Ethical Aspects of Neural Prosthesis - Research Paper Example

?Ethical Aspects of Neural Prosthesis John Jones Introduction One of the more controversial aspects of the medical and psychologicalcommunity has been the possible breakthroughs in the field of neural prosthesis, especially as they deal with memory enhancement. Those with severe injuries and debilitating diseases to the brain and central nervous system certainly look forward to such breakthroughs with much hope. So this paper will examine the ethical outlook of such procedures. Will all patients be afforded the treatment or will the poor suffer while the wealthy benefit? How intrusive is this and what are the long term effects of such a thing? How much relief would be afforded the patients? Abstract The human brain is a remarkable device in that although scientists haven’t totally figured out how much memory the brain has, an article in Scientific American tells that each of the brain’s one billion neurons connect with more than one thousand others for a total of over one trillion connections. The author further estimates the total memory storage to exceed 2.5 petabytes or the equivalent of three million hours of recorded television so that one could never fill up his brain (Reber). In order to store memory the brain acts somewhat like the modern computer in that there is short term and long term memory storage. For the short term, like the computer, memory is held in the brain for a small period of time and divested when no longer required. A good example would be a small grocery list for that day’s shopping and when one gets home with the groceries that information is no longer required. This sort of memory is held in the brain’s Hippocampus of the temporal lobe. Long term memory means exactly that, memories are stored for months and years. Like the computer, the long term memory has to be encoded and stored. That is why if you are trying to remember an old grade school friend’s name, it might take a good while for the brain to process and retrieve the name. Yet long term memory is also responsible for such things as smells being associated with a specific occurrence in one’s life. Long term memory is encoded in the Hippocampus but stored elsewhere in the brain, although the exact location is undetermined, possibly the temporal cortex. Therefore, memory robbing events can be devastating to the victim. Such instantaneous things as traumatic brain injury (TBI), oxygen deprivation and strokes can render the patient helpless in seconds, no matter what the age. Then there are the debilitating diseases such as meningitis, cancer, epilepsy, thyroid disorders which again can strike at any age and cause memory loss. Sometimes with any of the above, especially in the young, the brain can be “reprogrammed” and some if not all of the memory functions can be restored. But for older people, the one event that destroys their memories are various forms of dementia, especially Alzheimer’s. Discussion However it occurs, all patients and their caregivers would certainly welcome any improvement in the person’s condition. With that goal in mind researchers are seriously trying to develop a neural prosthesis. Similar to current devices such as cochlear implants, pacemakers for the heart, and items for the eye, the neural prosthesis would offer help and hope to those with memory loss. Similar in appearance to the Intel memory chipset, the implant currently being used on laboratory rats has increased their memory in which they could then retain which lever to pull. With the tiniest of chips and thirty-two electrodes, it is placed at or near the rat’s Hippocampus, in two areas called the CA1 and CA3. The experiments are considered successful, even though the commands from the implant is specific to one set of lever pulling, unlike the thousands of memory commands the normal human brain endures on a normal basis (Berger). Therefore it goes without saying the implementation in human beings is many years off. But now would be the most excellent time to examine the ethic of such procedures. After all, it is believed by many that breakthroughs in treating spinal cord injuries are within sight and the controversies that community have gone through should show their neurological counterparts what struggles they will probably endure in their endeavors to help those with memory loss. In another instance, one only has to look at the controversies surrounding stem cell research. Simply implanting a device inside somebody’s head would lead to grave Orwellian allegations. For example, the United States military has been seriously toying with the idea of implanting a microchip in service members’ heads since the late eighties. Their ideas are somewhat noble, so that a medic on the battlefield, armed with a handheld scanner, would be able to tell such life vital things as allergies, medical history, and blood type instantly and perhaps more soldiers would survive the initial treatment. Yet every time the subject has been broached, the military members and those in the general public raise fears that is the first step in “666” registration for the general populace and fringe groups are the first to cry foul. True, once the devices are ready for experimental human implementation, the researchers would probably an unlimited supply of volunteers. Everybody knows how extremely frustrating it is to try to remember something and not have the ability. But what if the mortality rate for the implantation is extremely high? Would the participants still wish to volunteer? Probably, but the Food and Drug Administration (FDA) would be under intense public pressure and scrutinize the tests fiercely. Consider the fact that the artificial heart pacemaker was first described in 1899 and models were made as early as 1932. Yet it was the 1960’s before US FDA approval was obtained and use of the device became widespread. Of course Alzheimer’s is the number one cause of memory loss and with the baby boomer generation growing older, the incidence of the disease is only going to grow. It therefore stands to reason then that one of the ethical considerations would be how much care older people should receive. Sure people are already talking about one hundred years being the new life expectancy. But memory failure and the shrinkage of the brain tissue is only one of the considerations when it comes to treatment of the elderly. It stands to reason that older folks and their relatives would want to prolong life as long as possible. Yet if one gets his memory back and his brain is again active, what about the other organs of the body? Barrack Obama and his healthcare plan (The Affordable Care Act of 2010) caught a lot of flack about a certain provision that required doctors and other professionals to have serious discussions with their patients concerning end-of-life options. This provision was quickly named the “Death Panel” and took a life of its own. People on both sides of socialized medicine were quick to condemn this act and could quite possibly be the death knell of the entire plan when the United States Supreme Court rules on the plan, as early as later this year. Even a respected organization such as the American Medical Association (AMA) issued an opinion of “advanced care planning” in that Sarah Palin’s version of a shadowy group of Government officials making decisions over life and death is probably a bit of science fiction. However the AMA does agree in its opinion that there should be some sort of decision making when it appears healthcare has reached a saturation point and the patient should be allowed to die peacefully (Tinetti). Yet some things are already decided by age and lifestyle. Transplants and prostheses that are available today are generally reserved for the younger. It is not necessarily because of age but because the elderly mortality rate after surgery is significantly higher than for those below age fifty. For instance, bone marrow transplants for those inflicted with such malignancies as leukemia have been reserved for those much younger. However a study by those in the know suggests that prognosis for the elderly is no less severe than for those much younger. Indeed the authors of the study indicate that medical professionals should evaluate the “physiological age, rather than chronological age in making decisions about suitability of individual patients as transplant candidates” (Popplewell). One other thing will be the biggest ethical dilemma when it comes to the future implementation of neural prosthesis and that is money, or more importantly the lack of it. Two wealthy and influential people have received transplants in the past few who might not gave gotten such care had they not been wealthy and famous, both for entirely different reasons. One was Mickey Mantle, arguably one of the best baseball players in Major League history. Less than forty-eight hours after he was identified as needing a liver transplant, Mantle received the transplant in 1995. This was in spite of the fact of his lifestyle (cirrhosis from heaving drinking and contraction of Hepatitis C) and his poor prognosis of survival (he actually died less than two months after the surgery). Baylor Transplant Center, where the surgery was performed, argued the reason for the transplant was his poor condition when put on the transplant list and the fact that he was fortunate in that a donor liver was found so quickly near to Baylor. Another more recent case was the heart transplant of former US Vice President Dick Cheney earlier this year. Even though Mr. Cheney was in relatively good health, he was seventy-one years old when he received the transplant. To be fair, the man had been living with an artificial heart device for twenty months when he got the surgery, when the mean time for the waiting list is six to nine months. Some would question whether that in itself is a political pundit. Still Cheney is famous and there are members of public and the medical community who question the validity of transplanting a person that old when they are nearing the end of their life expectancy, So it appears that youth, money and power do seem to play a factor when it comes to current practices. So it stands to reason that things would be no different when it comes to neural prosthesis for memory loss. Two of the most famous cases for that in recent memory are President Ronald Reagan and his Press Secretary James Brady. Reagan was no doubt the most famous Alzheimer’s patient in recent memory and his wife Nancy has been at the forefront in ensuring that the former Chief Executive’s memory has been at the forefront of research into the disease. She has even testified before Congress and spoken with President Obama in trying to obtain more funding for Alzheimer’s research. James Brady was shot in the head and severely wounded during an assassination attempt on Reagan in March of 1981. Suffering from paralysis and memory loss, even thirty years later he still has cognitive impairment, Brady would be a great candidate for such an implant. So let’s compare the two men. Nearing eighty when he was diagnosed, if based strictly on age, Reagan would be a poor candidate for memory implants under current standards. By contrast, at forty when wounded, Brady would be in the prime consideration for such a procedure. But what about the gang banger, or the little ten year-old girl, who is hit by the stray bullet in a drive-by shooting? The injuries they suffer are probably comparable to Brady’s but the poor and minorities are two categories of people that historically receive less medical care and by definition less transplants. It is argued that Blacks trust the transplant system less than Whites, mostly because of moral considerations yet with sufficient education on the benefits on medical implementation, those statistics might change considerably. So with a neuron implant, somewhere in the future the little girl above might grow up to be the next Marie Curie. One must also bring up a subject that has much taboo in today’s society, the aspect of selling transplantable organs for financial profit. People have grown urban legends to gigantic proportions based upon horror stories of some poor soul having one of his kidneys jerked out by some sinister outfit. Some countries such as Canada allow for living donors to be reimbursed for their medical and other sundry expenses (Klarenbach). Although theft does not imply to neuron implants, those with money and able to qualify for the implants would have a definite advantage over the poor. Would implants be sold on the open market so that those who are born a bit slower than others have an economic and scholastic edge over those who could not afford them? It might therefore increase their chances of success in the job market and make the chasm between the have’s and have not’s even greater than it is now. Conclusion No matter how far it is in the future, the ethics of neuron implants for memory loss assistance need to be studied now. Mistakes made with the present implementation devices in the present can perhaps be averted and the technology can be made available to all who would benefit from it, not a device for the rich or a toy for the lazy. References Reber, Paul, “What Is the Memory Capacity of the Human Brain?”, Scientific American, April 19, 2010, Web, viewed May 8, 2012, http://www.scientificamerican.com/article.cfm?id=what-is-the-memory-capacity. Berger, Theodore W et al, A cortical neural prosthesis for restoring and enhancing memory, Journal of Neural Engineering, August 2011, Web, viewed May 8, 2012, http://iopscience.iop.org/1741-2552/8/4/046017. Tinetti , Mary E, MD, The Retreat From Advanced Care Planning, JAMA, May 9, 2012, Web, viewed May 9, 2012, http://jama.ama-assn.org/content/307/9/915.extract . Popplewell, LL, and Forman, SJ, “Is there an upper age limit for bone marrow transplantation?”, Bone Marrow Transplantation, 2002, Web, viewed May 9, 2012, http://www.nature.com/bmt/journal/v29/n4/full/1703382a.html. Klarenbach, Scott et al, Living organ donors face financial barriers, Canadian Medical Association Journal, March 2008, Web, viewed May 9, 2012, http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1402383/ Read More