The Return of Lombroso? Ethical Aspects of (Visions of) Preventive Forensic Screening

Munthe, Christian; Radovic, Susanna

In the new Lombrosian case, the negative sides of false negatives are quite different from health screening, where the I risks harm due to undetected health problems, which could have been attended to. In a Lombrosian programme, something similar might hold, but only if detection of F and the following application of P is in the interest of I. Since P may mean that I's freedom is curtailed (restriction) or that I is barred entirely from society or even existence (exclusion), without any treatment being administered that benefits I by reducing risk while he/she is free and societally included, it may very well be in I's interest not to have F adequately identified. At the same time, there may remain an interest of society and of potential crime victims to correctly identify I as high risk, so that a P to reduce that risk may be applied, even if that implies downsides for I. False positives, in contrast, are problematic in a health screening mainly due to risks of unwarranted anxiety and risky or burdensome treatment. In the new Lombrosian case, the picture is similar in that an I falsely identified as possessing F risks being subjected to unmotivated measures. 13 In contrast to the health case, however, these may, as we saw, be to the disbenefit of I even in the case of a true positive, with reasons referring to the protection of others and society motivating why they should nevertheless be applied. In the most extreme instance, there will be Is who never come to exist at all or who will be excluded from society due to a falsely attributed risk of future criminality. In addition, there is a general risk that the information about an increased forensic risk will by itself increase the same risk via psychological identification akin to stigmatization (see below), where I so identifies with the forensic labelling that actual criminality becomes more likely, so that the end result even with an effective treatment may be a zero effect or even worse. 14 A further layer of complication is added by the fact that even if a detection method is reasonably precise in terms of positives and negatives, the accuracy of its predictions (whatever they are) may nevertheless falter. This is due to the fact that the PPV of a test, besides its precision, also depends on how common a condition is in a population and how complex is its aetiology. The less common the condition, the more the detection method needs to pick up on less certain indicators for or against the presence or non-presence of the condition and the more complicated are the causes, the more likely it is that there are indicators not being picked up by the method, and thus the likelihood for mistaken predictions increases (Juth and Munthe, 2012: 67-72) .