Wednesday, December 28, 2011

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, we don’t know that it IS true yet, which is where the problems arise. 
 
There are questions of biology; the biggest being that we don’t completely understand the neurobiology of a memory. Scientists working on drugs like propanolol, are careful to specify that they serve only to dampen memories, not to erase them entirely. The theory is that these beta-blockers target memories with high emotional arousal, disrupt the consolidation process of the memory, and somehow dissociate the negative emotional response from it[i]. In other words, we have another new drug (or a repackaged old one) that uses an extensive package insert to inform us that the “precise mechanism of action remains unknown.” True, that’s a risk we run with almost any drug, but is it one worth taking in this case? What if you end up losing not only the negative but also the positive memories? Also, assuming a specific targeting and elimination of the emotion associated with a memory is someday possible, the biological and biochemical substrates and consequences of a traumatic incident could still remain, and probably have equally significant effects.

Then, there are questions of self-identity. Bioethicists argue that “giving people too much power to alter their life stories could ultimately weaken their sense of identity and make their lives less genuine.[ii]” The counter argument to this, presented by Adam Kolber in his somewhat biased article is that the emotional baggage of a traumatic incident can sometimes dominate an individual’s life, thereby making them and their actions less true to themselves. The premise here is that our memories and experiences are what define us as individuals, like Oscar Wilde’s idea of a “diary that we all carry about with us.” It’s true that every experience shapes our life, but it is also true that we constantly go through a process of modification, enhancing and dampening of our own memories, a Darwinian natural selection of memories for our optimal functioning. Does this process diminish our self-identity, or does the choice we make to retain or forget further define our self-identity?

A number of psychologists argue that the counseling and therapy used to turn negative experiences into positive ones is more rewarding and healing than any pharmaceutical interventions, and that learning from these experiences can be a positive thing. They also believe that a crucial aspect of the healing process is to acknowledge the traumatic incident and work through the negative emotions, as opposed to blocking them out altogether; but while we’ve all heard that what does not kill us makes us stronger, it is important to note that some people are just more equipped to handle a traumatic incident than others. So while these people may not need a stronger intervention than counseling to deal with their problems, others may. And if an alternative of “therapeutic forgetting[iii]” exists, it should probably be made available to anyone who chooses it. After all, don’t we have a right to pursue the highest possible level of happiness and comfort?

With which, I can segue into the panoply of questions of social implications and responsibility: Do we really have that right? When our personal comfort conflicts with the benefit of society as a whole, are we morally obligated to take one for the team? If you choose to erase the memory of a traumatic incident where you were a victim, this could prevent you from providing important information that could apprehend the criminal. Alternatively, should you choose to reduce the emotional effect of a traumatic incident, and are required to testify in court against the perpetrator, ethicists argue that the emotional blunting could affect your judgment of their actions as right or wrong. So, are your memories always entirely your own to do away with, even when they have socially valuable information?

Finally there are a host of legal implications including the potential overuse, over-prescription, and misuse of such powerful drugs. The most obvious threat is the use of these agents by terrorists and offenders, either to escape punishment or to obtain exculpation. There is also the crucial question of assessing the degree of a trauma and determining whether or not it merits the use of such a therapy. One of the main issues with propanolol treatment is that it is most effective within 6 hours of the trauma[iv], and victims of trauma may not be able to make an objective decision regarding whether or not they would like to retain the memory so soon after the incident.

As Kolber rightly points out, it is important to encourage adequate research into the efficacy of both pharmaceutical and non-pharmaceutical therapeutics to ensure that this treatment option could be available. At the same time, we must ensure that the use of such drugs is highly regulated. If not, we may be headed for that highly hedonistic, yet dystopic future described in so many sci-fi stories, and we all know how those end...

--Nisha Raj
Neuroscience Graduate Program


Want to cite this post?
Raj, N. (2011). Memory-Altering Drugs, Do We Really Have the Right? The Neuroethics Blog. Retrieved on , fromhttp://www.theneuroethicsblog.com/2011/12/memory-altering-drugs-do-we-really-have.html


Sources
[i] Vaiva G, Ducrocq F, Jezequel K, Averland B, Lestavel P, Brunet A, Marmar CR (2003). Immediate treatment with propranolol decreases posttraumatic stress disorder two months after trauma. Biological Psychiatry, 54(9):947-9
[ii] Kolber A. (2011) Neuroethics: Give memory-altering drugs a chance. Nature, 476(7360), 275-276.
[iii] Adam J. Kolber (2006). Therapeutic Forgetting: The Legal and Ethical Implications of Memory Dampening. Vanderbilt Law Review 59 (5),1561-1626
[iv] Elise Donovan. (2010). Propranolol use in the prevention and treatment of posttraumatic stress disorder in military veterans: Forgetting therapy revisited. Perspectives in Biology and Medicine 53(1), 61-74

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