Part 2: Can I Know What’s on Your Mind?

Last week we addressed the issue of the slow pace of science, compared to the fast-paced world of military technology. Tennison and Moreno published an article in PLoS Biology delineating their concern that the production and implementation of certain new technologies may move faster than the time it takes scientists to determine the dangers and side effects as well as establish guidelines for use. We looked at computer-brain interfaces, and the potential problems with such an intimate connection to technology. Today we will briefly look at combatant enhancement. This was originally going to be a two-part series, but the issue of using magnetic resonance imaging for lie detection merits its own post.  We will look at this issue next week.

Technically a computer-brain interface could be considered a type of cognitive enhancer; however Moreno and Tennison put it in a separate category. By cognitive enhancement, they are referring to the use of pharmaceuticals to enhance mental capabilities. This is one type of technology that has already been implemented. Combatants, particularly pilots, have used regimens of uppers and sedatives for decades (so called “go” and “no-go” pills). In 2003, the military’s use of amphetamines was put in the spotlight after an accidental friendly fire in which the pilot reportedly thought he was under attack (see here for a Wired article). Oftentimes these regimens are used to help pilots stay alert for longer missions. The military is continuing to look into pharmaceutical possibilities to improve pilot alertness, stave off jet lag, improve reaction time, and manage longer missions and longer hours, as well as pharmaceuticals to deal with depression, anxiety, and post traumatic stress disorder. As Tennsion and Moreno report, they are also looking into transcranial direct current stimulation, a noninvasive procedure to target particular areas of the brain.

There are several ethical concerns with the use of cognitive enhancers in society and those concerns are the same for military personnel. However, combat situations are special circumstances, which make the ethics a little less clear. One concern that was mentioned in this article was the pressure to take enhancers to keep up so that one’s career is not jeopardized. Theoretically, people are free to refuse medications; however, this freedom is only in name if there is pressure or coercions to use cognitive enhancers. In a combat situation, if it is an issue of who can better stay alive, then the “choice” to take medications is not really a choice and may be more justified than the everyday person taking enhancers for a leg up.

Another issue is that different people react to medications differently. Using amphetamines on a continuous basis in a high-stress situation may have different affects on the body than use under less stressful situations. What is particularly troubling is how little we know about the mental effects from taking these pharmaceutical regimens. What does it do to a person to have him or her take an amphetamine to complete the mission, Ambien to sleep at night, and anti-depressants to deal with the mission?

From a more philosophical standpoint, one could ask: Are we chemically creating a different kind of soldier? Do we want our soldiers to have paranoia or confusion, a possible side effect of amphetamines, some memory loss from sleeping pills, and emotional numbness from Prozac?

(See here for a thought-provoking Time article on antidepressants for military combatants.)

Part 1: Can I Know What’s on Your Mind?

A recent article in PLoS Biology, “Neuroscience, Ethics, and National Security: The State of the Art,” has drawn some attention from various media outlets. In this article, Tennison and Moreno discuss military interests in neuroscience research and the ethical, legal, and social implications of this interaction between the military and science. They caution that “[t]he military establishment’s interest in understanding, developing, and exploiting neuroscience generates a tension in its relationship with science: the goals of national security and the goals of science may conflict.”

What they mean by this is that while some scientists may be developing techniques to better understand how the brain works or to find therapeutic solutions to health problems, the military is looking at this same technology for how it can be advantageous for defense purposes.  These dual goals might cause a conflict of interest and raise ethical concerns. Scientific research moves slowly. Even when a novel technique, technology, or drug is produced, it still undergoes testing, calibration, or FDA approval. This process can take years to refine. The military, on-the-other-hand, needs to move quickly. They are looking for solutions to problems that they are encountering now. Therefore, some technologies may be employed for military use before they have been properly tested or before certain regulations have been put into place.

Tennison and Moreno briefly address three areas where the military has funded research: Brain-computer interfaces, combatant enhancement, and lie detection. In this two-part series, we will be looking at each of these technologies, and some of the ethical issues surrounding them.

I have been reading a military science fiction series that was supposed to be for fun, not for research. However, sometimes it is the science fiction author’s imagination that foresees a world where possibilities have become actualities. Some of the characters in this book are marines with brain-computer interfaces. The setting is several hundred years into the future. The “Empire of Man” is a conglomerate of several planets, with Earth as its main hub. It has the strongest military with the latest technological innovations. One of these innovations is a brain-computer implant that the marines, the royalty, as well as key political leaders and academics have. This implant is interfaced with the user’s neurological network. Each user has a hard drive, and can access data (perform the future equivalent of a Google search) by thinking. The user can view this data by seeing images that are uploaded to his* visual cortex. He can access data, make notes to himself, communicate either through voice or text to others on his network, monitor his crew’s vital signs, and upload software (such as translation software that allows him to speak in another language). The closest analogy would be having an iPhone implanted into your brain and being able to do everything by thinking about pressing the buttons.

From the start of the series, the reader is introduced to some of the drawbacks of such powerful technology. Even though these devices have security features, one of the military officer’s implant was taken over (hacked) by an enemy. The officer then became a type of zombie that was remotely controlled by the enemy. Through this hacking, the enemy gained access to ships, weapons, information, and personnel. Mayhem ensued, and the officer had to be shot down. Throughout the series, the reader is exposed to various situations where the implants are incredibly helpful and powerful, but the vulnerability of these devices is always in the background. Eventually, a key political leader’s implant becomes hacked and unbeknownst to the other officials and the citizenry, is under the control of the enemy.

In 2012, we do not have implanted devices, but we certainly have small, portable devices that are able to access huge amounts of information at a single touch. And while remotely controlling someone may sound like the stuff of sci-fi, Tennison and Moreno’s article discusses research on augmented cognition and brain-machine-interfaces that tailor combatant’s equipment to his particular needs. Furthermore, research has already been done on remotely controlling robots through cognitive commands:

Much of the technological evolution of warfare has introduced a distance between the parties involved. From the advent of firearms to airplanes, aerial bombs to remotely operated drones, the visceral reality of combat afforded by the physical proximity to one’s enemy has steadily eroded. In 2007, researchers taught a monkey to neurologically control a walking robot on the other side of the world by means of electrochemical measurements of motor cortical activity [reference removed]. Considering this in light of the work on robotic tactile feedback, it is easy to imagine a new phase of warfare in which ground troops become obsolete.

The thought of putting robots rather than people in harm’s way is certainly appealing, but this kind of technology needs to be approached with more than just idealized scenarios. The reality is that cognitively controlled robots may have many more benefits than risks, but how far should we take the idea of cognitive control?

 

* The pronoun “he” is used for simplicity. The book has male and female military and political figures.

Cyborgs and Design Constraints

A recent article in BBC News asks the question: Can we build a “Six-Million-Dollar man”? If that reference is lost on you, the Six-Million-Dollar Man was a made-for-TV movie and television show that aired in the 1970s based on a book, Cyborg. The main character was an astronaut who was in a debilitating accident. He was equipped with bionic legs, left arm, and left eye and with these bionic features was able to save the world using his super-human abilities.  The underlying point of the reference is to ask if we can go beyond prosthetics and enhance the human body beyond its normal capabilities.

Ironically, many cyborgs in film, television, and literature are people who suffered from some sort of trauma causing their bodies to become vulnerable, or to operate as sub-standard levels. Examples include Darth Vader/Anakin Skywalker, who became a cyborg after almost dying in an epic battle; Luke Skywalker, who lost his hand in another epic battle between him and his cyborg father; Robocop, who was a cop that almost died at the hands of a gang; Ironman/Tony Stark, whose heart was irrevocably damaged when he was kidnapped; and the already mentioned Six-Million-Dollar Man. Rather than restoring their bodies to their previous level of mobility and functionality, these characters are enhanced to amazing levels. (Although Luke Skywalker’s enhanced abilities do not come from technology but from mastering the Force, an important point in Lucas’ films).

The article asks whether we are at a point where enhancement to super-human abilities is possible, and offers the example of humans being able to run at 60mph. While this may have every science fiction fan salivating, there’s this small problem of design constraints:

Bipedalism was not really designed for that kind of running. There’s considerably more efficient ways of moving at 60mph. I don’t know if there’s enough benefit to overcome the difficulties of 60mph running speed…It might be possible to attach a bionic arm with enough strength to lift a car. However, actually doing so could cripple the rest of the body. Falling over while running at 60mph could be equally damaging.

 

The human body is a work of engineering with all of its integrated parts interacting as a functioning whole. One does not need an anatomy and physiology class to understand this; just throw out your back or injure your hamstring and see how integrated your body really is. Or run in a pair of bad running shoes and see what happens to your feet, ankles, knees, hips, and back. Every movement employs a series of muscles, tendons and joints, not to mention the neural networking required to tell your body to make those movements. It is an interacting whole, and like any piece of engineering, there are design constraints.

Our culture has an obsession with enhancement. In this sense medicine is not about healing; it is about conquering. But what is it that we are conquering? The transhumanists would say that we are raising our fists at Nature by taking control of our own evolution. No longer are we going to be the products of chance and necessity; we will take it from here and will be the products of our own making.

I think if we are honest with ourselves, what we’re fighting against is our own frailty. We want to watch athletes conquer world records. We want superheroes that are stronger than all of the bad guys. We want to see man on the top of the tallest mountain or on the moon or surviving in the wilderness. We want to feel like we are not nearly as vulnerable as we really are.

Perhaps for some of us, we want solace that maybe someone has conquered the very thing that horrifies us the most about our frailty: Death. Death is confounding. Why do creatures like us die like an animal? We can create, have consciousness, are individually unique yet also relationally connected, have ideas, and contemplate our own mortality.  With every world record, every amazing feat of ingenuity, achievement, and technological advancement that pushes our design constraints, there is a background hope that we are one step closer to overcoming our ultimate enemy.

Of course, the BBC article is not talking about immortality. It is only speculating on running faster or lifting heavier objects. But the subject is so tantalizing because, “Eventually you reach the point where you can start doing things that normal people can’t do…” The point isn’t to be “normal” or to restore normal function. Normal people can get in a car wreck, can lose an arm, can go blind, and can hurt themselves doing mundane things. Normal people die.* The point is to be anything but normal. But design constraints place limits on just how far from “normal” we can go. We will never be able to out-run or “out-react” or out-smart every danger. Even if we somehow overcame one design constraint, another becomes more pronounced to the point that what may have started as an enhancement in one sense becomes a detriment in another sense.

The “Six-Million-Dollar-Man” idea is only feasible to a point. It will not save us and it will not give us the resurrected body that we ultimately desire.

 

 

*See Isaac Asimov’s Bicentennial Man for an interesting take on this concept in regards to robots with human qualities, the opposite of a cyborg, perhaps.

Who Will Do This?

There are several contributors to this blog that are medical health professionals. I am not one of them. My background is in chemistry, so my interests tend to be a little less on the gritty front-lines of the interface between society and technology and a little more research and idea-oriented. However, I never want to stray too far from my medical health professional colleagues or their stories of being on the front lines because a danger in any academic field is forgetting the “people factor.” Perhaps the recent controversy over an article published in the Journal of Medical Ethics on after-birth abortions would be a good example.  The authors laid out an argument that seemed to be fairly consistent with their particular assumptions and worldview, and they admit that this was speculative and for an academic audience. Their article is building on the work of other bioethicists such as Peter Singer.

 

But then we have to consider the “people factor.” I do not want to imply that the authors do not consider the “people factor;” they do. Where I would differ from the authors is in the limits they place on who is considered a person, as well as who is a person of relevance. Also the authors only consider certain people in a certain way. My question is, what about the medical health professional? If this scenario was a real option, would this be asking too much from a doctor or nurse? For example, it is one thing, as an academic, to say that it is ethically permissible to remove a ventilator in a particular situation; it is quite another to actually do it. After-birth abortions are neither legal (in the U.S.) nor ethically permissible, but we have to wonder about the ramifications of such a proposition. What is it to ask a doctor or nurse to “abort” a crying, living, breathing baby? This goes beyond definitions of personhood, because whatever intellectual theory on personhood one may hold, everyone has held a baby and many have held his or her own baby so there is a connection between a loved one and this other one. I do not think the authors are suggesting that the doctors or nurses should enjoy this aspect of their job. Actually, my point is that the authors do not mention the role of doctors or nurses at all other than in detecting abnormalities after birth. They discuss points about family burdens, societal burdens, and material burdens, but nothing on the burden on medical health professionals, who, I am supposing, would be the ones to carry out the after-birth abortion.

Stem Cells May Help Turn Back the Biological Clock

In biology we learn that a woman has a set number of oocytes, or eggs, within the ovaries and over her lifetime there is no way to increase this number. However, a new report in Nature indicates that this may not be the case. Scientists at Massachusetts General Hospital published a paper in Nature Medicine on their work with a potential source of ovarian stem cells that can produce oocytes. (A news brief and reference to the article can be found here.)

This group had done extensive work with mice in the past, and claimed to have found ovarian stem cells. However, their work was met with skepticism. Now they have developed more sensitive techniques for distinguishing between a normal oocyte and a stem cell. They used a type of fluorescence sorting technique:

Their method, based on a technique called fluorescence-activated cell sorting (FACS), attaches a fluorescently labelled antibody to a protein, Ddx4, that is present on the outer surface of the stem cells but not on the surface of the later-stage egg cells or oocytes. The FACS instrument lines up cells in single file and sorts them one by one, separating the labelled ones from the rest; it also gets rid of dead or damaged cells, such as oocytes, in which internal Ddx4 might become accessible to the antibody. This method is more selective than previous isolation methods, which did not get rid of such cells.

The authors followed these mouse studies with human studies. They harvested oogonial stem cells (OSCs) from the discarded ovaries of six women between the ages of 22 and 33, or at prime reproductive age. These OSCs generated what appeared to be normal oocytes within the laboratory setting. The group has not confirmed that these oocytes are capable of being fertilized and producing an embryo, but the OSC-formed oocytes seem to have the genetic markers of normal oocytes. Follow up studies indicated that OSCs exist in ovaries of women that are in their 40s.

The article reports that possible uses are for IVF procedures and increasing a woman’s reproductive lifetime:

…it could mean an unlimited supply of eggs for women who have ovarian tissue that still hosts OSCs. This group could include cancer patients who have undergone sterilizing chemotherapy, women who have gone through premature menopause, or even those experiencing normal ageing…In addition, growing eggs from OSCs in the lab would allow scientists to screen for hormones or drugs that might reinvigorate these cells to keep producing eggs in the body and slow down women’s biological clocks.

As the article notes, by increasing a woman’s reproductive lifetime by five years, this would cover most women who opt for IVF.

These findings raise several ethical considerations:

  • Because these experiments would involve the formation of an embryo, funding must be from either private sources or in collaboration with the U.K. (with a license from the U.K. Human Fertilisation and Embryology Authority).
  • While the article reports that this procedure could slow down a woman’s biological clock in the sense that she could produce more oocytes into her forties, this does not mean that the rest of her body is younger or healthier. Pregnancy is hard on the body at any age, and some women, who have had children when they are over forty, have commented on the difficulties in managing the physical demands of pregnancy as well as the subsequent physical demands of early motherhood. Some women’s bodies can handle this better than others, but that varies. The health and safety of the mother should be considered beyond just the health of her particular oocytes.
  • We do not know the developmental consequences of producing a baby in this manner. There are delicate factors involved in the developmental process, some of which are still mysterious to scientists. There is no way of knowing if a baby conceived from these types of gametes will have developmental abnormalities until it is tried. For all we know, this procedure may go the way that mammalian cloning has gone where for every “healthy” clone there have been hundreds of botched clones. In the case of Dolly, some of the clones were allowed to completely gestate, but were born with severe deformities.
  • Lastly, conspicuously omitted from this article is that this would provide a ready supply of oocytes for embryonic stem cell research. One of the issues scientists run into in trying to conduct embryonic stem cell research is the limited supply of eggs. There are several ethical issues with harvesting eggs from reproductively healthy women, none-the-least of which are commodifying women by offering them financial compensation for usage of their body, as well as under-reported substantial health risks  associated with hyperovulation (see here for Jennifer Lahl’s documentary, Eggsploitation). These findings provide a way for scientists to circumvent some ethical roadblocks, but does not remove the overall ethical dilemma of producing and destroying embryos for scientific research.

Clinical Trials or Off-label Use?

Case Western University recently reported promising results from mouse studies using bexarotene, a drug that is FDA-approved for treating cancer. Case Western’s findings were not for bexarotene’s FDA-approved use, but for alleviating Alzheimer’s disease. The group published their research in Science (by subscription only). The gist of their findings shows that bexarotene seems to target the processes which clear out beta amyloid from the brain. Researchers do not know exactly what causes Alzheimer’s disease, but they know that patients with Alzheimer’s have higher numbers of beta amyloids and of tau proteins in their brains than what are typically seen as people age (See www.alz.org for a good resource on Alzheimer’s disease). Bexarotene was given to mice with high levels of beta amyloid. Their symptoms of Alzheimer’s, which included not using tissue to build a nest, disappeared within six hours of taking the drug, and the effects lasted up to three days.

The Wall Street Journal recently reported on a drug that is typically used to treat multiple sclerosis (MS) but studies show that it could be used to treat Lou Gehrig’s disease (ALS). Both of these studies bring up ethical questions regarding how to handle a drug that has been FDA approved for one disease, but preliminary animal studies show that it might be effective in treating a different disease. Standard procedure is to put the drug through clinical trials to see if it is safe for patients with the particular disease. However, understandably anxious patients do not always want to wait on clinical trials, or enroll in the trial and risk being put in the placebo category. The result is that patients will often ask their doctors to prescribe a drug for off-label use.

The problem with off-label use of drugs is that medical professionals do not know the risk to patients with the particular disease. For example, as reported in the Wall Street Journal article, the antibiotic, minocycline seemed to slow the progression of ALS in mice. Clinical trials needed to be done, however, to determine if it was safe for ALS patients. Unfortunately, it was difficult to find people to enroll in the trials because many patients were taking minocycline off-label. As it turns out, minocycline does not work to alleviate ALS, and actually accelerated the disease. With complex diseases such as Alzheimer’s or ALS, indications in mice are only preliminary. Human beings are far more complex, and clinical trials need to be done.

Additionally, off-label use raises questions of fairness. Insurance companies do not usually cover off-label use of a drug, which means the patient will have to pay for the cost out-of-pocket.  This can be prohibitively expensive. For example, the WSJ report on the drug approved to treat MS and may relieve ALS symptoms is called Gilenya and costs around $52,365 per year. Therefore, only those who can afford the hefty price tag are able to try Gilenya off-label, while poorer patients, or those that do not have an extra $50,000 available, do not have the option of using Gilenya for off-label use.

Overall, there are several factors to consider. The Case Western results may provide hope for patients in the early stages of Alzheimer’s disease. However, the announcement says that they have seen results in mice studies, and while animal studies are very helpful in protecting human life, animal systems are still not the same as human systems. Alzheimer’s and ALS are devastating, complex diseases and both of these studies show that research is being done and perhaps progress can be made. Patients are eager because time is of the essence. However, trials should be done to make sure that the drug does not actually have adverse effects in patients with that particular disease. There are some things that could be done to speed up the clinical trial process. Also guarantees can be made to patients that if researchers find that the drug is working, then the placebo patients could be taken off of placebo and started on the trial drug.

This is a very difficult situation where emotions can foster false hopes and perhaps lead to dangerous decisions, but we should not ignore the promising results of this research. It would be great if a drug that is already on the market is found to relieve other diseases. It would be horrible if a drug that was supposed to be used for curing actually ended up killing because proper precautions were not taken.

Sex, Dignity, and the Superbowl

Several news and media sources have posted articles about the prevalence of sex trafficking during big sporting events, such as the Super bowl (see here and here for a couple of interesting articles). As a bioethics blog we would be remiss to not address this issue. Often in bioethics we address medical technology, research ethics, or healthcare. Underlying the perspectives on these topics is a commitment to human dignity.

 

Some believe the statistics for sex trafficking are exaggerated. Others believe that the statistics are inaccurate and cite that there was NOT a marked increase in commercial sex trade surrounding the Greek Olympics or the World Cup. These groups grant that South Africa was already a hub for sex trade and trafficking, but that the sporting events did not lead to an increase.

 

Part of the problem in reporting accurate statistics might be in how exactly statistics are obtained. For example, there is child trafficking, which UNECEF defines as “the recruitment, transportation, transfer, harbouring or receipt of children for the purpose of exploitation.” (http://www.unicef.org/protection/57929_58005.html).  This is certainly a violation of human dignity and is illegal. This industry preys on the weak and vulnerable, where children are coerced and manipulated. This is different from the adult commercial sex industry. This is also illegal (except in parts of Nevada), and is a violation of human dignity. However, these numbers may be difficult to obtain because not all prostitutes want to be caught. Some are making money (working for themselves); others may have been forced or coerced (working for someone else); and still others may have felt like there was no choice.  Finally, should people who “hook up” with the intent of getting some kind of payment (e.g. seats at the game) be considered part of the commercial sex industry or an arrangement between consenting adults?

 

Nancy Pearcey, in her recent book Saving Leonardo, traces the history of ideas that has lead to our cultural atmosphere today. One of those is an ambiguous view on sex where the person and the body are distinctly different, a type of dualism. It is as though the body was just an object (or machine) while the person’s emotions, goals, desires, personality, and true identity are separate from the functions of the body. This has lead to a fragmented view of sex, making it difficult to articulate what we know is wrong. For example, most people would agree that child trafficking is certainly wrong, however, our culture also promotes an “anything goes” attitude towards sex making boundaries difficult to justify even when we have an instinctive sense that some things are just wrong. All of the above examples, child trafficking, prostitution, and sexual bartering, degrade the dignity of all those involved. However, most people would agree the first one is wrong; some people argue that there is some validity in legalizing and regulating prostitution; most people think bartering for sex is a personal choice.

 

In a culture where people view themselves and treat others like animals who are just servants of their basic needs and desires, Christ offers a remarkably different example. Jesus encountered a Samaritan woman at a well who had been with many men, a loose woman for the time period. Jesus treated her with dignity and told her that he was the Messiah (John 4:7-26). When the sinful woman anointed him with oil and cleaned his feet with her hair, he forgave her sins (Luke 7:36-50). In these cases Jesus treated these women with dignity even if they and their culture do not deem them worthy of dignity. He did not objectify them or value them for the functional ability, but forgave them.

 

Sports are not evil or immoral in-and-of-themselves. Sporting events are not the problem. The problem is a deeper disregard for the inherent dignity of our fellow man, and, in many sad cases, one’s disregard for one’s own dignity and worth as being made in the image of God.

Morality in a Pill

Micheal Cook of Bioedge, an excellent source for the latest Bioethics news, reports on a New York Times column by Peter Singer and Agata Sagan. This is an interesting subject that merits some discussion. Feel free to comment on his site or our site on this.

 

The title of the New York Times op-ed is “Are We Ready for a ‘Morality Pill’?” Singer is known for his secular preference utilitarian perspective. His worldview certainly colors the answer to the question he and Sagan pose:

“Why are some people prepared to risk their lives to help a stranger when others won’t even stop to dial an emergency number?” (NYT article)

While Singer and Sagan acknowledge that “situational factors” and “moral beliefs” might influence a person’s decision to render aid, they believe that humans are likely predisposed to act morally, and this predisposition explains why there are such a variety of responses along the moral scale to a particular situation.

 

Singer and Sagan believe that as neurological research continues, it may show a biochemical difference between people who help others and people who do not. If morality can be traced to biochemical factors, then perhaps a “morality pill” is possible. Singer and Sagan envision several possibilities for deterring crime:

 

Given the many other studies linking biochemical conditions to mood and behavior, and the proliferation of drugs to modify them that have followed, the idea is not far-fetched. If so, would people choose to take it? Could criminals be given the option, as an alternative to prison, of a drug-releasing implant that would make them less likely to harm others? Might governments begin screening people to discover those most likely to commit crimes? Those who are at much greater risk of committing a crime might be offered the morality pill; if they refused, they might be required to wear a tracking device that would show where they had been at any given time, so that they would know that if they did commit a crime, they would be detected.

 

There are a number of problems here that require a much more extensive discussion than what this post allows, so I will just touch on a few of the troublesome issues:

 

First, who will define morality? While many of us would agree that rendering aid to the hurt child mentioned at the beginning of the New York Times article is moral, what if someone has competing moral factors? For example, what if a man is rushing his wife to the hospital because she is in labor, but he sees a hurt child. Both of these issues require immediate attention, but the man has a different moral priority to care for the emergency of his wife and soon-to-be-born child than to another child. A strict utilitarian ethic would say that one’s relationship does not matter; it is merely the greatest good for the greatest number of people. (Singer is known for espousing preference utilitarianism). However, not everyone adheres to strict utilitarian ethic. Different people hold to different ethical systems.  While even the most pluralistic societies have common ideas of good and bad, there are other areas where one is free to choose. The case of the man and the pregnant wife might be a case where a person should be allowed to choose their moral priority between the hurt child and the wife. This, also, brings up a secondary issue: How do we know that everyone who failed to render aid was doing something less moral or immoral as implied by the article? We are not seeing the entire context of a person’s decisions. Would these “morality pills” allow someone to weight out competing priorities?

 

Secondly, there are some questions as to exactly what we know about neurological factors. Neurological studies can show us which parts of the brain are active when a person is thinking certain kinds of thoughts. This has been done with functional MRI studies. Also, we know that certain psychological issues can be correlated to the biochemistry of the brain. For example, certain types of depression are correlated to serotonin levels. However, what is not certain is whether the biochemistry causes the factors or if the biochemistry is the result of the factors. The same can be said for the functional MRI studies. Which one is the cause and which one is the effect? One’s interpretation of neurological studies may be different based on one’s views on the immaterial mind and physical brain. To assume purely biochemical reasons for a person’s moral choices is to reduce someone to merely chemical reactions, a perspective that is otherwise known as reductionism. To say that they do not have choice other than to act on their chemistry is to assume a strong determinism. While Sagan and Singer acknowledge other factors, proposing a ‘morality pill’ assumes both reductionism and determinism.

 

Thirdly, it is one thing to give a criminal medicine to “treat” him after he has committed a crime. This is an ethical mine field in and of itself. However, it is quite another to preemptively give someone pills or tracking devices because he or she has certain features, chemical or not, that are associated with immoral behavior. This harkens back to a time in America’s history when people were considered “imbeciles” because of the structure of their forehead or criminals because of their parents’ behavior.  These actions were deemed inappropriate because they de-valued the individual and presumed no free will or personal responsibility.  Giving certain individuals a choice between taking drugs and losing their freedom is hardly a choice at all. This looks a lot more like pharmacological eugenics rather than compassion and crime prevention.

Cloned Pets

TLC aired a special called “I Cloned My Pet” that traces the journey of three former pet owners through the process of cloning their beloved pet who had died (see here and here). Watching the interviews with the pet owners, particularly Danielle, the owners sought cloning in order to bring their beloved pets back rather than deal with closure and the loss of their pet. However, my interest is less in the psychological factors and more in the technology and appropriate use of technology. I understand that there is a psychological factor here, but I think it is important to look at how technology is being used and if it is ethical.

 

Our society finds solace, comfort, and sometimes salvation in technological progress. It is the cultural air that we breathe. When having to deal with some of the most devastating things in life, we turn to technology to help us: reconstructive surgery after a severe accident, IVF for infertility, cosmetic surgery for the effects of old age, arthroscopic surgery for joints, and a myriad of other technologies that are used every day in hospitals. Thankfully, we live in a world where many of these technologies are available, and people who have had to deal with trauma or sickness can benefit from them. However, our technological capabilities also raise questions, such as distinguishing the difference between therapeutic and enhancement technologies. Now let us add that technology can help a former pet owner deal with the loss of a beloved pet by cloning.

 

Distinguishing between therapeutic and enhancement technologies is an area that many bioethicists are working on. There is most certainly a gray area here; not all of the above technologies are strictly therapeutic, however some may argue that they have psychologically therapeutic effects. However, there are similarities between certain technologies listed above. IVF and cosmetic surgery seem to be marketed differently than the other technologies. Infertility and the effects of old age are very emotional topics, and it seems that the reproductive industry and the cosmetic industry banks off of people’s fragile emotional state. That is where I see a similarity between those industries and cloning a pet. I believe all three of these industries sell happiness (or solace or security) to people.

 

The way the former pet owners talked in their interviews, it is as if they believed cloning would bring their pet back to them. And they evidently believe this strongly enough that they are willing to pay $100,000 price tag for it ($50,000 for the people on TLC per an agreement with the South Korean cloning company). Let’s examine the technology:

 

  1. Cloning is a very inefficient process, so much so that Ian Wilmut, the scientist whose team cloned Dolly the sheep, has abandoned the notion of human cloning (he moved on to ESC research). For every one successful clone, there were hundreds of botched clones. Many were botched at the embryonic or gestational stage. Some had severe abnormalities at birth. Less than 1% of clones are successful (this is a very generous estimate), so for everyone 1 successful clone 99 (or more) had to die.
  2. Cloning does not make a copy of the original. One of the pet owners was hoping that his cloned dog would recognize him. This is not possible. A clone is analogous to an identical twin that is displaced in time.* Anyone who knows identical twins knows that you end up with two completely different individuals. It is unclear to me if the cloning company is up-front about this, or if it allows people to believe whatever they want to believe, including the idea that the clone has some of the memories of the original. This is visually seen when we look at other cloned animals. The coat color does not always match the original animal because environmental factors play a role.
  3. Dolly the sheep, famous for being not only the first cloned mammal, but also the first healthy cloned mammal that could reproduce, died an early death from age-related issues. Dolly started developing problems with arthritis and other age-related issues when she was only six years old (normal life span is about eleven years old). Very little has been reported on the longevity of a cloned mammals, but the idea is that cells have a shelf life. They cannot go on replicating indefinitely. Again, it is unclear to me whether the South Korean cloning company has been able to fix this “little” problem of old DNA and shorten life-spans or not. The former pet owners were obviously very upset over the loss of their pet the first time, and rather than move on, they have opted to clone their pet. If the clone’s lifespan is expected to be much shorter than normal, comparable mammals, this sets them up for further disappointment, let alone reliving the loss of their pet. Cynically, this does set the cloning company up for repeat business

*Technically, once the DNA starts replicating, identical twins do not have identical genomes.

Finally, aside from assessing the technology, there is a stewardship issue here. I have always had pets. Growing up we had a variety of cats, dogs, birds, hamsters, lizards, and even a chinchilla. I loved all of our pets, and each one seemed to have its own little personality. I currently have an incredibly sweet cat and a rather clumsy aquatic turtle. I had adopted my current cat when she was about a year old from an animal shelter, and she truly has been one of the friendliest, most docile cats I’ve ever had.  For people that have a soft spot for caring for domesticated animals, there are a lot of animals that need homes. Here in Texas, we receive quite a few displaced animals from natural disasters. Given the inefficient and expensive cloning procedures, it seems that the best way to care for animals is not to clone them, but rather to consider caring for another animal. Animals are not people, and while I would not necessarily be so bold as to recommend adopting a child because that is a big decision for a couple to make, animals are always adopted. So, if these owners would like to have a pet, why not adopt one of the thousands of animals that are too domesticated to survive in the wild? The answer is likely that these pet owners want their old pet back. Unfortunately, no matter what the cloning company promises them, they are still adopting a completely different pet than their original.

New Year’s Resolution: Grow Younger

I wrote an article several years ago on sports and steroids. From my research, much of the steroid and hormone use by professional athletes is for anti-aging purposes than for getting bigger and stronger. They want to run like they did when they were twenty. And, importantly, they want to heal faster like they did when they were younger. One of the components often used in this regimen is human growth hormone (HGH, see here for the Mayo Clinic’s article on human growth hormone). Our bodies naturally produce HGH, but as we age, we start producing less. We see the affects of this when a child’s broken bone heals in four weeks, but the same break heals in six to eight weeks in an adult. Athletes will use HGH to recover more quickly, and to feel younger and faster. HGH has also become the anti-aging drug of choice by some celebrities and others who can afford its expensive price tag. However, it is technically not supposed to be used for cosmetic reasons.

Unfortunately, as is the case with many cosmetic and anti-aging chemicals, the side effects are not fully known. Furthermore, anti-aging is not an area of oversight by the American Board of Medical Specialists. So anti-aging doctors or medical professionals cannot become “board certified” in this area. This can pose risk to patients because there are not set guidelines and oversight.

The anti-aging industry is lucrative. It is important to not overlook botched procedures, inappropriate practices, or adverse side effects even if the result is a loss in millions of dollars for the industry. I recommend this CNN article that came out recently, because it covers many aspects of anti-aging, including a report on a woman who likely died from HGH injections. This article gives a survey on the anti-aging industry, anti-aging doctors, as well as cautions, caveats and honest assessments about what really works.

Historically, people have gone to great lengths to stave off the effects of aging. From quests for the fountain of youth, to downing hundreds of supplements, to taking growth hormones, these practices generally involve more money than science. Ironically, when it comes to anti-aging, the tried and true formula with fewest adverse side effects is: eat right, exercise regularly, get plenty of sleep, don’t get too much sun, and don’t smoke.