Some Ethical Considerations About the Use of Biomarkers for the Classification of Adult Antisocial Individuals

Abstract

It has been argued that a biomarker-informed classification system for antisocial individuals has the potential to overcome many obstacles in current conceptualizations of forensic and psychiatric constructs and promises better targeted treatments. However, some have expressed ethical worries about the social impact of the use of biological information for classification. Many have discussed the ethical and legal issues related to possibilities of using biomarkers for predicting antisocial behavior. We argue that prediction should not raise the most pressing ethical worries. Instead, issues connected with "biologization", such as stigmatization and negative effects on self-image, need more consideration. However, we conclude that also in this respect there are no principled ethical objections against the use of biomarkers to guide classification and treatment of adult antisocial individuals.

Neurocognitive predictors of treatment completion and daytime activities at follow-up in multiproblem young adults

“…This is in line with the biopsychosocial model in which combinations of biological, psychological, and social factors should be taken into account in the prediction of antisocial behavior (Popma & Raine, 2006). Jurjako et al (2019) conclude that these issues are important to consider, but they do not argue against the use of biomarkers in the prediction of antisocial behavior; rather, they advise to take caution when using biomarkers.…”

“…Biomarkers (including neurobiological markers) provide objective and measurable indices that could aid in the individualization of treatment and the prediction of antisocial behavior. However, several ethical concerns have been raised about the use of such markers for the prediction of antisocial behavior (Jurjako, Malatesti, & Brazil, 2019). These include the extrapolation of group-level information to gain knowledge on an individual level (Dawid, 2017), large error margins in risk estimates (Monahan, 2014), differences in the conceptualization of behavior between the legal system and science (Buckholtz & Faigman, 2014;Francken & Slors, 2018), and the heterogeneous, symptomatic conceptualization of most psychiatric disorders (Jurjako et al, 2019).…”

Biocognitive Classification of Antisocial Individuals Without Explanatory Reductionism

“…According to Brazil et al’s (2018) proposal for stratifying and rebuilding categories of antisocial behavior, the first step is to delineate individuals who exhibit extreme forms of antisocial behavior defined by deviations from socially adopted standards. Because it is accepted that these standards vary cross-culturally, this implies that the categorization, biological substrates, and symptom severity might vary cross-culturally as well (Jurjako et al, 2019; Sadler, 2008). The next step is to collect and integrate within this behaviorally defined group of people genetic, physiological, cognitive, and brain data to form subtypes that will reflect more homogeneous clusters of people.…”

“…First, we discuss how scientific study and design of treatments and management responses for severe forms of antisocial behavior can be improved by adopting a biocognitive approach. Second, putting aside the ethical worries raised by the use of more biocognitive variables for classifying antisocial behavior and adjudicating the culpability status of such individuals (for a discussion, see Jurjako & Malatesti, 2018a; Jurjako et al, 2019), we argue that the proposal at issue does not imply a conceptually problematic form of reductionism. This conclusion is of great importance.…”

“…The biocognitive approach to psychiatric classification, however, besides practical difficulties in its realization, faces some theoretical and conceptual objections. A general criticism is that this approach is based on a biological reductionism that suffers from conceptual, empirical, and even ethical problems (Jurjako, Malatesti, & Brazil, 2019). A recent forceful formulation of this accusation was advanced by Borsboom, Cramer, and Kalis (2019), who maintained that approaches in the spirit of RDoC are committed to an untenable “explanatory reductionism.”…”