In a democratic society, adults are viewed as moral agents who are
responsible for their acts. A crime is a violation of a widely agreed upon
set of rules by an individual presumed to understand that he is committing
the offence. In the long run, new insights provided by molecular genetics
could influence society to adopt a disease model for some types of crime.
Claims that a genetic condition is the underlying cause of an
individual's criminal act have already appeared (albeit rarely) in
the courts.1
Denno DW. Legal implications of
genetics and crime research. Ciba Foundation Symposium
1996;194:248–56; Reilly PR, Page DC. We're off to see the
genome. Nature Genetics 1998;20:15–17, see p. 17.
In their article on medical ethics in the 21st century, M. Parker and T.
Hope
2 Parker M, Hope, T. Medical ethics in
the 21st century. Journal of Internal Medicine
2000;248:1–6.
predict that “criminal responsibility
will … come to be seen as a thing of the past…. The age of
Prisons will be looked back upon with horror in much of the same way that
we now look back to the workhouse. The treatment of
‘criminals’ will therefore become a medical issue, and the
ethical issues, issues of medical ethics” (p. 5).
Until recently, evidence for the genetic influence on criminal
behavior has been poor and controversial.3
Alper JS. Biological influences on criminal behaviour: How
good is the evidence? British Medical Journal
1995;310:272–3; Jensen P, Fenger K, Bolwig TG, Sorensen SA. Crime in
Huntigton's disease: A study of registered offences among patients,
relatives, and controls. Journal of Neurology, Neurosurgery and
Psychiatry 1998;65:467–71; Gotz MJ, Johnstone EC, Ratcliffe SG.
Criminality and antisocial behaviour in unselected men with sex chromosome
abnormalities. Psychological Medicine 1999;29:953–62;
Brennan PA, Mednick SA, Jacobsen B. Assessing the role of genetics in
crime using adoption cohorts. Ciba Foundation Symposium
1996;194:115–23; Lyons MJ. A twin study of self-reported criminal
behaviour. Ciba Foundation Symposium 1996;194:61–70; Coid
B, Lewis SW, Reveley AM. A twin study of psychosis and criminality.
British Journal of Psychiatry 1993;162:87–92; Freyne A,
O'Connor A. XYY genotype and crime: 2 cases. Medicine, Science
and the Law 1992;32:261–3.
However, a recent,
often-cited study points to the influence of a particular genotype on
aggressive behavior. This study
4 Caspi A,
McClay J, Moffitt TE, Mill J, Martin J, Craig IW, Taylor A. Role of
genotype in the cycle of violence in maltreated children. Science
2002;297:851–4.
showed that a certain form of a gene that
breaks down neurotransmitters makes men more likely to be violent, but
only if they were maltreated as children. Eighty-five percent of cohort
males having a low-activity MAOA genotype who were severely maltreated
developed some form of antisocial behavior.
5 See note 4, Caspi et al. 2002:853.
According to E.
Stokstad,
6 Stokstad E. Violent effects of
abuse tied to gene. Science 2002;297:752.
legal
implications of this study are less clear because experts do not think
that “judges will buy it.” Some criminologists remain
skeptical, citing earlier claims to have identified a biological basis of
criminality that later were not confirmed.
7 Crusson M. La criminologie. Paris: Hachette, 2000;
see note 3, Alper 1995.
In autumn 2002, the Nuffield Council on Bioethics published its report
on “Genetics and Human Behaviour.”8
In its chapter 14, the report considers
“the status of biological explanations of behaviour in the context
of criminal law and the possible impact of behavioural genetics on the
legal system.” The working party that wrote the report concluded
that “research in behavioural genetics does not pose a fundamental
challenge to our notions of responsibility as they are applied in the
legal context … at least for the foreseeable future. If progress in
behavioural genetics were to be such that close and clearly identifiable
association between particular genetic variants and particular forms of
antisocial acts were to be demonstrated, there would be a case for a
re-examination of the legal implication” (articles 14.24, 14.25). It
concluded also that predictive use of genetic information may be
“used only if the aim is to benefit the individual, and in doing so,
to benefit society also … prediction of behaviour with a view to
detaining an individual who has not committed a crime is not justified,
whether such predictions are based on information about genetic or
non-genetic influences on behaviour” (art. 14.44). In contrast, with
regard to sentencing of convicted offenders, the report concludes that it
“would be unwise to assume that genetics will not be able to assist
in determining degrees of blame, even if the ‘all-or-nothing’
question of responsibility is not affected by genetic factors
themselves” (p. xxxi) … the justice system should be open to
new insights from disciplines that it has not necessarily considered in
the past” (p. xxxii). The “criminal law should be receptive to
whatever valid … evidence is available…. Credible evidence
of influence and a robust test for the genetic factor in question would be
essential: the weight to be accorded to such information would be
determined by the judge” (art. 14.34).
Concerning prenatal selection, the working party expressed its opinion
that “the use of selective termination following PND [prenatal
diagnosis] to abort a foetus merely on the basis of information about
behavioural traits in the normal range is morally unacceptable” (p.
152). It also recommended that preimplantation genetic diagnosis
“should not be extended to include behavioural traits in the normal
range such as intelligence, sexual orientation and personality
traits” (art. 13.78).
We are not aware of any other study concerning the Nuffield Council
report on genetics and human behavior. The aim of our study was to explore
the attitudes of law and psychology students, taking part in a course on
criminology, toward genetic testing for a disposition to violent and
antisocial behavior and the use of these tests by the criminal system. We
chose this group of students because they represent, first, a group of
educated young adults interested in criminology, and second a group of
future lawyers, judges, and psychologists who will be faced by the issue
of making use or not making use of genetic knowledge. To determine a
possible need for more general education of interested members of the
public about the subject, it is important to know about attitudes of young
educated adults, which they have most probably gained from their
education, the media, and perhaps other more personal sources. On the
other hand, we were interested in knowing whether the recommendations of
the Nuffield Council are in tune with the views of these students who
will, as future professionals, act or not act according to the cited
recommendations. Our hypothesis was that the years of study, the field of
studies (law versus psychology), cultural background, and religion might
influence students' attitudes as has been established for other
ethical issues.9
Christakis NA, Asch DA.
Physician characteristics associated with decisions to withdraw life
support. American Journal of Public Health
1995;85:367–72.
Participants and Methods
We developed a standardized questionnaire (see the Appendix) about
attitudes to genetic testing for behavioral traits, including violent and
antisocial behavior, based on the Nuffield Council report,10
See note 8, Nuffield Council, 2002.
citations of the chairman of the council's working party in a press
report,
11 Holden M. Judges urged to consider
criminal genes. Wed Oct 2, 2002, 11:02 AM ET. London Reuters.
which have been approved by N. Perrin (Public liaison Officer, Nuffield
Council, personal communication 2002), and other studies about
students' and the public's attitudes toward genetic testing for
behavioral traits.
12 Milner KK, Collins EE,
Connors GR, Petty EM. Attitudes of young adults to prenatal screening and
genetic correction for human attributes and psychiatric conditions.
American Journal of Medical Genetics 1998;76:111–9; Wertz
DC. Eugenics is alive and well: A survey of genetic professionals around
the world. Science in Context 1998;11:493–510.
The
questionnaire was pretested among a group of bioethicicists, former law
students, and individuals with university education in the field outside
genetics, in order to test for comprehension of the questions and ethical
validity. Several corrections were made to remove ambiguities.
At the first session of the criminology course at the University of
Geneva (law school, winter semester 2002/2003), before any teaching
had taken place, the 91 students present in the auditorium filled out the
anonymous questionnaire. They were informed that the research was
conducted by an independent researcher from the medical faculty with the
aim to find out about the students' attitudes on some ethical issues.
Besides the questions, we asked students about their age, sex, field of
studies, study year, mother tongue, religion, and frequency of
participating in religious activities.13
See
note 9, Christakis, Asch 1995.
The answers to the questions were
coded on a five-point Likert scale ranging from 5 (completely agree) to 1
(completely disagree).
All statistical analyses were performed with the personal computer
version of the Statistical Package for the Social Sciences (SPSS).
Comparisons between the scores (responses to the questions) of dichotomic
groups (e.g., psychology students vs. law students or Catholic students
vs. non-Catholic students) used the Student's t-test for
independent variables. For other simple comparisons we used chi-square and
two-tailed t-tests where appropriate.
Results
Eighty-seven of the 91 participants (96%) returned completed
questionnaires. Sixty-two (71.3%) were law students, 21 (24.1%) were
psychology students, and 4 (4.5%) students were from other faculties,
mostly educational sciences. Overall, 70% of students were women, 30% men.
The mean age of students was 23.5 years. Most of them were second to
fourth year students, a few students being more advanced (minimum 2,
maximum 10, mean 3.2). The mother tongue of 80% was French, of 5% German,
of 6% Italian, of 6% Spanish, and of 3% other languages. Twenty-three
percent of students were without religious affiliation, 46% Catholic, 19%
Protestant 7% Jewish, 4% Orthodox, and 1% Moslem. The 64 students with a
religious affiliation attended religious activities from 0 to 52 times per
year (mean: 6.7 ± 13.85). No significant differences existed
between law and psychology students with regard to sex, age, study year,
mother tongue, the writing of a comment, attendance of religious
activities, and religious affiliation, except Catholic religion. Forty-one
percent of law students versus 67% of psychology students (p =
0.4) were Catholic.
The answers to the questions are shown in Table
1. No significant differences were found between the answers of
psychology and law students and between older and younger students. The 23
students who were in their fourth year or more advanced agreed
significantly more often than less advanced students with question 5 (mean
2.6 vs. 1.8, p = 0.2), question 9-2 (mean 2.6 vs. 1.8, p
= 0.46), and question 9-3 (mean 2.9 vs. 2.2, p = 0.06). Female
students agreed significantly more often than male students with question
3 (mean 1.6 vs. 1.2, p = 0.02), question 7a (mean 3.5 vs. 2.7,
p = 0.02), question 8a (mean 3.1 vs. 2.4, p = 0.048),
question 8b (mean 2.1 vs. 1.4, p = 0.002), and (less
significantly) question 7b (mean 2.0 vs. 1.6, p = 0.07). Catholic
students agreed significantly less often than non-Catholic students with
question 8a (mean 2.6 vs. 3.2, p = 0.05). Protestant students
agreed more often with question 7a than non-Protestant students (mean 3.9
vs. 3.2, p = 0.03). The most important differences were found
between students who indicated French as their mother tongue and students
with other languages as mother tongue (from now on referred to as
“foreign” students, although of course in Switzerland, German
speaking and Italian speaking may mean coming from another part of
Switzerland). Foreign students agreed less often than native French
speakers with all 15 questions, differences being significant for question
2 (mean 2.3 vs. 1.4, p = 0.001), question 3 (mean 1.6 vs. 1.1,
p < 0.001), question 7a (mean 3.5 vs. 2.4, p =
0.005), and question 8a (mean 3.2 vs. 1.8, p < 0.001).
Students' Answers to Questions 1–10b (1–6. Ranged
from Highest to Lowest Disagreement)
A reliability analysis obtained a Cronbach's alpha coefficient of
0.9 for the 15 questions. A factor analysis (principal component analysis)
showed a main component that explains 42% of variance. In the component
matrix, most questions obtain a value of at least 0.6. The exceptions are
questions 7a and 8a, with lower values (0.3). When comparing the sum of
the scores of all 15 questions, significant differences were found between
native French speakers and foreign students (mean 35.8 vs. 29.0,
p = 0.04) and between students who wrote comments and those who
did not write any comment (mean 30.0 vs. 36.0 of the maximum 45 score,
p = 0.04). Foreign students and students who wrote comments had
lower agreement with the statements.
Overall, one-third of students wrote a comment at the bottom of the
questionnaire. Apart from some comments (identification number of
questionnaire in brackets) indicating that the questions were interesting,
complicated, and difficult to answer because “the issue is
delicate,” (28) and some other comments explaining that answering
the questions is of no use to the student, the comments brought about the
issues shown in Table 2.
Students' Comments (Identification Number of Questionnaire in
Parentheses)
Discussion
Genetic Testing for Criminal Behavior
Most law and psychology students at the University of Geneva who are
interested in criminology have critical attitudes toward genetic testing
for criminal behavior. The majority of them, independent of whether they
studied law or psychology, disagreed with the use of genetic testing for
aggressive or antisocial behavior in different circumstances. The greatest
opposition was that concerning preventive measures, including deprivation
of freedom, in regard to individuals with a genetic disposition to
criminal behavior (question 3). The attitudes of 90% of students were in
accordance with the recommendations of the Nuffield Council: “We
don't think the case is made out yet for preventive detention or
anything of that kind. That would be horrifying science fiction stuff, he
[B. Hepple, chairman of the council's working party]
said.”14
Overall, students' attitudes were more generally against the use
of all testing and less differentiated than the recommendations of the
Nuffield Council report.15
See note 8,
Nuffield Council 2002.
This report concludes that genetics might
be able to assist in determining degrees of blame (p. xxxi) and recommends
that “the criminal justice system should be open to new insights
from disciplines that it has not yet considered in the past” (p.
xxxii). In a recent press report, M. Holden
16 has written: “A
criminal's genetic disposition toward anti-social behaviour, such as
violence or aggression, should be as valid a factor for judges as
psychiatric reports or personality disorders, Britain's Nuffield
Council on Bioethics said.” The information that we have obtained
from the Nuffield Council by e-mail is that “should” is to be
replaced by “could” in order to accurately describe the
Council's opinion. Of law and psychology students from our sample,
74.2% did not agree with this statement, and only a minority agreed (17.2%
partially, and 3.4% completely; “could”-version, question 5).
“If you found that someone had a genetic make-up of this kind
together with certain environmental factors, you might find probation plus
anger treatment or therapy more appropriate than sending them to
prison,” Professor Bob Hepple, chairman of the council's
working party, told Reuters.
17 Again, most students from our sample (60.5%), but less
than concerning the previously cited question 5, disagreed that
“genetic disposition toward antisocial or aggressive behaviour
should be relevant for the decision between medical treatment
(psychotherapy or psychiatric treatment) and imprisonment” (question
6).
The reason most students reported such a consistent opposition to
genetic testing for criminal behavior was apparently their conviction that
nurture is more important than nature in causing criminal behavior (see
comments, Table 2). Most students did not think
that the evidence of reliable genetic influence on different kinds of
behavior is sufficient nor that it will ever be sufficient. This
conviction can also explain why most students (64.4%) did not believe
that, in the future, research on genetic factors of criminal behavior will
have significant contributions, for example, to public safety (question
4).
As shown in the comments, students who wrote them shared the Nuffield
Council's opinion against genetic determinism, implying the
possibility to “correct” the genetic predisposition through
environmental influences. “If you are aggressive you can go and have
anger management courses. You can restrain your genetic predisposition or
channel it in certain ways, he [B. Hepple] said.”18
To a lesser
degree, students' attitudes seemed to have been influenced by the
idea that criminal behavior is not a behavior that can be characterized in
itself but is caused by societal norms that vary over time. If aggressive
or antisocial behavior only depends on the particular definition of
different societies, the use of genetic testing would be complicated
because in one particular type of society a defined predisposition would
lead to criminal behavior, but in another society the same gene would, by
definition, lead to noncriminal behavior.
On the other hand, it is also important to see that an important
minority (one-fourth to one-third of students) were constantly at least
partially in favor of the use of genetic testing for antisocial or violent
behavior in the context of the criminal justice system, the most important
exception being the use of preventive measures for genetic reasons (only
6.8% of students in favor).
Students' Attitudes to Prenatal Testing for
Serious Genetic Disease versus Predisposition to Criminal Behavior
One of the most striking results of the study is the clear difference
between students' attitudes on the “fairness” of bringing
into the world a child at great risk of suffering from a serious genetic
disorder (61.6% thought this would be “unfair”) and bringing
into the world a child with a genetic predisposition to criminal behavior
(only 13.8% thought this would be “unfair”).
Critical voices have warned that the availability of genetic tests not
only for diseases but also for undesirable characteristics will create a
pressure on women to request testing.19
Lippman A. Prenatal genetic testing and screening:
Constructing needs and reinforcing inequities. American Journal of Law
and Medicine 1991;17:15–50; Hubbard R. Transparent women,
visible genes, and new conceptions of disease. Cambridge Quaterly of
Healthcare Ethics 1995;4:291–5.
If prenatal testing
and selective abortion are judged not to be acceptable,
20 See note 8, Nuffield Council 2002:152.
selection by
preimplantation diagnosis could perhaps be justified.
21 Savulescu J. Procreative beneficience: Why we should select
the best children. Bioethics 2001;15:413–26; Savulescu J.
Why genetic testing for genes for criminality is morally required.
Princeton Journal of Bioethics 2001;4:79–97.
This
pressure is indirect through the idea of “responsible
parenthood,” which means that parents should take steps to have
children who are as healthy as possible.
22 See note 12, Wertz 1998; Mill JS. On liberty and other
essays (1855). Oxford: Oxford University Press, 1991.
The
view that a responsible parent needs to do prenatal testing is in general
motivated by two reasons. The first is the wish to avoid harming a child.
This idea, which underlies also the wrongful birth claim, is contradictory
in itself, because avoiding harm to an affected child by not selecting it
or by terminating the pregnancy means avoiding its life altogether. In
general, parents rather compare the life of an unborn affected child with
the life of a future nonaffected child than, concerning the same unborn
child, compare no life with an affected life. The second reason could be
the feeling that having an affected child would be socially unfair,
because the child would be a burden to society or to other siblings (and
also to the parents). The idea of “unfairness” to the child is
accepted by a greater percentage (61.6%; question 7a) of our sample of
young educated adults in the case of serious disease than by Western
geneticists, physicians, and patients. In an international study, less
than 40% of geneticists in the United States, Canada, the United Kingdom,
Switzerland, and Germany, 52% of U.S. primary care physicians and 46% of
U.S. patients agreed to the same question (“it is not fair to a
child to bring it into the world if it is at great risk of suffering from
a serious genetic disorder”).
23 Fewer students from our sample, but still
almost half of them (47.1%) found it “socially irresponsible”
knowingly to bring into the world in this era of prenatal diagnosis an
infant with a serious genetic disorder (question 8a).
A great majority of students (81.6%) did not agree with the idea that
responsible parenthood requires prenatal testing for undesirable behavior
such as aggression, alcoholism, or criminal behavior in general (questions
7b and 8b). The reasons for these critical attitudes toward prenatal
testing for criminal behavior were apparently the same as for such testing
in the context of the criminal justice system: the lack of belief (a) that
such behavior is sufficiently genetically determined, and (b) that, if
existing, the part of genetic determinism could be measured by gene
tests.
The Nuffield Council's report identified “the start of a
trend towards selection on other [than clinical]
grounds”24
See note 8, Nuffield
Council 2002.
(p. 150). Most students from our sample were
opposed to the idea of reproductive freedom concerning genetic testing for
criminal behavior. Seventy-five percent disagreed that it is important to
develop “presymptomatic” tests “in order to give
individuals who desire children the possibility to know whether they risk
transmitting a gene predisposing to criminal behaviour” (question
2). The belief (b, see paragraph above) that precise gene tests are not
possible in this field apparently influenced attitudes less than the
belief in (a), the preponderance of nurture: If asked to imagine the
existence of such a precise test (questions 9-1 to 9-3), the majority of
students thought that confidential prenatal testing should
not be
available to individuals who want this information concerning a
predisposition to antisocial behavior (74%), alcoholism (62%), and
aggression (56%). Another possible reason for the disagreement of the
students could have been the feeling that prenatal testing and selective
abortion are not adequate for predisposition to undesirable behavior.
However, as shown by the answers to question 2, this cannot have been the
major reason against testing, because even presymptomatic testing of
adults who desire the tests has not been found acceptable by
three-quarters of the students. Attitudes of students from our sample were
more critical toward prenatal testing for a predisposition to the
mentioned types of behavior than were two groups of undergraduate students
at the University of Michigan.
25 See note
12, Milner et al. 1998.
Among these young North American students
of childbearing age, almost 70% agreed that prenatal testing for
alcoholism, and about 63% that prenatal testing for violent behavior
should be made available at least in some circumstances to individuals who
desire it. The students from this USA study cited as a reason for the
endorsement of prenatal genetic testing the possibility for the individual
to take preventive measures against the undesired behavior. Students from
our study clearly thought that possible negative consequences of testing
to the child (e.g., fulfilling prophecy, stigma; see
Table 2) outweigh the autonomy rights of parents in
this area.
Hepple resumes the opinion of The Nuffield Council's working
party in the following way: “If you allow it [prenatal
testing] for abnormal conditions such as chronic diseases, it
doesn't follow that you have to allow it for what we regard as the
normal make-up of mankind.”26
The Nuffield Council's report does not clearly
state whether particularly violent behavior (murder, attempted murder,
etc.) would be considered as the normal makeup of mankind or rather as a
form of psychiatric pathology (“There seems to be a consensus in
clinical genetics and in public opinion against use of PGD or PND in order
to select babies on the basis of non-clinical characteristics.”
27 See note 8, Nuffield Council
2002:151.
). Antisocial and violent behavior are part of
personality disorders and could be considered as a disease. Surveys in the
literature show that respondents were more likely to endorse prenatal
testing for phenotypes that they felt to be indicative of pathology.
28 See note 12, Milner et al. 1998; Smith LB,
Sapers B, Reus VI, Freimer NB. Attitudes towards bipolar disorder and
predictive gene testing among patients and providers. Journal of
Medical Genetics 1996;33:544–9.
Eugenic Ideas with Regard to Criminal Behavior
Eugenic practices in the 20th century have aimed at among others
things decreasing aggression and antisocial behavior in society by
decreasing the birth rate of the “feeble minded” and
“morally incompetent.”29
See
note 8, Nuffield Council 2002:14; Paul DB. Controlling Human Heredity
1865 to the Present. Amhurst, NY: Humanity Press, 1998.
Among the means used to obtain this goal were involuntary sterilization,
incarceration, and elimination. At present, the use of coercion as a means
is condemned in Western countries, but it is less clear (1) how precisely
to define eugenics.
30 American Society of
Human Genetics. Eugenics and the misuse of genetic information to restrict
reproductive freedom: ASHG statement. American Journal of Human
Genetics 1999;64:335–8; Garver KL, Garver B. The human genome
project and eugenic concerns. American Journal of Human Genetics
1994;54:148–58; see note 12, Wertz 1998.
Partly, but not
completely, dependent on these problems of definition, it is also less
clear (2) where exactly to draw the line between eugenics as an
intervention on behalf of public health, and clinical genetics as a
service for individuals and families,
31 See
note 8, Nuffield Council 2002:18.
and (3) whether eugenics should
be considered wrong in its very inception.
32 See note 8, Nuffield Council 2002:16.
The Nuffield
Council's working party acknowledges the possibility “that
contemporary understanding of the heritability of … behavioural
characteristics … could provide a scientific foundation for a
programme of positive or negative eugenics, were there to be the political
will or power to construct and implement such a policy”
33 See note 8, Nuffield Council 2002.
(p. 22). It does not give any definite answer, but encourages historical
and philosophical studies of eugenic practices “so that it may be
clearly understood what was, and what was not, unacceptable about the
past”
34 See note 8, Nuffield Council
2002.
(art. 2.20, p. 22).
Students' agreement with eugenic ideas might be concluded from
several questions. Some 34.5% of students agreed that if precise gene
tests for aggression existed, such tests “should be proposed to all
adults of an age to have children who have in their family a person
convicted for a particularly violent crime (murder, trial of murder,
etc.)” (question 10b); a lesser percentage (23%) agreed with the
proposal of tests if the relative in question had been convicted more
generally for “violence against a human being” (question 10a).
More important, 30% of students agreed that “society should do
everything possible to diminish the frequency of genes predisposing to
criminal behaviour” (question 1). This statement not only has a
clear eugenic goal, it also does not exclude the use of coercive means.
Seventy-one percent of the students from our sample disagreed with the
idea of reproductive autonomy in the form of a positive right to select
children according to a predisposition to criminal behavior (question 2).
Such acceptance of a limitation of reproductive autonomy might be the
first step on a slippery slope to other types of coercion, including
eugenic coercion. According to Wertz,35
Wertz DC. Commentary to the Nuffield Council Report, cited in
note 8, Nuffield Council 2002:152.
“in an increasingly
autonomy-oriented climate, it may be impossible to draw firm lines against
such selection. Use of law to prevent such selection is the worst possible
alternative, because it opens the door to other restrictions on
people's decisions about reproduction.” However, reliability
and factor analysis of our study shows that most students who agreed with
questions 10b and 1 disagreed with question 2; that is, contrary to Wertz
fears, acceptance and not restriction of selection goes together with
acceptance of eugenic ideas.
A General Attitude toward Genetic Testing for Criminal
Behavior
We found a main component that influenced the answers to the 15
questions. This component seems to be a general belief in the influence of
genes on behavior and leads to a general agreement with genetic testing
about socially undesired behavior such as antisocial behavior, violence,
or alcoholism. Part of this component, although of less importance, was
also the agreement that socially responsible parents who want to be fair
to their child would do prenatal testing for serious genetic disease.
Students seemed to be of two types: either they disagreed with all
statements about genetic testing (the majority) or they agreed to some
extent to the use of genetic testing for antisocial or violent behavior in
the context of the criminal justice system as well as to prenatal testing
(a sizable minority of one-fourth to one-third of students). This tendency
to generalization for or against testing could be due to several factors.
First, a lack of more detailed information could have led to a general,
most often critical, position nourished by fears of abuse of genetic tests
and adverse effects on society (see Table 2). As
reflected by many critical comments to the Nuffield Council report from
official organizations and the public,36
See
note 8, Nuffield Council 2002:13.
this is the prevalent position
in Western society. Second, the opposite general positions could reflect
the different “schools” of thinking, as to whether behavior is
determined more by nature or nurture (see
Table
2).
Factors Influencing Attitudes
The critical attitudes do not seem to be the result of particular
university education in law or psychology. Contrary to our hypothesis,
whether students belonged to one or the other “school”
apparently was not related to the type of studies (psychology vs. law).
Only in 3 (questions 5, 9-2, 9-3) of the 15 questions was higher agreement
associated with advanced study year. The fact that more advanced
students' attitudes were closer to the opinion of the Nuffield
Council's working party concerning question 5 could be due to the
fact that these students had more detailed knowledge on the role of
psychiatric reports in the courts. Interestingly, in all three questions,
advanced students' attitudes were more in favor of testing than less
advanced students' attitudes. A prudent conclusion would be that both
types of university education (law or psychology) might contribute to a
more differentiated, less generally critical, attitude toward behavioral
genetics.
Our hypothesis that cultural origin and religion would be associated
with different attitudes was confirmed. “Foreign” students
(i.e., those whose mother tongue was not French) showed significantly more
critical attitudes toward testing than did native French speakers.
Cultural differences are known to influence ethical attitudes.37
Blackhall LJ, Murphy ST, Frank G, Michel V,
Azen S. Ethnicity and attitudes toward patient autonomy. JAMA
1995;274:820–5; Thomsen OO, Wulff HR, Martin A, Singer PA. What do
gastroenterologists in Europe tell cancer patients? The Lancet
1993;341:473–6.
Foreign students from our sample were
mostly German, Italian, and Spanish speakers. The history of Nazi eugenics
is known to have shaped attitudes in Germany, with some probable influence
on other German-speaking countries, toward more critical attitudes to
presymptomatic and prenatal testing.
38 Kolb
S. Medizin und Gewissen: Wenn Würde ein Wert würde.
Frankfurt a.M.: Mabuse, 2002.
Foreign students could also be more
aware of society's tendency toward stigmatization due to nationality,
race, or differences in behavior and therefore anticipate negative
consequences of a belief in genetic differences of behavior.
Female students were more often in favor of statements 7a and 8a
affirming that prenatal testing for serious genetic diseases would be fair
to the future child and socially responsible. This seems to indicate that
potential mothers are more sensible to the pressures resulting from the
idea of responsible parenthood. Possible reasons could be that women are
particularly concerned about having a healthy child and feel personally
guilty of transmitting a genetic disease to a future child. Women might
also be more concerned about social responsibility in general39
Jones NJ. Sex and racial differences in
preference for a caring morality in a corporate environment that promotes
diversity and equal opportunity. Psychological Reports
2002;91(2):641–9.
(question 8a), as seem to be Protestant
students, confirming thereby a typical image of the Protestant religion as
particularly concerned by social problems and tolerant toward prenatal
testing and abortion. On the contrary, Catholic students were more often
than other students against the idea that prenatal testing for serious
genetic diseases would be socially responsible behavior (8a). The
disagreement with this statement could be explained by the disagreement of
Catholic students with abortion. If abortion is considered morally wrong,
then not accepting prenatal testing and the possibility of selective
abortion would not be “socially irresponsible.”
Strengths and Weaknesses of the Study
Strengths of our study are the high participation rate and the good
reliability of the different parts of the questionnaire. Our study has
also several weaknesses. First, all questions have been formulated in the
same direction (in favor of testing). We can therefore not completely
exclude that the high interitem reliability as well as differences found
between students generally in favor and students generally against testing
are in part due to a psychological tendency of some to rather agree, and
of others to rather disagree. The different percentages found concerning
different questions show, however, that many students gave differentiated
answers according to the content of the questions.
A second weakness might be that some of the significant associations
we found between sociodemographic characteristics and responses might be
due to chance alone. However, because the differences we found are
consistent and confirm typical differences toward ethical issues found in
other studies speaks against the influence of chance.
Third, a problem of all questionnaire studies using hypothetical
questions is that the reported attitudes might not be representative of
attitudes that future judges, lawyers, or psychologist will show in a real
situation.
Last, another weakness concerns the limited generalizability of our
study. Our sample was composed of students interested in the course about
criminology taught at the University of Geneva. Not all of these students
will intervene later in the field of criminology. The personality of the
two teachers (a university professor in criminal law and another in legal
medicine) might have attracted a particular type of student—for
example, students who agreed with the general opinion of the teachers
known from previous courses. The course has been attended by mostly women.
Their attitudes might not be representative of judges or psychologists who
will later intervene in the field of criminology, the majority of whom
will not be female. On the other hand, we were interested in comparing the
attitudes of students interested in criminology with the recommendations
of the Nuffield Council. Less important than the exact majorities in favor
or against particular statements is the fact that we found groups of
students who hold opposite opinions, as well as a general component
distinguishing students generally against and students generally in favor
of testing. This finding is important independent of the generalizability
of our sample.
Conclusion
More detailed education of the interested public and in particular of
present and future professionals intervening in the criminal justice
system is needed in order to ensure a more differentiated view about the
justified use of genetic testing for violent or antisocial behavior in
different areas of the justice system, as well as about the usefulness of
more research on genetics and human behavior.
However, given the limited scientific evidence for the time being, it
is difficult to imagine teaching in this area that is entirely ethically
neutral.
