In modern societies, people talk a lot about the body and health. This is because biomedical sciences have influenced their lives. They must enhance the culture, health, and living conditions of citizens. Solving crime remains hard. Finding antisocial children early is critical. They will become future offenders. This detection promises to solve crime with science and medicine. For instance, as the early detection of problem gambling can prevent issues related to online betting, early detection of behavioral disorders might curb future delinquency. Yet, in a democratic society, it values solidarity and pluralism. It tends to preserve the social link. So, we must question whether this way of managing crime is ethical. This paper proposes to analyze these questions. It will do so in light of debates that have troubled France for years.
Early Detection of Behavioral Disorders: Sarkozy’s Crime Prevention Initiative
In 2005, former French President Nicolas Sarkozy supported a “crime prevention” report that called for early detection of behavioral disorders in children. The report was by the Institut national de la santé et de la recherche médicale (Inserm). The report highlighted that some behavioral disorders are genetic. They’ve got early signs of aggression and can predict future delinquency. It suggested finding risk factors in early pregnancy and using regular help for at-risk families. This is especially important for young mothers in challenging situations. The goal was to spot behavioral disorders by age 3. This was done through regular checkups and follow-ups. They’re in the child’s health records.
After Inserm released the report, a group of citizens came together to establish Pas de 0 de conduit (1).In March 2006, the group sent an open letter and a petition to the General Director of Inserm. A group urging a critical review brought the overmedicalization of educational, psychological, and social issues to the attention of the National Consultative Ethics Committee (CCNE).
The CCNE released a report on ethical issues in February 2007. The early detection of behavioral disorders in children raised the problems. This was found by the Comité consultatif national d’Éthique in 2007. This brief report questions INSERM’s expertise. It highlights three significant issues:
- Concerning the epistemological issues and semantic uncertainty surrounding ‘conduct disorder.’
- On the neglected importance of environmental factors;
- On the risk of stigmatization.
Can early medical screening of behavioral disorders prevent crime? Can we use formal diagnosis to deal with suffering children? Is this an acceptable civic and societal initiative? Could it be a social connection? These questions raise essential and urgent ethical challenges for the citizens. The discussion we’re having now is a good illustration of this. It revolves around this debate, which is a great example. It is built around two “groups of wise persons”: a group of scientists and the Ethics Committee. Does this elitist dynamic reserve a spot for a renowned voice?
In this paper, I will analyze the knowledge and ethics arguments of CCNE, which disagree with the experts of Inserm. We will then be able to analyze the relevance of the proposal, which is about “early detection of future offenders.” It relates to democratic civic values: solidarity and pluralism.
The Inserm Report
The Inserm expert group aims to predict major crime-related disorders. They will do this by finding early risk factors. These include aggression toward people or animals. They include property destruction, deceit, theft, and serious rule violations. They suggest finding these risk factors early. This should happen even during pregnancy. The factors are based on genetics, environment, temperament, and personality. Studies show that children with conduct disorders can be as young as 3. This is especially true for those in unstable, abusive, and poor environments. They’re at high risk of becoming violent. About two-thirds of these children continue to have conduct disorders into their teens. There are many risk factors for conduct disorder. The risk factors associated with elevated levels of physical aggression are identical to those for other types of aggressive behavior. Also for antisocial behavior and delinquency.
First, harmful parental attitudes and inappropriate child-raising strategies appear to be necessary. A parent’s history of bad teenage behavior is the main factor. The other is the mother being young at the birth of her first child. There is also family conflict, poverty, and the parents being mean to the child. (Institut national de la santé et de la recherche médicale 2005, p. 14; Cadoret et al., 1995; Farrington and Loeber, 2000; Loeber et al., 2000; Rutter, 2001).
In co-morbidity studies, conduct disorder in children is often diagnosed with both ODD and ADHD (Angold et al.). 1999; Koenen et al., 2006). The term “disruptive behavior” brings them together. It does so in the two central international classification systems, the DSM and ICD.
The meta-analysis shows that genes and the environment both play significant roles. This is true for conduct disorder, ODD, and ADHD. Conduct disorder is about 50% heritable, which is less than ADHD. Inserm experts believe these findings support the search for vulnerability genes. Various brain chemicals contribute to impulsiveness, aggression, and violence. For example, the dopamine system affects motor activity and concentration.
Many studies show that a child’s personality and temperament are key. They’ve played a significant role in conduct disorder. Traits like a lousy mood raise the risk of easy distraction. They also increase the risk of solid emotions, hyperactivity, and social withdrawal. This is especially true if the child comes from a dysfunctional family.
Final Thoughts
The experts focus on neurocognitive deficits. These link to conduct disorder in kids and teens. They include impaired verbal skills and executive inhibition (Pineda et al.). 2000). From a therapeutic view, the report recommends using proven treatment strategies. These include personal or group therapy for the child and parent training, alone or in a group. The interventions are for children. They aim to promote social, cognitive, and emotional skills such as empathy. They also aim to improve anger and impulse management. They aim to foster the ability to make relationships with others, especially peers. They also seek to enhance their communication skills (2005, p.40). Then, if that fails or they aren’t compelling fast enough, the Inserm report says to use medication. This includes psychotropic stimulants and mood stabilizers. They suggest using them as early as six years of age. Ritalin treatment for hyperactivity becomes a standard practice every year.
