SCIENCE: Tabula rasa and what it means to be human

Imagine the ability to erase a traumatic childhood memory, curb an addiction or control a fear -- all with the flick of a few neurons.
For years, such an idea has been subjugated to the realm of speculative fiction and Hollywood, but now, thanks to new advances in neuroscience, yesterday's fantasy is becoming today's reality.
Naturally this reality is raising a host of ethical questions.
Will people want to have their memories erased? If Jane Doe decides to scrub a memory of her infant son's death, would Jane Doe still in fact be Jane Doe? Is it not the summation of our experiences that defines who we are? Or will the conveniences of science change how humanity defines individuality?
These questions are nothing new.
In 2007, Time Magazine posted an engaging feature by Dr. Scott Haig, an orthopedic surgeon practicing in New York City.
Haig was faced with a troubling ethical dilemma when his patient, "Ellen," refused to undergo anesthesia for an operation on a lump growing on her collarbone.
Haig was able to convince Ellen to allow an anesthesiologist in the room during the operation, but with the stipulation that he was to be used only if the surgery went horribly wrong.
Unfortunately, things did go wrong when doctors from pathology mistakenly called Haig over the operating room intercom.
At full volume they unabashedly relayed the troubling news -- it was cancer, very, very bad cancer -- as a fully-lucid Ellen stared on in disbelief.
That lucidity quickly gave way to panic. Ellen began screaming and begged to know what this diagnosis meant not only for her, but for her children.
Within seconds the anesthesiologist injected Ellen's IV with propofol, a drug that both puts patients under and erases their most recent memories.
Haig relates:

The drug, sometimes called "milk of amnesia," stings some patients sharply in the veins, but what it also does is erase your last few minutes. (Think of the "neuralyzer" from the Men in Black movies.) Oh, and it puts you to sleep. An amazing molecule, a great anesthesiologist and a great save.

Not everyone agreed. I looked up at three sets of eyes, the nurses' eyes, that bored into Frank (the anesthesiologist) and me accusingly. How can you do that? they demanded to know. Don't you need consent or at least fill out some kind of form before you steal a patient's last 10 minutes? But all I could say was, "Awesome job, Frank." Somehow with that, and with the calm sleep on their patient's face, we were given not forgiveness, but a reprieve.

Ten minutes later Ellen woke up, happy and even-keeled, not even knowing she'd been asleep. From the recovery room she was home in time for dinner. "The procedure went smoothly, but we'll have to wait for the final pathology reports," I said, which was not exactly the whole truth, but it let me get the oncology people cued up, a proper diagnosis, and Ellen herself emotionally prepared. I would give her the bad news at a more appropriate time.

Eventually, Ellen died because of the tumor, but Haig said she never learned of the horrifying mix up in the hospital. Ellen died not knowing doctors stole part of her memory.

Haig continues:

Over a decade later, I'm still not sure that was right.

Questions of withholding bad news, wiping out bad memories — plastering over wayward cracks in our minds with chemicals — are answered thousands of times everyday, without ever being asked. Ethics committees and experts exist in our hospitals, but what they have to say counts precious little down in the trenches, where intercoms fail and human minds treat human minds, in real time. You would think, by now, that the distinction between treatments using words (or ideas) and chemicals (or electric currents) is starting to blur. (If an hour of psychotherapy accomplishes the same thing as 20 mg of Prozac — that is, a boost in mood and serotonin levels — is there a difference?) But it is not. Everyone I know who deals with medicines that affect minds seems to operate with a very clear functional distinction between personhood — the realm of virtue, vice, responsibility and creativity — and brain chemistry. That distinction was clear in the eyes of my nurses that day. Something more important than a chemical balance in Ellen's brain had been violated — only a little and, obviously, with benevolent intent. But it hadn't been as simple as pushing a rewind button. Something there had borne the unmistakable quality of wrong.

In a few decades, Haig's extraordinary tale may become an everyday decision for doctors around the world.
Consciousness, the core essence of what defines us as individuals -- an immutable, ever-evolving inner essence forged over decades of life experience -- could become as fleeting as the oil filters in an automobile.
It's a scary prospect.
The inner depths of the mind, previously reachable only by the pinnacles of humanity's art, literature and experience could now be altered at the whim of a doctor's scalpel.
The possibilities are legion. The benefits, potentially endless.
But so are the pitfalls.
As neuroscience climbs to new heights this must always be remembered.
Scientists must always be willing to ask, "Are we really ready?"

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