By Chris Kahn
There was something wrong with the schoolteacher with the headache - doctors could see that from the start.
Although charming and intelligent, the 40-year-old man couldn't stop leering at female nurses. He had been in trouble with the law for sexual advances toward his stepdaughter, and now he was talking about raping his landlady.
University of Virginia Medical Centre neurologists Russell Swerdlow and Jeffrey Burns had never seen a case like this.
'Some people simply don't have the frontal lobe capacity to stop what they're doing' The man had an egg-sized brain tumour pressing on the right frontal lobe. When surgeons removed it, the lewd behaviour and paedophilia faded away. Exactly why, the surgeons cannot quite explain.
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"It's possible the tumour released some pre-existing urges," Burns said. "But that's a tough debate, we just don't know."
The outcome raises questions not only about how tumours alter brain function, but also how they can influence behaviour and judgment.
Daniel Tranel, a University of Iowa neurology researcher, said he had seen people with brain tumours lie, damage property, and, in rare cases, murder.
"The individual simply loses the ability to control impulses or anticipate the consequences of choices," Tranel said.
'I've seen them make people hyperactive, forgetful, apathetic' Dr Stuart Yudofsky, a psychiatrist at the Baylor College of Medicine who specialises in behavioural changes associated with brain disorders, has also seen brain tumours can bend behaviour.
"This tells us something about being human, doesn't it?" Yudofsky said. If one's actions were governed by how well the brain was working, "does it mean we have less free will than we think?".
It's a question with vast implications in the criminal justice system.
The United States Supreme Court has ruled that executing mentally retarded murderers is unconstitutionally cruel because of their diminished ability to reason and control urges.
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