Moral medicine

Paul Raven @ 11-04-2011

Always keen to fabricate spurious definitions of illness in need of treatment on the lookout for problems to solve (so long as there’s a good profit margin involved), the world of pharmacology is looking to the sticky and complex field of human morality for its next conquest. This Guardian piece earns bonus points for including an “it’s a long way from being science fiction” soundbite

… would pharmacologically-induced altruism, for example, amount to genuine moral behaviour? Guy Kahane, deputy director of the Oxford Centre for Neuroethics and a Wellcome Trust biomedical ethics award winner, said: “We can change people’s emotional responses but quite whether that improves their moral behaviour is not something science can answer.”

He also admitted that it was unlikely people would “rush to take a pill that would make them morally better.

“Becoming more trusting, nicer, less aggressive and less violent can make you more vulnerable to exploitation,” he said. “On the other hand, it could improve your relationships or help your career.”

Kahane does not advocate putting morality drugs in the water supply, but he suggests that if administered widely they might help humanity to tackle global issues.

Gee, thanks, Doctor Kahane – it’s good to know you think that spiking our water is a step too far. That’s hugely reassuring. No, really.

I’m far from being the only person to find the whole idea instantly repellent. Elegantly-outfitted author Ryan Oakley sums up my main concerns concisely:

I don’t want any of that. I don’t trust the morality of people who’d make a pill to make moral people.

Besides, morality? What the fuck is morality? Is that like gravity? Some measurable force?

Cops, soldiers or leaders won’t be taking these pills. Just criminals and problem people. And guess who gets to decide who those people are.

Kyle Munkittrick takes a more moderate stance:

… drugs like Prozac and chemicals like oxytocin have the ability to make some people calmer, more empathetic, and more altruistic. Calm, empathetic, and altruistic people are far more likely to act morally than anxious, callous, and selfish people. But does that mean mood manipulation going to let us force people to be moral? And if it does, is that a good thing? Is it moral to force people to be moral?

[…]

Some drugs affect, that is, influence or temper a person’s response to a moral dilemma. Your initial response might be, “I don’t want my decisions being influenced by a drug!” We see ourselves as rational beings in control of our emotions. But our mood is often critical to our decision making, particularly in regard to how we react to others.

[…]

I might take a pill that makes me more more likely to be empathetic and altruistic, but it doesn’t guarantee that I will be any more than me having a crummy day will make me a jerk to others. Humans are able to exercise reason and willpower over our emotions and moods to control our actions. The great thing about mood enhancers is that they make it so that our reason and willpower don’t have to overcome anger, fear, and angst to enable us to do the moral thing. A person in the right mood has an easier time making good choices when faced with moral dilemmas.

As Munkittrick’s post title summarises: [mood manipulation] != [mind control]. But mood and character are deeply interlinked, and the ceaseless goldrush to identify, diagnose and treat behavioural or emotional “dysfunction”does not fill me with trusting appreciation for the idea of a pill that can “help us be better people”. If some kid chewing at his own lower lip in a rave made the same claim for MDMA, we’d rightfully think he or she was being naive at best, or deluded at worst; why is such a statement more acceptable when it comes from someone who wears a labcoat and (presumably) doesn’t eat their own dogfood, so to speak?

I guess the issue for me boils down to “who gets to define what’s morally good?” Given the historical record, I’m afraid that governments and pharmacology companies would be a long way down my list of reliable authorities on morality.


Interview with an organ printer

Paul Raven @ 15-03-2011

Doctor Gabor Forgacs of the University of Missouri is one of the clever people working to make bioprinting a reality; via Fabbaloo, here’s an interview with him at PopTech:

We have worked with pharmaceutical companies, most of which spend $1 billion to develop and market a drug, if it is successful. When they go from animal trials to human clinical trials there is a good chance that they will lose the drug. In fact, 65% of the drugs that are developed in the labs that go through successful animal trials are thrown away once human clinical trials commence because what is good for the animal is not good for the human.

We tell them, we’re going to print you a truly 3D little organoid – let’s say a liver from human cells. We take human liver cells and we build a 3D little teeny tiny liver that still can be maintained in culture and we tell them, OK, why don’t you try the drug on the 3D human structure and if the drug does not work and the little liver dies, well then don’t go any further because chances are that when you put it into a human, it’s not going to work. We are already working with some pharmaceutical companies and they realize the value of this.

Even if we’re never able to print an organ, which I don’t believe, because there are already good results, our ability to print expanded 3D structures will have serious and very far-reaching implications and applicability in many other places.


Biopharming: transgenic animals as medicine-factories

Paul Raven @ 03-02-2011

That sound you can hear is sound of bioconservatives gnashing their teeth in horror: COSMOS Magazine has a decent long piece on transgenic animals and the role they may play in tomorrow’s pharmacology:

The greatest impact biopharming will have on the world’s medicine cabinet is one of supply – it will dramatically boost the availability of biopharmaceuticals, also known as ‘biologics’. Biologics are defined as medicinal products extracted from or produced by biological systems – many are made by genetically manipulating cells of bacterial, animal or human origin.

The majority of biologics are proteins such as hormones, enzymes, growth factors and antibodies, which can be collectively called therapeutic proteins, as well as viral proteins for use in vaccines.

This method of drug manufacture will make things cheaper… but not to the degree that you might expect:

A review of the scientific literature shows that a slew of antibody-based drugs manufactured in transgenic animals are poised to enter the market as soon as their branded competitors’ patents expire.

Traditionally, this would result in the transgenic animal-manufactured drugs being labelled as generic drugs – a non-patented, cheaper alternative to brand-name medications with the same active ingredient.

But because the antibodies that the transgenic animals produce are extremely complex monoclonal antibodies – large protein-based structures that specifically recognise one part of a target molecule – no two are alike. This means that, unlike the less complex ‘small molecule’ (non protein) structure of most drugs, they cannot technically be called generics.

“When GTC Biotherapeutics start marketing Herceptin from transgenic cows, it will be classed as a biosimilar, not a biogeneric. We may even end up having a better Herceptin, what we’d call a ‘biobetter’,” notes Heiden.

The ‘better’ refers to aspects of a drug’s profile that may be more desirable than those of its competitor, such as better efficacy or fewer side effects. These traits will affect pricing, but biosimilars will still be cheaper.

“The cost savings will be in the order of 30% – not the 80% price drops we see when a generic small molecule drug goes to market,” says Heiden. That’s because of where in the manufacturing process the savings impact. “Where we save money is at the front end. But the downstream cost of goods, which is about half of the total, is the same regardless of whether you are using cell culture or animals on a farm. You still have to extract and purify your product.”

Well, you do if you’re playing by the rules… I’ll bet there’s plenty of corners that can be cut if you’re not too bothered about meeting safety standards. Hmmm, the ideas for my genetic police procedural are all falling rapidly into place…


The case for cognition enhancement advocacy

Paul Raven @ 04-11-2010

It’s yet another hat-tip to George Dvorsky, this time for pointing out a paper by Gary Miller in which he lays out the obstacles in the path of supporters of cognitive enhancement pharmacology, and ways for overcoming such:

I argue that, regardless how miniscule the risks or how blatantly obvious the benefits, a majority of U.S. citizens is unlikely to support the unrestricted dissemination of cognition enhancing drugs, because each individual member of the majority will be led astray by cognitive biases and illusions, as well as logical fallacies.

If this premise is accurate, then the people of the United States may already be suffering an opportunity cost that cannot be recouped. While a minority of the U.S. electorate can challenge the constitutionality of a policy enacted by a majority, a minority cannot sue to challenge the legislature’s refusal to enact a specific policy. In other words, we in the minority have no way of claiming we were harmed by what “good” could have come—but did not come—due to the legislature’s inaction. We cannot claim the “opportunity cost to the greater good” as an injury, and we cannot compel a court to balance that opportunity cost of inaction against the individual interests that dissuaded the majority from action. Our only recourse is to compel the majority to change its stance via persuasion.

Sounds remarkably like Mike Treder’s suggestion that calm rational discussion of the pros and cons is the best way to advance the transhumanist project, no? No big surprise, I guess, given the overlap between the groups in question… though as I said before, as much as it’s the most morally sensible course of action available, I don’t know how much good calm rational advocacy will be on a an irrational and sensationalist political landscape. I guess we’ll just have to wait and see.


Reasons not to worry about brain enhancement drugs

Paul Raven @ 20-08-2010

Professor Henry Greely reckons it’s high time (arf!) that we stopped trying to ban cognitive enhancement drugs and focus our attentions on developing rules governing their use [via SentientDevelopments]. It’s a pragmatic approach; as Greely points out, the current grey legality of “revision drugs” like Ritalin isn’t doing anything to stop their use, and as the pharmacological industry introduces more cognition-boosting chemicals onto the market (albeit ostensibly as treatments for various maladies of the mindmeat), that situation is unlikely to reverse itself.

Of course, lots of people are scared of the idea of brain enhancement, and there are some good reasons for that. But there are also some bad (or at least illogical) reasons. take it away, Mr Greely:

There are at least three unsound reasons for concern: cheating, solidarity, and naturalness.

Many people find the assertion that enhancement is cheating to be convincing. Sometimes it is: If rules or laws ban an enhancement, then using it is cheating. But that does not help in situations where there are no rules or the rules are still being determined. The problem with viewing enhancements as cheating is that enhancements, broadly defined, are ubiquitous. If taking a cognitive-enhancement drug before a college entrance exam is cheating, what about taking a prep course? Using a computer program for test preparation? Reading a book about taking the test? Drinking a cup of coffee the morning of the test? Getting a good night’s sleep before the test? To say that direct brain enhancement is inherently cheating is to require a standard of what the “right” competition is. What would be the generally accepted standard in our complex and only somewhat meritocratic society?

The idea of enhancement as cheating is also related to the idea that enhancement replaces effort. Yet the plausible cognitive enhancements would not eliminate the need to study; they would just make studying more effective. In any event, we do not reward effort, we reward success. People with naturally good memories have advantages over others in organic chemistry exams, but they did not work for that good memory.

Some argue that enhancement is unnatural and threatens to take us beyond our humanity. This argument, too, suffers from a major problem. All of our civilization is unnatural. A fair speaker could not fly across a continent, take a taxi to an air-conditioned auditorium, and give a microphone-assisted PowerPoint presentation decrying enhancement as unnatural without either a sense of humor or a good argument for why these enhancements are different. Because they change our physical bodies? So do medicine, good food, clothing, and a hundred other unnatural changes. Because they change our brains? So does education. What argument justifies drawing the line here and not there? A strong naturalness argument against direct brain enhancements, in particular, has not been—and I think cannot be—made. Humans have constantly been changing our world and ourselves, sometimes for better and sometimes for worse. A golden age of unenhanced naturalness is a myth, not an argument.

I’m guessing that most readers here are open to the idea of cognitive enhancement (by whatever method)… but even so, what’s the most compelling argument you’ve heard against it?


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