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Showing posts from December, 2011

Ethics and Memory-Altering Drugs

In the last several years new research has come out that may indicate that our memories are not set in stone and may perhaps be erasable. In the article Give memory-altering drugs a chance, author Adam Kolber presents many ethical challenges facing research of memory altering drugs. Kolber writes that society is alarmed by the prospect of altering memories fearing a person’s sense of identity may be lost as well as the ability to lead a true and honorable life. However, this fear and excessive debate over the ethics of memory alteration is, at this point, extreme and could delay key research in therapies for people who are debilitated by their memories. I believe that the current research on memory modification is worth pursing and with proper regulations, like any intense therapy, can meet most ethical challenges. Current research has shown that beta blockers, used to control hypertension like propranolol, can reduce the emotional association to a memory when taken after a distressin...

The Benefits of Memory-Altering Drugs

Pharmaceutical drugs that dampen memories and/or dissociate memories from physiological reactions have the potential to provide powerful benefits for society. There are widespread wars, natural disasters, and other traumatic events that cause people to suffer from their memories of these events, the most extreme manifestation being PTSD. Post-traumatic stress disorder has been notoriously difficult to treat with therapy alone and the addition of pharmaceutical drugs to the treatment regimen may speed the healing process and make it more complete. Propanolol, for example, has been shown to reduce physiological responses during mental imagery of a traumatic event (Brunet et al. 2007). In PTSD, strong physiological responses tag memories as important and increase the frequency with which the brain recalls the traumatic memory, thereby driving a positive feedback loop, which is difficult to disrupt. A drug like propanolol that decreases physiological responses associated with a trauma...

Memory-Altering Drugs, Do We Really Have the Right?

The debate surrounding the use of memory-altering drugs is an important one – mainly because the social implications and the ethical questions raised are huge and varied, and also because there’s a compelling argument to be made for both sides. The case for the use of such technology – specifically, memory dampening drugs for the treatment of victims of trauma – is fairly straightforward. A number of individuals who have suffered a traumatic experience go on to develop post-traumatic stress disorder (PTSD), and have to deal with a host of long-term psychological and physiological symptoms that severely affect their day-to-day life. Many of them believe that making that traumatic memory disappear would provide them with much-needed relief, allowing them to live happier lives. If this is truly the case then surely, every effort should be made to restore to these people the quality of life they deserve, unfettered by any emotional scarring caused by a traumatic incident. But of course, w...

Give Mind-Altering Drugs a Chance

Recent studies in posttraumatic stress disorder (PTSD) research have identified several pharmacological treatments that promise to lessen the emotional pain associated with memories of traumatic events. These recent advances have sparked early debates surrounding the ethics of pharmaceutically “dampening” memories, fears of unwanted memory manipulations, and misconceptions of full-blown memory erasing in the future. In a recent Nature article, Adam Kobler, a Professor of Law at Brooklyn Law School, and the editor of the Neuroethics and Law Blog, argues that these fears surrounding pharmaceutical memory manipulation are “overblown” and instead hinder important research that is needed to help individuals cope with and recover from emotionally distressing memories 1 . Several drugs are undergoing research for their potential applications in PTSD, such as Propranolol, which is a non-selective beta-adrenergic blocker used to treat hypertension 3 . Preliminary research has shown that when ta...

Ethics of Memory-Altering Drugs

Disturbances in memory represent some of the most frightening aspects of several psychiatric and neurological diseases. It gets right to our sense of self as in many ways our memories shape our view of the world and are critical for our ability to function normally in it. We are often surprised, though, to find just how fallible our memories can be, especially for highly stimulating or traumatic events. Kubie took a particularly cynical view of the matter in a 1959 comment suggesting that humans have trouble telling the truth even when they try. [i] There is little doubt that our memories are inherently subjective and are affected by myriad factors. Why, then, are so many worried about the potential implications of memory altering drugs? Is it because we recognize how susceptible our memories are to producing errors and do not want to push it further from reality, or, is it rather that we hold our memories as real records of truth and thus something that should not be manipul...

Fourth Installment: First Year Neuroscience Students at Emory Write about the Ethics of Memory-Altering Drugs

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This year, Emory's First Year Neuroscience Graduate Students were asked to write a blog post for the Neuroethics portion of their Neuroscience and Communications Course. These posts are delivered in 4 weekly installments, each week featuring a commentary on a different neuroethics piece. This is final installment! This week, we feature blogs covering the following article: Neuroethics: Give memory-altering drugs a chance Nature 476, 275–276 (2011) Want to cite this post? Rommelfanger, K. (2011). Fourth Installment: First Year Neuroscience Students at Emory Write about the Ethics of Memory-Altering Drugs. The Neuroethics Blog. Retrieved on , from http://www.theneuroethicsblog.com/2011/12/fourth-installment-first-year.html

Sham Surgery: All Options Should be on the Table

The issue of whether or not a sham brain surgery is necessary for the research of Parkinson’s disease is complicated. Following several decades, different treatments for Parkinson’s disease have been developed, such as cell implantation, fetal nerve-cell transplantation or gene therapy. There was some common point that the radical or significant effect on the improvements of motor disability or balance control was found during the phase I trial; however, during the phase II trial, the treatment effect did not precede that in the sham-surgery control group. In an ethical point of view, is it ethical to easily and immaturely shift studies failed in the phase II trial without regard to the potential values to patients? Besides, due to the shortage of funding resource, fewer and fewer research groups could afford the expensive sham-surgery which is also too risky to find enough subjects of the control group to compare with the experimental group. Therefore, increasing numbers of scientists...

In Support of Sham Surgery

A control group seems to be an undisputed cornerstone to a strong study. So what happens when people say the control group is muddling the conclusions? This is the opinion dividing researchers who develop surgical treatments for Parkinson’s disease. In the last decade, several interventions that appeared promising in Phase I trials failed to have a significant impact in Phase II (sham-controlled) trials and subsequently were abandoned [1,2,3,4]. Many patients who benefited from the early trials say that the sham controls are obscuring the efficacy of the much-needed treatments. Meanwhile, proponents of the sham controls claim that the controls are necessary to demonstrate the efficacy of a treatment, especially in light of the robust placebo effect in the Parkinson’s population. Katsnelson’s article “Why Fake It?: How ‘Sham’ Brain Surgery Could Be Killing Off Valuable Therapies for Parkinson’s Disease,” presents an interesting discussion of this issue [5]. The ethical concerns of the t...

Questioning Controls in Sham Surgery

The article Why Fake It? How ‘Sham’ brain surgery could be killing off valuable therapies for Parkinson’s disease brought up differing viewpoints on sham surgery. Proponents of sham surgery claim that they are critical about discovering whether new treatments actually work or if the positive outcomes are based solely on placebo. While opponents of sham surgery argue that the sham surgeries are unnecessary and detrimental to advancing therapies. From a researchers perspective a well-designed study includes several components, the most important being controls. Some people believe that controls should undergo the same treatment regimen the individuals actually receiving the therapy undergo except for the actual treatment because this is the best way to compare to see whether the treatment itself was useful. Others believe that controls should be individuals at a similar disease state who do not receive the treatment. The need for controls in a good research design is important and I bel...

In Defense of Sham Treatment

There is an ethical dilemma in neurosurgical trials regarding the use of sham surgeries as placebo controls. There have been countless instances of treatments that showed promise during preliminary trials, but failed to move past phase II clinical trials when the treatments proved ineffective compared to sham controls (Freed et al., 2001 & Olanow et al., 2003). The article “Why Fake It? How ‘Sham’ brain surgery could be killing off valuable therapies for Parkinson’s disease” discusses the issues regarding using shams in neurosurgical studies particularly in Parkinson’s disease. There is one group that encourages the use of shams as the only true way to statistically prove that a treatment is effective. Without proper double blind, control studies, how can you move a drug past clinical trials and not be worried it won’t actually help anyone? The other group discourages the use of shams arguing that they are expensive, yield abundant false negatives, and can potentially cause detrime...

The Ethics of Sham Surgery: Thoughts from a graduate student of neuroscience

I am on my way to become a scientist. In this phase of my life I am finding out how to, as one of our ethics professors puts it, “tease apart the fabric of the universe!” It is an interesting journey! The pursuit of science has taught us much through the millennia: how to build great monuments to the sky, how to heal our sick, what lies beyond the stars, what lies within our minds, etc. Scientists before me have expanded the scope of that which is accomplishable today. More so, they have shifted the views of our selves, of each other, and of the space in which we live. With such an impactful pursuit, it is incumbent upon any who would practice science to perpetually consider the effects of each contribution. Likewise, the public must be mindful of their role in guiding the arm of research—through public opinion, financial support, and the law—and develop thoughtful stances on the topics of the day. Let’s consider this topic: sham human neurosurgery in the study of treatments for Parkin...

Third Installment: First Year Neuroscience Students at Emory Write about the Neuroethics of Sham Surgeries

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This year, Emory's First Year Neuroscience Graduate Students were asked to write a blog post for the Neuroethics portion of their Neuroscience and Communications Course. These posts will be delivered in 4 weekly installments, each week featuring a commentary on a different neuroethics piece. This is the third of four installments. This week, we feature blogs covering the following article: Experimental therapies for Parkinson's disease: Why fake it Nature 476, 142-144 (2011) http://www.frontiersin.org/integrative_neuroscience/10.3389/fnint.2011.00069/full Want to cite this post? Rommelfanger, K. (2011). Third Installment: First Year Neuroscience Students at Emory Write about the Neuroethics of Sham Surgeries. The Neuroethics Blog. Retrieved on , from http://www.theneuroethicsblog.com/2011/12/third-installment-first-year.html

Conflicts with Pinker's Assumptions

Congratulations, citizen of the world! You’ll be pleased to know the world you live in has become remarkably less violent in the past 50-100 years AND on top of all that, it’s all thanks to YOU! You, and absolutely every other fellow human being currently living, are amazingly intelligent, exceedingly compassionate, and astonishingly advanced in your use of logic and reasoning. As a result of these impressive improvements beyond the traits of previous generations you’re responsible for making the world a safer, less violent place. Sound too good to be true? I think it’s a bit audacious myself, but according to a recent article and book by author Steven Pinker this is exactly what has been happening over the course of the past century. Pinker argues that contrary to popular notions, incidences of violence world-wide have been shockingly low compared to other periods in world history, and that this decline stems directly from our capacity for reason. As Pinker states, “the most important...

Pinker's Wishful Thinking

Steven Pinker’s particular brand of wishful thinking reeks of pandering at best, ivory tower blindness at worst. In citing a few convenient “statistics” (evoking the term liberally), sprinkled with a few self-serving platitudes, Pinker deftly paints a caricature of reality and history that converges to his thesis. To say that Pinker isn’t an entertaining artist would be disingenuous. It simply makes sense: reasonable people would be much more interested in working together for the common good. Intelligent beings seek to further their intelligence, an effort that necessitates a peaceful landscape and rocking chair. A rise in educated citizenry should necessarily see a corresponding rise in peace metrics. However, the bits of evidence brought forth to support his argument, come severely under-armed. It’s almost difficult to directly address the points made in “Taming the devil within us” due to the nature of most of his arguments: appeals to narcissism. His self-congratulatory reasoning ...