Alyssa Reads Memory Blunting: Ethical Analysis- suffering and authenticity

I read "Memory Blunting: Ethical Analysis" by the President's Council on Bioethics, excerpted from Beyond Therapy: Biotechnology and the Pursuit of Happiness (2003) and appearing in Neuroethics: An Introduction with Readings, edited by Martha J. Farah. I did so because I am taking a neuroethics class and we're supposed to show that we're thinking about neuroethics stuff at least a bit outside class. Also because I'm super-interested in how neuro-stuff (especially neurodivergence but really all things neuro-) is represented in fiction (especially young adult speculative fiction.) I'm pretty much chucking my notes (drawn parallels, expressions of annoyance, and the occasional "OK that's legitimate") on my blog because as important as a lab notebook is, I like notes that are typed and searchable. I started with some connections to Allegiant, then some thoughts on collective effects of blunting trauma, and then cognitive liberty. Now here's suffering and authenticity.

The concerns about what we might do to others minds if it were an issue of what person X does/chooses for person X, not what we are choosing for others. The concern seems to be about changing someone's true self, so suffering and authenticity come in again, just like cognitive liberty. These two seem frequently connected to me. If we recognize that people get to define their own "true selves", we don't get to moralize over which experiences are real and true anymore, which kind of kills the "not their true self" argument. Which is an argument I'm really not a fan of, especially considering which experiences it tends to be applied to.

This quote ... gives me the noble suffering/virtuous suffering sort of feeling, where whatever positive you might (not will, might) drag from the hell you go through means you shouldn't try to avoid that hell or save others from going through it.

Or will he succeed, over time, in 'redeeming' those painful memories by actively integrating them into the narrative of his life. By 'rewriting' memories pharmacologically, we might succeed in easing real suffering at the risk of falsifying our perceptions of the world and undermining our true identity. (90)

The version of a person that went through more bad things isn't automatically more real. The version of a person that's suicidal from trauma isn't automatically more real than the version of a person that takes medication to not be suicidal. Our choices define us, not just what we've been through, and using chemicals to get the parts of our histories we never chose to back the heck off? That's not less real. Suffering isn't the only way to be real. Enough of the noble suffering narrative. Enough.

Now to bring back a quote that I also talked about with cognitive autonomy:

And yet, there may be a great cost to acting compassionately for those who suffer bad memories, if we do so by compromising the truthfulness of how they remember. We risk having them live falsely in order to cope, surviving by whatever means possible. (92)

  (Survival is resistance etc)

And the concerns about what happens if we take out everything difficult? Those take a huge slippery slope argument, and not the kind where we've seen from experience that most people stop early or don't stop at all (destructive obedience is one of those.) Trauma is not the same thing as everything difficult in a person's life. Having to spend a lot of time and effort on reading and writing in order to become a good writer is not the same as witnessing a murder or being mugged or being a victim of abuse. One of these things is a choice: we're not under any obligation to become good writers. The other's aren't choices. They're things that happen to us. How we deal with the results is at least partially a choice. (Not entirely. Especially when, due to technological or social constraints, dulling the pain while working through it isn't an option.) There is plenty of opportunity for hard work and achievement without forcing others to keep horrors in their heads for the sake of ill-defined authenticity.

Alyssa Reads Memory Blunting: Ethical Analysis- cognitive liberty

 I read "Memory Blunting: Ethical Analysis" by the President's Council on Bioethics, excerpted from Beyond Therapy: Biotechnology and the Pursuit of Happiness (2003) and appearing in Neuroethics: An Introduction with Readings, edited by Martha J. Farah. I did so because I am taking a neuroethics class and we're supposed to show that we're thinking about neuroethics stuff at least a bit outside class. Also because I'm super-interested in how neuro-stuff (especially neurodivergence but really all things neuro-) is represented in fiction (especially young adult speculative fiction.) I'm pretty much chucking my notes (drawn parallels, expressions of annoyance, and the occasional "OK that's legitimate") on my blog because as important as a lab notebook is, I like notes that are typed and searchable. I started with some connections to Allegiant, then some thoughts on collective effects of blunting trauma. Now here's cognitive liberty.

The concerns about what we might do to others minds if it were an issue of what person X does/chooses for person X, not what we are choosing for others. Cognitive liberty. We don't seem to have a coherent definition of the self, and autonomy is complicated, but there is definitely a thing where a person either is or is not making the decisions about interventions taken (or not taken) on their own minds. Also on how folks define their own "true selves." What about who you are is important to you? Not what's important to me about who you are. Of course, that would stop us from moralizing over what experiences other people have are real and true vs. somehow fake. Changing one's own cognition by one's own choice isn't as acceptable as I think it should be. 

And yet, there may be a great cost to acting compassionately for those who suffer bad memories, if we do so by compromising the truthfulness of how they remember. We risk having them live falsely in order to cope, surviving by whatever means possible. (92)

Again, we do to them. Not, we offer them the option. Do we think we know better than them what's right for them? That way lies all sorts of abuse "for their own good." And ... do we really think everyone would choose to dull the pain of a memory or to forget it (remember also that those two things are not the same.) Because I don't think that. I think lots of people would, but not everyone. Despite (because of?) my arguments about cognitive autonomy leaning towards letting people choose to blunt the trauma,  I want the right to remember in my relatively unchanged way. It's just that the arguments run towards why everyone needs to be doing it that way, and I don't believe everyone needs to be remembering that way. I think enough people would choose to remember that we'd get whatever collective benefits the memory would provide, even if we let people choose to dull their pain. Not that I think the supposed benefits are nearly as strong as seems to be argued. Intentional ignorance is already a thing.

Alyssa Reads Memory Blunting: Ethical Analysis- collective effects

I read "Memory Blunting: Ethical Analysis" by the President's Council on Bioethics, excerpted from Beyond Therapy: Biotechnology and the Pursuit of Happiness (2003) and appearing in Neuroethics: An Introduction with Readings, edited by Martha J. Farah. I did so because I am taking a neuroethics class and we're supposed to show that we're thinking about neuroethics stuff at least a bit outside class. Also because I'm super-interested in how neuro-stuff (especially neurodivergence but really all things neuro-) is represented in fiction (especially young adult speculative fiction.) I'm pretty much chucking my notes (drawn parallels, expressions of annoyance, and the occasional "OK that's legitimate") on my blog because as important as a lab notebook is, I like notes that are typed and searchable. I started with some connections to Allegiant. Now here's thoughts about the collective effects of forgetting, as worried about by the authors (and as I tend to think we deal with even without dulling memories pharmacologically.)

I have a concern about this supposed legal argument against using beta blockers or similar medications to reduce the emotional impact or trauma from publicly important events. (The given example was a terrorist attack. I can ... kind of tell this was written not too long after 9/11.)  The idea is that it's important to have some witnesses remember the event accurately. There's a problem: I remember from my introductory neurobiology class that when a memory is super emotional, we feel quite certain of our recollection ... but that we can still be completely wrong in our memory of what happened. Ask people where they were on 9/11, or when the space shuttle exploded, and some will tell you they were listening to or watching other events that didn't happen on those days. Sometimes didn't even happen that time of year. But we are confidently wrong! So as useful as accurate recollection would be for legal purposes, maintaining the traumatic impact on the witnesses doesn't make accurate recall happen anyways. Also, eyewitness testimony is notoriously unreliable to begin with. This is a bad argument because the thing we're claiming to want to preserve already doesn't exist.

On that note, I wish the authors had said something more about the social and personal effects of blunting our collective traumas. I'm not entirely convinced that leg of the argument is going to hold either. After all, I'm a Jewish (and Queer, and Disabled) descendant of Holocaust survivors, and I know how we're never supposed to forget. I'd be a lot more inclined to buy into the value of collectively remembering and the consequences of forgetting if we'd stopped having genocide or deciding that certain religions are inherently more dangerous or lesser. But we didn't. These things all still happen. The things we're claiming to want to prevent already happen with our supposed preventative in place, and that means I don't trust the argument.

The murder witness example actually does concern me. "Yes, I was there. But it wasn't so terrible." (91). We don't want murder to be thought of as not so terrible. I know we don't want that because sometimes it is already considered not so terrible. See also: "mercy" killings of disabled people by the folks who are supposed to take care of them. It already just depends on the choice of victim, and that's terrifying. I don't want the idea of murder as not so terrible spreading any further than it has. I want it gone. I want all the murders being recognized as being as bad as they are.

I also have issues with the juxtaposition (and sometimes what seems like conflation) of giving a victim relief and medicating away (or relieving, I suppose I should use the same language for each) the guilt of perpetrators. Those are not morally equivalent. Victims and attackers or abusers are not the same. When we're talking about a mutual conflict, as in the case of war (the most talked about cause of PTSD, but far from the only one), there may not be a clear aggressor or victim. There also may be. It depends on what's going on, really (and remember how often the military is painted as the only way out for people in poverty, at the same time we remember the atrocities soldiers often commit.) Still, when we're talking about accidents and survivors of terrorist attacks, there's clear innocents. (Not "perfect victims" in the sense that they never did anything else even slightly wrong, but innocent in the sense that they didn't choose what happened to cause the trauma.)

Alyssa reads: Ethical Analysis of Neuroimaging in Alzheimers Disease

I read “Ethical Analysis of Neuroimaging in Alzheimer’s Disease.” J. Illes, A.Rosen, M. Greicius, and E. Racine. NIH Public Access manuscript, eventually in Ann N Y Acad Sci2007 February under the title "Prospects for Prediction: Ethics Analysis of Neuroimaging in Alzheimer's Disease." My page numbers come from the NIH version, when I quote stuff.

Anyone else bothered by the consistent framing where we demonstrate the significance of disability related research by citing a significant/increasing “public health burden” and the money spent on care? Anyone? (Fellow citizens, that is your money too.)

Now we're going to focus on ethical issues around imaging/detection. (Which, I note, remain ethical issues surrounding imaging/detection whether or not you talk about public health burden and money!!!)

The “Roles for current imaging capabilities” section seems to take it as a given that identifying risk factors (for this thing we really can't treat that well) in order to predict who's going to get Alzheimer’s before they get it is important. I would have expected that to be one of the ethical issues to discuss: do we identify folks who are going to develop Alzheimer’s even though there's not really a way to change this? (And that's at the 100% certainty level, which, to be clear, is not current reality. We can't predict who will/won't experience this. We can't predict what cognitive changes a person will (or won't) experience as they age with anywhere near that level of certainty.)

(Yes, I think with something that would fall under the neurodiversity paradigm. Also cognitive liberty or freedom – people being in charge of their own minds while also valuing diversity on a societal level! I'm still inclined to treat neurological things that will eventually kill you as things I would like us to know how to change or prevent, because death. And Alzheimer’s will eventually kill you. Cognitive freedom also goes with “people can choose what to do with their own minds” and “not dying of dementia” is a common preference, let us science so people can make that choice.)

Ah, yes, good, stigma is getting addressed.

• Predictive imaging may expand the pool of disease to people who are much younger, and therefore expand the pool that is stigmatized.
• Both earlier prediction and stigma have the potential to reduce quality of life, including autonomy and the privilege to drive, and other daily functions.
• There may be medical discrimination against people at risk, for example, with respect to eligibility for organ transplantation. (4)

My preference is for not stigma at all. Expanding the stigmatized pool is not doing this. Neither is reducing it. Both of those are justmoving the line of acceptable minds around. Nope. (Still don't like shoving people unwittingly or unwillingly into a stigmatized population.)

It's important to point out the quality of life issues where being in a stigmatized group, all on its own, causes problems. Because it does.

 

Organ transplant discrimination is a thing. I might not be able to get an organ (autism, people get rejected for that all the time, sometimes even when there's a family member willing to donate who isn't offering this for anyone else re: kidney or liver.) 

 

I think we need to work on the stigma in addition to working with the reality that it currently exists.

I appreciate that “Scan everyone who wants a scan” is one of the considered options. It gets the shortest discussion (probably because “do for person X what person X wants” isn't that complicated) and the issues brought up there are common to the other groups as well. (Who should have access to the results of testing is not only a question when the test was done without medical indication. It might have different answers depending on the level of medical indication for the test. I'm very much inclined towards “The person who had the test decides who even knows the test took place, and similarly who gets results.” It's hard to coerce test results out of someone if you don't know there's anything to coerce. The tricky thing is to make sure employers can't coerce the test itself.) Unequal access remains an issue, but let's not pretend it's a non-issue for any of the other options.

I'm betting the impact of results on personal liberty and similar closely resemble the impacts of other known cognitive disabilities. Just a hunch.

OH MY GOD. NO. “the greater predictive power combined with the growing number of people with AD might be the brick that breaks the back of the current health care system. (6)” NO. YOU DO NOT PUT THE BLAME FOR OUR MESSED UP SYSTEM EVENTUALLY BREAKING ON SICK OR DISABLED PEOPLE. NO. NO. NO. YOU. DO. NOT. DO. THIS. Go yell at insurance companies and congresspeople instead. NO. I hate you when you do this nonsense with autism and I hate you when you do it with AD and just generally hate it when you do this with the people who get screwed over by the current system that really, really wants everyone to be abled and to get briefly and treatably sick in ways that follow the textbook. And you know, this idea that we're a burden on some system always, always gets used to justify measures that reduce our personal liberties. When you write things like this, you are part of the stigma problem. Stop it.

(Try instead “The current health care system is designed for XYZ and not ABC. Given ABC, changes are needed.”)

The incidental findings question. Yes, protocols being decided on for these before the imaging. (Ulysses contract connection?)

“Much remains to be learned about functional anomalities.” (8). Well. Yes. We only seem to study this stuff when there's a perceived deficit. If it's worked for the person their whole life, why would we have noticed anything? [Hi, Galton the eugenicist deciding not totake issue with the lack of a minds eye because it seemed most commonin “men of science.” We're biased as heck about what unusual things we decide are problems and what unusual things we decide to study like the people who have them are objects.]

Alyssa Reads Memory Blunting: Ethical Analysis -- Divergent Thoughts

I read "Memory Blunting: Ethical Analysis" by the President's Council on Bioethics, excerpted from Beyond Therapy: Biotechnology and the Pursuit of Happiness (2003) and appearing in Neuroethics: An Introduction with Readings, edited by Martha J. Farah. I did so because I am taking a neuroethics class and we're supposed to show that we're thinking about neuroethics stuff at least a bit outside class. Also because I'm super-interested in how neuro-stuff (especially neurodivergence but really all things neuro-) is represented in fiction (especially young adult speculative fiction.) I'm pretty much chucking my notes (drawn parallels, expressions of annoyance, and the occasional "OK that's legitimate") on my blog because as important as a lab notebook is, I like notes that are typed and searchable. This part is just the connections I've drawn to Allegiant. More later.

The council starts by asking when we would want to reduce the emotional impact of an experience, and why we should/shouldn't in a given situation. Definitely good questions to consider.

These questions remind me of the ending of Allegiant. We have the protagonists wiping the memories of everyone at a government agency in what boils down to self-defense -- the agency was going to do the same to their entire city "experiment." Not that the experiment was particularly experimental, nor was it particularly based on how genetics actually works, though it was certainly eugenic as all heck. So here we get memory wipe as government control over a eugenic project and as self-defense against said government control.

We also see individual level decisions about memory elimination: Four brings a vial to the city with the plan of using it on one of his parents, who are leading opposing factions in what has become a civil war. He believes that if one of them will stop, so will the fighting as a whole (and then maybe the government won't memory wipe the entire city.) He gives his mother a choice instead of using this vial (he doesn't like memory wipes as an act of war/control/defense/greater good) and this winds up working. She agrees to leave the city.

Or Peter: He is cruel. He knows it. He wants to change. He knows people are the product of their experiences and choices to enough of an extent that he'd have a hard time doing this (and therefore just ... wouldn't) without the aid of wiping his memories. He wants to forget himself. Interestingly, he's the only individual-level memory wipe that we see go through. He forgets himself. In the epilogue, we find out that he's still not the nicest of people, but he's not the person he was before, either. He did make a (slightly) different self, and the difference matters. (Things like not stabbing rivals in the eye while they sleep are just slightly important.)

Four/Tobias, again. After Tris dies, he takes a truck and goes into the city with a vial of the memory serum. His friend Christina stops him, because "The person you became with her is worth being. If you swallow that serum, you'll never be able to find your way back to him." And with eliminating the memory entirely of who he had been and what he had done, I even think I might buy this argument. I will, however, note that this would be a complete elimination of memory. This isn't blunting the emotional impact, making a thing you can remember be less traumatic to recall. This is making the event gone, like it never was, instead of softer, so you can look at it instead of needing to bury it. 

And why do I read and understand the neuroethical arguments in dystopian science fiction?

Maybe it’s something you have to be Autistic to see, but all of their storytelling is 
     rhetoric.
Every writer is making a narrow and overly specified claim about
the nature of social pressure, taboo, deviance policing, human fulfillment, and
the methods by which a person located in a certain sociological position might resolve
     the needs inherent in their system.

When I read, this is what I examine. A writer’s inability to fully represent society
is simply a way of stating their warrants to me, and the individual scenes carry
not only emotional value, but grounds for the conclusions drawn in the depiction
of the change in the main character’s state. All of your fiction is an argument about a
     time and place. (Monje 29)

That's why.

(That's also from The Us Book, which I read and which you should read. Specifically, it's from "Reintroducing Art to the House of Rhetoric.")