Friday, August 19, 2011

The Ethics of Forgetfulness Drugs

Drugs that could modify or erase memories could soon be possible. We shouldn't rush to judge them unethical, says a Nature opinion piece by Adam Kolber, of the Neuroethics & Law Blog.



The idea of a pill that could make you forget something, or that could modify the emotional charge of a past experience, does seem rather disturbing.



Yet experiments on animals have gone a long to revealing the molecular mechanisms behind the formation and maintanence of memory traces. Much of the early work focussed on dangerously toxic drugs but recently more targeted approaches have appeared.



Kolber argues that we should not shy away from research in this area or brand the whole idea unethical. Rather we should consider the costs and benefits on a case-by-case basis.

The fears about pharmaceutical memory manipulation are overblown. Thoughtful regulation may some day be appropriate but excessive hand-wringing now over the ethics of tampering with memory could stall research into preventing post-traumatic stress in millions of people. Delay could also hinder people who are already debilitated by harrowing memories from being offered the best hope yet of reclaiming their lives.
He says that

Given the close connection between memory and a sense of self, some bioethicists...worry that giving people too much power to alter their life stories could ultimately weaken their sense of identity and make their lives less genuine.



These arguments are not persuasive. Some memories, such as those of rescue workers who clean up scenes of mass destruction, may have no redeeming value. Drugs may speed up the healing process more effectively than counselling, arguably making patients more true to themselves than they would be if a traumatic experience were to dominate their lives.
This is a complex issue. I can see his point, although I'm not sure the rescue worker example is the best one. A rescue worker, at least a professional one, has chosen to do that kind of work. The experiences that are part of that job are ones they decided to have - or at least that they knew were a realistic possibility - and that may be an expression of their identity.



The argument is perhaps more convincing in the case of someone who, quite unexpectedly, suffers an out-of-the-blue trauma. In this case, the trauma has nothing to do with their lives; if it interferes with their ability to function, it might "stop them from being themselves".



Kolber ends by quoting a fascinating story from Time magazine in 2007, which I didn't catch at the time:

Take a scenario recounted by a US doctor in 2007 (ref. 9). The doctor had biopsied a suspected cancer patient and sent a tissue sample to a pathologist while the woman was still in the operating room. Thinking she was completely sedated, the pathologist announced a bleak prognosis over the intercom.



The patient, who had received only local anaesthesia, heard the news and began to shriek, “Oh my God. My kids!” An anaesthesiologist standing by quickly injected her with propofol, a sedative that causes some people to forget what happened a few minutes before they were injected.



When the woman woke up, she had no memory of hearing her prognosis.
ResearchBlogging.orgKolber A (2011). Neuroethics: Give memory-altering drugs a chance. Nature, 476 (7360), 275-6 PMID: 21850084

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