Monday, April 22, 2013

Identity Crisis: The Challenges of Curing Mental Disabilities


Is it possible to reverse the cognitive disabilities associated with Down Syndrome? According to BioEdge, the Swiss pharmaceutical company Rouche began conducting human studies this week designed to answer precisely this question. Although the study so far is small and is being done primarily to test safety, the drug being tested, RG1662, might also be able to reverse the effects of the neurotransmitters that cause cognitive impairment in individuals with Down Syndrome.

While this study, if successful, could change the treatment of disabled individuals forever, it also raises the ethical question of such drugs could affect the personal identity of disabled individuals over time. If drugs like RG1662 were perfected such that they could almost perfectly reverse the symptoms associated with Down Syndrome, would the individuals after the treatment be the same as those before it? This might sound like a simple question, but it must be noted that the individuals who finish the treatment will have memories, intentions, habits, and personal characteristics that the individuals who entered the treatment would have lacked when starting the treatment. Would the pre-treatment and post-treatment individuals be the same persons who merely have a greater ability to express themselves after the treatment, or would they be different persons?

This occasions another related philosophical question: how much can a person’s psychological makeup change before that person ceases to exist? Many philosophers believe that rapid, irreversible psychological changes destroy one’s personal identity. (For instance, they might say that Phineas Gage was actually a different person after the accident than before it.) How slowly must one’s psychological makeup change in order for personal identity to be retained? I suspect that one's answers to these questions will strongly influence how such mental-enhancement treatments will be carried out and for how long they will last.

Of course, the difficulty will be finding an answer to these philosophical quandaries in the first place, and one of the challenges that will inevitably arise once drugs like RG1662 are refined is finding a way to make sense of personal identity in the light of modern science.

2 comments:

Unknown said...

All medicines change an individual in some way. Generally, such drugs simply induce minor alterations in the immune system and the identity of the individuals is not altered at all. However, other very common drugs do change the chemistry of brain, such as caffeine. Is a person who decides to have a cup of coffee a different person once the beverage is consumed? Most of us would think not.

Though caffeine is a very different drug than RG1662, the same principle holds true. Suggesting that the individual’s identity is fundamentally altered by a medication only serves as a deterrent to those who seek to get rid of a disability like Down Syndrome. Though having new memories, habits, or even a new personality are certainly changes, the brain is still the same brain. In a way, alleviating an individual with Down Syndrome through RG1662 would be like allowing the brain to reach its full potential.

Furthermore, even if an individual’s identity were altered through the use of RG1662, this would not necessarily be cause for prohibiting RG1662. Certainly, RG1662 should not be forcibly imposed on any individual with Down Syndrome. However, if a relatively competent adult with Down Syndrome choose to take RG1662, it seems that there should be no barrier in this decision. In the case of newborns, RG1662 could be selected for use by the parents. This should not be objectionable because infants will have few, if any, long-term memories, habits or character traits that are evident during this early period of their lives. While adolescents may present more of a dilemma regarding whether or not to treat with RG1662, if this drug becomes standard then it will most likely be employed during infancy. In any case, parents caring for children with Down Syndrome would have to carefully weigh the costs and benefits, and should involve the child in the decision-making process.

Because RG1662 would only be allowed if the individual with Down Syndrome (or in some cases a guardian) chose to use it based on how much it would benefit the disabled individual, it should not matter whether or not that individual is altered slightly. Even if the individual was in fact an entirely new person afterwards (which is doubtful), the new person would likely be able to lead a better-quality life overall.

http://www.thearc.org/page.aspx?pid=2547

Alyssa said...

There have long been discussions regarding the effects that minimizing or eliminating disability can have on an individual’s identity. This extends beyond Down Syndrome.

For example, some deaf patients do not want cochlear implants because they feel that being deaf is extremely integral to their identity. In fact, many deaf individuals view deafness as defining a culture. This culture is so important to them that many pray to have deaf children who will fit in to their culture. Given these facts, it is clear that some members of the disabled community view their disability as defining an important aspect of their self. They might feel that removing that unique characteristic would change who they are.

Furthermore, some people oppose attempts to cure autism because they see autism as a kind of diversity rather than a disability. According to this viewpoint, autism should not be viewed as something problematic that needs to be cured but rather it should be celebrated as a unique characteristic that is central to a person’s identity. Once again, we can see how curing a disability might be viewed as changing the individual’s self.

Nonetheless, a person who becomes paralyzed, who loses his memory or who becomes deaf would still be the same person even though his future experiences would drastically change. Conversely, a person who loses his disability would still be the same individual, although his experiences would be different. In either scenario, there would likely be resistance to losing a trait (disability or ability) because these characteristics are integral to identity. However, these changes do not mean that the individual is entirely different, just that he will have different capabilities and experiences.

And of course, I do not mean to imply a cure or other modification would affect identity to the same degree for all disabilities. So, curing down syndrome would affect lifestyle and sense of self very differently from reversing deafness or eliminating autism.

http://muse.jhu.edu/books/9781563685040?auth=0
http://wwwcgi.cnn.com/CNN/Programs/presents/shows/autism.world/notebooks/sue/notebook.html