Ronald Pawl
  1. Department of Neurosurgery, University of Illinois, Chicago (Retired), USA

Correspondence Address:
Ronald Pawl
Department of Neurosurgery, University of Illinois, Chicago (Retired), USA


Copyright: © 2013 Pawl R This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

How to cite this article: Pawl R. It is our moral obligation and the time is now. Surg Neurol Int 18-Jul-2013;4:94

How to cite this URL: Pawl R. It is our moral obligation and the time is now. Surg Neurol Int 18-Jul-2013;4:94. Available from:

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The recent outbreaks of violence in the United States that took lives by gunfire and bombings have stimulated numerous commentaries and concerns. Local and Federal officials have rushed to create new laws to limit the availability of firearms, both rifles and handguns. Such laws in the past have had limited effect on violence as attributed to in my native Chicago, which has perhaps the most restrictive such laws and still has one of the most violent, if not the most violent murder rates by handguns in the United States. Also such laws do not hinder bombers. The other major resulting concern has been with the medical community. Lay people do not understand why such troubled individuals, some of who have been under Psychiatric care, have not been recognized as potentially violent and handled accordingly. Their concerns are realistic and important, but the reality is that there are not well documented guidelines Psychiatrically regarding the diagnosis and effective treatments in such individuals. The Diagnostic and Statistical Manual of Mental Disorders, the official guide for diagnosis and treatment used by Psychiatrists, is constantly being changed. There is a clear need for a review of the problem and development of scientifically based solutions. The issue needs a broader view than Psychiatry alone.

During the past 15 years there has been a significant research surge in both basic and clinical brain science, especially in intricate and dynamic imaging of the nervous system. All these areas are highly specialized and complicated. It seems logical then that the complex issue of mental illness and potential violence is best evaluated by a multidisciplinary approach that includes the basic brain scientists, anatomists, physiologists, chemists, and now nanotechnologists, clinical experts, Neurologists and Neurosurgeons, and Psychiatrists and Forensic Psychologists. There are a number of Forensic Psychologists practicing, but the singular work of Robert Hare, PhD stands out in this matter; his publications, The Psychopathy Checklist Revised and Without Conscience are landmarks.

Funding of such an effort will be important. Initial funding could come through the scholarly societies that guide each subspecialty and when the group is established, funding could then come through the local, regional or State Law Enforcement Agencies using the service of the group. Such a group would also shed light on the mental functioning of terrorists that hound the civilized world today and might well contribute ways to deal with that massive problem.

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