As science advances, emergence of
new technologies requires greater moral responsibility on the part of the
scientific community. More specifically, such technologies call for deliberate consideration
of realities that were not previously thought possible outside of a dystopian
science fiction film. Thus, philosophers are considering such ethical dilemmas
that arise in neuroscience. Memory modifying technologies have been of special
interest due to recent research that has demonstrated the malleability of
memory.
In Richard Freidman’s article A Drug to Cure Fear he identifies the
prevalence of phobias, panic attacks, and PTSD in the modern world. The
frequent cause of anxiety and trauma and stress-related disorders is the emotional
core of memory. Associations between stimuli and bad outcomes stick with us.
Previously, these associations were thought to be permanent and exposure therapy,
in which a patient is exposed to the aversive object or memory in a safe space
such that a new memory can be formed, is a common treatment. This method,
however, is only 50 % effective in those with PTSD. Current research has
suggested that memories can be erased during memory consolidation (formation) and
reconsolidation (retrieval). The author cites Kindt’s latest study in which arachnophobes
were given propranolol, a beta blocker. When exposed to a spider, they had significantly
diminished anxiety (to the extent that some participants could touch or hold
the spider) when shown again three months later. Propranolol blocks epinephrine
activity, which decreases learning. During the retrieval event, the emotional
memory could be partially erased and therefore, the fear response was less
intense. Freidman also cites fear conditioning studies with anisomycin, a drug that lessens
synthesis of proteins in the brain, which found similar results in rats. On the
other hand, anxiety and stimulants (e.g. Ritalin and Adderall) strengthens
memory formation. A recent study found a correlation between soldiers using
stimulant prescriptions and incidence of PTSD.
The author assures that biographical memory remains and that
such drugs simply dull the fear response. He argues that this treatment is a
welcome alternative to exposure therapy given its limitations. He acknowledges
that these studies are preliminary and will require testing to see how they generalize
in the real world. Friedman addresses the view that human memory should not be
tampered with to preserve history and that fear responses exist, from an
evolutionary standpoint, for a reason. Rebutting the latter claim, he maintains
that what was once adaptive (the sympathetic fight or flight response) can have
limited utility in certain situations today. With this, he supports propranolol
as a psychiatric treatment.
Joseph Vukov, Ph.D. explores the
ethical landscape of the topic discussed in Friedman’s article. I would argue
that they both reside in the same school of thought on the issue. In addition
to the findings referenced in the article, Joseph Vukov, Ph.D. further references
the effects of propranolol in Cahill’s initial study (neutral versus emotional narrative
recall), Kindt’s earlier fear conditioning studies, and Brunet’s narrative
recall studies with subjects with PTSD. Given the demonstrated effectiveness of
propranolol, ethicists and philosophers are left to ask if these interventions
should be pursued. There are three distinct perspectives on the topic: the
Alarmists, the Modifiers, and the Treatmentalists. The Alarmists believe that
memory modification is rarely if ever morally permissible in order to maintain
the true self and learn from bad memories. This view fails to acknowledge the
impact of traumatic memories (e.g. those who witness violence or have PTSD or
an anxiety disorder). Alternatively, the Modifiers believe that it is morally
permissible if one does not harm him/herself or others. Liao and Sandburg,
whose article was referenced for the seminar, are in this camp. They value
improvement of well-being and hold that the self is dynamic and readily changes
in response to the environment, so memory modification is not a danger to one’s
identity. Finally, the Treatmentalists believe that the Modifiers have too low
of a threshold on who should be using drugs like propranolol. The
Treatmentalists think these technologies should only be used as treatments to
restore someone to a normal level of functioning, not enhancement (beyond
normal functioning). The idea is that a specific bad memory will be altered, so
all other bad memories, that we may learn from, would be intact. In addition,
the true self may even be improved since the individual would be getting back
to a normal level of functioning.
With the numerous research studies,
proposed ethical perspectives, and what this may mean for the field of
psychology and psychiatry in mind, only time will tell where this technology
may lead. This topic demonstrates the important role of ethics in research,
scientific development, and mental health treatment. This fascinating topic
leaves the task of determining future research directions and what policy may
look like, while mental health professionals will need to decide when such a
treatment is appropriate. A Treatmentalist myself, I believe that memory
modifying technologies, which are being met with a high ethical standard, offer
exciting prospects for those dealing with mental illness rooted in emotional
memory.
Friedman, R. A. (2016,
January 22). A Drug to Cure Fear. The New York Times. Retrieved December
7, 2016, from
http://www.nytimes.com/2016/01/24/opinion/sunday/a-drug-to-cure-fear.html?_r=0
Liao, S. M., & Sandberg,
A. (2008, April 10). The Normativity of Memory Modification. Neuroethics,
1(2), 85-99. doi:10.1007/s12152-008-9009-5
Photo:
Jillian Tamaki
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