, but not so fortunate to be here. What's rather interesting, I work with one of the forensic psychiatrists in Ottawa on this particular project, actually, and talking to him, I'd assumed that nobody would ever want to take chemical castration drugs. I assumed that it would only be under threats of sort of a bad sentence. And he said, oh, no, no. Some people actually regard it as very helpful that they have wanting to get better and are finding sort of sexual thoughts very intrusive and difficult, and that it's sort of like if you think about the odyssey and Homer lashing himself to the mast, it can actually increase autonomy to be able to have help with self-control, and that this is the way we should look at stuff like this, that it's a help, not a coercive imposition from the outside, and that people could legitimately and autonomously ask for this sort of self-control crutch. So I don't know, talking to him, he seems to think that this treatment is quite helpful for many of his offenders. Yes? Thanks so much, that was wonderful. You started, I think, with kind of advising us that there are important questions here about moral blame-worthyness and how it plays into a criminal justice system. And as you well know, the criminal justice system, and you've alluded to this, has a number of aims in terms of what it's trying to accomplish, and on the one hand we have the retribution and punishment, slightly different from each other, but retribution and punishment, which fit into the moral blame-worthiness category, I think, and then we have protection of society on the other, and you've given us some reflections, but not enough in my view yet, I'm just opening it up to your further reflections on sort of whether we can accomplish these range of aims all at once, or whether we have to think hard about whether protection of society is what it's all about, in which case moral blame-worthiness becomes irrelevant. Anyway, I'm just opening it up to, I just want to know more from you, please. Well, all of this neuroscience is getting me, philosophers going like crazy, there's huge amounts of discussion around free will, do we have free will, do we not have free will, and all of this explanation of behavior in terms of biological mechanism is said to be shaking the very foundations of criminal law and the attribution of moral blame because it shows that none of us have free will, we're all, it's the brain that did it, I didn't do it, my brain did it, and that we, frankly, all can say that about every action we ever take, and that in a way that this is a very old debate that philosophers have worried about for thousands of years, do we have free will or not, and what is it? But I think that one of the resolutions that's made to that question is saying, well, we are, of course, where else is our behavior coming from? We're a product of our physical being interacting with this environment, it's gonna, unless there's some sort of randomness injector, that's where our behavior is coming from, and that if we require our actions to be completely undetermined, that's not realistic for anybody, that in fact what we worry about in criminal law is not so much whether we have free will or not, but whether we as mechanisms are capable of responding to signals from the environment, such as the threats and promises from others in the society and other things, is our organism able to respond to that? Translated into legal terms, do we have capacity? And that what really matters is whether we have that requisite level of responsiveness to our environment, and that one of the signals in the environment is this funny thing we call moral blame, it's just this crazy idea that humans have come up with, but that's a useful signal to an organism, and if we can respond to it, well we should be held morally responsible. So there's a story you can tell that brings us together that allows us to be determined, and yet to retain the concept of moral blame, just because it is a useful thing that helps to operate on everybody to constrain behavior in a way that allows us all to live together. So at the philosophical level, that's sort of some of the discussion that's going around, will this, all this neuroscience take down criminal justice at its knees or not, doesn't mean to, but you do see, I've heard philosophers talk about it as almost like you need binocular vision, you need to think of us as mechanisms, but also think of us as agents, undetermined agents, and somehow keep these two incompatible ideas sort of coexisting, because it's useful. That's not a very satisfying answer, but that seems to where people are coming to. Yes? One argument depends on type of surgery. In fact, they read that people who need it don't have men's wear. They don't know that they are guilty, and if this way they were able to conduct themselves in a more normal fashion, then it would be to their advantage, and then trying to compare the situation to heart rate problems where you have, you can have an aberration, and thereby stop that problem and stop the figuration of time currently, but also with epileptics, they do this almost like aberration and erratic. So what is the difference? And in psychosurgery, we might even defend or prevent these people from committing crimes, and that would be a social benefit, and so what is the personality changes? It is for the better, and for the better, not only for him, but for the rest of us. So we are not so concerned with the personality changes when it comes to facial plastic surgery, except when it comes to early surgery, because everybody's up in arms, and maybe she includes it, but this is a very, very interesting question. I have a couple things I could say to that. I think, I read a paper recently where there was a survey of neurosurgeons asking, how would you feel about DBS to cure antisocial personality disorder? And the response was, hmm, well, you know, having that disorder is really, it really blights your life. Yeah, okay, I think it'll be a good idea if we could do that for someone. And there's a therapeutic objective, right? But I think that, the other part of this, though, is that, I mean, our history of using psychosurgery has been highly checkered. It's true that we look back in horror, how could they do that at that time? Now, we have to evaluate it in its context where people were institutionalized and there were no other options. This was before antipsychotics were available. Maybe at the time it looked like it was the least bad option available, but it then went on to be used in a variety of abusive ways for two people who were inconvenient to their family were shipped off to be quieted down with a lobotomy and things like that. So there's a real risk of drift and of abusive, exploitative use of these things that are such a profound kind of change to the self. Because I think people do, in my view rightly, but others may disagree, regard the brain and personality as the core essence of the self. And so, yes, if we're changing the heart rhythm or we're changing the pancreas or we're adding some insulin, they're not perceived as threatening to the self, whereas starting to try to change behavior and personality are. And there's also a lot of political reasons why one might want to control people at the level of the brain and thinking. So there's various locations in the world where there's evidence of political uses of psychiatry. So we need to be worried about that, so the exercise of power over people. And I had one other point. Yeah, it's eluded me at the moment, but these are some of the things I would say about that. I think there is something different about it and something scarier about it. Oh, and my points come back. We also have to note the social definition of what is problematic behavior. Things that we thought were problems in the past no longer are. Alan Turing was sentenced and forced to have chemical castration at a time when homosexuality was criminal in the UK. We would now regard that as a miscarriage of justice in his case. So if we're starting to pressure people to change their biology, because we've decided to define this as criminal or problematic, there's a lot of dangers. A lot of dangers, I think, yeah. But even that, the crimes, we change the definitions over time. Yeah. Yes. I think somebody listening to you established that the criminal justice system basically needs to be totally abolished and replaced by much more contemporary knowledge, whatever, being made to get rid of this entire system. Right now, none. In fact, it's being made more punitive and more rigid and more energetic. Unfortunately, I think, for example, one of the recent changes of the criminal code has basically said, for people found not permanently responsible by reason of mental disorder, normally what happens is if they are in need of treatment, they go to hospital, and a provincial review board has to review them every, I forget what it was, every one year or two years or whatever. The government has just changed that now for a new designation of people they call high risk offenders who only have to be looked at every three years. So you just stick them in jail, and the evidence is people who are in jail or in hospital in this case for a longer period of time are usually the end of the queue for resources and energy, because the people in charge of letting them out want to make sure they get the treatment to those whose release is imminent. So the more we put people in for long periods, it's counter therapeutic, like you don't have to devote your energies to them. So I don't think it's a very hopeful picture, I'm afraid. Is there evidence of the tools we have to change spouse feelings that behave here are really ineffective? Well, I think it depends. Some people, there was a big study, it's called a liver pool desistence study, a criminological study from England in early 2000s, looking at a huge number of offenders and identifying the characteristics of those who went on to re-offend and those who went straight, so to speak. And there are whole classes of people who do end up not re-offending. But it can be difficult because the kind of support that people get when they get out of jail often is not adequate and they're left really with not very good options. So it's not just treatment, it's a whole surrounding social reaction and support for them. That's part of whether the treatment's gonna work. And I think one of the risks of this kind of thinking is that we focus only on the biological, which is probably the only part of it. Yes. I'm interested in something that you mentioned in the past thing and that was the warrior gene or the genetic, I'm wondering if you could speak to either epigenetics or genetics. And what I'm thinking of in particular is the way you're talking about intervention is something that is a physiological intervention, which I think is being displaced by genetic interventions in many ways, like our consideration of what is it that we can, what protein can be added to modify, for example, the warrior gene, such that that gene gets turned off, and given that we can increasingly recognize certain correlations between, say, monotendencies and genetic configurations. And you mentioned that in the past thing, I know you're talking, I'm really interested if you could speak to that. Yeah, I have another project going on tracking the use of genetics in a similar way. And so this warrior gene thing is sort of the perfect demonstration of gene-by-environment interaction because it came from a big study that was done in New Zealand. Several thousand men incarcerated for crimes of violence. And there were two alleles on this MAOA gene, monoamine oxidase A, I think it is. And they went through all these men and found out what the frequency of the different genes was. They also found out about their childhood histories where child abuse was known, suspected, or non-existent, suspected non-existent. And what they found was if you have a good childhood, you are close to the normal risk level. If you have a good childhood, plus the risky gene slightly elevated, but not greatly elevated risk. If you have the risky gene, or I say the bad, so I'm getting all confused here, the risky gene plus an abuse of childhood, the risk goes way up. So the conclusion was one gene is actually protective against abuse, abuse of childhood. And the other one increases the vulnerability of the child. So essentially you couldn't go and test everybody's genes and say, ooh, you're likely to be a violent offender unless you also knew something about their childhood. The two had to go together. Now in terms of what to do with that information, so far what courts have done is only very few courts have used that as mitigating information. Other people have suggested we should be going out and screening children. We should go find out who has the risky gene. And to be, this always tricks me as a kind of funny thing to say because surely we should be going out and finding out which children are vulnerable to abuse and look after all of them, right? Are we suggesting we're only looking for those who are likely to be worst harmed by that abuse? The other issue about trying to get ahead of a problem, and a lot of this discussion of FAS has been we should have a lot more screening of children in early intervention so they don't go into, get into the kinds of problems with school and then eventually criminality. And there, it's both a good idea, but it has its risks as well. If it focuses resources to people who need it, that seems like a good thing. But I think we need to keep in mind and attempt as much as possible to ward off the kind of labeling and stigmatization issue because if you, there's this phenomenon, social psychology called the Golem phenomenon and the Pygmalian phenomenon is essentially a self-fulfilling prophecy thing. If you tell children you're really good at this and we expect you to do really well, well, guess what, they do really well. If you tell them, oh, it's really hard for you, don't worry, well, they don't do very well for obvious psychological reasons. And this is replicated across all kinds of dimensions, school performance, stereotype threat, racial bias and how it plays out. So if we get into starting to identify all kinds of people we say are at risk of criminality, we have to be pretty careful how that's communicated, both to them as well as to everyone around them because it's the treatment of the child by those around them that can produce that self-fulfilling prophecy, too. I don't, that doesn't really answer the genetics, but. It's interesting, because what I can imagine is, well, goodness, that I'm sure there's a genetic explanation for that difference in your capacity to be infected by the origin of the problem to the female. Yeah, that's true, yeah. Okay, last question. Whenever the subject of expert evidence comes up, I always think of the very practical questions, things like who exactly are doing these reports, who's ordering them, the crowning of them, and who's paying for them and how much they cost. I think on that last question, I'm not quite sure how much they cost, and who's paying for them. I think most of the time, the state will be paying for them because most offenders don't have much money and will have legal aid support. So I think it's being state funded most of the time. The people who are doing or giving these expert reports, reading the cases, I see the same names coming up all the time. It's a particular group of forensic psychiatrists across Canada who do the bulk of these kinds of assessments. Now, there's supposed to be an assessment provided, like there's a report provided at every sentence, it's for every sentencing hearing, but whether it includes this whole range of neuroscientific evidence, many of them will never go anywhere near that. And I think what my results are showing is that it tends to be the more serious offenses where it's thought worthwhile to go and get that evidence. That's why we have more of the homicide, robbery, sexual assault cases, which I think there's a vast bulk of these kinds of decisions that are going forward without evidence of this type when, in fact, it may be present or may be brain damage present. I have one tip up there, although I'm sure we could go on, I was particularly struck by these days hearing your opening comments that I think came out in the discussion, which is going to the worry of this focus on neuropsychiatric conditions, taking a focus off of social directors and putting them on individual conditions. So I think that your work has helped us to put these phenomena into a bigger picture. So before I formally thank Professor Chandler, I want to remind you folks that next term features four more exciting health law seminar sessions starting with Friday, January 23rd, when Quebec National Assembly member, Véronique Bonne, kicks off, as it were, with her subject, medical aid in dying reflections on the Quebec experience. So please put that in your calendar to come out to that. Jennifer, once again, thanks so much for delivering a little bit of needed deep brain stimulation this afternoon on your topic and pulling together a host of challenging and worrying questions for law and policy as they interface with mind and brain. So thanks.