[gramontblanc]

This reads as extremely ethically dangerous. I'm not sure it's possible to justify any course of treatment leading towards individual neurocircuitry 'tweaks', even for an unambiguously good cause.

Harkens too closely to 'scientist seeks to cure homosexuality through direct brain stimulation' in the 1950s. ( en.m.wikipedia.org/wiki/Robert_Galbraith_Heath )

[stupidcar]

Isn't every treatment we have for depression some form of neuro-circuitry tweaking? Whether you're using prescription medication, electroconvulsion, psychosurgery, counselling or self-medicating with legal or illegal drugs, you're deliberately altering your brain function in the hope that it'll result in temporary or permanent changes to your feelings and behaviour. What makes this procedure more ethically dangerous than those?

[whatshisface]

>Harkens too closely to 'scientist seeks to cure homosexuality through direct brain stimulation' in the 1950s.

Let's say we lived in a world where in addition to having their sex changed, people could have their gender and sexual orientation changed. Would there really be anything wrong with that? In the 1950s, it was a forced medical procedure, but what if the wrongness came from its involuntary application and not its intrinsic nature?

[gramontblanc]

Yes? Do you approve of the idea of using any combination of therapies found effective to cure people of believing in their religion, or to 'solve' political dissidents?

Intellectual freedom,literally in this case, is important.(1)

1. Die Gedanken Sind Frie

[whatshisface]

>Do you approve of the idea of using any combination of therapies found effective to cure people of believing in their religion, or to 'solve' political dissidents?

What I'm suggesting you consider is, what if it's only done voluntarily? For example I can't imagine a political dissident voluntarily subjecting themselves to belief neutralization. I have a hard time imagining how the voluntary rule could allow any of the authoritarian outcomes.

[asdfman123]

Okay, you don't have to be treated for depression. Let the others who have it take back their lives.

[lstodd]

This.

If you want to keep your depression, please feel free to.

[asdfman123]

People who underestimate it actually make me angry. Not only does it take your life away, it takes it away and leaves a giant black hole, and I wouldn't wish it on anyone.

[ceejayoz]

Ethics in human experimentation have come a long way since the 1950s.

[gramontblanc]

Is there an outside definition of medical ethics that can really be impartially compared from generation to generation? I'm certain all previous generations thought they were acting in good faith as well.

Progress towards 'changing people's minds' is dangerous for the same reasons across all times and places.

[whatshisface]

>Is there an outside definition of medical ethics that can really be impartially compared from generation to generation?

That's a legitimate criticism of doing anything, but the problem is that it applies to, well, anything. Anything you do today could be seen as a horrifying atrocity by future generations, unless there exists some kind of boundary on what ethical stances a culture might adopt. There could be limits, but in that case there is an outside definition of medical ethics. If there isn't an outside definition then maybe in 100 years haircuts will be seen as mutilation[0].

[0] There are some cultures with strict rules about facial hair, so even though this example might sound ridiculous it actually serves to illustrate the point.

[tcoff91]

How is this different than psychiatric drugs? Those change your mind as well.

[gramontblanc]

(if the study replicates), the targeted precision and long term persistence of therapeutic effects. If someone prescribes you a pill for being gay and you don't want to be cured of being gay, you could always just stop taking it later if you were able to leave the despotic regime / cruel family structure / religious community binding you.

[cat199]

> Is there an outside definition of medical ethics that can really be impartially compared from generation to generation?

well, doctors do take a form of the hippocratic oath which dates to ~400 BC, so ...

[Hydraulix989]

It seems less ethically dangerous than Electroconvulsive Therapy.

[gramontblanc]

I agree, and think both pose serious social problems (already realized with ECT) just by their availability as treatments.

[derefr]

What's the difference between this, and e.g. https://en.wikipedia.org/wiki/Eye_movement_desensitization_a..., or use of propranolol together with therapeutic hypnosis to recall—and then block/degrade—fear memories during reconsolidation?

In all three cases, you've got a specific "associative" pathway that's bothering someone and interfering with their lives, that they seek out treatment for; and in all three cases, the solution is to get their brain to just not activate that specific association any more, in effect just ripping/burning out the synapse that causes a memory of X to in turn activate emotions or memories of fear/shame/trauma/etc.

I say "in effect", because the brain is electrochemical; and so it wouldn't seem to matter whether you blow an association away at the electrical level (by e.g. physically removing/necrotizing/calcifying the synapse-as-"wire", as ECT does; or by increasing its "resistance" by reorganizing it at a molecular level, as TCM probably does), or you do it at the chemical level (by e.g. re-training nearby junctions so the "carrier signal" feeding into the synaptic junction is too "noisy" to pass signal along, so even if the path activates, descending connections don't receive useful information from it, and so learn to ignore it; and/or by temporarily starving/blockading the ion pores it uses to receive voltage-generating ions through, starving it of its ability to work as a transistor for the signal it wants to generate—until, again, descending connections learn to ignore it, even when it comes back fully functional after removal of the blockade.)

But, as a separate ethical argument, I'd like to also point out: people do, obviously, have the right to self-modify their neuronal architecture. They must be fully informed and consenting as to the consequences of such, and must want those consequences—think them better than the alternative, than all alternatives. But then they should be allowed to do so. And, since they—as lay-people—can't do so by themselves, trained specialists should be there to help them to safely perform the modification they want to perform.

That's the same bar that a patient already has to pass, to qualify for e.g. hormone-replacement therapy targeting gender dysphoria. Medicine already has an infrastructure for ensuring patients want what they want, here. And that infrastructure (mostly coincidentally) already prevents doctors from just deciding to do these things to patients without the patient putting in the effort themselves to go through this "one thousand consent forms over a space of months" rigamarole.

(Many people might say, in fact, that the existing infrastructure sets the bar too high—for example, that doctors make demands of patients to prove specific preferences over desired outcomes of treatment that align with the "on-label" use of the treatment, rather than accepting patient requests to use such treatments for their well-known "off-label" effects. In the HRT case, many people who identify as non-binary want to get HRT for their own reasons, but some doctors don't want to give it to them, because it's only indicated for a specific kind of gender dysphoria related to wanting to achieve a clear end-state of a binary gender.)

[gramontblanc]

Moral problems arise not from curing suffering being morally wrong, but the leakage of moral responsibility in medical/psychiatric practice outside of research.

Any tool to 'correct associative pathways' will be used for the conversion therapy of children, punishment of apostates by repressive states, and torture of the criminally convicted within one generation of it's inception. My primary hope for the memory reconsolidation therapies require some kind of actual moment by moment deliberate cooperation by the treated, and can't be performed without an expert (hopefully) bound by professed vows.

[derefr]

I don't see the argument. Pretty much anything can be used for torture. Taking tools of torture away doesn't do anything to stop torture—you can, ultimately, torture somebody (all the way into full-on brainwashing!) with nothing more than your own words and hands. That's how domestic abuse works, usually!

The ethics of state-sponsored torture (and/or state-sponsored "mind control" like conversion therapy) are fundamentally political ethics—i.e. the ethics of choosing which political "machinery" to build, where different formulations of a state can ensure to different degrees that any given (ultimately self-serving) state apparatus will be properly bound to human rights, and properly watched over by people empowered to see and report any human-rights violations that arise.

[gramontblanc]

The use of psychiatric techniques as torture is the history of psychiatry. This is not some petty joke or argumentative stance.

Do you think that Henry Cotton was a problem of political ethics? Supposedly his reputation and political status were so high in his society that patients and their families actively asked for their teeth, gallbladders, ovaries, testes, tonsils, ... to be spuriously removed.

Edit: I mean to say that serious contemplation of the risks and benefits of any medical interventions should always be taken seriously regardless of how severe a medical problem might seem or how exciting a miraculous new cure might appear to be. Most miraculous cures not only don't 'work', but also caused serious harm to their subjects throughout the history of psychiatric medicine.

[lstodd]

Correction of associative pathways is called "learning".

"Memory reconsolidation" my ass. It is used since before there was any civilization worth the name.