The Promise of Brain-Machine Interfaces: Recap of March's The Future Now: NEEDs Seminar

Image courtesy of Wikimedia Commons.

By Nathan Ahlgrim



If we want to – to paraphrase the classic Six Million Dollar Man – rebuild people, rebuild them to be better, stronger, faster, we need more than fancy motors and titanium bones. Robot muscles cannot help a paralyzed person stand, and robot voices cannot restore communication to the voiceless, without some way for the person to control them. Methods of control need not be cutting-edge. The late Dr. Stephen Hawking’s instantly recognizable voice synthesizer was controlled by a single cheek movement, which seems shockingly analog in today’s world. Brain-machine interfaces (BMIs) are the emerging technology that promise to bypass all external input and allow robotic devices to communicate directly with the brain. Dr. Chethan Pandarinath, assistant professor of biomedical engineering at Georgia Tech and Emory University, discussed the good and bad of this technology in March’s The Future Now NEEDs seminar: "To Be Implanted and Wireless". He shared his experience and perspective, agreeing that these invasive technologies hold incredible promise. Keeping that promise both realistic and equitable, though, is an ongoing challenge.

BMIs are currently designed as assistive technologies. They can take many forms: a cochlear implant, a cursor on a screen, a robotic arm, or even a complete exoskeleton. All serve the same general purpose: to restore a person’s ability to connect and communicate with the world. The most common patients are those with some form of paralysis. Given the potential to restore movement or speech to people, many see the development of BMIs as a moral imperative. However, agreeing that BMI research is a worthwhile and necessary endeavor cannot will these devices into being. There is a good reason why controlling a robot arm with your brain feels like something out of science fiction – it is incredibly difficult to do.

An example of an intracortical array.

Image courtesy of Wikimedia Commons.

Reliable BMIs depend on first being able to record brain activity. Scientists have been able to do this for decades at great precision, but the unfortunate trade-off is that the level of precision tracks directly with the level of invasiveness. As Dr. Pandarinath described, scalp electroencephalograms (EEGs) require no surgery at all, but analyzing the resulting data is like standing outside of a football stadium. You may hear the roar of the crowd, but you need to get in the stands before you can pick up individual conversations. For scientists, that means you need to open up the skull and place arrays of wires (known as intracortical microelectrodes) into the brain itself in order to eavesdrop on the brain’s conversations.

Display of the BrainGate system.

Image courtesy of Wikimedia Commons.

Figuring out what those brain conversations mean is the hard part. All our billions of neurons firing at once produce gigabytes of data, and the challenge of making sense of that data is what draws engineers and computer scientists towards neuroscience. Dr. Pandarinath is one of these people, a self-described “engineer that managed to run into the brain one day and thought it was pretty cool.” Approaching the problem as an engineer, he and many others have developed a host of technologies around the BrainGate system. Their tagline says it all: “Turning thought into action.” Targeting the motor cortex of the brain, which controls voluntary movements in healthy individuals, BrainGate technology allows paralyzed people to control robotics just by thinking about them (Pandarinath et al., 2017). Perhaps most shocking of all, learning to control the device is like learning to walk. At first it’s a struggle (there’s a reason we label toddlers as such), but adults do not consider walking a skill. As one patient described, “it was hard work getting [it to work]. I struggled greatly to [move the arm] up and down at the beginning, now up and down is so easy I don’t even think about it.” In effect, BrainGate lets patients control a robot as an extension of their own body. No mental gymnastics needed.

Is the ease of use a good thing? Once patients can “automatically” control BMIs, are they at fault for any harm caused by the machine? Dr. Karen Rommelfanger raised one possible scenario: following an argument between the patient and researcher, the patient’s robotic hand crushes the researcher’s hand during testing. Who is at fault? Did the patient misuse the technology, or did the researcher cause her own injury by creating a faulty system?

One possibility is to have a universal limit to the strength and ability of all BMIs. Even though we can create machines that rip cars apart like tissue paper, maybe we should never build a robotic arm to have more grip strength than that of a child. Such a solution prevents the person (or BMI) from doing any physical harm, but it then fails the primary goal of BMIs: to restore patients’ abilities. A universal set-point on what these abilities should be is problematic because, for better or worse, there is no singular ‘human ability.’

By the end of the seminar, the conversation landed on where to draw the line between restoration and enhancement. Of course, this debate is not new to BMIs. Everything from sports supplementation to psychostimulants like Adderall are subject to the same debate: who deserves to receive these treatments, and how much is too much? Researchers do not even need to design superhuman BMIs (although it is certainly possible) to join the conversation. The arm strength of an editorial intern is a far cry from Game of Thrones’ Hafþór Björnsson, but we are both decidedly human. If I became paralyzed, must I be restricted to my previous strength? I could always argue that I was just going to start a strongman program before I became paralyzed, and therefore I deserve a robotic arm to match.

Could and should BMIs make everyone

as strong as humanly possible?

Image courtesy of Wikimedia Commons.

The premise that researchers will be in charge of setting a limit (if any) may be inherently flawed, given that machine learning is starting to drive BMI research. Algorithms succeed by optimizing solutions, which in the case of BMIs would mean the most efficient, the most precise, and perhaps the strongest BMI possible. Normal humans are hardly the optimal physical form, so it is hard to imagine a sophisticated algorithm being complacent at returning me to my previous strength.

To many, “supplementing” people with artificial intelligence (AI)-guided BMIs is a good thing, and perhaps even necessary. Elon Musk, famous for his dire warnings on the impending AI threat, posits that coupling AI with humans via BMIs is the best protection our species has against it. By making ourselves more than human, we will at least have a fighting chance against the AIs we design with the express goal of being better than human.

In the end, BMIs do offer great promise. No, a paraplegic will not be able to walk normally in the next year using a BMI. Anyone who promises that is peddling in false hope and unrealistic expectations. But BMIs, like all other technologies, never stop improving. Questions about limits to and access to these incredible tools will only become more pressing as the technology improves. Who gets to set the limit? Who will act as gatekeeper? The patient or the manufacturer? Dr. Pandarinath does not think BMIs are different than any other cutting-edge product: “by default, it’ll be the wallet.” And adjusting for inflation, it will now take thirty-five million dollars to build the Six Million Dollar Man.

References

Pandarinath C, Nuyujukian P, Blabe CH, Sorice BL, Saab J, Willett FR, Hochberg LR, Shenoy KV, Henderson JM (2017) High performance communication by people with paralysis using an intracortical brain-computer interface. eLife 6:e18554.

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Ahlgrim, N. (2018). The Promise of Brain-Machine Interfaces: Recap of March's The Future Now: NEEDs Seminar. The Neuroethics Blog. Retrieved on , from http://www.theneuroethicsblog.com/2018/05/the-promise-of-brain-machine-interfaces.html

Self/less and transplanting (ID)entities

by Karen Rommelfanger



I recently sat on a panel discussion for an early screening of the movie Self/less. I'm quoted (mostly correctly) with my name (mostly) spelled correctly here.

In Self/less, an aging business tycoon with a terminal illess (played by Ben Kingsley) pays to "shed" his skin for a new, younger, fitter body (played by Ryan Reynolds). See trailer above.



The film, despite the futuristic theme, revisits mundane themes of the Faustian tradeoff or a deal with a devil, ultimately conveying the message that the costs, even for the rich, are too high when trying to cheat death. The title of the movie implies that for the greater good the selfless thing to do is to just die as nature intended.



While the film would surely be categorized as science fiction, there are entrepreneurs quite dedicated to making such a possibility a reality.



For example, the 2045 Initiative promises, for the starting price tag of $3 million, that your brain can be downloaded and that downloaded information can be used to animate or be “transplanted into" a personalized avatar or robotic copy of a human body remotely controlled by a brain computer interface or, if you fancy, a hologram (just press the immortality button on their site). Among its supporters, the website claims, is the Dalai Lama.

And, for the first time in human history, the neuroengineer Miguel Nicolelis recently connected two brains, rat brains, with one brain able to transfer electrical activity to another to facilitate learning a task. In this experiment, one rat learned through trial and error to press the correct lever for a reward. Electrical activity from one rat brain was sent to another through a wireless connection, allowing the other, untrained rat to choose the correct reward delivering lever without any training. This was followed up by studies connecting a human to a rat brain and then two human brains. Most recently, this month, Nicolelis connected more than two brains, either 3-4 rat brains or 3 monkey brains. In these experiments the animals were able to synchronize their brain activity to complete tasks. In the case of the monkeys, they operated an avatar.

Head transplants are also being touted as a near reality. While not as fancy as downloading electrical activity to an avatar or robot, such a transplant might allow an intact head to receive a new body. In this case one might ask who is receiving the transplant. Is the head receiving a body transplant or is the body receiving a head transplant?



All of these experiments and even the movie Self/less interrogate the question, where does the self originate and exist? And can we have a meaningful existence in any way that might be unfamiliar to ourselves? Is living forever a human right as some transhumanist groups might say? Or are we somehow designed by biology or some greater creator to have our bodies and maybe our minds along with or inside those bodies expire?



What we never learn in Self/less, perhaps because it would be too complex to address, is what *exactly* is transferred from Ben Kingsley to Ryan Reynolds’s body? It seems they simply transferred or transplanted an essence and the essence of Ryan Reynolds was held back through suppressive drugs designed by the entrepreneur-inventor Albright. Self/less leaves the viewers to their own devices to grapple with these issues.



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Rommelfanger, K. (2015). Self/less and transplanting (ID)entities. The Neuroethics Blog. Retrieved on , from http://www.theneuroethicsblog.com/2015/07/selfless-and-transplanting-identities.html

Neuroethics Journal Club: The Ethical Issues behind Brain-to-Brain Interface (BTBI) Technologies

The first Neuroethics Journal Club of the Fall 2013 semester was a discussion led by graduate student John Trimper on the ethical implications behind brain-to-brain interface (BTBI) technologies. John introduced the topic by presenting the experimental details and results from a recent paper, published by the Nicoleis lab at Duke University (Vieira et al.), where researchers utilized a BTBI to transfer sensorimotor information between two rats. The BTBI technology allowed for a transfer of information from an “encoder” rat to a “decoder” rat, not using typical bodily interactions, but instead through intracortical microstimulation (ICMS).

"Rodent Mind Meld" (Via Wired)

The researchers conducted three experiments that demonstrated an artificial communication channel where cortical sensorimotor signals, coded for a specific behavioral response, were recorded in the encoder rat and transmitted to the decoder rat. Once received from the encoder rat, the decoder rat was instructed by these signals in making behavioral choices.  In the first experiment, a motor task, the encoder rat pressed one of two levels indicated by a LED light. This information was transferred via ICMS to the decoder rat, who would then choose the same lever without the help of the LED light. While the encoder rat performed better than the decoder rat, the decoder rat did perform correctly at levels significantly above chance. In the second experiment, the decoder rat again performed significantly better than chance, but in a tactile discrimination task. The encoder rats were trained to discriminate the size of an aperture with their whiskers; if the aperture were narrow, then the rats would nose poke on the left, while if the aperture were wide, the rats would nose poke on the right. Encoder rats explored the aperture, nose poked the right or the left, and then again, through ICMS, this information was sent to the decoder rat. The decoder rat would then also poke to the right or the left, but without any hint about the size of the aperture. Not only did researchers conduct this experiment with encoder and decoder rats residing in the same Duke laboratory, but impressively the same tactile discrimination task was also completed with an encoder rat in Brazil and a decoder rat at Duke, showing the potential of long-distance BTBI technology.



The authors state at the end of the paper (Vieira et al.) that “multiple reciprocally interconnected brains,” as opposed to the dyad formed by one encoder rat and one decoder rat, would represent the “first organic computer capable of solving heuristic problems that would be deemed non-computable by the general Turing-machine,” and there is no doubt that this research is at the forefront of BTBI technology. While many of the mass media outlets sensationalized this story with headlines like “Two rats, thousands of miles apart, cooperate telepathically via brain implant” (NBC News) or “Rodent Mind Meld: Scientists Wire Two Rats’ Brains Together” (Wired), many of the journal club audience members were a bit more skeptical regarding the experimental details and the immediate consequences of the research on society. It was pointed out by more than one member of the audience that the decoder rat making the correct lever or nose poke choice was not a result of direct communication from the encoder rat, but instead was due to conditioning resulting from the training program. Both the encoder rat and the decoder rat underwent extensive training before being connected and allowed to communicate through ICMS. Potential encoder and decoder rats were first trained to respond to either the LED visual stimulus or the width of the aperture, the tactile stimulus, until 95% accuracy was reached. Rats then chosen for the decoder position underwent further training after being implanted with microstimulation electrodes; these mice were trained to recognize that multiple ICMS pulses were associated with the right lever/left nose poke, whereas a single ICMS pulse was associated with the left lever/right nose poke. When the encoder rat chose the right lever over the left lever, the decision was sent by ICMS to the encoder rat, where the encoder rat would perceive multiple ICMS pulses, a sequence that the animal had already been trained to associate with the right lever. It was generally agreed that the decoder rat’s choice is not completely due to a “mindmeld” like popular media would suggest, but also involves the rat’s ability to perceive a difference in stimulation.

The encoder and decoder rats (Pais-Vieira et al.)

Even if directly transferring complex thoughts among individuals will remain science fiction for now, this research and other experiments, such as the BTBI between a human and rat (Yoo et al.), are important because of the numerous ethical issues that accompany BTBI. BTBI takes brain-machine interface (BMI) to a new level, and for that reason, BTBI is already associated with multiple ethical issues, such as the likelihood of the extraction of incidental information, neurosecurity to protect individual neural mechanisms, and the potential of hacking. Since BTBI is a direct transfer of thoughts though, BTBI takes many ethical issues to a new level as well, and journal club took time to discuss many of these concerns. If two individuals are sharing ideas, then does a collective identity result? Who is responsible for the actions committed by the decoder if the encoder is on the other end of the communication line dictating the decoder’s moves? If responsibility for any decision is shared or not, does the encoder or the decoder have ownership over any ideas? In an ideal situation, the communication line would never be flawed, but what if the computer’s algorithm made a mistake and the wrong information was transferred? Many of these questions were framed for a discussion involving a military scenario: The encoder is a soldier, completely removed from combat, but still with a complete view of the battlefield, and the decoder is an active duty military personnel physically experiencing the fighting. A friendly fire ensues and the decoder kills a fellow solider due to the transfer of information from the encoder. Who should be held accountable for the kill – the decoder, encoder, or the scientists responsible for BTBI military setup? This kind of long-distance combat could also lead to new and complex forms of PTSD for the decoder and the encoder, which could potentially require new research and treatments. After discussing many of these questions, it was agreed that not only will many more scientific breakthroughs have to accompany the transition from the current BTBI set-up with rats pushing levers or nose poking to a militaristic BTBI, but so will many more important ethical discussions and decisions. Perhaps BTBI is a novel form of social interaction as well, and in the future, journal club meetings with powerpoints and spoken dialogue will become archaic – we will instead use BTBI to communicate and transfer the material.





References



Trimper, J. (2013). Let’s Put Our Heads Together and Think About This One: A Primer on Ethical Issues Surrounding Brain-to-Brain Interfacing. The Neuroethics Blog. Retrieved on October 1, 2013, from http://www.theneuroethicsblog.com/2013/05/lets-put-our-heads-together-and-think.html.



Pais-Vieira, M., Lebedev, M., Kunicki, C., Wang, J., & Nicolelis, M.A.L. (2013). A Brain-to-brain interface for real-time sharing of sensorimotor information. Scientific Reports, 3, 1319.



Subbaraman, N. (2013). Two rats, thousands of miles apart, cooperate telepathically via brain implant. NBC News Science. Retrieved on October 1, 2013, from http://www.nbcnews.com/science/two-rats-thousands-miles-apart-cooperate-telepathically-brain-implant-1C8608274.



Miller, G. (2013). Rodent Mind Meld: Scientists Wire Two Rats’ Brains Together. Wired. Retrieved on October 1, 2013, from http://www.wired.com/wiredscience/2013/02/rodent-mind-meld/.



Yoo, S-S., Kim, H., Filandrianos, E., Taghados, S.J., Park, S. (2013). Non-Invasive Brain-to-Brain Interface (BTBI): Establishing Functional Links between Two Brains. PLoS ONE, 8(4), e60410.





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Strong, K. (2013). Neuroethics Journal Club: The Ethical Issues behind Brain-to-Brain Interface (BTBI) Technologies. The Neuroethics Blog. Retrieved on
, from http://www.theneuroethicsblog.com/2013/10/neuroethics-journal-club-ethical-issues.html

Let’s Put Our Heads Together and Think About This One: A Primer on Ethical Issues Surrounding Brain-to-Brain Interfacing

By John Trimper

Graduate Student, Psychology

Emory University

This post was written as part of the Contemporary Issues in Neuroethics course



Remember the precogs in Minority Report? The ones who could sync up their brains via the pale blue goo to see into the future?

The precogs from the movie Minority Report

Recent findings published in Scientific Reports (Pais-Vieira et al., 2013) suggest that the ability to sync up brains is no longer purely sci-fi fodder, and instead, has moved into the realm of laboratory reality. The relevant set of experiments, conducted primarily at the Nicolelis laboratory at Duke University, demonstrated that neural activity related to performance on a discrimination task could be recorded from one rat (“the encoder”) and transferred into a second rat’s brain (“the decoder”) via electrical stimulation. This brain-to-brain transfer of task-relevant information, provided the encoder rat was performing the task correctly, significantly enhanced the decoder’s ability to perform the task correctly (see Figure 2 for task description). That is, the decoder rat, who received no external clues as to which of two levers would provide a food reward, responded to the brain-to-brain transfer of information as if it cued him to choose the correct, food-rewarding lever. As a further proof of concept, the experimenters demonstrated that it wasn’t necessary for the rats to be hooked up to the same laboratory computer. In fact, it wasn’t even necessary for the rats to be on the same continent. Using the internet, the researchers were able to transfer information from the brain of an encoder rat at Duke University in real time to the brain of a decoder rat located in Brazil. Performance enhancements in this scenario were similar to those noted above (i.e., decoders chose the correct lever more often if brain-to-brain transfer was allowed).



The work by Pais-Vieira and colleagues (2013) is an important step forward for the field. As the authors suggest, the present findings mark progress towards “an organic computer capable of solving heuristic problems that would be deemed non-computable by a general Turing machine” (Pais-Vieira et al., 2013, p. 8-9). Indeed, Nicolelis’s group continues to be at the forefront of brain interfacing technologies. For example, in previous experiments, Carmena, Nicolelis, and colleagues (Carmena et al., 2003) trained monkeys to reach for and grasp virtual objects with a robotic arm using only their brains and visual feedback (i.e., without moving their own arms). Task relevant neuronal activity was recorded with implanted microelectrode arrays and computer algorithms converted the recorded signals into commands for the robot arm. The technologies hold great promise for the future of prosthetics and stroke rehabilitation.

Two of the mice (an "encoder" and a "decoder") from the experiment

But do the present findings mean that a brain-net is right around the corner? That human brains can be synced up to exchange to the kind of complex thoughts that one intuitively associates with terms like “telepathy”?



Well, no – not quite. Despite what the titles of many popular press articles seem to suggest (search Google for ‘telepathy rat brain transfer' for a laugh), at present, progress is hampered by several considerable limitations. These include the number of neurons that can be sampled, their neuroanatomical locations, and neural decryption/encryption capabilities. Brain-to-brain transfer of complex human thoughts will have to remain a sci-fi fantasy for the time being.



But, given that we’re at least at the point where this sort of technology is being discussed in earnest, it’s appropriate for ethical discourse surrounding the topic to receive a proportional degree of attention. Brain-to-brain interfacing (BTBI), in its current embodiment, involves extracting information from one individual’s brain and delivering this information to a second individual via implanted microstimulation electrodes (microstimulation electrodes, which are similar to the recording microelectrode arrays noted above, allow for the delivery of highly spatio-temporally precise stimulation patterns into the brain).  Thus, BTBI is associated with the same sorts of ethical issues that surround mind-reading (e.g., Kuebrick, 2012), deep brain stimulation (e.g., Schermer, 2011), and brain-computer interfacing (BCI) technologies (e.g., Vlek et al, 2012). However, given that BTBI involves a direct transfer of information between two individuals’ brains, the technique is also privy to its very own host of other ethical issues (e.g., legal and moral responsibility, issues of identity, and privacy).



Consider an illustrative example that is at least somewhat grounded within the framework of the technique’s current capacity. It’s not unreasonable to think that the military, with its appreciably liberal approach to “enhancement,” would be the first to employ BTBI technologies in humans. Imagine that one soldier in ground combat (“the decoder”), fitted with microstimulation electrodes and a helmet-mounted 365-degree camera, was able to neurally receive information directly from a second soldier (“the encoder”) watching the video-feed in a separate location. When the encoder detected a threat on the video feed, this information could be immediately transferred to the decoder, who could respond appropriately. This brain-to-brain transfer of threat information has the potential to be far faster than verbal transmission, and could potentially save many lives. Now imagine that the encoder, watching the video feed, accidentally recognizes a fellow soldier as a threat and a friendly-fire incident ensues. The decoder soldier fires the bullet that ends his comrade’s life. Who is responsible for the soldier’s death – decoder or encoder? What if the neural stimulation pattern was misinterpreted by the encoder (or, importantly, by the computer’s transfer algorithm)? What if the transfer was intentional on the part of the decoder?



According to some, issues surrounding liability as it relates BCI (e.g., one brain only) already have a strong framework for legal consideration. Tamburrini (2009) points out that by using the technology, the decoder is accepting some degree of responsibility for actions of the machine he/she becomes integrated with. To extend this to the current context, one would assume that the encoder individual would also be acknowledging his/her responsibility by taking part. Does this suggest that both would be tried as equally responsible if something went awry?



Of extreme importance for assessing liability would be the transfer algorithm’s ability to accurately decode the extracted neural information. Recording this information would ideally facilitate the post-hoc dissociation between transferred information and decoded/interpreted information, as well as, perhaps, providing some information regarding intention. A feat such as this, however, capable of identifying neural information content with 100% confidence, may be even farther out of reach than the transfer technology itself. As is currently the case for brain-interfacing technologies, each decoding algorithm employed must be carefully and rigorously calibrated (and re-calibrated later on) based on the individual implanted (e.g., “Nigel” in Vlek et al., 2012). One-hundred percent accuracy for the decoding of an intricate neural representation may not be feasible. Thus, a general decoding algorithm that could also extract intention, especially considering the brain regions that would be sampled from, seems unlikely (at present).



Of course, as is the case with any ethical dilemma, each scenario would need to be considered in terms of the specific conditional variables surrounding the event. The findings of Pais-Vieira and colleagues (2013) suggest an exciting future with BTBI technologies, and an equally spirited future of ethical discourse on the topic.

References

Pais-Vieira, M., Lebedev, M., Kunicki, C., Wang, J., & Nicolelis, M.A.L. (2013). A Brain-to-brain interface for real-time sharing of sensorimotor information. Scientific Reports, 3, 1319.



Wessberg, J., Stambaugh, C.R., Kralik, J.D., Beck, P.D., Laubach, M., Chapin, J.K., Kim, J., Biggs, S.J.,Srinivasan, M.A., & Nicolelis, M.A. (2000). Real-time prediction of hand trajectory by ensembles of cortical neurons in primates. Nature, 408(6810), 361-365.



Carmena, J.M., Lebedev, M.A., Crist, R.E., O’Doherty, J.E., Santucci, D.M., Dimitrov, D.F., & Nicolelis, M.A. (2003). Learning to control a brain-machine interface for reaching and grasping by primates. PLoS Biology, 1(2), E42.



Kuebrich , B. (2012). When the government can read your mind. The Neuroethics Blog. Retrieved on April 13, 2013, from http://www.theneuroethicsblog.com/ Schermer, 2011



Vlek, R.J., Steines, D., Szibbo, D., Kubler, A., Schneider, M-J., Haselage, P., & Nijboer, F. (2012). Ethical issues in brain-computer interface research, development, and dissemination. Journal of Neurologic Physical Therapy, 36(2), 94-99.



Tamburrini, G. (2009). Brain to computer communication: Ethical perspectives on interaction models. Neuroethics, 2, 137-149.

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Trimper, J. (2013). Let’s Put Our Heads Together and Think About This One: A Primer on Ethical Issues Surrounding Brain-to-Brain Interfacing. The Neuroethics Blog. Retrieved on , from

Now Available! Neuroethics Journal Club Video Archives on YouTube

The Neuroethics Journal Club videos are now available on YouTube. Watch each discussion to learn about a variety of neuroethics issues, from treatments for pedophilia to neural plasticity in mice. For each video, one presenter introduced the journal topic and opened discussion to the audience. 

Neuroethics Journal Club: The Sexed Brain

The Sexed Brain: Between Science and Ideology

Catherine Vidal, Neuroethics, 2012 

Abstract: Despite tremendous advances in neuroscience, the topic “brain, sex and gender” remains a matter of misleading interpretations, that go well beyond the bounds of science. In the 19th century, the difference in brain sizes was a major argument to explain the hierarchy between men and women, and was supposed to reflect innate differences in mental capacity. Nowadays, our understanding of the human brain has progressed dramatically with the demonstration of cerebral plasticity. The new brain imaging techniques have revealed the role of the environment in continually re-shaping our brain all along our lifetimes as it goes through new experiences and acquires new knowledge. However, the idea that biology is a major determining factor for cognition and behavioral gender differentiation, is still very much alive. The media are far from being the only guilty party. Some scientific circles actively promote the idea of an innate origin of a gender difference in mental capacities. Experimental data from brain imaging, cognitive tests or genetics are often distorted to serve deterministic ideas. Such abuse of “scientific discourses” have to be counteracted by effective communication of clear and unbiased information to the citizens. This paper presents a critical analysis of selected examples which emphasize sex differences in three fields e.g. skills in language and mathematics, testosterone and financial risk-taking behavior, moral cognition. To shed light on the data and the methods used in some papers, we can now—with today’s knowledge on cerebral plasticity—challenge even more strongly, many false interpretations. Our goal here is double: we want to provide evidence against archaic beliefs about the biological determinism of sex differences but also promote a positive image of scientific research.

Neuroethics Journal Club: Pedophilia

Real-time functional magnetic imaging—brain–computer interface and virtual reality: Promising tools for the treatment of pedophilia 

Renaud et al, 2011

 

Abstract: This chapter proposes a prospective view on using a real-time functional magnetic imaging (rt-fMRI) brain-computer interface (BCI) application as a new treatment for pedophilia. Neurofeedback mediated by interactive virtual stimuli is presented as the key process in this new BCI application. Results on the diagnostic discriminant power of virtual characters depicting sexual stimuli relevant to pedophilia are given. Finally, practical and ethical implications are briefly addressed.

Neuroethics Journal Club: Social Pain 

The pain of social disconnection: examining the shared neural underpinnings of physical and social pain 

Eisenberger, 2011 

Nature Reviews Neuroscience

Abstract: Experiences of social rejection, exclusion or loss are generally considered to be some of the most 'painful' experiences that we endure. Indeed, many of us go to great lengths to avoid situations that may engender these experiences (such as public speaking). Why is it that these negative social experiences have such a profound effect on our emotional well-being? Emerging evidence suggests that experiences of social pain--the painful feelings associated with social disconnection--rely on some of the same neurobiological substrates that underlie experiences of physical pain. Understanding the ways in which physical and social pain overlap may provide new insights into the surprising relationship between these two types of experiences.

Neuroethics Journal Club: Plasticity and Learning 

Forebrain Engraftment by Human Glial Progenitor Cells Enhances Synaptic Plasticity and Learning in Adult Mice 

Han et al, 2013 Cell Stem Cell

Abstract: Human astrocytes are larger and more complex than those of infraprimate mammals, suggesting that their role in neural processing has expanded with evolution. To assess the cell-autonomous and species-selective properties of human glia, we engrafted human glial progenitor cells (GPCs) into neonatal immunodeficient mice. Upon maturation, the recipient brains exhibited large numbers and high proportions of both human glial progenitors and astrocytes. The engrafted human glia were gap-junction-coupled to host astroglia, yet retained the size and pleomorphism of hominid astroglia, and propagated Ca²⁺ signals 3-fold faster than their hosts. Long-term potentiation (LTP) was sharply enhanced in the human glial chimeric mice, as was their learning, as assessed by Barnes maze navigation, object-location memory, and both contextual and tone fear conditioning. Mice allografted with murine GPCs showed no enhancement of either LTP or learning. These findings indicate that human glia differentially enhance both activity-dependent plasticity and learning in mice.

Stay tuned for more Neuroethics Journal Club videos next year. Also, to get daily updates about emerging ideas in neuroethics, follow Emory Neuroethics on Facebook here and Twitter here.

The Military and Dual Use Neuroscience

If there’s one thing I learned from the most recent installment of Christopher Nolan’s Batman trilogy, it’s this:  if you’re doing interesting research, it probably has a military application.

In the interest of spoiler avoidance, let's just call this Wayne Enterprises invention "dual-use." (http://ixpower.com/2012/07/dark-knight-rises-batman-movie-does-infant-smr-industry-no-favors/)

Dual Use Technology

The formal name for it is “dual-use technology,” and it’s difficult to find an area of research in which it’s not a relevant concern. Innovations in renewable energy may avert catastrophic global warming, but they also promise to significantly lower military fuel costs and improve the mobility of forces newly unconstrained by the logistics of fossil fuel transportation. Research into nuclear fusion foreshadows essentially inexhaustible carbon-free energy at the same time as it provides a technological foundation for fusion-triggered nuclear weapons that some believe may lower the threshold for nuclear weapons use. Even ostensibly benign anti-obesity campaigns have military implications, as suggested by a recent CBS News article ominously titled “Too Fat To Serve: Military Wages War on Obesity.”



Physics and engineering tend to be the disciplines most readily associated with high-profile military innovations, but it’s biology – and neuroscience in particular – that has increasingly captured the interest of the military research establishment. In 2006’s Mind Wars: Brain Research and National Defense, University of Pennsylvania bioethicist Jonathan Moreno estimates that “most of [DARPA’s][1] desired research proposals directly or indirectly involve the brain” and, in a journal article published this year, finds that the fiscal year 2011 budget contains over $350 million in military neuroscience research. A 2009 Army report entitled “Opportunities in Neuroscience for Future Army Applications” similarly emphasizes the importance of neuroscientific research, declaring that “emerging neuroscience opportunities have great potential to improve soldier performance and enable the development of technologies to increase the effectiveness of soldiers on the battlefield."

Jonathan Moreno’s Mind Wars, to my knowledge the most comprehensive work on the military applications of neuroscience.  (http://scienceprogress.org/wp-content/uploads/2012/05/MindWars_cover.jpg)

The military applications of neuroscience are vast, but can be divided[2] into three categories: performance enhancement and degradation, surveillance and threat assessment, and neural interface.



Performance Enhancement and Degradation

Performance and cognitive enhancement technologies are not new to the military, though they’ve certainly taken on new forms in recent years. The use of stimulants - methamphetamine in Germany and Japan, and amphetamine among the British and Americans – was widespread throughout militaries during World War 2, and the 2009 Army report includes a section on good ‘ol caffeine as a means to “to improve cognitive functioning during sustained military operations.” Recent military research has investigated new drugs, most notably ampakines[3], that attempt to combat the negative effects of sleep deprivation without incurring the abuse potential and side effects often attributed to traditional stimulants. A 2012 report on neuroscience and conflict published by the UK Royal Society cites a number of additional substances – notably, the Parkinson’s drug and dopamine precursor L-DOPA for learning enhancement, the social-behavior-modulating hormone oxytocin for unit cohesion, and anxiety-dulling beta-blockers for decision-making under stressful conditions – with apparent potential for military use. Which substances will find an ultimate military application remains, at this point, unclear. For all the well-publicized success of underground chemists in producing euphoric knockoffs of popular recreational drugs[4], however, it seems inevitable that the military’s best pharmaceutical minds will eventually develop a set of chemicals appropriate to the wide variety of tasks faced by military personnel.

This woman’s oxytocin foot tattoo inspires a certain degree of love in me, though I’m told by more studied colleagues that “looking at molecular diagrams” doesn’t constitute an effective route of drug administration (http://io9.com/5925206/10-reasons-why-oxytocin-is-the-most-amazing-molecule-in-the-world)

Military interest in performance enhancement extends well beyond chemicals. “Opportunities in Neuroscience for Future Army Applications” recommends medium-term field deployment of transcranial magnetic stimulation (TMS), a form of direct electrical brain stimulation that has been associated with memory enhancement. The 2009 DARPA Strategic Plan references a DARPA program, intended for intelligence analysts[5], that aims to develop a neuroimaging system capable of detecting visual information below the level of conscious apprehension. The same strategic plan cites applications for neuroimaging in prescreening potential recruits and in expertise development for high-skill activities such as marksmanship and language acquisition.



In addition to the performance enhancement of its own personnel, the military stands to benefit from the performance degradation of the enemy. Techniques for achieving this goal, which might be categorized broadly as “chemical incapacitation,” have applications in crowd control, counter-terrorism, interrogation, and direct warfighting[6]. Incapacitating substances include opiates, notably utilized by Russia during the Moscow Theater hostage crisis for purposes of mass sedation, as well as other agents with established or theoretical sedating properties such as benzodiazepines, alpha-2 adrenoreceptor agonists, and orexin antagonists[7]. The U.S. military has also conducted research into the somewhat more science-fiction suggestive (and, depending on your political preferences, substantially more sinister sounding[8]) “directed energy weapons,” concentrated beams of small particles or electromagnetic radiation with the ability to cause cognitive impairment as well as physical incapacitation.



Surveillance and Threat Assessment

An EEG device marketed as the Veritas TruthWave helmet has received a fair bit of media coverage over the past several months for its supposed “mind-reading” properties. Attached to the head of a suspicious individual, TruthWave uses EEG to determine if a subject recognizes a given suspicious visual stimulus[9]. If the suspect responds with a pattern of brain activity known as a “P300 signal,” recognition – and therefore, it is thought, guilt – can be inferred. The CEO of Veritas Scientific, Eric Elbot, has been about as ominous as any person could realistically be about a product they hope to sell, telling the Institute of Electrical and Electronics Engineers that “The last realm of privacy is your mind… This will invade that.” Veritas’ research is funded by the U.S. military, and Elbot claims that a similar Veritas product has already been deployed in a border control context.

Veritas Scientific, the company behind theTruthWave helmet (http://www.veritasscientific.com/)

Along similar lines, a company called No Lie MRI has marketed fMRI truth detection technology to the Department of Defense. If you’re a loyal reader of the Neuroethics Blog, this likely won’t strike you as too surprising: the accuracy and usability of fMRI for lie detection have been discussed extensively here in the past. While fMRI has demonstrated impressive lie-detection capabilities in some studies, Neuroethics blogger David Nicholson points out that the current generation of fMRI machines also “take up an entire room and… sound like a dishwasher powered by the souls of unborn babies,” a fact which likely limits their usability in a field context. TruthWave, which neither takes up an entire room nor (to my knowledge) sounds anything like unborn children, may go some way towards ameliorating these limitations.



Neural Interface

Of all the neuroscience technologies currently under investigation by the military, it is neural interface that may produce the most far-ranging implications. Civilian researchers have made remarkable strides in direct neurological control of limbs and other objects, including the successful neural control of prosthetic robotic arms in both primates and humans. Neural interface technology has clear short-term applications in producing high-quality prosthetics for injured servicemembers, to the point where the website for DARPA’s Revolutionizing Prosthetics program suggests that “servicemembers with arm loss may one day have the option of choosing to return to duty.”

The guy on the left looks amused out of his mind. (http://www.defense.gov/news/newsarticle.aspx?id=62114)

In the medium-to-long term, it is conceivable that neural interface systems may revolutionize warfare in its entirety. The UK Royal Society report suggests a number of applications that appear at first glance to border on science fiction: imagine, for instance, remote-operated and brain-controlled vehicles for operations in enemy territory, neutrally-interfaced weapons systems that use unconscious brain data to enhance reaction times, or magnetic implants in the fingers that, when connected to the brain, allow the user to “feel” heat at a distance. In a fascinating Penn State interview, Jonathan Moreno is asked which military neuroscience technologies he feels are most “eye-opening or scary.” Dr. Moreno responds that neural interface technologies enabling what is “essentially a robot army… with the creativity and spontaneity of a human operator” may constitute the ultimate future of warfare (though perhaps, he cautions, not in his lifetime). Such warfare would be conducted not with “boots on the ground,” but by military personnel sequestered safely in a bunker dozens or hundreds of miles away.



Concluding Remarks

A generation ago, a young, patriotic science student might have aspired to work at the Lawrence Livermore or Los Alamos national laboratories, designing multi-megaton nuclear weapons to contain the Communist threat. Today, that same student – perusing a DARPA budget now easily accessible to her online – might reasonably conclude that it is neuroscience, not physics, in which the bulk of future military research opportunities lie. The implications of this paradigm shift for present-day neuroscientists are substantial, a fact which has increasingly been recognized by publications in the field (see here, here, and here). The potentially coercive use of performance enhancing substances among military service members, the consequences of EEG and fMRI for privacy, and the legal and ethical implications of next-generation chemical incapacitants are just some of topics that have been discussed extensively in this literature.



In my next post, I’ll look more comprehensively at the legal, ethical, and geopolitical implications of novel military neuroscience technologies, and discuss the role of neuroscientists in influencing possible future applications of their research.

Want to cite this post?

Gordon, R. (2012). The Military and Dual Use Neuroscience. The Neuroethics Blog. Retrieved on
, from http://www.theneuroethicsblog.com/2012/08/the-military-and-dual-use-neuroscience.html





--------------------------------

[1] Defense Advanced Research Projects Agency, the federal agency responsible for research into military-relevant technology.



[2] Imperfectly, and according to a more or less arbitrary system of personal categorization.



[3] Drugs whose action is mediated, as might be expected, through the AMPA subtype of glutamate receptors.



[4] e.g. “bath salts” and synthetic cannabis, among others.



[5] Neurotechnology for Intelligence Analysts (NIA).



[6] Although many of these applications are either clearly or ambiguously restricted by international law.



[7] See the UK Royal Society report (http://royalsociety.org/uploadedFiles/Royal_Society_Content/policy/projects/brain-waves/2012-02-06-BW3.pdf) for more information on these and similar incapacitating substances.



[8] Sinister sounding enough, in fact, that a Google search for “‘directed energy weapons’ conspiracy” yields 58,000 results, the first page of which contains diverse allegations involving mind control, the anti-Christ, 9/11 truth, and a Russian scheme to melt the polar ice caps.



[9] It’s not clear to me what constitutes a “suspicious visual stimulus,” but one article (http://spectrum.ieee.org/biomedical/diagnostics/the-mindreading-machine/) suggests “bomb specs or Osama bin Laden’s face” as possible examples.

Brain Connectomes: Your ticket to the future

Science often provides us with thrilling and
puzzling scenarios in which our imaginations are forced to conceive the
possibilities the future may bring. Life after death is an old concept that is getting
a facelift. The Connectome, a very real development in neuroscience, is being
used to conceptualize another very interesting piece of science-[fiction]:
mind uploading.

Image from http://www.mindcontrol.se/?attachment_id=3021

Fast-forward a few centuries. Bear with me,
as this requires imagination. You have just died and are beginning the journey
to the next stage of your life. For this trip, you won’t have to pack any bags.
If all goes smoothly, you will be back home in time for the evening sitcoms.
Your casket was lowered into the Earth this morning and because your driver’s
license indicated ‘Continue Life’ you are scheduled for resurrection this
afternoon. Suddenly, a message appears.

There are
three ticket options for you today. Our Elite ticket (1 million USD) and our
most comfortable ride in to the future comes with a wide assortment of amenities.
While fully reinstating your memory, personality and acquired skills, you will
be presented with the opportunity to make any adjustments you wish. A memory of
violence, depression or hardship can simply be erased, liberating you from a
particularly difficult moment. Using our advanced technology, we can also
augment or sharpen certain memories with algorithms that accurately calculate
how an event may have occurred. You will enjoy our most luxurious Back2LiFE
Robotics model, the Elite Humanoid, which comes fully equipped with our AWAKE®
(Automated Work And Knowledge Environment) interactive software, allowing you
to sense the world and all its warmth, just as your previous body did.

The next
option, the Premium ticket (600,000 USD), provides you with all of your
memories and your personality. The Premium Back2LiFE model provides a full
range of motion while also allowing you to interact with the world using the
AWAKE® versions of the 5 human senses: touch, taste, sight, smell and hearing.
Upgrades for this plan are available at any time.

The Economy
ticket (125,000 USD) allows you to return to life free of the weight of any
memories or personality and you will enjoy our basic Back2LiFE model. Upgrades
are not available for this plan…

The choice to Continue Life may not be so far
away. While I am aware that this may sound a bit out there, I am not the only
one who thinks like this. Tom Scott has created a video describing the process of coming back to life and I highly
recommend watching it. It is a chilling, yet extremely believable take on what
re-entry may look like and the choices the human race may someday face. There
are many highly qualified individuals that belief life as we know it will end
very soon. Ray Kurzweil believes that brain uploading will be possible by 2040. Transhumanism,
continuation of life and something called the Singularity are all hot topics.

Before we enter this discussion I should
preface with this: I do not intend to answer questions, proclaim that I know
the answer or make any definitive suggestions on a future course of action. I
am here to ask questions, prompt you to think, and hope that collectively, we
can figure out what to do with this issue.

Image from http://fanart.tv/movie/2277/bicentennial-man/

If you have ever seen the Bicentennial Man, it may have changed the way you think about life, death or what
it means to be ‘human.’ In short, Robin Williams, with all of his magnificent
charm, is a robot of the 21^st century with no greater desire than to
become human. The film, filled with Williams’ knee slap humor and tear-jerking
moments, outlines this ‘unique’ robot’s transition from machine to man. A key
and defining factor is that in order for Williams to be recognized as human, he
must be able to die. According to the film, the ability to die is the proof
that says you had lived a human life.

Imagine for a moment the reverse of the
process. Take an old and dying human body and turn it into a shining, advanced
new machine. Upon death, all of a person’s thoughts, memories and emotions
would be recorded, transferred, and translated into a mechanical body and the
person would be brought back into consciousness. I am not saying that this is
possible, plausible or that it will ever be, but there are people working very
hard to make it so. Kenneth Hayworth, Ph.D., is one of those people. Dr. Hayworth
graduated from University of Southern California before moving on to work at
Harvard. A project that relates directly to his work is the Human Connectome Project, a $40-million collaborative study funded by the National
Institute of Health. The goal of the project is to create a map of the entire
brain, similar to what the Human Genome project set out to do with DNA. The
Connectome project feeds into Dr. Hayworth’s theories, as he believes that an
understanding of the brain’s infrastructure will help in its reconstruction.
However, he understands that there is more. He says, “You can’t look at a road
map of Manhattan and know what its like down there. You have to dig deeper.”

Scientists at Washington University, St. Louis,
the University of Minnesota, UCLA and the Massachusetts General Hospital are
doing the digging for the Human Connectome. They’re not digging for a source of
immortality. Instead, they hope that a thorough understanding of the brain will
unlock secrets to treating neuropathologies. At the University of Georgia and
Emory University, connectomics is already is use. Tianming Liu (U.Ga) and his team have mapped the brain, using
landmarks as they navigate through the dense network of cells. They call the
landmarks DICCOL; dense individualized and common connectivity-based cortical
landmarks. Dajiang Zhu, a student working on the project, says, “DICCOL is very
similar to a GPS system. [It’s] a map of the human brain.”

Image from

http://cercor.oxfordjournals.org/content/early/2012/04/05/cercor.bhs072.full

Xiaoping Hu and
Claire Coles at Emory University are collaborating with Liu and hope to use their map to compare ‘normal’ brains to the brains of
children who were exposed to cocaine while in the womb. As you might expect,
exposure to cocaine can be extremely harmful to children, with the potential to
cause serious damage to their brain networks.

Brain mapping technology has huge potential. Consequently,
there are many issues that it brings, some in the far future but several that
are very relevant now. There are three major topics I will touch on: death,
identity, and property. They are all interconnected within the scope of this
discussion.

First, I will start with death, as it was the
impetus for having this discussion. This is not the first time that someone has
challenged the definition of death. Over the centuries as technology and
medicine advance, our understanding of death has grown and changed. Before
1970, the main identifiers for death (and life, actually) were the cessation of cardiopulmonary function. As we push
forward, we have come to see that a heartbeat and respiratory action signify
that the brainstem is intact but higher brain function may be absent (think
coma or persistent vegetative state). While the science is still disputed, it
is generally understood that when the brain ceases to be active, the individual has died. We have yet to discover have to
discover how to jumpstart the brain back into action, which has caused us to
deem those without neural function as brain dead. Thus, we have another
definition of death, looking beyond heart and lung function and into neural
activity.

Brain uploading challenges both of the aforementioned
definitions of death. After ‘conventional’ death, the possibility of returning to
life makes me wonder if we actually died in the first place. It’s very tricky,
actually. When biological death takes place, what can we say about our
consciousness?

A less abstract thought to consider is the
right to die. Currently, suicide and euthanasia are illegal in most countries and are controversial. As such, Dr. Hayworth and those who are
riding his train of thought must wait to die before they can undergo pre-upload
procedures. It would greatly increase the ability to harvest information from
the brain if it could be taken before death to avoid any associated damages
(cell death from lack of oxygen or damage from a head impact during an
accident). So, should a person be allowed to undergo a ‘life-ending’ surgery
with the intent (or perhaps hope is a better word) of returning to life in the
future? On the other hand, should advanced directives be used, such that an
individual can request to not be uploaded in the same way they can ask not to
be resuscitated?

Dr. Hayworth’s plan has interesting religious
implications. His kind of resurrection clashes with the after-life/next-life
beliefs of many religions. Can Heaven, Hell or reincarnation exist if our minds
are re-synthesized with science? In the brain-uploading situation, what appears
to happen is one ‘consciousness’ dies and another is constructed (a bit like
the movie The Prestige. If you
haven’t seen it yet, pretend like you didn’t read that). You are then stuck
with this tricky situation with identity and determining what really is going
on here.

Dr. Hayworth has an interesting answer to
this conundrum. Though he is answering in the context of creating multiple
reincarnates, his thoughts apply here as well. As each new being is brought
into awareness, they become their own individual. You could have two clones of
the same person. As soon as they awake, they have both begun their own unique
experience and instantly become distinct beings. As such, you are not faced
with identical copies but two distinguishable persons. It’s similar to maternal
twins; the reincarnates have the same physical make up and in this case, the
same memories, but they will experience the world separately from each other.

So, perhaps you are not really coming back to
life. Someone else is just picking up where you left off.

This transition makes for a very interesting
scenario. As a 21-year-old college undergraduate, I have acquired a whole lot
of stuff. By age 85-90, I imagine that I will have built upon my stash. When I
die, I expect to write my possessions off in a will, distributing some here and
there, or perhaps I will just be buried with the entirety of my estate
converted into gold. Property I expect, would be turned over to a relative,
sold or forfeited to the government. However, if I am coming back to life, can
I just put everything on hold until I return? Do I get to keep my things after
my biological death? For how long do I have to reclaim it? Can I decide to put
it into storage for 200 years because I would really like to experience the 23^nd
century? Does my estate roll over? Does debt?

Image from

http://onlyhdwallpapers.com/high-definition-wallpaper/clones-desktop-hd-wallpaper-589675/

Then again, if it isn’t really ‘me’ who is coming
back to life, does the reincarnate have rights to my estate? Who is going to
make that call? While I cannot imagine why someone would want to leave his or
her next-generation self in the dirt, say someone is low on cash but wants to
‘Continue Life.’ Can they use an IOU and promise that their reincarnate will
pay for the costs of the procedure? Here’s a fun
scenario: Why not get two reincarnates and let one work off the debt and have
the other have some fun? You could turn yourself into an indentured servant. In
this case, who is granted personhood as well as the rights and liberties of
being a person? If there are three reincarnates, can all three vote in
elections? It get’s quite messy quickly. The thought of these possibilities is
terribly exciting and excitingly terrifying.

I know that many of the topics I touched on
were skimmed over and deserve much more attention. I encourage you to dig
deeper into these subjects, discuss them with your peers and let me know what
you come up with. This is a huge topic and a full discussion would be well
beyond the scope of this blog post. My goal was to bring up some questions, get
people talking about this and let you readers find your own opinion. In the
meantime, pay attention to connectomes and brain mapping, as I believe that
they hold a lot of promise for the future of neuro-healthcare.

Want to cite this post?

Craig, E. (2012). Brain Connectomes: Your ticket to the future. The Neuroethics Blog. Retrieved on

, from http://www.theneuroethicsblog.com/2012/08/brain-connectomes-your-ticket-to-future.html 

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Related Links

http://www.brainpreservation.org/content/killed-bad-philosophy

http://www.youtube.com/watch?v=IFe9wiDfb0E

http://www.independent.co.uk/news/science/by-2040-you-will-be-able-to-upload-your-brain-1792555.html

http://www.time.com/time/magazine/article/0,9171,2048299,00.html

http://consc.net/papers/singularity.pdf

http://youtu.be/nfVYSbjYZjE

http://www.humanconnectomeproject.org/

http://news.uga.edu/releases/article/gps-for-the-brain-uga-researchers-develop-new-brain-map/

http://news.uga.edu/releases/article/gps-for-the-brain-uga-researchers-develop-new-brain-map/

http://www.psy.vanderbilt.edu/courses/hon182/whocares.pdf

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2772257/

http://www.bbc.co.uk/ethics/euthanasia/overview/problems.shtml

http://www.youtube.com/watch?v=a1AqrIkD7vU