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Thinking outside the box coming of age, little by little
OPINION
Thinking outside the box Should the UK’s voting age be cut from 18 to 16? Let our knowledge of adolescent brains guide the debate, urges Laurence Steinberg A WAVE of interest in lowering the voting age is sweeping the UK, catalysed by Scotland’s recent independence referendum. For the first time in the country, the ballot was open to people aged 16 and 17. Other countries watched this political experiment closely and are looking afresh at their voting age limits – but politics, not evidence, is generally driving the discussion. Societies have long had a raft of legal boundaries between adolescence and adulthood, decreeing at what age we can or cannot do things such as drive, drink alcohol or vote. In most countries, 18 is the age of majority for most purposes, but there are all sorts of exceptions. The US has probably the most diverse and logically inconsistent array of limits. You can drive at 16 but not drink alcohol until 21. In between those two extremes fall the ages at which you can see a movie intended for adults, enter into a legally binding contract, or buy cigarettes. Moreover, in most US states 12-year-olds who commit a serious violent crime can be tried as adults, because they are viewed as “old enough to know better”, whereas a 25-yearold with a clean driving record might not be able to rent a car without paying an “immaturity premium”. Sentiment, be it political or public, tends to dictate these limits, with little regard for what we know about the psychological maturity of young people. Which begs the question: can the age of majority be better determined by paying heed to 30 | NewScientist | 11 October 2014
science? Advances in the study of should other boundaries be eased brain development have greatly as well? In the 1970s, for example, furthered our understanding of the US lowered the age of alcohol how, why, and in what ways consumption when the voting age intellectual capabilities change fell to 18 (although most states during the transition from later reverted the drinking age to adolescence to adulthood. Let us 21 amid drink-driving concerns). apply this to the issue at hand. Research on adolescent brain Over about 40 years – not long development does not point to an in the grand scheme of things – obvious age at which a sharp legal the voting age in Scotland has distinction between adolescents dropped from 21 to 16, although and adults should be drawn for 16 applied only in the case of the all purposes, but it is very independence referendum. From informative. People reach various the perspective of brain science, kinds of maturity between the is one of these ages a wiser choice than the other, or should the UK “Science cannot be the only consideration in drawing continue to split the difference at legal boundaries, but it 18? And if the voting age were ought to play a role” lowered to 16 across the UK,
ages of roughly 15 and 22. Adolescents’ judgement in situations that permit unhurried decision-making and consultation with others – what psychologists call “cold cognition” – is likely to be as mature as that of adults by 16. In contrast, adolescents’ judgement in situations characterised by heightened emotions, time pressure or the potential for social coercion – “hot cognition” – is unlikely to be as mature as that of adults until they are older, certainly no younger than 18 and perhaps not until they are 21. This distinction is partly related to our understanding of changes in the brain’s prefrontal cortex, which usually continue for the first 20 years of life. If science were an important consideration in establishing the age of legal adulthood, as I believe it should be, a reasonable starting point would be to distinguish between regulations for activities that involve cold cognition and those in which hot cognition is involved. Cold cognition is relevant to matters such as voting, granting informed consent for medical procedures or taking part in a scientific study, and competence to stand trial in court. In these, adolescents can gather evidence, consult advisers (such as parents, physicians or lawyers), and take time before making a decision. Time pressure and peer pressure aren’t usually factors. I see no reason why a pregnant 16-year-old, given adequate time and the opportunity to discuss the decision with an adult,
For more opinion articles, visit newscientist.com/opinion
shouldn’t be able to get an abortion or contraception without her parents’ involvement, or why we shouldn’t let 16-yearolds vote. Indeed, they can vote in Austria, Argentina, Brazil, Ecuador, and Nicaragua. I certainly wouldn’t recommend changing the age limit to 16 for all purposes, though. A later threshold is more sensible for matters that involve hot cognition, such as driving, drinking and criminal responsibility. Here the circumstances are usually those that bring out the worst in adolescents’ judgement. They frequently pit the temptation of immediate rewards against the prudent consideration of longterm costs, occur against a backdrop of high emotion, and are influenced by other adolescents. These are the very conditions under which adolescent decisionmaking is more impulsive, more risky and more myopic than that of adults. Given this, we ought to set the minimum driving age and the minimum age of adult criminal responsibility at 18, and continue to restrict minors’ access to alcohol, tobacco and, where it is legal, marijuana. Science cannot be the only consideration in drawing legal boundaries, to be sure, but it ought to play a role in these discussions. I don’t harbour any delusions about the use of scientific evidence to inform policy-making, though. If the political will is absent, no amount of science, no matter how persuasive, will change the law. Politicians and advocacy groups use science in the way that drunks use lampposts – for support, not illumination. That quip, ironically, originated from the pen of one Andrew Lang, a poet, scholar and son of Scotland. n Laurence Steinberg is professor of psychology at Temple University in Pennsylvania. His new book is Age of Opportunity: Lessons from the new science of adolescence (Eamon Dolan)
One minute interview
Fighting fake malaria meds A global health campaign is being undermined by criminal gangs and lack of vigilance, says epidemiologist Paul Newton Why are fake and poor-quality drugs a particular challenge in South-East Asia? Most countries in the area have endemic malaria and a high impact of infectious diseases. So there is high demand for anti-infectives, including for malaria. Criminal gangs exploit this demand for medicines, which are not always readily available in the more remote areas.
Profile Paul Newton is head of antimalarial quality at the WorldWide Antimalarial Resistance Network in Oxford, UK, and director of the Wellcome TrustMahosot Hospital-Oxford Tropical Medicine Research Collaboration in Laos
How big a problem are fake antimalarials? It’s big. A recent review by the WorldWide Antimalarial Resistance Network found that 30 per cent of malaria drugs tested globally failed either chemical or packaging quality tests. Of these, 39 per cent were fake. Many of the falsified pills were from southern China. Given the global burden of malaria, if even a small percentage of drugs are fake, it will translate into significant, and avoidable, increases in sickness and death. How vital is the distinction between the fake drugs and substandard ones? In essence, fake antimalarials are frauds, produced by criminals who intend to deceive health workers and patients. They contain none of the stated active ingredient. Substandard medicines, on the other hand, usually contain insufficient amounts of the active ingredient and result from negligent, but unintentional, errors in factory production. It’s an important difference as the root causes and solutions differ.
Resistance to antimalarials is growing in the region. Are fake or substandard drugs the cause? When taken on their own, fakes, which contain none of the active ingredient, will not risk resistance: there is no drug for any resistant parasites to survive attack from and then multiply. But if the antimalarial contains low amounts of active ingredient, susceptible parasites in the blood are killed but resistant ones multiply – and then are sucked up by mosquitoes to spread. The Greater Mekong area is now the epicentre for resistance to the most potent drug, artemisinin, and there are concerns this could spread to Africa, costing millions of lives. What other factors drive drug resistance? There are many: patients not taking full courses at the correct doses, availability of antimalarials over the counter and patients taking a single drug instead of a combined therapy. The World Health Organization recommends that artemisinin always be given with another antimalarial in the same tablet. The artemisinin kills most parasites in the first three days of treatment, then the partner drug eliminates the rest. How do you get fake drugs off the market? The steps that have been taken are woefully inadequate. The WHO estimated that 30 per cent of countries have effectively no drug regulation, and many of these have endemic malaria. Without functioning regulatory authorities, most interventions are doomed. To improve the quality of our medicine supply, we need much more international political will, backed by investment. Interview by Curtis Abraham
11 October 2014 | NewScientist | 31
Thinking outside the box Should the UK’s voting age be cut from 18 to 16? Let our knowledge of adolescent brains guide the debate, urges Laurence Steinberg A WAVE of interest in lowering the voting age is sweeping the UK, catalysed by Scotland’s recent independence referendum. For the first time in the country, the ballot was open to people aged 16 and 17. Other countries watched this political experiment closely and are looking afresh at their voting age limits – but politics, not evidence, is generally driving the discussion. Societies have long had a raft of legal boundaries between adolescence and adulthood, decreeing at what age we can or cannot do things such as drive, drink alcohol or vote. In most countries, 18 is the age of majority for most purposes, but there are all sorts of exceptions. The US has probably the most diverse and logically inconsistent array of limits. You can drive at 16 but not drink alcohol until 21. In between those two extremes fall the ages at which you can see a movie intended for adults, enter into a legally binding contract, or buy cigarettes. Moreover, in most US states 12-year-olds who commit a serious violent crime can be tried as adults, because they are viewed as “old enough to know better”, whereas a 25-yearold with a clean driving record might not be able to rent a car without paying an “immaturity premium”. Sentiment, be it political or public, tends to dictate these limits, with little regard for what we know about the psychological maturity of young people. Which begs the question: can the age of majority be better determined by paying heed to 30 | NewScientist | 11 October 2014
science? Advances in the study of should other boundaries be eased brain development have greatly as well? In the 1970s, for example, furthered our understanding of the US lowered the age of alcohol how, why, and in what ways consumption when the voting age intellectual capabilities change fell to 18 (although most states during the transition from later reverted the drinking age to adolescence to adulthood. Let us 21 amid drink-driving concerns). apply this to the issue at hand. Research on adolescent brain Over about 40 years – not long development does not point to an in the grand scheme of things – obvious age at which a sharp legal the voting age in Scotland has distinction between adolescents dropped from 21 to 16, although and adults should be drawn for 16 applied only in the case of the all purposes, but it is very independence referendum. From informative. People reach various the perspective of brain science, kinds of maturity between the is one of these ages a wiser choice than the other, or should the UK “Science cannot be the only consideration in drawing continue to split the difference at legal boundaries, but it 18? And if the voting age were ought to play a role” lowered to 16 across the UK,
ages of roughly 15 and 22. Adolescents’ judgement in situations that permit unhurried decision-making and consultation with others – what psychologists call “cold cognition” – is likely to be as mature as that of adults by 16. In contrast, adolescents’ judgement in situations characterised by heightened emotions, time pressure or the potential for social coercion – “hot cognition” – is unlikely to be as mature as that of adults until they are older, certainly no younger than 18 and perhaps not until they are 21. This distinction is partly related to our understanding of changes in the brain’s prefrontal cortex, which usually continue for the first 20 years of life. If science were an important consideration in establishing the age of legal adulthood, as I believe it should be, a reasonable starting point would be to distinguish between regulations for activities that involve cold cognition and those in which hot cognition is involved. Cold cognition is relevant to matters such as voting, granting informed consent for medical procedures or taking part in a scientific study, and competence to stand trial in court. In these, adolescents can gather evidence, consult advisers (such as parents, physicians or lawyers), and take time before making a decision. Time pressure and peer pressure aren’t usually factors. I see no reason why a pregnant 16-year-old, given adequate time and the opportunity to discuss the decision with an adult,
For more opinion articles, visit newscientist.com/opinion
shouldn’t be able to get an abortion or contraception without her parents’ involvement, or why we shouldn’t let 16-yearolds vote. Indeed, they can vote in Austria, Argentina, Brazil, Ecuador, and Nicaragua. I certainly wouldn’t recommend changing the age limit to 16 for all purposes, though. A later threshold is more sensible for matters that involve hot cognition, such as driving, drinking and criminal responsibility. Here the circumstances are usually those that bring out the worst in adolescents’ judgement. They frequently pit the temptation of immediate rewards against the prudent consideration of longterm costs, occur against a backdrop of high emotion, and are influenced by other adolescents. These are the very conditions under which adolescent decisionmaking is more impulsive, more risky and more myopic than that of adults. Given this, we ought to set the minimum driving age and the minimum age of adult criminal responsibility at 18, and continue to restrict minors’ access to alcohol, tobacco and, where it is legal, marijuana. Science cannot be the only consideration in drawing legal boundaries, to be sure, but it ought to play a role in these discussions. I don’t harbour any delusions about the use of scientific evidence to inform policy-making, though. If the political will is absent, no amount of science, no matter how persuasive, will change the law. Politicians and advocacy groups use science in the way that drunks use lampposts – for support, not illumination. That quip, ironically, originated from the pen of one Andrew Lang, a poet, scholar and son of Scotland. n Laurence Steinberg is professor of psychology at Temple University in Pennsylvania. His new book is Age of Opportunity: Lessons from the new science of adolescence (Eamon Dolan)
One minute interview
Fighting fake malaria meds A global health campaign is being undermined by criminal gangs and lack of vigilance, says epidemiologist Paul Newton Why are fake and poor-quality drugs a particular challenge in South-East Asia? Most countries in the area have endemic malaria and a high impact of infectious diseases. So there is high demand for anti-infectives, including for malaria. Criminal gangs exploit this demand for medicines, which are not always readily available in the more remote areas.
Profile Paul Newton is head of antimalarial quality at the WorldWide Antimalarial Resistance Network in Oxford, UK, and director of the Wellcome TrustMahosot Hospital-Oxford Tropical Medicine Research Collaboration in Laos
How big a problem are fake antimalarials? It’s big. A recent review by the WorldWide Antimalarial Resistance Network found that 30 per cent of malaria drugs tested globally failed either chemical or packaging quality tests. Of these, 39 per cent were fake. Many of the falsified pills were from southern China. Given the global burden of malaria, if even a small percentage of drugs are fake, it will translate into significant, and avoidable, increases in sickness and death. How vital is the distinction between the fake drugs and substandard ones? In essence, fake antimalarials are frauds, produced by criminals who intend to deceive health workers and patients. They contain none of the stated active ingredient. Substandard medicines, on the other hand, usually contain insufficient amounts of the active ingredient and result from negligent, but unintentional, errors in factory production. It’s an important difference as the root causes and solutions differ.
Resistance to antimalarials is growing in the region. Are fake or substandard drugs the cause? When taken on their own, fakes, which contain none of the active ingredient, will not risk resistance: there is no drug for any resistant parasites to survive attack from and then multiply. But if the antimalarial contains low amounts of active ingredient, susceptible parasites in the blood are killed but resistant ones multiply – and then are sucked up by mosquitoes to spread. The Greater Mekong area is now the epicentre for resistance to the most potent drug, artemisinin, and there are concerns this could spread to Africa, costing millions of lives. What other factors drive drug resistance? There are many: patients not taking full courses at the correct doses, availability of antimalarials over the counter and patients taking a single drug instead of a combined therapy. The World Health Organization recommends that artemisinin always be given with another antimalarial in the same tablet. The artemisinin kills most parasites in the first three days of treatment, then the partner drug eliminates the rest. How do you get fake drugs off the market? The steps that have been taken are woefully inadequate. The WHO estimated that 30 per cent of countries have effectively no drug regulation, and many of these have endemic malaria. Without functioning regulatory authorities, most interventions are doomed. To improve the quality of our medicine supply, we need much more international political will, backed by investment. Interview by Curtis Abraham
11 October 2014 | NewScientist | 31