Modification and optimization of human behavior is one of the law’s fundamental aims. Criminal law schemes contemplate deterrence and utilitarian rationales; the law of torts is designed to internalize externalities, compensate for damage, and otherwise incentivize efficient actions; the laws of contracts and corporations are structured to facilitate more efficient transactions, and so on. On some level, these systems resonate as good to us. Most people would probably say they help create necessary order, and improve our world (at some point, anyhow).

But what about when that modification of behavior is achieved technologically, is immediately physical, and effectively compulsory? This is the case with a method of behavioral disorder treatment called S.I.B.I.S. (“sigh-bus”). What is “SIBIS?” It sounds like something from a science-fiction novel or a badly-scripted video game. SIBIS is an acronym that stands for “Self-Injurious Behavior Inhibiting System.” Crudely, this system involves shocking a person whenever they display self-injurious behavior to stop the person from continuing with the behavior.

The technology can be better understood in the context of one of the primary behaviors it is used to treat; “head-banging.” This is far more serious than head-banging to do with heavy metal bands. People exhibiting head-banging behavior, usually children, will injure themselves by butting their head into solid objects (walls, floors, chairs, any hard surface), often so severely as to cause concussions. To treat this behavior, a SIBIS device, equipped with a “sensor module” and a “stimulus module,” can be fitted to the person’s head. Whenever the sensor of this particular device (skip to “Apparatus” section) senses a threshold impact indicating a headbutt is occurring, the sensor tells the stimulus module to produce an uncomfortable shock on the wearer. Ultimately, SIBIS is intended to permanently stop the wearer from proceeding with the self-injurious behavior.

If you are like me, this method of behavior modification probably creates a visceral and strongly negative, even disgusted reaction in you, very much unlike your reaction to the bodies of law mentioned above. Yes, psychologists and health professionals still shock people to change their behavior. They even still engage in electroconvulsive therapy (ECT), which involves inducing seizures with heavy shocks as a last-ditch effort to abate symptoms of mental illnesses.

SIBIS is likely so disturbing, because, in addition to the fact that it seems like corporal punishment, SIBIS can effectively legally be done involuntarily, and its use on an involuntary patient does not even require a judicial hearing and order to proceed as does ECT treatment. SIBIS is largely performed on children, with the consent of their parents. This is admittedly done in other areas of law (e.g. administration of depression drugs), but this is still the removal of the individual person’s ability to consent, and the impact of the technique is dire, because its consequences are a rapid, likely permanent, physiological change in the person’s behavior.

This treatment method is not sponsored by some nefarious man in a white coat wearing gloves, however. SIBIS is seemingly not as bad as it might sound at first blush. The technique is exclusively used as a last resort method to prevent extreme self-injurious behavior (concussion-inducing head-banging, eye gauging, and other types of self-mutilation) when the patient will not respond to counseling, medication, or other forms of behavioral psychology intervention. This self-injurious behavior can be life-threatening, and even the patient may acknowledge the behavior as undesirable, though many SIBIS treatment candidates are so mentally affected that they are unable to express themselves regarding their views toward treatment. Researchers have demonstrated that SIBIS treatments can be extremely effective at eliminating self-injurious behavior essentially permanently, using short treatment periods, without any observed harmful, long-term side-effects.

The use of this treatment prompts important legal questions, both specific to SIBIS and applicable to a broader legal and institutional context. When should SIBIS be applied? Should it even be continued as it is currently applied? The mechanism of action seems to be unknown, though some behavioral and biochemical models have been suggested. Perhaps resources should instead be expended to find a better and more certain way of treatment for patients exhibiting self-injurious behavior.

Further, what license does society have that allows it to dictate when deviation from its norms becomes so aberrant that the behavior merits compulsory behavioral modification? Implementing technology to modify a person’s behavior for their health seems relatively safe, but this could lead to a slippery slope of allowing behavioral modification in less defensible contexts. Additionally, with societal advancement, there will undoubtedly be further development of technologies that more precisely and effectively modify human behavior, be these a new method of electrical shock-based treatment, fine-tuned drugs, or something entirely different. The legal system might even consider discouragement or encouragement of innovation and development in such areas. Regardless, individuals and the legal system will have to sort out which of these methods are ethically allowable and in which scenarios.

 

Dan Ward

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