The Normativity of Memory Modification

Neuromodulation and memory: exploring ethical ramifications in memory modification treatment via implantable neurotechnologies

Invasive implantable neurotechnologies capable of simultaneously altering and recording neural activity are no longer the exclusive province of science fiction but a looming reality that will revolutionize medical practice. These advancements, particularly in their memory-altering capabilities, herald a vast array of opportunities for addressing the complex landscape of neurodegenerative and psychiatric conditions linked to memory impairments. However, the panoply of ethical implications arising from such a novel neurotechnology remains relatively unexplored by the neuroethics literature. This study examines and contrasts the potential ethical implications of memory modification treatment via implantable neurotechnologies. The study contends that undesired side effects resulting from memory modulation can lead to significant identity harms, disrupting the coherence of self-narratives and impinging on our authenticity. To evince the practical impact of this moral argument, the study conducts a practical ethical assessment of how employing implantable neurotechnologies to modulate memory may jeopardize (i) our moral responsiveness to events and core system of values and (ii) the emotional component associated with the altered memory. From a first-person standpoint, changes to the way we reasonably feel and react to past events and future intentions may be deemed ethically problematic as these profound changes can yield significant moral disruptions and negatively impact our personal lives and interpersonal relationships. In addition, the study discusses further ethical conundrums from a third-person perspective as these disruptions can inhibit social activism against structural injustices, thereby hindering societal progress. Thus, taking into account this societal dimension is paramount when evaluating the ethical permissibility of memory modification procedures.

The Ethics of Memory Modification: Personal Narratives, Relational Selves and Autonomy

For nearly two decades, ethicists have expressed concerns that the further development and use of memory modification technologies (MMTs)—techniques allowing to intentionally and selectively alter memories—may threaten the very foundations of who we are, our personal identity, and thus pose a threat to our well-being, or even undermine our “humaneness.” This paper examines the potential ramifications of memory-modifying interventions such as changing the valence of targeted memories and selective deactivation of a particular memory as these interventions appear to be at the same time potentially both most promising clinically as well as menacing to identity. However, unlike previous works discussing the potential consequences of MMTs, this article analyzes them in the context of the narrative relational approach to personal identity and potential issues related to autonomy. I argue that such a perspective brings to light the ethical aspects and moral issues arising from the use of MMTs that have been hidden from previously adopted approaches. In particular, this perspective demonstrates how important the social context in which an individual lives is for the ethical evaluation of a given memory-modifying intervention. I conclude by suggesting that undertaking memory modifications without taking into account the social dimension of a person’s life creates the risk that she will not be able to meet one of the basic human needs—the autonomous construction and maintenance of personal identity. Based on this conclusion, I offer some reflections on the permissibility and advisability of MMTs and what these considerations suggest for the future.

Rationally Navigating Subjective Preferences in Memory Modification

Discussion of the ethics of memory modification technologies (MMTs) has often focused on questions about the limits of their permissibility. In the current paper, I focus primarily on a different issue: when (if ever) is it rational to prefer MMTs to alternative interventions? My conclusion is that these conditions are rare. The reason stems from considerations of autonomy. When compared with other interventions, MMTs do a particularly poor job at promoting the autonomy of their users. If this conclusion is true, moreover, it provides a fresh perspective on debates about the permissibility of MMTs. On the one hand, for those who would limit the use of MMTs to a narrow range of circumstances, the conclusion that MMTs are rarely preferable gives them further reason to eye MMTs with suspicion. On the other hand, for those who view MMTs as permissible in a wide range of circumstances, the conclusion may deflate their endorsement.

Memory Modification and Authenticity: A Narrative Approach

The potential of memory modification techniques (MMTs) has raised concerns and sparked a debate in neuroethics, particularly in the context of identity and authenticity. This paper addresses the question whether and how MMTs influence authenticity. I proceed by drawing two distinctions within the received views on authenticity. From this, I conclude that an analysis of MMTs based on a dual-basis, process view of authenticity is warranted, which implies that the influence of MMTs on authenticity crucially depends on the specifics of how memory modification would eventually work. Therefore, I continue with a systematic analysis of possible properties of MMTs in which I distinguish between the dimensions of memories and the kinds of experiences that can be modified as well as the properties of the process of memory modification. The impact of MMTs on authenticity is analyzed regarding the possible properties of MMTs and based on a narrative approach to authenticity which fulfills the requirements of a dual-basis, process view of authenticity. Lastly, I explore the potential of MMTs to shift the balance between self-discovery and self-creation within authenticity and thereby alter the concept itself as well as the value of authenticity.

Personality and Authenticity in Light of the Memory-Modifying Potential of Optogenetics

There has been a growing interest in research concerning memory modification technologies (MMTs) in recent years. Neuroscientists and psychologists are beginning to explore the prospect of controllable and intentional modification of human memory. One of the technologies with the greatest potential to this end is optogenetics-an invasive neuromodulation technique involving the use of light to control the activity of individual brain cells. It has recently shown the potential to modify specific long-term memories in animal models in ways not yet possible with other MMTs. As the therapeutic potential of optogenetics has already prompted approval of the first human trials, it is especially important and timely to consider the opportunities and dangers this technology may entail. In this article, we focus on possible consequences of optogenetics as an MMT by analyzing fundamental threats potentially associated with memory modifications: the potential disruption of personality and authenticity.

Modulation of Human Memory by Deep Brain Stimulation of the Entorhinal-Hippocampal Circuitry

Neurological disorders affecting human memory present a major scientific, medical, and societal challenge. Direct or indirect deep brain stimulation (DBS) of the entorhinal-hippocampal system, the brain's major memory hub, has been studied in people with epilepsy or Alzheimer's disease, intending to enhance memory performance or slow memory decline. Variability in the spatiotemporal parameters of stimulation employed to date notwithstanding, it is likely that future DBS for memory will employ closed-loop, nuanced approaches that are synergistic with native physiological processes. The potential for editing human memory-decoding, enhancing, incepting, or deleting specific memories-suggests exciting therapeutic possibilities but also raises considerable ethical concerns.

Memory, Neuroscience and Memory Enhancement

This paper advances a new and updated understanding of memory that should also change the coordinates of the memory enhancement debate. Instead of thinking of memory as a storehouse, we should think of memory from a narrative perspective. This view allows for a better understanding of the process in which we actually construct our memories by elaborating meaningful summaries, rather than adding discrete elements. I argue that this new way of thinking about memory makes most of the memory enhancement technologies we have or will have in the near future much less ethically problematic. The main idea is that (biological) memory interacts with memory enhancement in the creative and re-elaborative way it ordinarily does. To conclude, I discuss some cases to illustrate the previous points.

Preventive efforts in the aftermath of analogue trauma: The effects of Tetris and exercise on intrusive images

BACKGROUND AND OBJECTIVES

Efficacious interventions soon after trauma exposure to prevent posttraumatic stress disorder (PTSD) are scarce. Evidence suggests that post-trauma, reminder cues to reactivate trauma memory followed by a cognitive visuospatial task, such as Tetris, reduce later intrusive images. Furthermore, studies indicate that aerobic exercise may reduce PTSD symptoms. The present study aimed to test whether playing Tetris, without prior reminder cues, after an experimental trauma limits the development of analogue symptoms and to compare Tetris to aerobic exercise, which could plausibly alter cognitive-affective processing of the trauma as well.

METHODS

Participants (N = 71) watched a distressing film and were randomly assigned to either playing Tetris, cycling, or remaining sedentary for 25 min without prior reminder cues. Intrusive images and co-occurring distress were recorded in a diary during the following week. After one week, participants completed a recognition test to assess voluntary memories of the film.

RESULTS

Neither Tetris nor exercise, without prior memory reactivation, reduced intrusive images and associated distress nor impeded voluntary memory compared to the control condition. There were no effects of physical fitness level at baseline or voluntary exercise during the subsequent week on analogue symptoms.

LIMITATIONS

Although participants were instructed to record intrusions as they occurred in diaries, they did not receive additional reminders throughout the follow-up period.

CONCLUSIONS

Our findings suggest that neither a single bout of aerobic exercise, nor playing Tetris without prior memory reactivation, after an analogue trauma reduces stress symptoms. Potential explanations and clinical implications are discussed.

Bioconservatism, bioenhancement and backfiring

The prospect of enhancing ourselves through the use of new biotechnologies is for the most part, hypothetical. Nevertheless, the question of whether we should undertake such enhancement is worthy of discussion as it may become possible in the future. In this article, we consider one form of argument that conservative opponents of biotechnological means of enhancement (bioconservatives) deploy in opposition to the use of enhancement technologies-the backfiring objection. This is the objection that the use of such technologies is liable to go wrong and lead to outcomes that are inferior to the outcomes intended. We will argue that the objection is not nearly as significant as bioconservatives suppose it to be. Bioconservatives sometimes supplement the backfiring objection by arguing that change will be irreversible, that the new (or the unconventional) is especially liable to backfire and that humans possess severe and permanent limitations which cannot be overcome. We consider these ways of supplementing the backfiring objection and argue that each of them, when properly understood, is of limited value to the bioconservative. We also consider how traditional approaches to moral education can be supplemented by bioenhancement.

Memory-Modulation: Self-Improvement or Self-Depletion?

Autobiographical memory is fundamental to the process of self-construction. Therefore, the possibility of modifying autobiographical memories, in particular with memory-modulation and memory-erasing, is a very important topic both from the theoretical and from the practical point of view. The aim of this paper is to illustrate the state of the art of some of the most promising areas of memory-modulation and memory-erasing, considering how they can affect the self and the overall balance of the “self and autobiographical memory” system. Indeed, different conceptualizations of the self and of personal identity in relation to autobiographical memory are what makes memory-modulation and memory-erasing more or less desirable. Because of the current limitations (both practical and ethical) to interventions on memory, I can only sketch some hypotheses. However, it can be argued that the choice to mitigate painful memories (or edit memories for other reasons) is somehow problematic, from an ethical point of view, according to some of the theories of the self and personal identity in relation to autobiographical memory, in particular for the so-called narrative theories of personal identity, chosen here as the main case of study. Other conceptualizations of the “self and autobiographical memory” system, namely the constructivist theories, do not have this sort of critical concerns. However, many theories rely on normative (and not empirical) conceptions of the self: for them, the actions aimed at mitigating or removing specific (negative) memories can be seen either as an improvement or as a depletion or impairment of the self.

Multiple memory systems, multiple time points: how science can inform treatment to control the expression of unwanted emotional memories

Memories that have strong emotions associated with them are particularly resilient to forgetting. This is not necessarily problematic, however some aspects of memory can be. In particular, the involuntary expression of those memories, e.g. intrusive memories after trauma, are core to certain psychological disorders. Since the beginning of this century, research using animal models shows that it is possible to change the underlying memory, for example by interfering with its consolidation or reconsolidation. While the idea of targeting maladaptive memories is promising for the treatment of stress and anxiety disorders, a direct application of the procedures used in non-human animals to humans in clinical settings is not straightforward. In translational research, more attention needs to be paid to specifying what aspect of memory (i) can be modified and (ii) should be modified. This requires a clear conceptualization of what aspect of memory is being targeted, and how different memory expressions may map onto clinical symptoms. Furthermore, memory processes are dynamic, so procedural details concerning timing are crucial when implementing a treatment and when assessing its effectiveness. To target emotional memory in its full complexity, including its malleability, science cannot rely on a single method, species or paradigm. Rather, a constructive dialogue is needed between multiple levels of research, all the way 'from mice to mental health'.This article is part of a discussion meeting issue 'Of mice and mental health: facilitating dialogue between basic and clinical neuroscientists'.

Public Attitudes on the Ethics of Deceptively Planting False Memories to Motivate Healthy Behavior

Researchers have proposed that planting false memories could have positive behavioral consequences. The idea of deceptively planting ‘beneficial’ false memories outside of the laboratory raises important ethical questions, but how might the general public appraise this moral dilemma? In two studies, participants from the USA and UK read about a fictional ‘false‐memory therapy’ that led people to adopt healthy behaviors. Participants then reported their attitudes toward the acceptability of this therapy, via scale‐rating (both studies) and open‐text (study 2) responses. The data revealed highly divergent responses to this contentious issue, ranging from abject horror to unqualified enthusiasm. Moreover, the responses shed light on conditions that participants believed would make the therapy less or more ethical. Whether or not deceptively planting memories outside the lab could ever be justifiable, these studies add valuable evidence to scientific and societal debates on neuroethics, whose relevance to memory science is increasingly acute. Copyright © 2016 The Authors Applied Cognitive Psychology Published by John Wiley & Sons Ltd.

Memory Interventions in the Criminal Justice System: Some Practical Ethical Considerations

In recent years, discussion around memory modification interventions has gained attention. However, discussion around the use of memory interventions in the criminal justice system has been mostly absent. In this paper we start by highlighting the importance memory has for human well-being and personal identity, as well as its role within the criminal forensic setting; in particular, for claiming and accepting legal responsibility, for moral learning, and for retribution. We provide examples of memory interventions that are currently available for medical purposes, but that in the future could be used in the forensic setting to modify criminal offenders' memories. In this section we contrast the cases of (1) dampening and (2) enhancing memories of criminal offenders. We then present from a pragmatic approach some pressing ethical issues associated with these types of memory interventions. The paper ends up highlighting how these pragmatic considerations can help establish ethically justified criteria regarding the possibility of interventions aimed at modifying criminal offenders' memories.

Brain-brain integration in 2035: metaphysical and ethical implications

Purpose

– The purpose of this study is to think ahead into the year 2035 and reflect on the ethical implications of brain-to-brain linking.

Design/methodology/approach

– Philosophical argument.

Findings

– It is quite likely that the direction of technological research today is heading toward a closer integration of mind and machine in 2035. What is interesting is that the integration also makes mind-mind or brain-brain integration possible too. There is nothing in principle that would prevent hooking up more than one brain to a machine, or connecting two or more brains together to harness their processing power to tackle a very complicated task. If that happens, the whole notion of what it is to be an individual and a self will have to be rethought. I have offered a way in which that can be done: Instead of viewing the self as being contained in a closed space traditionally defined by the skin, the self can expand outside of the skin and merge temporarily with other selves too. This also has profound implications on the notion of privacy, especially on how it is conceptualized and justified.

Research limitations/implications

– This research is limited to theoretical argumentation only. It relies on the current empirical and scientific investigations that are going on at the moment and provide ethical reflections on them.

Practical implications

– We need to anticipate technological innovations to be more proactive in deliberating and formulating policy and ethical guidelines; otherwise, ethicists will just muse after the fact, implying that there is nothing further to be done.

Social implications

– Brain-to-brain linking has tremendous social implications, so is the ethical reflection on the issue.

Originality/value

– Argument purporting to show the specific content in ethical guidelines on brain-to-brain interlinking based on the metaphysics of the self that is directly implicated by the technology has not been done before, according to the author’s best knowledge.

The ethics of molecular memory modification

Novel molecular interventions have recently shown the potential to erase, enhance and alter specific long-term memories. Unique features of this form of memory modification call for a close examination of its possible applications. While there have been discussions of the ethics of memory modification in the literature, molecular memory modification (MMM) can provide special insights. Previously raised ethical concerns regarding memory enhancement, such as safety issues, the 'duty to remember', selfhood and personal identity, require re-evaluation in light of MMM. As a technology that exploits the brain's updating processes, MMM helps correct the common misconception that memory is a static entity by demonstrating how memory is plastic and subject to revision even in the absence of external manipulation. Furthermore, while putatively safer than other speculative technologies because of its high specificity, MMM raises notable safety issues, including potential insidious effects on the agent's emotions and personal identity. Nonetheless, MMM possesses characteristics of a more permissible form of modification, not only because it is theoretically safer, but because its unique mechanism of action requires a heightened level of cooperation from the agent. Discussions of memory modification must consider the specific mechanisms of action, which can alter the weight and relevance of various ethical concerns. MMM also highlights the need for conceptual accuracy regarding the term 'enhancement'; this umbrella term will have to be differentiated as new technologies are applied to a widening array of purposes.

Erasing traumatic memories: when context and social interests can outweigh personal autonomy

Neuroscientific research on the removal of unpleasant and traumatic memories is still at a very early stage, but is making rapid progress and has stirred a significant philosophical and neuroethical debate. Even if memory is considered to be a fundamental element of personal identity, in the context of memory-erasing the autonomy of decision-making seems prevailing. However, there seem to be situations where the overall context in which people might choose to intervene on their memories would lead to view those actions as counterproductive. In this article, I outline situations where the so-called composition effects can produce negative results for everyone involved, even if the individual decisions are not as such negative. In such situations medical treatments that usually everyone should be free to take, following the principle of autonomy, can make it so that the personal autonomy of the individuals in the group considered is damaged or even destroyed. In these specific cases, in which what is called the "conformity to context" prevails, the moral admissibility of procedures of memory-erasing is called into question and the principle of personal autonomy turns out to be subordinate to social interests benefitting every member of the group.

How does enhancing cognition affect human values? How does this translate into social responsibility?

The past decade has seen a rise in the use of different technologies aimed at enhancing cognition of normal healthy individuals. While values have been acknowledged to be an important aspect of cognitive enhancement practices, the discussion has predominantly focused on just a few values, such as safety, peer pressure, and authenticity. How are values, in a broader sense, affected by enhancing cognitive abilities? Is this dependent on the type of technology or intervention used to attain the enhancement, or does the cognitive domain targeted play a bigger role in how values are affected? Values are not only likely to be affected by cognitive enhancement practices; they also play a crucial role in defining the type of interventions that are likely to be undertaken. This paper explores the way values affect and are affected by enhancing cognitive abilities. Furthermore, it argues that knowledge of the interplay between values and cognitive enhancement makes a strong case for social responsibility around cognitive enhancement practices.

Enhance, delete, incept: manipulating hippocampus-dependent memories

•

Newly developed methods allow manipulation of hippocampus-dependent memories.

•

Cued reactivation during sleep and transcranial stimulation can enhance memories.

•

Pharmacological agents can delete memories.

•

Optogenetics and DREADDs can be used to incept memories.

•

Electrophysiology and fMRI have been used to investigate the underlying mechanisms.

Here we provide a brief overview of recent research on memory manipulation. We focus primarily on memories for which the hippocampus is thought to be required due to its central importance in the study of memory. The repertoire of methods employed is expanding and includes optogenetics, transcranial stimulation, deep brain stimulation, cued reactivation during sleep and the use of pharmacological agents. In addition, the possible mechanisms underlying these memory changes have been investigated using techniques such as single unit recording and functional magnetic resonance imaging (fMRI).

This article is part of a Special Issue entitled ‘Memory enhancement’.

If I could just stop loving you: anti-love biotechnology and the ethics of a chemical breakup

"Love hurts"-as the saying goes-and a certain amount of pain and difficulty in intimate relationships is unavoidable. Sometimes it may even be beneficial, since adversity can lead to personal growth, self-discovery, and a range of other components of a life well-lived. But other times, love can be downright dangerous. It may bind a spouse to her domestic abuser, draw an unscrupulous adult toward sexual involvement with a child, put someone under the insidious spell of a cult leader, and even inspire jealousy-fueled homicide. How might these perilous devotions be diminished? The ancients thought that treatments such as phlebotomy, exercise, or bloodletting could "cure" an individual of love. But modern neuroscience and emerging developments in psychopharmacology open up a range of possible interventions that might actually work. These developments raise profound moral questions about the potential uses-and misuses-of such anti-love biotechnology. In this article, we describe a number of prospective love-diminishing interventions, and offer a preliminary ethical framework for dealing with them responsibly should they arise.

Ecological Engineering: Reshaping Our Environments to Achieve Our Goals

Human beings are subject to a range of cognitive and affective limitations which interfere with our ability to pursue our individual and social goals. I argue that shaping our environment to avoid triggering these limitations or to constrain the harms they cause is likely to be more effective than genetic or pharmaceutical modifications of our capacities because our limitations are often the flip side of beneficial dispositions and because available enhancements seem to impose significant costs. I argue that carefully selected environmental interventions respect agents' autonomy and are consistent with democratic decision making.

Key steps in developing a cognitive vaccine against traumatic flashbacks: visuospatial Tetris versus verbal Pub Quiz

BACKGROUND

Flashbacks (intrusive memories of a traumatic event) are the hallmark feature of Post Traumatic Stress Disorder, however preventative interventions are lacking. Tetris may offer a 'cognitive vaccine' [1] against flashback development after trauma exposure. We previously reported that playing the computer game Tetris soon after viewing traumatic material reduced flashbacks compared to no-task [1]. However, two criticisms need to be addressed for clinical translation: (1) Would all games have this effect via distraction/enjoyment, or might some games even be harmful? (2) Would effects be found if administered several hours post-trauma? Accordingly, we tested Tetris versus an alternative computer game--Pub Quiz--which we hypothesized not to be helpful (Experiments 1 and 2), and extended the intervention interval to 4 hours (Experiment 2).

METHODOLOGY/PRINCIPAL FINDINGS

The trauma film paradigm was used as an experimental analog for flashback development in healthy volunteers. In both experiments, participants viewed traumatic film footage of death and injury before completing one of the following: (1) no-task control condition (2) Tetris or (3) Pub Quiz. Flashbacks were monitored for 1 week. Experiment 1: 30 min after the traumatic film, playing Tetris led to a significant reduction in flashbacks compared to no-task control, whereas Pub Quiz led to a significant increase in flashbacks. Experiment 2: 4 hours post-film, playing Tetris led to a significant reduction in flashbacks compared to no-task control, whereas Pub Quiz did not.

CONCLUSIONS/SIGNIFICANCE

First, computer games can have differential effects post-trauma, as predicted by a cognitive science formulation of trauma memory. In both Experiments, playing Tetris post-trauma film reduced flashbacks. Pub Quiz did not have this effect, even increasing flashbacks in Experiment 1. Thus not all computer games are beneficial or merely distracting post-trauma - some may be harmful. Second, the beneficial effects of Tetris are retained at 4 hours post-trauma. Clinically, this delivers a feasible time-window to administer a post-trauma "cognitive vaccine".

Does Memory Modification Threaten Our Authenticity?

One objection to enhancement technologies is that they might lead us to live inauthentic lives. Memory modification technologies (MMTs) raise this worry in a particularly acute manner. In this paper I describe four scenarios where the use of MMTs might be said to lead to an inauthentic life. I then undertake to justify that judgment. I review the main existing accounts of authenticity, and present my own version of what I call a "true self" account (intended as a complement, rather than a substitute, to existing accounts). I briefly describe current and prospective MMTs, distinguishing between memory enhancement and memory editing. Moving then to an assessment of the initial scenarios in the light of the accounts previously described, I argue that memory enhancement does not, by its very nature, raise serious concerns about authenticity. The main threat to authenticity posed by MMTs comes, I suggest, from memory editing. Rejecting as inadequate the worries about identity raised by the President's Council on Bioethics in Beyond Therapy, I argue instead that memory editing can cause us to live an inauthentic life in two main ways: first, by threatening its truthfulness, and secondly, by interfering with our disposition to respond in certain ways to some past events, when we have reasons to respond in such ways. This consideration allows us to justify the charge of inauthenticity in cases where existing accounts fail. It also gives us a significant moral reason not to use MMTs in ways that would lead to such an outcome.