1. Stephen G. Post, Ph.D., Professor of Bioethics, School of Medicine, Case Western Reserve University and & President, The Institute for Research on Unlimited Love. 216-368-6205
"Science is learning more and more about genetic susceptibility factors in childhood and adolescence which, coupled with environmental factors, elevate the risk for developing serious mental illness or behavioral problems. For example, an entire volume of Schizophrenia Research (51, 2002) was devoted to genetic susceptibility to schizophrenia and the ongoing research programs to prevent its manifestation through the protracted use of psychotropic medications in as-of-yet undiagnosed teens. Of course, medicating young people based on family history, vague genetic factors, and the perception by parents that their adolescent's behavior is abnormal in some poorly defined way raises a host of ethical questions. It also labels the adolescent as a "prodromal," a new unofficial diagnosis for a child who is supposedly at high risk for schizophrenia, all in the context of the remarkable power differential that defines the parent-child axis.
"Caspi et al. have perhaps identified a genetic susceptibility factor for anti-social personality disorder and violence among those young people who have been subjected to severe and probable maltreatment. If they are correct in their finding, the child with low MAOA expression (a gene located on the X chromosome) will have a much lower probability of overcoming the influence of maltreatment, and will become violent in turn. This finding needs to be verified, as the authors rightly state.
"If this is true, then what should we do? Anti-social personality disorder, violence, and related criminal conduct are huge problems in American society and in the world. We spend billions of dollars every year in the context of the criminal justice system, prisons, rehab programs, treatment, and the like. Many of us are terrorized by the violence in society, or even in our own homes. Like schizophrenia, this is a major problem and it is hard to imagine that many parents and society at large would not want to use medical means to "treat" those at risk. Is the MAOA finding the beginning of an endeavor to prevent violence in the name of public health and well-being?
"The problem, of course, is that we are engaged here in vague definitions of anti-social personality disorder, and we have no clear set of pre-symptomatic behaviors that would allow us to categorize a particular young person as especially prone. Moreover, genetic susceptibility, even if statistically impressive, is not genetic causation. Many people will have the genetic susceptibility and yet show remarkable resiliency in the face of maltreatment, going on to live constructive lives. It is well known that the only good predictor of violence is previous violent behavior, but in the young we usually have no track record of significance. Do children and youth have a right not to be treated by parents or social entities for crimes that they may never commit, despite their history of maltreatment?
"These are complex questions. I have an answer. Violence in maltreated children is a major issue. Stop the maltreatment, and don't add to the problem by layering in a new generation of so-called violence preventing drugs."
--Stephen G. Post
2. Ted Peters, Ph.D., Professor of Theology at Pacific Lutheran Theological Seminary and the Center for Theology and the Natural Sciences at the Graduate Theological Union, Berkeley CA. Tel: 510-665-8141. [Note: please direct inquiries through Mr. Gaymon Bennett.]
"That we human beings would inherit a predispostion toward anti-social or even violent behavior should come as no surprise to a Christian theologian. We have long worked with the concept of "inherited sin" and even "original sin." St. Augustine in the 5th century thought we inherit sin biologically through the procreative process. Walter Rauschenbusch, a Social Gospel Protestant in the early 20th century, believed we inherit prejudice and patterns of crime from the surrounding society we are born into. Whether influenced by biological inheritance or social inheritance, we are born already with propensities for aggressive behaviors that can be socially destructive and even self-destructive. Through studies such as this one, science can help us discern just how much influence both genes and environment have on our predispositions.
"Christian spirituality like the spirituality of other religious traditions is aimed at liberating us from both biological and social determinism. Religious visions are unsatisfied with the world as we find it; they are unsatisfied with the way we are born. Cultivating high minded moral ideals or strengthening the inner soul through prayer and meditation are ways in which, according to the ancient Stoics, our higher nature can draw us up and out of our lower nature. In the New Testament, St. Paul described this as a struggle between flesh and spirit. Perhaps such scientific research leading to advances in pharmacological therapy may serve these children and the rest of us in gaining spiritual strength over the inherited propensities of the flesh. Yes, medical science could serve the spirit by healing the body."
3. Ronald Cole-Turner, Ph.D., Professor of Theology and Ethics, Pittsburgh Theological Seminary. 412-441-3304 x2170.
"The study shows that genes and environment work together to determine personality and behavior. What's troubling here is that there seems to be no more room for human freedom. Everything is genetic or environmental, or so it seems. But our legal and political systems, not to mention ethics and religion, assume that we are not puppets controlled by genes and environment but are free to obey the law and do what is right.
"It is chilling to learn from the paper that 85% of the maltreated males with low MAOA expression exhibited some form of anti-social behavior. But it is critical to note that not all of them do, and even more important, those who do are not anti-social all the time or in every respect. They may be strongly inclined toward anti-social behavior but not rigidly predestined to act that way at every moment. There's room here for them to show personal responsibility even under the weight of their predisposition.
"For theology, this is not surprising at all. At least since St. Augustine (354-430) we have held that all human beings are in some ways twisted toward anti-social behavior, and that we inherit this condition (now we would say by genes and environment). Nevertheless, our genes and our environment also produce within us a capacity for genuine moral responsibility, so we can't blame our genes or our families for our sins."