Thursday, July 10, 2003
Teh question of the day comes from William Safire on the NYT:
The Risk That Failed
By WILLIAM SAFIRE
e no longer call them "Siamese twins," after Chang and Eng, the congenitally united brothers exhibited by P. T. Barnum in the 19th century. The twins now called "conjoined" are treated not as circus freaks but as infants deserving an attempt at surgical separation or — far riskier — as adults with the right to risk their lives in a quest for physical individuality.
In the 19th century, Chang and Eng had no such choice, and lived out their lives as sideshow curiosities, often called monstrosities, though they managed to father 22 children. In our time, two famed Iranian sisters, Ladan and Laleh Bijani — 29-year-old law school graduates whose brains were linked in the womb — found a hospital in Singapore and a score of neurosurgeons willing to carry out the Bijanis' decision to risk their lives for physical independence.
The world held its breath as the unprecedented separation of adult brains began. The attempt failed; both sisters bled to death; people everywhere were saddened.
We now step into the world of neuroethics. This is the field of philosophy that discusses the rights and wrongs of the treatment of, or enhancement of, the human brain.
Were these patients capable of making an informed choice? Nobody disputes the sisters' mental competency to stake their lives on their hopes for individuality. Doctors, not to mention pre-operation media interviewers, made them aware of the 50-50 chance of death. Most of us would hesitate to challenge their right to take that risk.
Was the medical team acting ethically, putting the patients' interests first, or was it influenced by the humanitarian prospect of the advancement of specific knowledge about the brain — or by the attraction of the world fame and professional prestige that would follow a high achievement?
The available evidence is that the doctors thought there was a reasonable chance for success. When added to the sisters' strong desire to live free of a connection they found unbearable, that seems to tip the balance to a conclusion that the operation was right to do, even though it could and did end in tragedy.
Not just neurosurgeons but other brain scientists are thinking long and hard about the morality (right or wrong) and the ethics (fair or unfair) of what such breakthroughs as genomics, molecular imaging and pharmaceuticals will make it possible for them to do.
In the treatment or cure of brain disease or disability, the public tends to support neuroscience's needs for closely controlled and informed experimentation. But in the enhancement of the brain's ability to learn or remember, or to be cheerful at home or attentive in school, many of the scientists are not so quick to embrace mood-manipulating drugs or a mindless race to enhance the mind.
The brain's ethical sense may run deeper than we think. "The essence of ethical behavior," writes the neuroscientist Antonio Damasio in "Looking for Spinoza," his newest book, "does not begin with humans." Ravens and vampire bats "can detect cheaters among the food gatherers in their group and punish them accordingly." Though human altruism is much further evolved, in one experiment "monkeys abstained from pulling a chain that would deliver food to them if pulling the chain caused another monkey to receive an electric shock."
Damasio does not believe that there is a gene for ethical behavior or that we are likely to find a moral center in the brain. But we may one day understand the "natural and automatic devices of homeostasis" — the brain's system that balances appetites and controls emotions, much as a constitution and a system of laws regulates and governs a nation.
This week's sad loss of the conjoined twins in Singapore should remind us of more than the risks inherent in the most modern neurosurgery.
Something mysterious is going on in the minds of brain scientists as they debate going beyond the cure of disease to the possibilities of meddling with memory or implanting a happy demeanor. What drives them to grapple with the ethics of the manipulation or the equalization of the powers of the mind?
Maybe the human brain has a self-defense mechanism that causes brain scientists to pause before they improve on the healthy brain. Would we feel guilty about discovering the chemistry of conscience?
From slate
Wednesday, July 9, 2003, at 12:14 PM PT
The Shu'bat al-Khamsa in Kathimiyya, North Baghdad, was Saddam's equivalent of Langley, Va. It was the seat of special political intelligence: a colossal, low-lying concrete complex, walled on all sides. For years, across Iraq and beyond, rumors have circulated about a mysterious machine. The few prisoners who ever got out all told the same story—that at the back of the largest compound, intelligence services kept a giant meat grinder. It has not been found, and may never have existed, but it's a legend that has cloaked Iraq for decades.
When the United States took the area, hundreds of Iraqis came to Kathimiyya, trying to find traces of lost relatives. Overwhelmed, the Army finally capitulated and let them in. This morning, people still lingered. One U.S. soldier told me about a woman who had come every day for two months, clutching a black-and-white photo of her son, pleading for information. She waved it at anyone who passed, too deep in grief to notice that, from so many years of thumbing the picture, his face had completely vanished.
Hundreds of filing cabinets fill the first two rooms of the compound, each one neatly labeled: Communist, Kurd, Independent, Islamic, etc. The file I picked at random was that of Jinan Mohammed al-Khalidi, 1985, who was refused work at the Directorate of Public Security on family grounds: uncle, communist; aunt, communist; uncle (mother's brother), currently in prison in Karbala for membership of the Islamic Da'wa Party; father, ex-security services, sacked for the same reason. There are piles of paper that reach a meter high. Each file has a fading photo stapled to the top left-hand corner. Thousands upon thousands of faces.
In the temporary police station next door, six prisoners lie in a room. Some get up to talk to me through the hatch. One lies close to the door, his belly wrapped in bandages. He lost a kidney in a knife fight the night before last. He's here for the murder of the man he lost it to.
Along Palestine Street, a gigantic, empty, dust-covered artery through East Baghdad, field-sized garden nurseries are open for business. Uday Hussein's shattered Olympic complex faces the Martyrs' Monument—two blue-tiled teardrops that reach 40 meters high—which commemorates the 400,000 who died in the Iran-Iraq War. Beneath the monument is a camp for some of the officers of the U.S. 1st Armored Division. Down the road, the Iraqi Fashion Centre now houses the Free Iraqi National Movement, a party I've never heard of.
I dropped by the heavily barricaded Canal Hotel, where the United Nations is housed. A Japanese girl sat outside smoking. She's called an "Area Coordinator." In her words: "That's what I'm called, but there's not much active coordination. Frankly speaking, the U.N. has absolutely no authority here. At very best, we can act as consultants to the CPA [Coalition Provisional Authority]." The official U.N. people I've come to speak to are much less forthcoming.
Late afternoon I spent in Sadr City, named after Mohammed Sadeq al-Sadr, Shiite Maraji' (or "Supreme Authority") martyred in 1999 by Saddam. The name is only three months old. Until the war it was called Saddam City, and before the 1991 war, it was called al-Thawra (or "the Revolution"). Sadr City is deeply, religiously Shiite and very poor. There are no public services and no active police. U.S. patrols do not dismount here.
The Mohsen Mosque marks one extremity of the area. It has been closed since 1999, when a city-strong demonstration protesting the assassination of Mohammed Sadeq carried an empty coffin here from the Hikma Mosque on the other side of town. Many died in the ensuing battle with Saddam's Fedayeen, and the outer walls of the mosque are covered with henna handprints for the martyrs who lost their lives there.
At the Hikma Mosque, I met Sheikh Abbas al-Rubai', the editor of the Da'wa Party's newspaper, al-Hausa. The Da'wa is one of the biggest Shiite parties in Iraq today, led by the 22-year-old Moqtadr al-Sadr, the martyr's son. His weekly paper sells 12,000 copies, more than almost every other paper in Baghdad. We sit in the mosque's antechamber. There's electricity here so a slow fans whirrs. Before he joined the party, Abbas was a painter. He studied at the progressive College of Fine Arts in Baghdad.
He tells me about life under Saddam and the war: "It was worse than you can imagine. Women and children were killed for a word, or even a suspicious look at a picture of Saddam … and then during this war, the Fedayeen came, and with them Sunni Arab volunteers from Syria and Jordan. From the 14th to the 21st of April, they ransacked the city. They even used rocket-propelled grenades. And for no reason. They had already lost."
The Da'wa Party did everything it could to stave off anarchy. Its student groups took up arms and protected the hospitals, saving the al-Kindi hospital from arson after it was looted and preventing the Qadisiya and Chuwadira hospitals from being looted. Those last two hospitals saved the lives of many of the wounded from all around Baghdad. Now, the party is cleaning up the debris—the dirt and the weapons—of the war. Abbas tells me the Sunnis and Shiites are working together; since the war, their doctors have been sharing medical supplies.
Returning home, I passed the Souq al-Mraidi or Souq al-Haramiya or Souq of Thieves, which, at the end of the war, doubled as Iraq's biggest illegal arms market. I was frightened. It was near dark, much too late to be out almost anywhere in Baghdad, let alone here. As I stopped to take a photo, a man rushed me. He looked drunk, his eyes dulled by a lard-yellow film. He was screaming at me. He was screaming, "Kahraba! Kahraba!" He was begging for electricity.
The Risk That Failed
By WILLIAM SAFIRE
e no longer call them "Siamese twins," after Chang and Eng, the congenitally united brothers exhibited by P. T. Barnum in the 19th century. The twins now called "conjoined" are treated not as circus freaks but as infants deserving an attempt at surgical separation or — far riskier — as adults with the right to risk their lives in a quest for physical individuality.
In the 19th century, Chang and Eng had no such choice, and lived out their lives as sideshow curiosities, often called monstrosities, though they managed to father 22 children. In our time, two famed Iranian sisters, Ladan and Laleh Bijani — 29-year-old law school graduates whose brains were linked in the womb — found a hospital in Singapore and a score of neurosurgeons willing to carry out the Bijanis' decision to risk their lives for physical independence.
The world held its breath as the unprecedented separation of adult brains began. The attempt failed; both sisters bled to death; people everywhere were saddened.
We now step into the world of neuroethics. This is the field of philosophy that discusses the rights and wrongs of the treatment of, or enhancement of, the human brain.
Were these patients capable of making an informed choice? Nobody disputes the sisters' mental competency to stake their lives on their hopes for individuality. Doctors, not to mention pre-operation media interviewers, made them aware of the 50-50 chance of death. Most of us would hesitate to challenge their right to take that risk.
Was the medical team acting ethically, putting the patients' interests first, or was it influenced by the humanitarian prospect of the advancement of specific knowledge about the brain — or by the attraction of the world fame and professional prestige that would follow a high achievement?
The available evidence is that the doctors thought there was a reasonable chance for success. When added to the sisters' strong desire to live free of a connection they found unbearable, that seems to tip the balance to a conclusion that the operation was right to do, even though it could and did end in tragedy.
Not just neurosurgeons but other brain scientists are thinking long and hard about the morality (right or wrong) and the ethics (fair or unfair) of what such breakthroughs as genomics, molecular imaging and pharmaceuticals will make it possible for them to do.
In the treatment or cure of brain disease or disability, the public tends to support neuroscience's needs for closely controlled and informed experimentation. But in the enhancement of the brain's ability to learn or remember, or to be cheerful at home or attentive in school, many of the scientists are not so quick to embrace mood-manipulating drugs or a mindless race to enhance the mind.
The brain's ethical sense may run deeper than we think. "The essence of ethical behavior," writes the neuroscientist Antonio Damasio in "Looking for Spinoza," his newest book, "does not begin with humans." Ravens and vampire bats "can detect cheaters among the food gatherers in their group and punish them accordingly." Though human altruism is much further evolved, in one experiment "monkeys abstained from pulling a chain that would deliver food to them if pulling the chain caused another monkey to receive an electric shock."
Damasio does not believe that there is a gene for ethical behavior or that we are likely to find a moral center in the brain. But we may one day understand the "natural and automatic devices of homeostasis" — the brain's system that balances appetites and controls emotions, much as a constitution and a system of laws regulates and governs a nation.
This week's sad loss of the conjoined twins in Singapore should remind us of more than the risks inherent in the most modern neurosurgery.
Something mysterious is going on in the minds of brain scientists as they debate going beyond the cure of disease to the possibilities of meddling with memory or implanting a happy demeanor. What drives them to grapple with the ethics of the manipulation or the equalization of the powers of the mind?
Maybe the human brain has a self-defense mechanism that causes brain scientists to pause before they improve on the healthy brain. Would we feel guilty about discovering the chemistry of conscience?
From slate
Wednesday, July 9, 2003, at 12:14 PM PT
The Shu'bat al-Khamsa in Kathimiyya, North Baghdad, was Saddam's equivalent of Langley, Va. It was the seat of special political intelligence: a colossal, low-lying concrete complex, walled on all sides. For years, across Iraq and beyond, rumors have circulated about a mysterious machine. The few prisoners who ever got out all told the same story—that at the back of the largest compound, intelligence services kept a giant meat grinder. It has not been found, and may never have existed, but it's a legend that has cloaked Iraq for decades.
When the United States took the area, hundreds of Iraqis came to Kathimiyya, trying to find traces of lost relatives. Overwhelmed, the Army finally capitulated and let them in. This morning, people still lingered. One U.S. soldier told me about a woman who had come every day for two months, clutching a black-and-white photo of her son, pleading for information. She waved it at anyone who passed, too deep in grief to notice that, from so many years of thumbing the picture, his face had completely vanished.
Hundreds of filing cabinets fill the first two rooms of the compound, each one neatly labeled: Communist, Kurd, Independent, Islamic, etc. The file I picked at random was that of Jinan Mohammed al-Khalidi, 1985, who was refused work at the Directorate of Public Security on family grounds: uncle, communist; aunt, communist; uncle (mother's brother), currently in prison in Karbala for membership of the Islamic Da'wa Party; father, ex-security services, sacked for the same reason. There are piles of paper that reach a meter high. Each file has a fading photo stapled to the top left-hand corner. Thousands upon thousands of faces.
In the temporary police station next door, six prisoners lie in a room. Some get up to talk to me through the hatch. One lies close to the door, his belly wrapped in bandages. He lost a kidney in a knife fight the night before last. He's here for the murder of the man he lost it to.
Along Palestine Street, a gigantic, empty, dust-covered artery through East Baghdad, field-sized garden nurseries are open for business. Uday Hussein's shattered Olympic complex faces the Martyrs' Monument—two blue-tiled teardrops that reach 40 meters high—which commemorates the 400,000 who died in the Iran-Iraq War. Beneath the monument is a camp for some of the officers of the U.S. 1st Armored Division. Down the road, the Iraqi Fashion Centre now houses the Free Iraqi National Movement, a party I've never heard of.
I dropped by the heavily barricaded Canal Hotel, where the United Nations is housed. A Japanese girl sat outside smoking. She's called an "Area Coordinator." In her words: "That's what I'm called, but there's not much active coordination. Frankly speaking, the U.N. has absolutely no authority here. At very best, we can act as consultants to the CPA [Coalition Provisional Authority]." The official U.N. people I've come to speak to are much less forthcoming.
Late afternoon I spent in Sadr City, named after Mohammed Sadeq al-Sadr, Shiite Maraji' (or "Supreme Authority") martyred in 1999 by Saddam. The name is only three months old. Until the war it was called Saddam City, and before the 1991 war, it was called al-Thawra (or "the Revolution"). Sadr City is deeply, religiously Shiite and very poor. There are no public services and no active police. U.S. patrols do not dismount here.
The Mohsen Mosque marks one extremity of the area. It has been closed since 1999, when a city-strong demonstration protesting the assassination of Mohammed Sadeq carried an empty coffin here from the Hikma Mosque on the other side of town. Many died in the ensuing battle with Saddam's Fedayeen, and the outer walls of the mosque are covered with henna handprints for the martyrs who lost their lives there.
At the Hikma Mosque, I met Sheikh Abbas al-Rubai', the editor of the Da'wa Party's newspaper, al-Hausa. The Da'wa is one of the biggest Shiite parties in Iraq today, led by the 22-year-old Moqtadr al-Sadr, the martyr's son. His weekly paper sells 12,000 copies, more than almost every other paper in Baghdad. We sit in the mosque's antechamber. There's electricity here so a slow fans whirrs. Before he joined the party, Abbas was a painter. He studied at the progressive College of Fine Arts in Baghdad.
He tells me about life under Saddam and the war: "It was worse than you can imagine. Women and children were killed for a word, or even a suspicious look at a picture of Saddam … and then during this war, the Fedayeen came, and with them Sunni Arab volunteers from Syria and Jordan. From the 14th to the 21st of April, they ransacked the city. They even used rocket-propelled grenades. And for no reason. They had already lost."
The Da'wa Party did everything it could to stave off anarchy. Its student groups took up arms and protected the hospitals, saving the al-Kindi hospital from arson after it was looted and preventing the Qadisiya and Chuwadira hospitals from being looted. Those last two hospitals saved the lives of many of the wounded from all around Baghdad. Now, the party is cleaning up the debris—the dirt and the weapons—of the war. Abbas tells me the Sunnis and Shiites are working together; since the war, their doctors have been sharing medical supplies.
Returning home, I passed the Souq al-Mraidi or Souq al-Haramiya or Souq of Thieves, which, at the end of the war, doubled as Iraq's biggest illegal arms market. I was frightened. It was near dark, much too late to be out almost anywhere in Baghdad, let alone here. As I stopped to take a photo, a man rushed me. He looked drunk, his eyes dulled by a lard-yellow film. He was screaming at me. He was screaming, "Kahraba! Kahraba!" He was begging for electricity.
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