A Case Study on Damaged Brains & Legal Culpability

THEBACKGROUND&DEFINITIONS

Chronictraumaticencephalopathy(CTE)isaneurodegenerativedisordercausedby

repeatedheadinjuriesovertime.Characterizedbyacollectionofneuropsychiatricsymptoms

(e.g.,cognitiveimpairment,personalitychanges,depression,andsuicidality),CTEhistopathologicallyresemblesAlzheimer’s

diseaseandcanonlybedefinitivelydiagnosedpost-mortemonautopsy.Thereisnocure.

AaronHernandezandChronicTraumaticEncephalopathy:ACaseStudyonDamagedBrains&LegalCulpability

SunidhiRamesh,BSMDCandidateatSidneyKimmelMedicalCollegeinPhiladelphia,PA

THESTORYOFAARONHERNANDEZ

AaronJosefHernandezbeganplayingAmericanfootballateightyearsold,risingtofameovertheyearstoeventuallyjointheNewEnglandPatriotsandbecome“theNFL’sbest

tightend.”

2013:Hernandezischargedwiththefirst-degreemurderofOdinLloyd2014:HernandezisindictedonmurderchargesforadoublehomicideinBoston2015:Hernandezisconvictedofthefirst-degreemurderofOdinLloydbyagrandjury2017:Hernandezisfoundhangingbyhisbedsheetsinhisjailcell

AnautopsylaterfoundthathesufferedfromthemostseverecaseofCTEeverrecordedin

apersonhisage.Hewas27yearsold.

POSSIBLEGUIDELINESFORTHEUSEOFCT/MRIINCOURTS1. Understandingneuroimaging,itslimitations,anditsmeaning: Ifthisevidenceistobeadmissible,

judges,juries,andattorneysneedtobetrainedinthevalue,meaning,andlimitationsofthesescans— thatthesescansyieldpicturesthataretheninterpreted.

2. Recognizingtheslipperyslopeofinferringastateofmind:Wheredowedrawthelinebetweenperson-to-personvariationandaseriousabnormalitythatcausedacrimetobecommitted?Whataretheparametersofan“averagebrain?”Howdifferentis“abnormal?”Casestudiesshouldbereferencedtounderstandhowabnormalitiesinspecificregionscouldimpactbehavior.

3. Protectingtheprivacyofthedefendant: Onlypertinentneuroimaginginformationshouldbedisclosed,andonlyforaspecificpurpose.

4. Identifyingthereliabilityandaccuracyoftheresults:Atleasttwoindependent,separatetestsmustbeconductedwithmorethanoneneurologisttocorroboratethefindings.Ifanyinconsistenciesarefound,eitherbetweenthetwotestsorbetweentheneurologists’opinions,theinformationshouldbedeemedinadmissibleonthegroundsofbeingunreliable.

5. Implementingneuroimagingonlywhennecessary: Neuroimagingshouldnotbeopenforuseineverycase,andprotectionsarounditsusemustbeestablished.

6. Avoidingneuroimagingasthe“end-all-be-all”: Neuroimagingshouldneverbeusedasthesoleevidenceprovidedtodemonstratethementalcapacityofanindividual.

CONCLUSIONS

Withinthelegalsphere,adefendantcanshowthatthankstohisdisorder,hisbehaviorwasnotvoluntary,thathelackedthementalstateessentialtoenactthecrime,orthatheis

lawfullyinsane.Thisdefense,withthehelpofneuroimaging,couldhavechangedthe

outcomeoftheHernandeztrial.

However,thelinearcausalitybetweenaneurologicdiagnosisandanindividual’ssubsequentmentalstateand/orconductremainsunclear.Thelegalsystemmust

carefullyfollowdevelopmentsfromresearchonneuroimagingtoestablishcarefulguidelinesforthepermissibilityofneuroimagingincourts.

REFERENCES1. Aharoni,Eyal,etal."Canneurologicalevidencehelpcourtsassess

criminalresponsibility?Lessonsfromlawandneuroscience."AnnalsoftheNewYorkAcademyofSciences1124.1(2008):145-160.

2. Wasserman,David,andJosephineJohnston."Seeingresponsibility:canneuroimagingteachusanythingaboutmoralandlegalresponsibility?." HastingsCenterReport 44.s2(2014):S37-S49.

3. McKee,AnnC.,etal."Chronictraumaticencephalopathyinathletes:progressivetauopathyafterrepetitiveheadinjury." JournalofNeuropathology&ExperimentalNeurology 68.7(2009):709-735.

4. Gregory,Hollin."Makingamurderer:mediarenderingsofbraininjuryandAaronHernandezasamedicalandsportingsubject." SocialScience&Medicine 244(2020):112598.

5. Price,Greg."NFLPlayerChargedWithMurder:WhoIsSuspectAaronHernandez?FormerNewEnglandPatriotAppearsInCourt,PleadsNotGuilty." IBTimes.com (2013).

6. Redding,RichardE."Thebrain-disordereddefendant:Neuroscienceandlegalinsanityinthetwenty-firstcentury." Am.ULRev. 56(2006):51.

7. New,JohnG."Ifyoucouldreadmymind:implicationsofneurologicalevidencefortwenty-firstcenturycriminaljurisprudence." TheJournaloflegalmedicine 29.2(2008):179-198.

THEQUESTION

Thepost-mortemfindingsinHernandez’braintellaneeriestoryandbringtolightabiggerquestion:wouldwestillhaveconsideredHernandezguiltyknowingtheextentofhisbraindamage?

THEDILEMMA

AaronHernandezwasunawarethathehadCTEduringhislifetime.Hislawyersanddoctorsdidnottakestepstodetermineifhisbraincapacitywasnormal.Notably,whilefunctionalneurosciencedoesnotcorrelatefullywithcognitiveneuroscience,abasicCT/MRIofHernandez’brainmayhaveraisedalarmsabouthismentalstatusandpromptedresearcherstoconductfurtherpsychologicaltesting.

WHENCANALEGALARGUMENTBEMADE?

Therearethreemajorcriminalsanctionsthatmayapplytothiscase:voluntarybehavior,mensrea,andtheinsanitydefense.

Undereachofthesecategories,adefendantcanarguethat,inparttohisneurologicdiagnosis,hecannotbearthesamenatureoflegalaccountabilityforhisactionsasanother,healthyhumanbeing.Commonwealthv.PirelaandStatev.Reidestablishedthe

precedentforthisdefenseincriminalcourt.