There are certainly interesting discussions to be had around it, but this is well-covered territory.
There's something quite perplexing to me about the way people interpret these things. When someone murders their mother and goes on a big murder spree and then people try to differentiate "But were they insane?" ....Only, of course they are! Normal people don't go on murder sprees.
Some people go insane from brain tumors and CSF leaks. These can be cured, and can literally return a person to a "normal" state of mind overnight.
Then there are things we just can't cure yet because there's a seemingly unfathomable amount of stuff going on in the brain with regards to chemicals.
If their cause can be medically cured with past results backing a return to normalcy... I think that should be a large part of the legal discussion and attempted if the defendant requests. Whether or not they lie about being normal again after the procedures? Well, that's a question as hard as why are some people just dicks.
Anyways, it appears that there's a large amount of things that can go quite wrong in the form of tumors/lesions/CSF issues around the brain that can cause an unbelievably broad spectrum of strange to fucked up shit, and hilariously, be cured near overnight if they're found and treated.
It's awful/funny to me because 60 years ago, talk of this would probably have you ostracized from the medical community/seen as batshit insane. I really hope we're able to see great strides into readily accessible and reliable (as in, those interpreting them actually give a shit about the fine details, though I presume this will be solved by AI) brain screenings/imaging in my lifetime. Really, really hope so. It currently pains me there's only really three institutes, and furthermore really only three people pioneering serious research into inappropriate recurring CSF leaks (those being Stanford, Cedars-Sinai, and Duke - more specifically, Dr. Ian Carroll, Dr. Wouter Schievink, and can't speak for Duke)
If I ever have the ability, I think one of my actual life goals would be to put large amounts of money into awareness of CSF leaks and their prevalence in those with connective tissue disorders (which also need more awareness spread...) and funding of young scholars who really want to dig into solving them.
https://www.google.com/amp/s/www.nytimes.com/2017/11/02/maga...
I used to have an amazing vocabulary and placed in the top 10 of a state spelling bee when I was like 12 just from playing RuneScape. Never looked at a dictionary or spelling bee study book in my life at that point. Post CSF issues... my vocabulary is absolute arse, as can be seen in my poor choice of words in the bulk of my post.
Sorry for going off topic from the actual article... but uhh, brain stuff. Central diabetes insipidus is another absolutely ARSE thing that should have more awareness... Pituitary gland issues can be caused by so many different things and cause so many issues, which when properly diagnosed, are typically quite treatable.
https://www.nytimes.com/2007/03/11/magazine/11Neurolaw.t.htm...
[0] https://www.wnycstudios.org/podcasts/radiolab/segments/31762...
[0] https://smile.amazon.com/Saturday-Ian-McEwan/dp/1400076196/r...
A better question is what gives the best results (mainly for the public at large) as an overall system policy. I guess brain tumors are rare enough that you can probably err on the side of mercy supposing you don't believe the subject is likely to reoffend. But you don't want to make so many loopholes that the deterrent effect of punishment is compromised. And of course you don't want to let people go who are likely to harm innocent members of the public, regardless of whether they are responsible for that condition. These are all empirical questions though. Its incredibly hard to even establish a deterrent effect of punishment, much less measure it to the fine degree required to set detailed policy.
Peter Watts discusses this a little sort of as an aside during Blindsight, I believe.
...But that's literally exactly the question at play in the title. When the tumor DOES affect the decisions that make the defendant the defendant.
All I can add is that having spent a lot of time on the meditation cushion observing the workings of my own brain, it's laughable to me that people think they have control over their brain. And by some very objective standards most would consider me to have quite a bit of such control. I can attest that this control is a massive illusion.
