A member of a lab studying the beta-blocker, Propranolol, to treat soldiers with Post Traumatic Stress Disorder (PTSD) is violently physically assaulted. The PI suggests the Propranolol treatment could be helpful and lab members reflect on the possible outcomes of such a choice.
Case Study: Memory Suppressor as Cognitive Enhancement
Anthony is a neurobiologist who works as a researcher at a government-funded lab to develop memory-altering drugs. Recently, he has been studying the beta-blocker, Propranolol, to treat soldiers with Post Traumatic Stress Disorder (PTSD). Propranolol is a promising drug to act as a prophylactic and treatment for PTSD by reducing consolidation of emotional memory (Henry et al. 2007).
Here is how this pharmacologic intervention is thought to work: Shortly after experiencing or observing traumatic events, one’s memory of such an event is encoded in the brain. During this process, endogenous stress hormones, such as adrenaline, are released in the body. Memories with strong emotional content can lead to too much adrenaline release, which leads to high levels of noradrenalin (norepinephrine). That hormone helps to consolidate memories, and too much of it leads to over-consolidation and symptoms of PTSD, such as avoidance, anxiety, nightmares, irritability, and detachment. These effects can, in turn, lead to other conditions, such as depression and suicide. Propranolol can be administered before or after a traumatic event to block the effect of high levels noradrenalin, and thus block the consolidation of these traumatic memories and their emotional content (Henry et al. 2007).
Anthony’s co-worker, Joey, has just returned to work after a week of absence, after experiencing a violent physical assault from a group of hateful, anti-gay men. Everyone was shocked to hear of his assault and they have been extremely supportive during this time. Joey has expressed how grateful he is to have such supportive co-workers and he claims that he just really wants to forget about the traumatic event by concentrating on his research.
Yet, both Antony and his boss have noticed that Joey still seems to be suffering from memories of the event. Joey even confided to Anthony that he has difficulty sleeping and eating regularly and he feels it might be affecting his ability to focus at work. Both Anthony and his boss are concerned about Joey’s well-being. They have urged Joey to take more time off work to heal, but Joey is adamant that he wants to be back in the lab.
Yesterday, Joey confided to Anthony that their boss suggested that he should attempt the Propranolol treatment to help him recover from his traumatic experience and minimize any effect on his productivity as a researcher. He tells Anthony that the suggestion caught him off guard.
Joey explained to Anthony that while he believes in the aims of their lab’s research to treat PTSD, he’s not sure that he wants to take any drug that will alter his memories at this moment. He told Anthony that he currently volunteers in his community as a counselor for gay youth, and he thinks that his emotional memories of the traumatic event may serve him, not only in his own personal healing process as a survivor, but also as a voice for support of the LBGTQ community. Anthony is unsure what advice to give to his friend and co-worker.
Bostrom, Nick, and Anders Sandberg. "Cognitive enhancement: methods, ethics, regulatory challenges." Science and engineering ethics 15, no. 3 (2009): 311-341.
Cakic, Vince. "Smart drugs for cognitive enhancement: ethical and pragmatic considerations in the era of cosmetic neurology." Journal of medical ethics 35, no. 10 (2009): 611-615.
Farah, Martha J., Judy Illes, Robert Cook-Deegan, Howard Gardner, Eric Kandel, Patricia King, Eric Parens, Barbara Sahakian, and Paul Root Wolpe. "Neurocognitive enhancement: what can we do and what should we do?." Nature reviews neuroscience 5, no. 5 (2004): 421-425.
Fröding, Barbro Elisabeth Esmeralda. "Cognitive enhancement, virtue ethics and the good life." Neuroethics 4, no. 3 (2011): 223-234.
Goodman, Rob. "Cognitive enhancement, cheating, and accomplishment." Kennedy institute of ethics journal 20, no. 2 (2010): 145-160.
Glannon, Walter. "Psychopharmacology and memory." Journal of Medical Ethics 32, no. 2 (2006): 74-78.
Greely, Henry, Barbara Sahakian, John Harris, Ronald C. Kessler, Michael Gazzaniga, Philip Campbell, and Martha J. Farah. "Towards responsible use of cognitive-enhancing drugs by the healthy." Nature 456, no. 7223 (2008): 702-705.
Hall, Stephen S. "The quest for a smart pill." Scientific American 289, no. 3 (2003): 54-65.
Henry, Michael, Jennifer R. Fishman, and Stuart J. Youngner. "Propranolol and the prevention of post-traumatic stress disorder: Is it wrong to erase the “sting” of bad memories?" The American Journal of Bioethics 7, no. 9 (2007): 12-20.
Hurley, Elisa A. "The moral costs of prophylactic propranolol." The American Journal of Bioethics 7, no. 9 (2007): 35-36.
Maslen, Hannah, N. S. Faulmüller, and Julian Savulescu. "Pharmacological cognitive enhancement—how neuroscientific research could advance ethical debate." Frontiers in Systems Neuroscience, 8, 2014 (2014).
Racine, Eric, and Cynthia Forlini. "Cognitive enhancement, lifestyle choice or misuse of prescription drugs?." Neuroethics 3, no. 1 (2010): 1-4.
Repantis, Dimitris, Peter Schlattmann, Oona Laisney, and Isabella Heuser. "Modafinil and methylphenidate for neuroenhancement in healthy individuals: a systematic review." Pharmacological Research 62, no. 3 (2010): 187-206.
Rosenberg, Leah B. "Necessary forgetting: On the use of propranolol in post-traumatic stress disorder management." The American Journal of Bioethics 7, no. 9 (2007): 27-28.
Schermer, Maartje. "On the argument that enhancement is “cheating”." Journal of medical ethics 34, no. 2 (2008): 85-88.
Stix, Gary. "Turbocharging the brain." Scientific American 301, no. 4 (2009): 46-55.
 This material is based upon work supported by the National Science Foundation under Award No. 1355547, Karin Ellison and Joseph Herkert, Arizona State University sub-award Co-PIs. Any opinions, findings, and conclusions or recommendations expressed in this material are those of the author(s) and do not necessarily reflect the views of the National Science Foundation.
Posted 2 years and 4 months ago