Portfolio Health


Brain imaging IN BRIEF


Healthcare Improvement Scotland appointment The new chair to Healthcare Improvement Scotland has been named as Dr Denise Coia. Currently Principal Medical Adviser (Mental Health) within the Scottish Government, Dr Coia was previously Vice President of the Royal College of Psychiatrists in London and Chair of the College in Scotland.


Healthcare Improvement Scotland is a new organisation which will begin operating on 1 April 2011. As chair, Dr Coia will lead the transition arrangements for the establishment of HIS, which will take on the functions of NHS Quality Improvement Scotland and the regulation of Independent Healthcare function which is currently undertaken by the Care Commission.


It will have around 250 staff and an initial budget of around £19m.


Alcohol amendments


Scottish Labour has tabled a series of amendments to the Scottish Government’s alcohol bill, including proposing a legal limit on the level of caffeine in alcohol drinks.


Labour has also called for pilots for alcohol Treatment and Testing Orders and an end to price- based advertising of alcohol.


Labour MSP Richard Simpson has also tabled an amendment to remove the section from the bill that would allow police and communities to ask councils to introduce a ban on sales to under-21 year olds in problem areas.


Fairer lottery funding call


Public Health and Sports minister Shona Robison has called for the return of £114m of lottery funding diverted from Scottish good causes to fund the London 2012 Olympics. During talks with UK ministers, Robison stressed the need for equality of treatment for the Glasgow Commonwealth Games in 2014 when compared to the Manchester Games in 2002.


Autism strategy consultation A consultation on plans for a Scottish autism strategy has been launched by Public Health minister Shona Robison, who said: “Our long-term vision needs a major shift in society’s attitudes towards autism. This will only be achieved through partnership working between central and local government and the independent sector. I look forward to hearing Scotland’s views on the strategy and working together to improve services for people living with autism and their carers.”


42 Holyrood 20 September 2010 Inside out


Katie Mackintosh Health Correspondent


The unchecked use of brain imaging out with medicine is causing concern


Brain imaging may only have been around


for a few decades but it is a rapidly changing field that has a huge impact on the diagnosis, practice and treatment of neurological disorders, says Professor Joanna Wardlaw, Professor of Applied Neuroimaging at the University of Edinburgh. However, while this powerful new tool has “revolutionised” the practices of medicine and psychology, she warns that if close attention isn’t paid to its use out with these fields its successes could be tainted. Brain scanners are now so advanced they can


be used to determine people’s likes, dislikes, anxieties or fears. And as the technology becomes increasingly sophisticated, imagers have noticed an “explosion of interest” outside medicine – fuelled by some hyperbolic media reporting. She continues: “You open a newspaper and


almost every week there would be something about lie detection tests, or spotting terrorists at airports using scanning, or employers using scanning to tell whether somebody was lying about their past, or pain thresholds, or educational abilities – all sorts of things like that.” Wardlaw is part of a group called ‘Edinburgh


Neuroscience’, which has become increasingly concerned about some of these “wild claims” and how wide-reaching misuse has become. Te group is a diverse mix of imagers, lawyers and other interested individuals, she says, who each brings a different perspective to the issue. “I see this from the perspective of medical


imaging where I have heard about one or two cases in court where someone’s brain scan was being used as evidence to lock them up, or worse still, in America, to enact the death penalty. Or where the scan was being used as a way of saying this person couldn’t help what they are doing because their scan shows they have this particular pattern, therefore, you should let them off. And I don’t know if either of those is appropriate.


“…Lawyers come at this from a perspective


of thinking that these are well tried and tested technologies and therefore, it must be ok to use them as a form of evidence in court. “…While people from the Church of


Scotland are also very concerned. Tey are interested in technology in society generally, but they have become increasingly concerned about things like imaging and neuroscience because there was this increasing awareness that if you could see what you were thinking in a brain scan, or you could see the characteristics of the person, you were seeing the soul of the individual. What did that mean about individual self and where does God come in to all of this? What is this saying about where our society is going? “So it has turned out to be a really interesting


issue that actually touches on just about everything.” Neuroscience is “particularly tempting” for


lawyers, admits Burkhard Schafer, Professor of Computational Legal Teory at the University of Edinburgh, who fears the desire to know what is going on in other people’s mind might prove too appealing for some to resist. He explains: “We all know that the most


difficult thing to prove is intent. It is one thing to agree about what happened in the physical world – did you have the knife, did you have sexual intercourse? It is totally different to know what you thought at the time. Was is self-defence or was it an attack? Did he lie in his statement? Was it consensual or not consensual? All these things that go on in the mind, which of course are of extreme importance for the legal evaluation of the incident and are traditionally, historically, the big stumbling block. Ten the scientists come and say we can take the biggest issue you face in your day to day work away from you, so obviously there is temptation.” While he says the UK common law


system tends to be “pretty robust” in terms of these high-level conceptual debates, these discussions are more advanced in the US. While the American courts have proved reluctant thus far their line is weakening, he says. And the worry for the UK is that these developing American companies will try to move into the UK market. “I think that is likely to happen, and how


will the UK courts react,” he muses. “Will they be as sophisticated as some of the American courts were? Will careful attention be paid to the issue or will there be a premature acceptance of the technology? My worry is


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