Sunday, 10 June 2012

A Pill to Forget?

Ketamine is a painkiller
If you are ever unfortunate enough to be in an accident and be in extreme pain, then you may be given ketamine by medics. Ketamine is not only an incredibly powerful painkiller but can also cause one to lose memory - for example, if a bone in the leg needs to be 'snapped' back into place, you may first be given this to not just numb the pain, but also to prevent you remembering the moment of pain. Doctors do not ask you first whether you are happy to be given this, because there is no need - there is no question that one doesn't want to remember a moment of such agony. This has got me thinking about drugs that affect memory and question the ethics in relation to this.

In cases of emergency, like the example above, the fact that a painkiller has the side effect of memory loss is a benefit. But the idea of using drugs to remove memory isn't just a lucky side effect - scientists have been researching into this area for years. Drugs that remove memory could be used in order to prevent individuals developing post traumatic stress syndrome, and although there are no drugs fully developed as of yet, the idea of a pill to forget may not be so far away. This could be extremely beneficial for victims of attack, witnesses of horrific events and returning soldiers.

Propranolol
-a drug with potential?
So how would they work? Shortly after a traumatic event, there is a period when the memory of the event is consolidated in the brain. The strength of the memory relates to the release of endogenous stress hormones - such as adrenaline. When too much adrenaline is released levels of noradrenaline increase resulting in over-consolidation of the memory - this is what causes post traumatic stress syndrome. Drugs aimed at undoing this over-consolidation of memory would hence relieve symptoms of this condition. One drug of focus is propranolol, a beta-blocker. In several studies (named in the references if you're really interested), it was found that people given propranolol before being told a tragic story recalled less of the story than those not given propranolol. It was found propranolol had a significant affect on attenuating memory. 

But I think this raises another issue - if such drugs become mainstream, would they be used recreationally to extremes? If drug development allowed us to pop-a-pill to forget a specific memory from our life, would we? Would we "take one with water" to forget the memories of the lover who broke our heart? Would we forget our embarrassing moments? Or the memories of our bad days at work? Neuroethics are becoming increasingly acknowledged, as advances in neuroscience are now allowing us to manipulate the functioning of the brain, and we have to question the ethics of such tampering.

Homer has made his mind up
It could be argued that this principle of erasing memories already exists with alcohol when we head to the pub after a rough day to "drown our sorrows", for the purpose of escapism to forget our problems - however a temporary distraction is less severe than the permanent erasure of a memory, and drugs could take this to a new level. There is also the opportunity for misuse - would witness's of crimes be spiked so they would not remember the criminals face? Would they be used to manipulate others for financial benefit?

At present this is not so much of an issue, as such drugs are far from being ready to use on the human population and only tone down memories as opposed to erasing them - but with scientific advances, I would expect one day for there to be such memory altering drugs available. From a more philosophical view it could be argued that experiences make us who we are and we learn from difficult times. This leads to a very grey areas in neuroethics - would the benefit of relieving post traumatic stress syndrome outweigh the damage caused by misuse?

Would you erase?
Personally, I think the current prospect of using drugs to reduce the impact of tragic events on those with post traumatic stress syndrome is only a good thing. Propranolol, as a mainstream drug, is a front runner in the race to reduce the impact of such memories, although this is still far from the finish line.  However, I would say that we should not tamper further with our personal memories, as tempting as this would seem. But if such drugs were available, would you remember your pills to forget?

References

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