The Dice of Life

Wall Street banker Randolph Simens had never gambled much.  That is, until his mid-fifties, when he suddenly and seemingly without reason developed a severe gambling addiction.  He’d spend long nights in the casinos, showing up to work exhausted, only to spend the day in an online poker room.  Worse still, his habit began to spill into his work. Simens’ corner office became a private hell: sweating into his starched collar, he found himself making riskier and riskier trades.  As his habit spiralled out of control, he lost $400,000 in a single day-trade, and liquidated both of his sons’ bank accounts to support his habit.  Soon, he had gambled away over 3 million dollars.

Then, suddenly, he kicked his habit as soon as he had picked it up.  How?  For several years, Simens had been taking drugs to treat his Parkinson’s disease.  And, after stopping his medication, his addiction disappeared practically overnight. (1)

Mr. Simens is not alone.  In fact, it only occurred to him to try stopping his medication when he read about a similar case, in which a film director had also developed a gambling problem after taking the same Parkinson’s medication, Mirapex.  Another businessman gambled away 10 million dollars!  Cases like these are piling up, and the drug’s manufacturer, Pfizer, has begun to warn its users that Mirapex can cause impulsive behavior: not just gambling, but also addiction to sex, food, and alcohol!  In fact, the same businessman who lost $10 million also lost his marriage and became addicted to prostitutes.  One of the most perplexing cases was that of a French husband (to his wife) and father of two, who became addicted not only to gambling but also to gay sex.  (2) In all of these cases, the new behavior appeared soon after beginning Parkinson’s medication, and disappeared upon ceasing medication.  Pfizer and other manufacturers are facing a slew of lawsuits: early users of Mirapex claim that they were not duly warned of the danger of impulsive behavior.  Many of these lawsuits, including that of Mr. Simens, have already proved successful.

But wait: let’s hold on for a second here.  A judge held Simens not responsible for his gambling losses—even though it was he who rolled the dice and bought the stocks!  The logic was that Mirapex had produced a chemical change in his brain, which had produced impulsivity and led to gambling losses.  But what of those gamblers whose addictive brain chemistry is attributable to genetics?  They seem no more responsible than Simens.  In fact, if anything they should take less blame, since they have never known what it’s like to not be impulsive, where Simens has.

But if an irresponsible gambler is innocent, because his genes drove him to do it, can’t the same be said of a thief, or of a murderer?  Here arises the difficult question of responsibility in criminal justice.  If everything is attributable to brain chemistry, which in turn is attributed to genetic or even environmental factors, than nothing is attributable to free will and personal choice.  We’ve got to draw the line somewhere—at some point people must be held responsible for their actions.  It seems like the courts are drawing that line under Simens but above those who are born addicts.  Apparently it really is worse to pick up a bad batch of genes than a bad bottle of pills.

What exactly does Mirapex do?  Well, first let’s talk about Parksinson’s disease.  Parkinson’s is caused by the death of dopamine-producing cells in the Substantia Nigra.  The Substantia Nigra can be thought of as the gate to the Basal Ganglia, a group of brain regions important for motion, as well as emotion and cognition.  So, when Substantia Nigra cells die, the entire Basal Ganglia network slows down, causing Parkinson’s.  Mirapex acts by increasing sensitivity of Basal Ganglia cells to dopamine, thus counteracting the effects of the Substantia Nigra cell death.  So why does Mirapex lead to addiction?  Well, dopamine is also the primary agent of the reward pathway.  I like to think of the reward pathway as that which produces the gratification of having worked a hard day’s work.  Drugs like cocaine hijack the reward pathway, making it feel like you’ve accomplished something when you haven’t.  Gambling and other addictions have a similar affect.  Well, it appears that Mirapex increases dopamine sensitivity not only in the basal ganglia, but also in the reward pathway.  So, after starting Mirapex, the symptoms of Parksinson’s will lessen.  But winning at slots might change from mild amusement to an irresistible thrill.  Thus, until better, more specifically-acting drugs are produced, Parkinsonian patients may have to choose between poor motor control and poor life choices.  But at least they have the choice!

Or do they?  If our discussion today reveals anything, it’s that our concept of the “self” may be illusory.  The administration of a simple dopamine supplement is enough to change our mood, our habits, and even our sexuality.  Drugs can turn an introvert into an extrovert (Prozac) (3), produce empathy (MDMA), or even reproduce the symptoms of schizophrenia (PCP) (4).  Even to a non-drug-user it’s clear that our personalities are simply a product of whatever neurotransmitters and synaptic connections currently exist in our brain.  Yet somehow we still maintain the notion of personal responsibility–not just in our justice system, but in our moral code.  Maybe pure determinism isn’t all there is to it.

References and further reading:

  1. http://www.telegraph.co.uk/news/worldnews/northamerica/usa/2283068/Parkinsons-drug-gave-me-gambling-addiction-says-banker.html
  2. http://www.dailymail.co.uk/health/article-2240249/Didier-Jambart-said-Parkinsons-drug-gay-sex-addict-awarded-160k-French-court.html
  3. http://www.amazon.com/Against-Depression-Peter-D-Kramer/dp/0143036963
  4. http://www.ncbi.nlm.nih.gov/pubmed/15661633
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3 comments on “The Dice of Life

  1. Richard says:

    One possible response to the idea that the genetically disposed criminal is more culpable than the pharmacologically induced criminal is that in the latter case the normal behavior of the individual has been interrupted, or hijacked. Whereas in the former case it is in the nature of the individual to be criminal. And if we wish to say that a person’s identity is constituted by their genetic makeup then exonerating them because they are victims of some external force, i.e. their biology, no longer makes sense. It’s no use saying I would have been a better person had my genetic makeup been substantially different, because if it had been substantially different I might not have been me. On A Deeper note, some philosophers question whether moral conclusions can be legitimately drawn from scientific results. Consider reading: Berker, Selim. 2009. ‘The Normative Insignificance of Neuroscience’. Philosophy and Public Affairs 37: 293–329.

    • Ben says:

      “The normal behavior of the individual has been interrupted…”

      Josh observes that the judge’s exoneration reflects a refinement of the notion of criminal responsibility — now we deem responsible not those who did something bad but rather those who did something bad for a reason which actually engenders their guilt. The quest to define “normal” behavior that you mention, then, is nothing more than the attempt to designate, among the many factors which influence behavior and which constitute identity, certain ones as generative of guilt, or non-arbitrary.

      The catch is that our choices better be fair. When someone commits a crime for a reason which we do accept as guilt-inducing, we’re prepared to punish them.

      For example, it could be said that genetically based behavior induces guilt, while pharmacologically based behavior only interferes with genetically based behavior.

      I think the very act challenged by this article is that of designating genes as more non-arbitrary than pharmacology. Sure, an individual’s genetically induced behavior has been interrupted. But why was this genetic behavior any more constitutive of guilt, in the first place, than his pharmacological behavior would have been?

      You observe that if we destroy the capacity of even genes to determine guilt, we might have nothing left to punish. But this shouldn’t convince us to punish unjustly, just because we have nothing left to go after. The task, once again, is not to punish someone’s identity, somehow conceived, but rather to punish that and only that part of their identity which we understand to be rightly generative of guilt. If we were to conclude that even genes couldn’t create guilt, then, yes, we could be forced not to punish at all, I suppose. This seems, given the conditions of this thought experiment, the only fair option.

      This outcome wouldn’t leave us without a sense of identity. It would only leave us without a part of our identity which creates guilt, a part whose absence, truth be told, we might not entirely regret.

      • Josh says:

        Adding to this, I think that we choose to punish only those who have capacity to do right, and who have capacity to understand why what they did was wrong.

        Certain drugs, which might alter mental status or behavior, would interfere with these capacities. But having a “bad batch of genes” generally doesn’t. That’s why we punish those people who might argue that they committed the crime “only based on their genes”. Interestingly, the case has been made that individuals with XYY syndrome (two Y chromosomes, as compared to the normal one Y chromosome in males) are more prone to violence and criminality, and this has been tried as a legal defense for defendants with XYY syndrome. But to my knowledge these defenses are usually unsuccessful (at least in part, however, because the link between XYY and criminality is weak at best).

        Of course, we’re getting into questions about determinism and personal responsibility. But as we’ve mentioned in previous posts, personal agency, if not a “fundamentally true” concept, is at least a “functional” concept, which we experience every day. Thus this concept is taken to be valid in the legal system.

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