The Ethics of Live-Brain Research

Transcript

• 00:00No, no slides going old school.
• 00:04Oh, my goodness. All right.
• 00:08So welcome. I'm so glad you're here.
• 00:11And welcome to the folks who are
• 00:12here on the ZOOM meeting as well.
• 00:14So I think most
• 00:15of you know, and I'm delighted you're here,
• 00:17The, the program for Biomedical Ethics
• 00:19and the Yale Pediatric Ethics Program,
• 00:21we host an evening seminar twice a month.
• 00:23There'll be one more before Christmas.
• 00:25That's next week, in fact.
• 00:26But tonight we have something
• 00:27special and some of you are familiar
• 00:28with this work and some are not.
• 00:30I sent a note to you guys a couple
• 00:32weeks ago about it a little bit, but
• 00:34I had asked my colleague Steve Latham
• 00:36to come and speak to us this fall.
• 00:38Steve Latham it was is educated as an
• 00:43attorney and a bioethicist to thinking
• 00:44with the Harvard undergraduate as well as
• 00:45the Harvard Medical School and has a PhD.
• 00:49He's no medical school.
• 00:51I can't believe I let you take out.
• 00:53No, it was, it
• 00:54was the law school I remember.
• 00:56So he is an attorney and a philosopher
• 00:59and is importantly very well known
• 01:02in the world of health care ethics,
• 01:05has been very much involved in
• 01:06the American Society of Bioethics.
• 01:07He's a fellow of the Hastings
• 01:10Center and for us at Yale.
• 01:12He is also for several years now
• 01:13he's been the director of the
• 01:15Interdisciplinary Center for Bioethics.
• 01:17So you guys who have an interest
• 01:18in this stuff who may not be
• 01:19familiar with this, we have us,
• 01:20our sister program on the main campus and
• 01:22they host all sorts of various things,
• 01:25among others, a really amazing summer
• 01:27program which you can look into.
• 01:29But if you just looked up,
• 01:30you look up Yale Bioethics,
• 01:31you'll see a link for us and
• 01:32you'll also see a link for the
• 01:34interdisciplinary Center for Bioethics.
• 01:35Lots of lots of fascinating
• 01:37offerings over there.
• 01:38And so we do things back and forth,
• 01:39we help each other out.
• 01:40Steve is very well known teacher
• 01:44specifically on the main campus.
• 01:45He's taught a course in
• 01:46bioethics there for years,
• 01:47which has been either the most highly
• 01:50subscribed course or one of the two or three
• 01:52highly subscribed courses for many years now,
• 01:57recently.
• 01:57And so Steve's come over here,
• 01:59I'd say at least once a year.
• 02:00He does one of these sessions
• 02:01for us and they're always great
• 02:03because he's a very gifted teacher,
• 02:04as you'll see.
• 02:06He also has IRB experience and through
• 02:10his work in terms of research ethics,
• 02:12he got involved in a project
• 02:13about live brain research which
• 02:15is absolutely fascinating.
• 02:16And some of you are familiar with this stuff.
• 02:19Some of you historians who are sitting
• 02:21in the French Revolution might find
• 02:22some of this stuff fascinating.
• 02:23I mean there's there's various
• 02:25ways you can get into this.
• 02:26But I I I wanted so much to
• 02:28hear Steve speak about his
• 02:29work on live Brain research. And so
• 02:32I'm going to tell you guys some numbers,
• 02:34which is the texting code for
• 02:36credit for this for CME is 40966
• 02:40out of town, please call collect
• 02:4440966 to get CME credit.
• 02:47We're going to do this the way we
• 02:48usually do it, which is that Steve's
• 02:50going to speak for about 45 minutes,
• 02:52give or take a little bit.
• 02:54And then after that we are going to
• 02:56have a conversation and I'm moderate
• 02:57and you guys can ask Steve questions,
• 02:59you can fight with each other.
• 03:00We can do all sorts of things until 6:30,
• 03:03at which point I will be wrapping it up,
• 03:05no matter how fascinating
• 03:06the conversation is.
• 03:07We'll close it off at 6:30.
• 03:09But until then,
• 03:09it's going to be a great evening.
• 03:10I thank you so much for coming.
• 03:12And I turn this over to my
• 03:13friend and my colleague,
• 03:14the director of the Interdisciplinary
• 03:16Center for Bioethics at Yale,
• 03:18Steve Latham.
• 03:25Oh, thank you so much, Mark.
• 03:26It's great to be here turning on my timer,
• 03:30so I make sure I don't go too
• 03:32long without giving you guys
• 03:33a chance for some questions.
• 03:34So I have to start with a couple
• 03:38of mandatory disclosures.
• 03:40I'm not a neurologist.
• 03:42I'm not a neuroimaging expert.
• 03:44I'm not even a neuroethicist.
• 03:48So if you're here to learn about
• 03:51a specialty area, you won't.
• 03:53If you're here because you know everything
• 03:55about neurology and neuroethics,
• 03:57you will be hearing a non specialist
• 04:00dribbling his philosophical ideas
• 04:01over your field in a way that
• 04:04will undoubtedly be disappointed,
• 04:06disappointing to you.
• 04:07So you've been warned.
• 04:08Secondly,
• 04:09more importantly,
• 04:10I have a conflict of interest which
• 04:13is that I'm in an I'm an ethics
• 04:15advisor and a an equity holder
• 04:18of Bexorg LLC which is a Yale
• 04:21spin off company that originated
• 04:23in the Ceston neural lab at the
• 04:26medical school that is trying to
• 04:29commercialize some of the techniques
• 04:31that I'll be describing in the
• 04:34last and largest part of my talk.
• 04:36So I want to make money off this.
• 04:40So don't believe a word I say. OK.
• 04:44So having given you those warnings,
• 04:47let me tell you how this talk is organized.
• 04:50OK, first, I mean,
• 04:52I I'm going to kind of do a very,
• 04:55very fast overview of what I think
• 04:58of as main issues in the general
• 05:00field of neuroethics that have to
• 05:03do with research on live brains,
• 05:06including research on brains
• 05:07that are in live humans, OK.
• 05:11And then I will turn to the Bexorg work,
• 05:14which is actually on brains that
• 05:16are not in live people anymore,
• 05:20but that are nonetheless live
• 05:22in ways that I will describe.
• 05:25OK, so the plot of the talk is this.
• 05:27First I'm gonna give an opening
• 05:29section which basically says neuro
• 05:31research on live brains is just like
• 05:33all the other research on live folks,
• 05:36raising all the same basic issues.
• 05:39And I'll explain what I mean by that.
• 05:42And then there's a Part B,
• 05:44which is except when it isn't,
• 05:48OK,
• 05:49which is going to be some of the
• 05:51things that make neuro ethics and
• 05:52live brain research and neuro a
• 05:54little bit different from other
• 05:56kinds of medical ethics.
• 05:58And then I'm going to turn to
• 06:01the work that the Ceston lab and
• 06:03Bexorg LLC have been doing on
• 06:06live brains that are ex vivo.
• 06:10So why is a lot of neuro live
• 06:16brain work mostly very like?
• 06:18What? Why are the ethics issues
• 06:21associated with neuro live brain
• 06:23work mostly like ethics issues
• 06:24in lots of other research areas?
• 06:27I'll give you a few examples.
• 06:28Number one, animal ethics issues, right?
• 06:31Neuro uses regularly mice and rats,
• 06:35zebrafish for certain kinds of work
• 06:39where you require a sophisticated brain,
• 06:41non human primates for work,
• 06:44where you need a really good model of how
• 06:46the human brain responds to trauma pigs.
• 06:49So pigs do a lot of a lot of head
• 06:51trauma work is done on pigs.
• 06:52And you know
• 06:59all of the animal ethics issues
• 07:01that are raised in all other kinds
• 07:04of animal ethics research for for
• 07:06medicine are raised in the neuro
• 07:08context and they're not that different.
• 07:11If neuro is maybe a little bit harder,
• 07:15it's because some of the things
• 07:17that neuro folks are trying to
• 07:19map in their live brain research
• 07:21require a more sophisticated brain.
• 07:23So you can't do it with a zebrafish.
• 07:25You have to do it with you have to do
• 07:27your Parkinson's model or your stroke
• 07:29model in a non human primate or you have
• 07:32to do your brain trauma model in a pig.
• 07:40I have to say, and I've written
• 07:43a very little about this,
• 07:45I think we do way too much animal research.
• 07:48I'm very much more hesitant than the
• 07:50average person who approves of animal
• 07:53research at all about animal research.
• 07:57I am very worried about the FDA standard
• 07:59that says we need results in animals
• 08:01before we go on to human trials.
• 08:04Because, guess what, it doesn't work.
• 08:05Because most human trials for drugs
• 08:08come to the FDA with excellent
• 08:10animal evidence and then they fail,
• 08:12even at phase one,
• 08:13and they've almost none of
• 08:14them get through phase three.
• 08:16And that means the animal
• 08:17models are not working.
• 08:18And they're all kinds of good reasons
• 08:20why the animal models aren't working.
• 08:22We do it on all mice of the same
• 08:25gender from the same little colony,
• 08:27and mice aren't like us in
• 08:29many ways anyway and so on.
• 08:31And I think we waste a lot of
• 08:33animals and I think it's really an
• 08:35area where we need massive reform.
• 08:37But none the less I think that
• 08:40in neuroscience some use of
• 08:42animals is justified.
• 08:43And I'll say a little bit more about
• 08:45that later when we get to talking
• 08:47about the postmortem brain issue
• 08:51with with Siston Lab and Bexorg.
• 08:55Second,
• 08:57another category in which a lot of
• 09:00research in neurosciences on live
• 09:02brains resembles other kinds of humans,
• 09:04other kinds of research is human subjects,
• 09:07right.
• 09:08We've got some very well known
• 09:10standards for informed consent
• 09:12with human subjects research,
• 09:14I would say, you know,
• 09:16so it's not that different
• 09:18for live brain research.
• 09:20Humans consent to what?
• 09:22They're supposed to what?
• 09:24What will be happening to them.
• 09:26They're supposed to understand
• 09:27risks and benefits.
• 09:28And IRB is supposed to have made
• 09:32balancing choices about risks and
• 09:34benefits and is supposed to have
• 09:36approved the informed consent process.
• 09:38I was going to say it's not brain surgery,
• 09:40except that in many cases it is.
• 09:42So I'm going to say it's
• 09:44not rocket surgery. OK,
• 09:49so and there are many examples of
• 09:53these totally mainstream ethics
• 09:55issues in live brain surgery,
• 09:57but we don't, we shouldn't treat them
• 09:59any differently than we treat parallel
• 10:01issues in in in cancer surgery.
• 10:03So for example, right now Lori Bruce,
• 10:06my colleague at the Interdisciplinary Center,
• 10:08and a colleague of ours from
• 10:12Oxford University, Brian Earp,
• 10:14have been working on this problem with
• 10:17a lot of psychedelic studies in the
• 10:20brains of living people who have PTSD.
• 10:23There seems to have been a kind
• 10:26of systematic problem of not
• 10:29reporting unanticipated
• 10:34adverse events in association with those
• 10:37trials. Harms are not being reported
• 10:39and then when they're not reported,
• 10:40they're not being disclosed to new subjects
• 10:44in the in the informed consent findings.
• 10:48But the way you address that is exactly
• 10:49the same way that you would address a
• 10:51similar problem in a cancer trial, right?
• 10:53You try to reform the kinds of things
• 10:55that people report and you try to reform
• 10:57the kinds of things that people ask
• 10:59about in the course of informed consent.
• 11:03Another couple of big kind of brain live,
• 11:06brain study issues that arise,
• 11:08but they arrive in they arise
• 11:11in other areas as well.
• 11:13The problem of predictive diagnosis.
• 11:17Very often people who study brains,
• 11:21if they're studying them using
• 11:23genetic tools or even imaging tools,
• 11:25they can come up with predictions about
• 11:28brain diseases that someone might be,
• 11:30that that someone is more apt to suffer
• 11:34from than someone in the general population,
• 11:37even though they're asymptomatic
• 11:38at the moment.
• 11:40This raises lots of issues in
• 11:42particular can be quite dramatic,
• 11:44traumatic for people to be informed that
• 11:47they are at risk for certain disease
• 11:50where there's no treatment and no cure.
• 11:52But this is not a problem.
• 11:54That's again,
• 11:55it's not a problem that's unique
• 11:56to brain science.
• 11:57It's a problem that is exists across
• 12:00the board and it shows up particularly
• 12:03in every field that uses imaging and
• 12:06you and there's a a parallel issue here
• 12:08which has to do with incidental findings.
• 12:11You you can find some some traits that
• 12:15people have that are not actionable.
• 12:17You can find other traits that people have
• 12:20that you don't quite know what they mean.
• 12:23There's something abnormal
• 12:25in the person's body,
• 12:26but you have no idea what it means.
• 12:28And then you're going down the road
• 12:30toward lots of additional tests and
• 12:32a lot of uncertainty and a lot of
• 12:34worry because something cropped up on
• 12:37an image that you were doing for one
• 12:39reason that might be relevant to other stuff.
• 12:42And very often we don't adequately
• 12:44inform people about the risks that
• 12:46some kinds of imaging or some kinds of
• 12:49tests might inform them about things
• 12:51that we really don't know what to do about.
• 12:55But again,
• 12:56that's not a brain science specific problem.
• 12:58That's a problem that we get in
• 13:01lots of different kinds of medical
• 13:03research and medical practice.
• 13:06And there is growing wisdom on this.
• 13:07Lots has been written about how to
• 13:11handle the incidental findings issue and
• 13:14we can talk about this in discussion,
• 13:15but I I commend you to
• 13:17that growing literature.
• 13:18The point is that it's a thing that
• 13:20shows up in a lot of brain studies
• 13:23because we do a lot of imaging of
• 13:25brains and you could come up with
• 13:27something that looks a little unusual,
• 13:28doesn't quite look like a tumor.
• 13:30Is that a blockage? Right.
• 13:32And you know what?
• 13:33You do imaging on anyone,
• 13:36and you will come up with all
• 13:38kinds of unusual
• 13:38findings that are not causing
• 13:40any symptoms and that you will
• 13:42need to explain and work on.
• 13:43And it's burdensome and it's expensive.
• 13:46And if you haven't informed people
• 13:48of the risk of that in advance,
• 13:50you're doing something wrong. OK.
• 13:57Another another thing that live
• 14:02brain research and here I'm thinking
• 14:04particularly of emergency research
• 14:06has in common with many other
• 14:09fields is the problem of holding
• 14:11out the prospect of life saving
• 14:16but creating a a very low
• 14:20quality of life, right.
• 14:21So when we learned, for example,
• 14:24that cooling off a traumatically
• 14:27injured brain in the Ed could reduce
• 14:30brain swelling and could save
• 14:32some people from dying from the
• 14:34swelling pressure against the skull.
• 14:36When we learned that lots
• 14:38of lives were saved,
• 14:39but the lives that were saved
• 14:41were lives of people who had just
• 14:43gone through a traumatic brain
• 14:44injury and many of them were saved
• 14:47only to be profoundly disabled,
• 14:49including mentally disabled, right.
• 14:52So in every kind of cutting edge
• 14:54piece of research we have this issue
• 14:57of whether a new technology might be
• 15:01advantageous in terms of life saving terms,
• 15:04but that might might leave the
• 15:07patients very unhappy and also in
• 15:09a in a place where they need very
• 15:12expensive care or where they put huge
• 15:14demands on their families and so on.
• 15:16But again,
• 15:17this is not unique to brain sciences.
• 15:22Another thing that's not unique
• 15:24to brain sciences,
• 15:25the treatment versus enhancement distinction.
• 15:32You know, you can give someone Aricept
• 15:34who's got Alzheimer's and that will
• 15:37improve their short term memory.
• 15:39It'll help them hold on to a few more
• 15:42facts for the time that they're on it.
• 15:44But I'm sure no one in this
• 15:46room knows anything about this.
• 15:47But it has been rumoured that the
• 15:50occasional medical student has taken
• 15:52Aricept just before an exam because
• 15:56it is actually attention enhancing
• 15:58and allows you to really focus even
• 16:01when you're tired and so on, right?
• 16:04So many of the very same kinds of
• 16:07interventions that treat people can
• 16:09also enhance people and make them
• 16:13perform they're they're perfectly fine,
• 16:15but the treatment causes them
• 16:17to perform it a little bit more
• 16:19than perfectly fine, right?
• 16:21And we have endless debate about the
• 16:25treatment enhancement line, right?
• 16:27We give growth hormone to children
• 16:30of unusually short stature,
• 16:33but we don't give growth
• 16:35hormone to ordinary kids,
• 16:36so they can grow up to be 6 foot
• 16:386 basketball players, right?
• 16:40The very same treatment that
• 16:42treats a thing that we characterize
• 16:45as a condition also enhances.
• 16:48Well,
• 16:48this is coming up in brain science
• 16:50a lot because a lot of what brain
• 16:52science is focused on is trying
• 16:54to relieve medical problems for
• 16:56people who are losing their memories
• 16:58or are losing capacity to focus
• 17:01all these kinds of things.
• 17:02And the and the treatments for those things
• 17:07very often could also be used for
• 17:11enhancement therapies. There's someone,
• 17:13there are a couple of people who claim
• 17:16that the treatment enhancement thing in
• 17:18brain science is different from treatment
• 17:21enhancement in terms of the genetics of
• 17:25muscle firing and or other things because,
• 17:28and this is John Harris at
• 17:31Manchester University in in the UK.
• 17:33Because if you enhance someone's intellectual
• 17:37capacities, you make them smarter.
• 17:40They will become better people,
• 17:43They will make better ethical decisions.
• 17:46Because smarter people
• 17:47understand arguments better,
• 17:49take in better information, and so on.
• 17:51And I want to say, John,
• 17:52have you never seen a Bond film?
• 17:56Do you not know that there are evil villains?
• 18:02Have you never read Hannah Arendt Anyway?
• 18:06So I don't believe the argument that
• 18:09the treatment enhancement distinction is
• 18:11meaningfully different in brain science
• 18:13than it is in other kinds of science.
• 18:17And finally, in the long category of
• 18:21things that aren't different about brain
• 18:23science compared to things that are
• 18:28access and justice issues,
• 18:33in brain science, as in
• 18:38genetics, as in surgery,
• 18:41as in assisted reproduction,
• 18:43every time you invent a new thing,
• 18:47it's expensive and it always raises the
• 18:51question of who will have access to it.
• 18:54And that question is not
• 18:56different across different fields.
• 18:58It's really a question of how we will
• 19:01ensure equitable access to any new kind of
• 19:07intervention that we come up with.
• 19:10So those are all really important neuro
• 19:13ethics, live brain science issues,
• 19:17but they aren't unique to live brain science.
• 19:21OK, so Part 2, this is what's
• 19:26not usual in brain science.
• 19:29What does brain science have in terms of
• 19:32research that other fields don't have?
• 19:36One is this issue of neuro privacy,
• 19:41the idea that some kinds of
• 19:45brain interventions might give
• 19:47us eventually dangerous kinds
• 19:50of access to people's thoughts?
• 19:56You may have seen, I don't know,
• 19:57about four months ago,
• 19:58a new technology that implanted
• 20:00electrodes in the brain of a woman who
• 20:02had previously not been able to speak.
• 20:04And when she thought about sentences,
• 20:06her her thoughts were translated into
• 20:10words that were vocalized by, you know, AI.
• 20:14And I thought that was amazing, right?
• 20:17And then I thought,
• 20:20can she turn it off?
• 20:24Does everything that she thinks
• 20:26come up on this machine as long as
• 20:29the researchers have it on right?
• 20:31So this gives you a a a sense of of
• 20:33where neuro privacy issues might go.
• 20:35We're not super close to
• 20:37worrying about this really,
• 20:38because for example, F MRI images,
• 20:41it just sort of tells you which
• 20:42parts of the brain are getting
• 20:44more oxygen and things it doesn't.
• 20:45It doesn't tell you what anyone's thinking,
• 20:47but there are lie detectors and there
• 20:49are much better kind of neuroscience
• 20:51informed lie detectors than the
• 20:52ones that just keep track of your
• 20:54pulse and your breath rate, right.
• 20:56And we know that we can have people
• 21:00on exploratory kind of brain imaging
• 21:03machines and find out what kinds of
• 21:06things they're thinking or what parts of
• 21:08their brain are implicated in thinking.
• 21:11There's a really famous ethics
• 21:15problem called the trolley problem
• 21:17that probably many of you.
• 21:18Yeah, I see people nodding like,
• 21:20oh God, not again.
• 21:23So the the the trolley problem is
• 21:28trolley's coming along.
• 21:29You happen to be standing near
• 21:31a lever for no good reason,
• 21:33and the trolley is going
• 21:35to plow into five people.
• 21:37But if you push the lever,
• 21:39it'll be shifted to a different
• 21:42track and plow into one person.
• 21:44And the question is,
• 21:46do you push the lever?
• 21:48And most people, not everyone,
• 21:50but most people, when asked,
• 21:52are willing to push the lever because
• 21:54they would rather sacrifice one innocent
• 21:56person than five innocent people,
• 21:58given that they know nothing else
• 22:01about who the people are and so on.
• 22:03Some people say no because they
• 22:05don't want to be part of the
• 22:07causal chain that kills anyone.
• 22:08They feel like I'm just going to keep
• 22:10away from that lever and it's not my fault.
• 22:12Whereas if I push the lever,
• 22:13I killed that one person,
• 22:16even though I also saved the phone.
• 22:18OK.
• 22:18But then there's another version
• 22:20of the same problem,
• 22:21which is the the bridge problem,
• 22:25where the trolley is coming along,
• 22:27is going to hit 5 people and there's
• 22:29a bridge over the trolley track and
• 22:32you're standing there next to a big guy
• 22:36and you realize if I give this guy a shove,
• 22:39he's going to fall down in
• 22:41front of the tribe, block it.
• 22:42I mean the trials going to run into him and
• 22:45get all tangled up in his body and stop.
• 22:47So I will have sacrificed one
• 22:50innocent person and saved 5.
• 22:51So it's the same as the previous problem.
• 22:55Instead of pulling a lever,
• 22:58I push a guy.
• 23:00And apart from that,
• 23:01I'm to blame for the death of
• 23:04the one and I've rescued 5.
• 23:07And when you ask people about that,
• 23:09most people say I wouldn't do that.
• 23:13And all the people who say, oh,
• 23:14I'd push the lever in the first case say, oh,
• 23:15I wouldn't push the guy in the second case.
• 23:17And Josh Green at Harvard did brain imaging
• 23:23studies and proved that when we humans
• 23:26think about those two kinds of cases,
• 23:29we use different physical parts
• 23:31of our brain to think about them.
• 23:34The first one,
• 23:35because you're thinking about a lever,
• 23:37and it's very abstract and calculative.
• 23:39We deal with our prefrontal cortex,
• 23:41but when we're thinking about
• 23:44pushing someone to his death,
• 23:46a much deeper,
• 23:48older,
• 23:48more reptilian part of the
• 23:51brain is implicated.
• 23:53We think about that problem in a
• 23:55different part of our brain and we go
• 23:58that's just wrong in a in a really deep,
• 24:02responsive,
• 24:03automatic way.
• 24:06That was too long a story to make
• 24:09the point that we are already
• 24:11able to use imaging to determine
• 24:13which parts of someone's brain is
• 24:15engaged when they think about what.
• 24:17And it's not far from there
• 24:20to worries about how.
• 24:22Well eventually we will be able
• 24:24to understand what people are
• 24:26actually thinking just by seeing
• 24:28what portions of their brain
• 24:30they're using to do that thinking
• 24:32and and similar problems.
• 24:34So that is a unique kind
• 24:36of ethics of live brain research problem
• 24:39that we don't get in other areas.
• 24:41Second we have the problem of the moral
• 24:44status of the thing that's growing in
• 24:46the dish and here I'm thinking about
• 24:52brain organoids for example or something.
• 24:55You've got quite a few,
• 24:57quite a few articles and a lot of
• 24:59bioethics attention just a few weeks ago,
• 25:01these mix of of brain tissues and
• 25:06mechanical AI elements which in
• 25:11a recent publication have been
• 25:13shown to be able to play pong.
• 25:17OK, they can play pong,
• 25:19which some of you,
• 25:20if you're old enough,
• 25:21might remember as a really primitive
• 25:23video game from your youth.
• 25:27So the question is if this thing
• 25:30you can see an object coming and
• 25:33strategize about how to meet it and
• 25:35hit it in order to send it back
• 25:37toward the goal post at the other
• 25:39end of this hypothetical game field,
• 25:46is it sentient? It seems to
• 25:48be responding to external,
• 25:52external stimuli.
• 25:55That's what we do when we see.
• 25:56That's what we do when we feel and hear.
• 25:58Is this thing sentient?
• 26:00If it's sentient, is it thinking?
• 26:01Is it deciding what to do?
• 26:03If it's deciding what to do?
• 26:05Is it rational?
• 26:07Do we need to respect it as
• 26:09a moral character there?
• 26:10And it's a little dish,
• 26:11even though we made it and we
• 26:13turned it on yesterday, right?
• 26:15That doesn't come up in other
• 26:17fields other than brain sciences,
• 26:19except AI people are worried about.
• 26:22It's very strongly parallel.
• 26:24People are very worried about the
• 26:26acquisition of certain kinds of
• 26:29human like traits by AI or by brain
• 26:32organoids that might give them
• 26:34a certain kind of moral status,
• 26:36which would then limit us in the way
• 26:39that we could treat them in the dish.
• 26:40We might have to start thinking
• 26:42about them more like mice, say,
• 26:45than we think about just tissue samples.
• 26:51Another thing. I'll say another
• 26:54difference is there's a possibility
• 26:56in some kinds of live brain research,
• 26:58we've had some dramatic examples of this of
• 27:03of the research causing what we might
• 27:06think of as changes in personal identity.
• 27:13So for example, my colleague Joe Finns,
• 27:16who was I've been a visitor at my
• 27:18bioethics center and because of visits
• 27:20at my bioethics center is now affiliated.
• 27:22He's he's a neuroscientist from
• 27:25from from Weill Cornell Medical,
• 27:27but he's affiliated with the law school here.
• 27:29He works with law students on issues
• 27:32about various diminished states
• 27:34of consciousness, that you know,
• 27:37the difference between permanent vegetative
• 27:39state and persistent vegetative state
• 27:41and minimal consciousness and so on.
• 27:45Anyway, Joe has done some work on direct
• 27:48brain stimulation for Parkinson's that he's
• 27:51published some stuff about very recently.
• 27:53And direct brain stimulation for Parkinson's
• 27:56in many patients is fantastic in terms of
• 28:00restoring their physical ability to move.
• 28:04You put electrodes in the brain.
• 28:05You you stimulate some of the cells
• 28:07in the brain to be to some of the
• 28:11neurons to be charging and and working.
• 28:13And this results in improving
• 28:15dramatically the physically the physical
• 28:18mobility of Parkinson's patients.
• 28:21And it also some similar work that Joe
• 28:24has been working on that shows it it it
• 28:27takes people from minimally conscious
• 28:29states to slightly more conscious
• 28:32states because of stimulating the
• 28:34brain to do its work electronically.
• 28:36But there are cases,
• 28:38one from Scandinavia and
• 28:42guessing It's almost 10 years ago now,
• 28:44that it was the first documented
• 28:45case where someone had Parkinson's
• 28:47and the deep brain stimulation
• 28:51cured their mobility problem,
• 28:54but induced in them a really
• 28:58uncontrollable manic personality.
• 29:00So much so that the person needed
• 29:03to be civilly committed so he
• 29:06could walk around and move.
• 29:08He had all this restored mobility,
• 29:10but he had to be committed because he
• 29:13was uncontrollably manic and therefore
• 29:15a danger to himself and others.
• 29:18And you could imagine.
• 29:19And here I should give credit to
• 29:21Adina Roskis, who writes about this
• 29:23in her neuroethics article on the
• 29:26Stanford Encyclopedia of of Philosophy.
• 29:29But you could imagine circumstances in which
• 29:33somebody like this objects to their state.
• 29:37They they have capacity to
• 29:38understand the situation.
• 29:39And when they're manic and and
• 29:43and confined because they're a
• 29:45danger to themselves and others,
• 29:47they could say stop the treatment.
• 29:49I don't want this treatment anymore.
• 29:50It's causing me to be confined.
• 29:53And then they go back to the state
• 29:56where they have highly compromised
• 29:59mobility and they're depressed about
• 30:01that and they say give me the treatment,
• 30:05I hate this, right.
• 30:06And that's an extreme version of the
• 30:09problem that and we've seen this in
• 30:11all kinds of deep brain stimulation,
• 30:14everything from from the level where
• 30:17where mood can be dramatically changed
• 30:20just by the presence of deep brain
• 30:23stimulation to serious personality
• 30:28components more dramatically
• 30:31impactful than just mood changes can
• 30:34be changed by brain intervention.
• 30:36So that is a unique problem that
• 30:39brain research faces also.
• 30:42And finally I will mention, well,
• 30:45now I have two more things to mention.
• 30:47One is my colleague at the
• 30:48philosophy department here at Yale,
• 30:50Lori Paul has this has this idea
• 30:55of the transformative experience,
• 30:57and her examples are things like
• 30:58getting married or buying a house.
• 31:00What she says is you can talk
• 31:04to as many people as you want.
• 31:05You can watch as many movies and
• 31:07read as many novels as you want.
• 31:08But guess what?
• 31:10You don't know what it's like to
• 31:13be married till you get married.
• 31:15You don't know what it's like
• 31:17to buy your first house till you
• 31:19buy your first house.
• 31:20So you can't consent to that.
• 31:25No one can adequately tell you
• 31:27what it's going to be like for you.
• 31:28It's a transformative experience.
• 31:30It's going to be radically different from
• 31:32anything that you've ever thought about,
• 31:35and it might even change who you are.
• 31:38OK,
• 31:38it turns out that there might
• 31:40be quite a few of those.
• 31:41And it also turns out that many kinds of
• 31:46brain interventions might be those
• 31:50kinds of transformative experiences,
• 31:53and that might actually pose some
• 31:55interesting ethical problems about
• 31:56the nature of informed consent.
• 32:01Finally, there's the issue in Brain
• 32:03in Live Brain Science of the whole
• 32:06idea of a neurodiversity movement,
• 32:09which raises lots of questions about
• 32:11what is actually the condition
• 32:12that should be treated right.
• 32:14There are people with autism who
• 32:16claim that autism is not a disease.
• 32:20It's not the kind of thing we
• 32:21should be trying to eradicate.
• 32:22It's not the kind of thing
• 32:23that I require treatment for.
• 32:24It's just a different way of
• 32:26perceiving the world, in some cases,
• 32:28quite a radically different
• 32:29way of perceiving the world.
• 32:30But in many cases,
• 32:32it allows people with autism
• 32:35extraordinary kinds of access to
• 32:37all kinds of sensory input that
• 32:39other humans just don't get right.
• 32:42And the whole neurodiversity issue is
• 32:44a particular challenge in brain science
• 32:47in a way that is not in other areas.
• 32:53OK, so that was my, I don't know
• 32:58my 15 minute overview of of all
• 33:01of neuroethics and which bits
• 33:04of it are unique to live brain
• 33:07work and which bits of it aren't.
• 33:11So now I'm going to talk
• 33:13about mostly pig brains.
• 33:21So in 19, it was 19. That's how old I am. In
• 33:272018, I think it was, I got a panicked
• 33:31phone call from Nenad Sestan and a
• 33:34couple of his senior doctoral and
• 33:38postdoctoral students in his neural
• 33:40lab here at Yale Med, he said.
• 33:45With this project where we're trying
• 33:47to keep brain tissue alive so
• 33:49that we can do it in our research,
• 33:52and what we've been doing is we've
• 33:54been hooking up these brains to
• 33:56a perfusion machine that pushes
• 33:58A perfusate through the brain.
• 34:00And and just for caution's sake,
• 34:04we've been putting Eegs on them.
• 34:07And yesterday we saw some organized
• 34:11activity showing up on the EEG,
• 34:13so we shut down the entire experiment
• 34:14and we heard you were a bioethicist
• 34:16and we wanted to talk to you about
• 34:20it. So two things were great
• 34:23about that phone call.
• 34:24One is that it started me in a relationship
• 34:27with Sestine Lab that has lasted to now,
• 34:30which has been one of the more interesting
• 34:32and rewarding parts of my professional life.
• 34:34And two, the EEG signals they
• 34:36were getting were artifactual.
• 34:38They were just coming off other
• 34:39parts of their electrical equipment,
• 34:41and the brain had not actually woken up.
• 34:43So first we got to go, OK,
• 34:46but then we got to think, right?
• 34:50Because here's what they were doing.
• 34:53They were getting
• 34:56in an effort to preserve functional
• 35:00tissue for as long as possible
• 35:03for use in the lab, right?
• 35:05They wanted to have tissue that they
• 35:07could use and research that had did
• 35:09not have a lot of warm ischemic time
• 35:11and a lot of cellular damage and so on.
• 35:13So they thought, can we come up
• 35:15with a preservation method that
• 35:16we can use in the lab?
• 35:18And in an effort to try to preserve tissue,
• 35:20a couple of the postdocs in the
• 35:23lab came up with a perfusion
• 35:26machine and a perfusate
• 35:30that they could hook surgically
• 35:33to the vasculature of a pig brain
• 35:36and pump the fluid through it,
• 35:38supplying it with oxygen, supplying it with
• 35:43glucose and so on. And then
• 35:48and cycle that through again and again,
• 35:50filter out cellular waste that's
• 35:52taken out of the brain and
• 35:54just keep going with the brain.
• 35:56And at this point,
• 35:57they were able to keep brains going
• 36:00for about six hours or so post mortem.
• 36:04So they would they would go to a
• 36:07slaughterhouse near New Haven where
• 36:09pigs were being killed for sausage.
• 36:12And they would buy a head
• 36:15from the slaughterhouse dude,
• 36:16and take the head on ice back to the lab,
• 36:19exsanguinated.
• 36:19And it would take them about a
• 36:22full hour from the pig's death
• 36:25to attach the now ex vivo brain.
• 36:28The whole head has been removed,
• 36:31had no blood and therefore
• 36:34no oxygen for an hour,
• 36:37and at about the one hour point
• 36:38they could finish up the surgery
• 36:40and have the have the thing
• 36:41hooked up to the machine.
• 36:42And then they started to profuse it.
• 36:43And what they found was that a lot of
• 36:48the ischemic damage was successfully
• 36:50reversed by exposure to this fluid,
• 36:53and the brains began to function
• 36:58normally
• 37:01metabolically, taking in appropriate
• 37:03levels of oxygen and glucose,
• 37:06releasing appropriate
• 37:07levels of cellular waste.
• 37:09A lot of what happens with
• 37:11ischemic damage is that cells
• 37:13begin to swell with waste,
• 37:14and then they burst.
• 37:16But being exposed to this
• 37:18perfusate actually cleared a
• 37:19bunch of that waste and reversed
• 37:21ischemic damage across all the
• 37:23different kinds of cell types
• 37:25that you can find in a pig brain.
• 37:29So the paper in 2019 came out,
• 37:31Nature, basically showing that
• 37:33they've been able to reverse ischemic
• 37:36damage post mortem and sustain the
• 37:39brain metabolically for six hours.
• 37:45Why six hours?
• 37:46Because their controlled brains,
• 37:48which weren't being perfused,
• 37:50had turned into yogurt at six hours,
• 37:53so they had nothing more to
• 37:55compare their study brains to.
• 37:56So that's sort of where they
• 37:58had to stop because the control
• 38:00just didn't work anymore.
• 38:01Today, it's not hours, it's days.
• 38:06It's more than a week in some cases,
• 38:09that they can keep a pig brain
• 38:11metabolically functioning
• 38:12on this perfusion machine.
• 38:17Do they wake up? You may ask.
• 38:20No, they do not, and they cannot.
• 38:23And the reason that they cannot is that
• 38:25the perfusate contains no sodium and
• 38:28neurons cannot fire without any sodium.
• 38:32When you take a neuron out of one of these
• 38:36brains and rinse off the perfusate and
• 38:39give it the right kind of atmosphere,
• 38:42it'll it'll fire again.
• 38:44They're alive.
• 38:46They're metabolizing glucose and oxygen.
• 38:48They're releasing cellular waste.
• 38:50They're just not firing.
• 38:51So it's as if we had a perfectly
• 38:56functioning Ford Montego that we
• 38:59were studying because we wanted to
• 39:02learn things about Ford Montego's.
• 39:04We just don't turn it on.
• 39:07OK, so the pig brains are in there and
• 39:12they're being and they're being exposed
• 39:16to this perfusate and they are living
• 39:19at the metabolic and cellular level,
• 39:22not just for hours anymore,
• 39:23but for days and days.
• 39:24We've done this now with hundreds
• 39:26and hundreds of big brands.
• 39:28They're all EEG monitored.
• 39:29We've never seen any evidence of
• 39:31organized electrical activity of the
• 39:33sort that would be associated with
• 39:35consciousness or experience or anything.
• 39:37And besides that,
• 39:38they're just brains in a vast
• 39:40they're not connected to a nervous
• 39:42system or eyeballs or ears.
• 39:44So there's nothing coming in
• 39:46to them to stimulate anything,
• 39:48any kind of activity.
• 39:54So what kinds of issues does this raise?
• 39:57Ethical issues, does this raise?
• 39:59Because this is different from doing
• 40:01this kind of research in a living animal.
• 40:06You know, I think you and I will
• 40:09agree when we have the brain in
• 40:11the lab and we're perfusing it.
• 40:13And it's been going there for six hours
• 40:17and then it's been there for two days.
• 40:19The pig is dead by cardiovascular criteria,
• 40:24if nothing else, right?
• 40:25The pig is dead.
• 40:27It's been ground up for sausage.
• 40:29So the kinds of questions
• 40:31that we have are about,
• 40:33they're more like the moral
• 40:35status of what's in the dish,
• 40:37kind of questions that I raised earlier
• 40:39about what's going on with this,
• 40:40with this brain.
• 40:41There are of course the
• 40:43normal analytics issues.
• 40:45Pigs are smart social animals.
• 40:48Should we be using them
• 40:51for this kind of research?
• 40:53And I think I
• 40:59I work on this but I answer in the
• 41:01affirmative and the reason that I
• 41:03answer in the affirmative is that
• 41:05there is a huge amount of promise in
• 41:08if you can keep a a large mammalian
• 41:12brain functioning on a machine that
• 41:16is a much better platform for testing
• 41:18brain disease related drugs than
• 41:21mice which is the current standard.
• 41:24And it is also it is permitted
• 41:29some kinds of unprecedented and
• 41:32soon to be published brain mapping.
• 41:36If if you have a brain that is
• 41:38that you can observe while it's
• 41:41metabolically functioning for days,
• 41:44you can put markers in that brain
• 41:46and you can map the brain connectome
• 41:49in a cell by cell, way,
• 41:51that has just never been done before.
• 41:53And that will be incredibly
• 41:55awesome for brain science.
• 41:56Not only clinical,
• 41:58but just basic brain science.
• 42:00So there's lots of cool stuff about this.
• 42:03So the animal ethics thing,
• 42:04I think it is worth
• 42:06actually sacrificing pigs.
• 42:07The bonus is that we can say for the vast,
• 42:13vast majority of the hundreds
• 42:15and hundreds of pigs we've used,
• 42:16we can say that these pigs didn't die for
• 42:19the research because they died for sausage,
• 42:21right?
• 42:21So we're getting the brains from
• 42:23pigs that were going to be killed
• 42:26anyway that indeed were killed,
• 42:27right?
• 42:32Second,
• 42:35does this do anything to brain death?
• 42:40Most states in the country use
• 42:43the Uniform Determination of
• 42:45Death Act to decide who's dead,
• 42:47and they have two standards.
• 42:48They have cardio pulmonary standards.
• 42:50They have brain death standards.
• 42:52Cardio pulmonary Standards says
• 42:53complete and irreversible cessation
• 42:55of cardio pulmonary function.
• 42:58Brain death standards as complete and
• 43:00irreversible cessation of all brain function,
• 43:02including in the brain stem. OK.
• 43:09Irreversible might actually be a
• 43:13little bit undermined by this work.
• 43:16Because if you think about taking a
• 43:18brain that has not had any oxygen,
• 43:20not even any blood for an hour and
• 43:25getting it to turn on and function at
• 43:28the metabolic and cellular levels,
• 43:30that's at a minimum.
• 43:31That means that a lot of stuff
• 43:34that was thought to be irreversible
• 43:37a couple of years ago is now
• 43:40very possibly reversible.
• 43:42What we've discovered is,
• 43:44is a great deal more robustness.
• 43:47That's a word Robustity to to
• 43:51ischemic damage than anybody thought.
• 44:00Luckily for us, our work is hardly
• 44:02the only thing that's getting in the
• 44:04way of our current standards for
• 44:06brain death and of that law that
• 44:08determines what brain death is.
• 44:10There's a million problems
• 44:12with brain death right now.
• 44:14First of all, some groups,
• 44:16for religious and cultural reasons,
• 44:18object to the very idea of brain death.
• 44:20Like many Orthodox Jews think that
• 44:22in in the Torah and tell what
• 44:25a commentary's life is so fully
• 44:28associated with breath that they
• 44:30don't want to accept the brain death
• 44:31criteria and they only want to accept
• 44:33cardio pulmonary criteria for death.
• 44:36Apart from that, many other people just
• 44:39don't trust a diagnosis of brain death,
• 44:42partly for these very understandable
• 44:43reasons that someone who's brain dead,
• 44:45who's still hooked up to a vent,
• 44:48doesn't look dead.
• 44:49Their chest is rising and falling.
• 44:50Their heart is beating.
• 44:52Their skin looks not Gray or or, you know,
• 44:56I mean they they look alive and they
• 44:59sort of have to trust a Doctor Who
• 45:03says that your loved one is is dead.
• 45:06And many people in some cases for
• 45:09very good historical reasons,
• 45:10don't trust the doctors on
• 45:12that kind of thing.
• 45:15And in addition to that,
• 45:18there have been several court challenges
• 45:20around the United States that have
• 45:23basically effectively shown that
• 45:24many of the tests that are organized
• 45:27by specialty societies to to test
• 45:29for the presence of brain death
• 45:32don't actually test for complete and
• 45:35irreversible cessation of all brain function,
• 45:38including the brain stem.
• 45:41So many people have shown that
• 45:45particularly a lot of glandular
• 45:47function keeps on going after many
• 45:49people are actually declared brain
• 45:50dead and there's a bunch of isolated
• 45:53neuronal firing that's going on.
• 45:54So it doesn't mean that all
• 45:56the cells are dead.
• 45:57Is that continued function or not?
• 46:00Right.
• 46:00So there's a lot of controversy
• 46:03about brain death and about the
• 46:09UDDA, the Uniform Determination
• 46:10of Death Act, and a lot of people
• 46:12saying it needs to be revisited.
• 46:14And our research, I think,
• 46:16only adds to that pretty
• 46:21serious contemporary problem for
• 46:22bioethics and and and policy.
• 46:32But there's another issue,
• 46:34which is that sometimes brains that
• 46:36you get to use in research come
• 46:40from organizations that have simply
• 46:42gotten someone's blanket consent
• 46:45to donate their entire body for
• 46:47medical research after they die.
• 46:49And this is not a very well regulated area.
• 46:54People who you might actually
• 46:55just very recently, you might,
• 46:57you might profitably watch
• 46:58John Oliver on this.
• 46:59He just had a piece come out on
• 47:01this like this week right there.
• 47:03There's a lot of problems because the
• 47:07quality of consent necessary to have
• 47:10your body used after you're dead is
• 47:13it's not the standards of informed consent.
• 47:15You don't have to fully understand everything
• 47:16that's going to go on to your body.
• 47:18You just sort of say,
• 47:18I am yielding my body to research
• 47:21and the people who receive the body
• 47:23are not well regulated and some of
• 47:25them are totally upright and doing
• 47:27things that you might expect if
• 47:28you donate your body to research.
• 47:30And some of the some of them are doing
• 47:32things that you wouldn't expect.
• 47:34And for me,
• 47:35if somebody donated their whole
• 47:37body to research,
• 47:38I would like it if they had
• 47:41been told before they did that,
• 47:43that their brain might be kept
• 47:46metabolically functioning for a
• 47:48week or two postmortem right now.
• 47:52If we were to get a brain to do this,
• 47:55get a human brain to do this kind of
• 47:58research from one of these outfits
• 47:59that that takes these things,
• 48:01takes donations of bodies for research,
• 48:04I don't think we'd be getting the kind
• 48:06of consent that I wish that we were getting.
• 48:09But that might require
• 48:10changes in laws and so on.
• 48:12I will say
• 48:15the move to human brains from pig
• 48:18brains is definitely happening
• 48:21in our line of research,
• 48:24and in some ways that's great.
• 48:27For example, if you're getting
• 48:29brains from people who consent,
• 48:31that's my time up,
• 48:32but I'll be done in just a second.
• 48:35If you're getting brains
• 48:36from people who consent,
• 48:39you don't have any of the animal
• 48:40ethics issues that you used to have,
• 48:42right, 'cause people can understand,
• 48:43oh, you know, you're going to
• 48:44do this to my brain. That's OK.
• 48:46And and they donate post mortem,
• 48:50no humans will be killed for the research,
• 48:52even though it might be the case
• 48:54that the occasional pig might be
• 48:56killed for the research and so on.
• 48:58So there's there's ways in which moving into
• 49:01the human world is an unethical relief.
• 49:04If you're going to try to do this research,
• 49:07what kinds of research can you do with a
• 49:10human brain that's being sustained on this,
• 49:12on this machinery?
• 49:16There's there's a functional brain bug,
• 49:20brain barrier.
• 49:21You can look at the way brains metabolize
• 49:24different kinds of potential drugs.
• 49:27You can test drugs in the brains of
• 49:29people who actually had the disease
• 49:31that you're testing the drug for.
• 49:34It's just a really amazing model.
• 49:36And as I said, you could do
• 49:39amazing brain mapping of a kind
• 49:41that's not been possible before.
• 49:46So then the last thing that I will mention,
• 49:49which is the thing that most
• 49:51people really think about when
• 49:52they first hear about this,
• 49:53is this problem of consciousness.
• 49:56I've told you that our perfusate
• 49:59doesn't permit neuronal firing.
• 50:02I would happily donate my brain
• 50:04to this research project because
• 50:06I know that it won't wake up.
• 50:09OK, I'm entirely, 110% confident of that.
• 50:14Why won't it wake up?
• 50:16Because we don't want it to.
• 50:18And by the way,
• 50:19Yale owns the intellectual property
• 50:21to the Perfusade and the Machine,
• 50:23and they're not going to license it to
• 50:26anybody who wants the brain to wake up.
• 50:30But if you tinkered with
• 50:32the perfusion formula
• 50:36and put in some sodium and changed
• 50:40it in a couple of other ways,
• 50:44is it possible that a perfused
• 50:47brain could wake up in the machine?
• 50:52We don't know.
• 50:52But yeah, it's probably.
• 50:54It might well be possible now.
• 50:56It might be that in the total absence
• 50:58of any sensory stimulation whatsoever,
• 51:01it would have no desire to wake up.
• 51:03It would not be motivated to wake up.
• 51:04Doesn't hear anything.
• 51:05Doesn't see anything. Right.
• 51:06But let's say it did wake up,
• 51:08then what would that be like?
• 51:09Would it be wondering where it was?
• 51:11Would it be saying, oh damn,
• 51:13I should never have signed that consent form?
• 51:16Would it be having a dream?
• 51:17Would it be having a panic attack?
• 51:19What is a panic attack like
• 51:21if you don't have a body,
• 51:22what is a panic attack like if you
• 51:26don't have breath and muscles, right?
• 51:32And you might ask,
• 51:33in connection with the animal ethics thing,
• 51:34how would a pig brain waking up in
• 51:37the VAT compare to the brain of a
• 51:40pig that was used to model traumatic
• 51:42brain injury for human beings?
• 51:45I sort of feel like we're already
• 51:47doing much worse things to pigs
• 51:49than this would constitute doing,
• 51:50but I'm really also not sure of
• 51:52the moral status of that argument.
• 51:54I think it kind of assumes too much
• 51:56about what we're doing already being OK
• 52:02For my part, I think that I cannot
• 52:06imagine the research study that would
• 52:09justify inducing consciousness either
• 52:11in animals or in human brains that
• 52:13are hooked up to these machines.
• 52:16The kinds of things that I think about when
• 52:17I think about who would want to do that,
• 52:19I think about there's some characters
• 52:22out there who want to do brain
• 52:24transplants so they can move someone's
• 52:26brain into a non disabled body.
• 52:28I think that's an an illegitimate
• 52:30medical goal and I would oppose using
• 52:32this kind of technology to support that.
• 52:34On those reasons,
• 52:36there are transhumanists.
• 52:37I hear from them all the time.
• 52:40They want their because they're so,
• 52:42I guess because they're so important.
• 52:44They want their brains to be kept alive
• 52:47on machines for a really long time until
• 52:49we can supply them with robotic bodies.
• 52:52So they can just go on forever.
• 52:57And I don't think that's
• 52:59a legitimate goal either.
• 53:00And and then maybe if somebody were
• 53:04trying to create brain machine interfaces,
• 53:08maybe that would be a reason to
• 53:11allow a brain into that to wake up.
• 53:13But I actually think you'd probably
• 53:15do that much more effectively
• 53:17with living human volunteers.
• 53:18So I don't see any reasons at the
• 53:21moment to allow consciousness to occur.
• 53:27So I guess my quick conclusion, and I'm late.
• 53:32Neuroethics is its own field.
• 53:35It needs the space and the specialty
• 53:37journals that is carved out.
• 53:39It needs experts.
• 53:41I am not one, but many of the
• 53:46problems that neuroethics faces
• 53:47are entirely common with problems
• 53:50that non specialty bioethicists
• 53:52like myself face every day.
• 53:55And we can inform those debates.
• 53:57Some few are on their own and really
• 53:59need specialty people who understand
• 54:01the science in order to address
• 54:03them and and the problem of live
• 54:08brain research in ex vivo brains.
• 54:10I think the main ones that we face
• 54:14are the is the question of would
• 54:16it ever be legitimate in the future
• 54:20to permit a brain to experience
• 54:23or even to risk experiencing
• 54:26consciousness in this state.
• 54:28What kind of consent would
• 54:29we need for that and so on.
• 54:33Questions. Right. Mark. Yeah.
• 54:42So if you wanted, you can have a seat.
• 54:44You can stand however
• 54:45you want to do this. And
• 54:46I'll look here I've got a this is,
• 54:48this is on. So I can set Michael.
• 54:50Work. Is that working?
• 54:51Yeah. So that works.
• 54:53So I invite your questions and folks,
• 54:56Karen will eventually bring me a laptop
• 54:58up and we'll work with that.
• 55:00First, I just wanted to let you
• 55:02know that I heard from the guys
• 55:03in my club during the talk,
• 55:06the big guys and and here's The thing is
• 55:09we are large guys, we're affectionate,
• 55:12we like the hug. So just be aware,
• 55:14should any of you choose to throw
• 55:16any of us off the bridge. OK,
• 55:20Just be aware you're coming
• 55:22with us. OK. All right.
• 55:24Just so just so we're just
• 55:25so we're clear on that.
• 55:26I thought that was a fascinating
• 55:27talk, a lovely overview,
• 55:29as well as of course very tantalizing
• 55:32talk on the on the cutting edge
• 55:34stuff that's been going on the last
• 55:36couple years over in the main campus.
• 55:38So there's, there's much to talk about.
• 55:39So let's start, Please wait one
• 55:43second. I nearly forgot.
• 55:44We got to do this properly so
• 55:45that the people on Zoom can
• 55:48hear and also there we go.
• 55:51Thank you. So please do wait until you have
• 55:53a mic so the folks on Zoom could hear and
• 55:55also so that everyone in the room could
• 55:57hear You hold it up nice and close so
• 55:58it doesn't work like you. Really. Yeah.
• 55:59So interesting talk.
• 56:00I just want to ask you a quick question.
• 56:03So I don't know how many billion
• 56:05neurons a pig brain has.
• 56:07The human has about 100 billion,
• 56:10of which there's enormous
• 56:11variability in susceptibility
• 56:14to oxygen deprivation, right.
• 56:16So you you, you made the assertion
• 56:20that these neurons were alive.
• 56:23And it's unclear to me how you made that
• 56:26assertion and how much you're sampling,
• 56:28because you're saying there's no neuronal
• 56:31activity because there's no sodium.
• 56:32And yet you're seeing,
• 56:34you're saying you can
• 56:35measure that they're alive.
• 56:39What do you mean by that?
• 56:40Yeah, a couple of ways.
• 56:43When you take them out of the brain,
• 56:45they twitch. How many?
• 56:48How many cells do you look at?
• 56:51It is not 100% of the cells that
• 56:54recover from ischemic damage.
• 56:56And how many cells?
• 56:59I don't know. You have to read the
• 57:02Nature cover story that ran in 2019.
• 57:04That was the first one to talk about
• 57:06the restoration of metabolic and
• 57:08cellular function in the pig brains.
• 57:10The exact numbers are in that article,
• 57:12but I don't know them.
• 57:13But my general impression of the
• 57:16result is that it was a small minority
• 57:19of cells that had not survived
• 57:22the hour and had not been revived.
• 57:26And one of the major ways that
• 57:28you can tell this is by comparing
• 57:31controlled brains that
• 57:35in live pigs, by measuring input and
• 57:37output in the vasculature of live pigs,
• 57:40to the brains in the machinery and
• 57:43looking at the amount of oxygen and
• 57:46glucose that is taken in and used and
• 57:49the amount that comes out at the other
• 57:50end after having gone through the brain.
• 57:52Right. So you're looking at what goes
• 57:55into the brain and what comes out of
• 57:58the brain in terms of food and waste.
• 58:00And what my understanding of what they
• 58:03saw in the 1st paper was that very
• 58:06rapidly the brain began behaving in a way
• 58:10that was completely characteristic of a
• 58:13traumatized brain in a living animal, right.
• 58:16So it was acting like an injured brain in
• 58:18terms of how much material it was taking
• 58:20in and how much cell it was giving out,
• 58:22more than the usual amount of cellular
• 58:24waste because it's trying to clear out
• 58:25some of the stuff from the damage.
• 58:27And then by the end of the multiple
• 58:30hours of perfusion,
• 58:31it was looking more like a normal
• 58:34brain in terms of how the whole
• 58:36brain is metabolizing material.
• 58:40I think there's much better and much
• 58:42more detailed information now that
• 58:44hasn't yet been published because
• 58:46these days the lab is keeping the
• 58:48brains going for a week at a time
• 58:50rather than for hours at a time.
• 58:56Please.
• 59:04Hi. Thank you for the talk.
• 59:06I'm curious like what what
• 59:08kind of evidence or response
• 59:10might convince you that a brain
• 59:12or a system has become conscious?
• 59:14And then maybe even a more pressing
• 59:15question like what what kind of evidence
• 59:17would convince you that we should start,
• 59:19like to be safer, to be ethical,
• 59:21like we should act as if
• 59:22it's conscious just to be just to be safe?
• 59:30I I think the baseline would be some
• 59:33kind of network neuronal firing.
• 59:37We know that in people who have
• 59:39been diagnosed brain death, we see
• 59:41isolated neurons firing here and there.
• 59:43That doesn't give rise to experience.
• 59:50And we have, you know, pretty,
• 59:53pretty good understanding of the kinds of
• 59:55the way that the way that network firing
• 59:59looks in certain kinds of situations.
• 01:00:01And I think we'd need to
• 01:00:03detect something like that.
• 01:00:05But again, in the research that's
• 01:00:09currently being done at Yale,
• 01:00:11the perfusate doesn't allow
• 01:00:13any neuronal firing at all.
• 01:00:16It allows the neurons to feed
• 01:00:19themselves and take in oxygen and
• 01:00:21expel cellular waste and so on,
• 01:00:23but it doesn't allow them to fire.
• 01:00:25So in that circumstance,
• 01:00:28there's there's not anything there.
• 01:00:30But if if you,
• 01:00:32if you were to set up the perfusase
• 01:00:35so that neuronal firing was possible,
• 01:00:36then you'd be looking for some kind
• 01:00:40of organized network firing activity.
• 01:00:43What would count as the place
• 01:00:44where you would say, oh,
• 01:00:45now is the time to shut this off.
• 01:00:48I don't know enough about,
• 01:00:50but I actually think that there are
• 01:00:52some neuroscientists out there who
• 01:00:54know an awful lot about what different
• 01:00:56kinds of states of awareness or
• 01:00:58experience or sensation look like.
• 01:01:02So I want to push back on one of the on
• 01:01:07a fundamental premise this whole thing.
• 01:01:10Just so I'm clear on this, We as a society,
• 01:01:14we as a species have long ago decided
• 01:01:17and we as a society still accept with
• 01:01:20a notable minority who feel otherwise.
• 01:01:25We have a society accept the fact
• 01:01:26that one can take a pig and put it
• 01:01:30in a little tiny pen forever, right?
• 01:01:32And then when we're finally done
• 01:01:34growing to a certain size,
• 01:01:35we can then slaughter it, OK, and eat it.
• 01:01:38Now many people,
• 01:01:39including some good friends of mine,
• 01:01:41would say, well that's the wrong thing to do.
• 01:01:43But the fact of the matter is this is
• 01:01:45widely practiced throughout the world,
• 01:01:47has been throughout human history.
• 01:01:49So I'm actually a little bit it
• 01:01:52it doesn't quite pass for me the
• 01:01:54straight face test to say,
• 01:01:55hang on a second,
• 01:01:56we're going to take this pig. We're going
• 01:01:57to just treat it in for lots of better worth,
• 01:01:59these incredibly cruel circumstances
• 01:02:01throughout its entire existence.
• 01:02:03But geez, we're not going to let
• 01:02:04that brain wake up for a couple days,
• 01:02:05because that would really be me to me.
• 01:02:08What might be happening to
• 01:02:09that brain for that six hours
• 01:02:11or seven days now has got to
• 01:02:15be infinitesimally trivial
• 01:02:18compared to the experience that
• 01:02:20Pig had throughout his life.
• 01:02:22So I'm fascinated that there
• 01:02:24has been such resistance.
• 01:02:25Some people I'm amazed we took the
• 01:02:28salt out of the perfusate that there
• 01:02:31isn't more interest in seeing if they
• 01:02:32can create that and and to me to say
• 01:02:34that well this is this is because to
• 01:02:36do so would be unkind to the pig,
• 01:02:38to me that strange credulity
• 01:02:40given the rest of the pig and Full
• 01:02:43disclosure I eaten my share of pigs.
• 01:02:45OK, but as most people in the room have.
• 01:02:50But is there honestly a feeling
• 01:02:52that we can't do this?
• 01:02:53Because it would be unethical
• 01:02:54for this pig brain to experiencing something
• 01:02:57totally disregarding everything he's
• 01:02:58experienced for its entire existence?
• 01:03:02Two things. One is there are a lot of
• 01:03:07people very close to all the members
• 01:03:09of the research community who are
• 01:03:10really worried about the premise.
• 01:03:12Like maybe we shouldn't be treating
• 01:03:13those pigs that way at all.
• 01:03:15Maybe that is fundamentally wrong.
• 01:03:16And if that's fundamentally wrong, you know,
• 01:03:19why should our little world be different?
• 01:03:21Why should we use the horribleness
• 01:03:23of Agri business to justify our
• 01:03:26own horribleness, right?
• 01:03:27That's one kind of response.
• 01:03:32Another kind of response is anything
• 01:03:35you do with a pig brain today,
• 01:03:37you might do with a human brain tomorrow.
• 01:03:40And there is therefore some reasonable
• 01:03:47prudential argument for not facilitating,
• 01:03:52not creating the technology that might
• 01:03:55allow us to do things that we find
• 01:03:58fairly appalling with human brains.
• 01:04:01Right. There's that kind of slippery
• 01:04:03slope argument is is out there as well,
• 01:04:08and those things, and
• 01:04:16maybe this isn't an ethical statement at all.
• 01:04:18This is just kind of a a a statement of fact.
• 01:04:23There's nothing as far as I know,
• 01:04:24there's nothing that Ceston lab or
• 01:04:27that the Bexorg spin off company
• 01:04:30that's trying to commercialize some
• 01:04:32of the Ceston Labs techniques.
• 01:04:34There's nothing that we want to
• 01:04:35do with big brains that would be
• 01:04:37assisted by having them be awake.
• 01:04:41So if we can do our science
• 01:04:45without even coming close to
• 01:04:48stepping on an ethical landmine,
• 01:04:51that's what we want to do.
• 01:04:54Got it? I
• 01:04:55have a question from someone in
• 01:04:56the Zoom world who says could
• 01:04:59you characterize the control?
• 01:05:01I'm soon we're talking about
• 01:05:02the pig experiments here again.
• 01:05:02Could you characterize the control
• 01:05:04conditions in a little more detail?
• 01:05:07What are the control conditions
• 01:05:08you referred to the control conditions
• 01:05:10for the 1st paper where that we were
• 01:05:15comparing a perfused the brain that was
• 01:05:18being perfused with our perfusate to a
• 01:05:21a brain that was not being perfused and
• 01:05:24just comparing the conditions and the
• 01:05:27ischemic damage that happened over time.
• 01:05:30And we also had considerable measurements
• 01:05:34about the activities of brains.
• 01:05:36And you would not believe how well
• 01:05:40mapped out the contours of pig
• 01:05:42brains have been by Agri business.
• 01:05:45They know what EEGS and pig brains
• 01:05:48look like when pigs are hungry.
• 01:05:50They know what Eegs look like.
• 01:05:52And pigs that have been hurt
• 01:05:53by being hit in the head,
• 01:05:55they know what pigs brains EEG readouts look
• 01:05:58like when pigs want to have sex, right.
• 01:06:00It's incredibly well mapped.
• 01:06:02So we had access to all that
• 01:06:04kind of literature,
• 01:06:05but we also had controlled brains that
• 01:06:07were just being allowed to degrade.
• 01:06:10And the reason,
• 01:06:11my understanding of the reason for
• 01:06:13why we stopped in the first article,
• 01:06:15why we stopped reporting about
• 01:06:17what was going on in hour six,
• 01:06:19was that the controlled brain
• 01:06:20at that point was just useless
• 01:06:23and not creating any data.
• 01:06:24It didn't just turn to mush.
• 01:06:27So we're
• 01:06:28looking at serial, presumably
• 01:06:30serial Histology and watching
• 01:06:31the necrosis progress until
• 01:06:32the point until it's liquefied
• 01:06:34or looking at the conditions of
• 01:06:37cells at different points in time
• 01:06:40and looking at input and output from
• 01:06:44the perfused brains. Yeah, Thank you.
• 01:06:49So I think like we can all think of like
• 01:06:5310 people at least who would pay 50 to
• 01:06:56$100 billion for this technology, right.
• 01:06:58And and will, I mean the the patent's only
• 01:07:01going to last for like 20 years, right.
• 01:07:03And they will 18 now or something like that,
• 01:07:05Yeah. But leaving aside that those folks,
• 01:07:09it seems to me that that there are like a
• 01:07:11a number of like very legitimate uses I I
• 01:07:15can think of for for this technology in,
• 01:07:20you know, life saving medical care
• 01:07:22for humans. So you know the number
• 01:07:24one killer in in the developed world
• 01:07:27is heart disease, right?
• 01:07:28And you have potentially here a technology
• 01:07:32that could restore life to a brain after
• 01:07:36a catastrophic cardiac event, right?
• 01:07:39And and allow, you know,
• 01:07:44intervention and treatment
• 01:07:45potentially even like you know,
• 01:07:48heart transplant to repair the cardiac injury
• 01:07:52and the person could go on with their life,
• 01:07:54you know, in their body if you
• 01:07:57could just restart the brain.
• 01:07:58I mean that that I can,
• 01:08:01I can multiply the examples of the ways
• 01:08:03that this could be used clinically the
• 01:08:06the perfusate itself since it is very
• 01:08:08good at keeping very complex organs alive.
• 01:08:11It's like a substitute blood and
• 01:08:12it might well help with transplant.
• 01:08:15You might be able to take organs from
• 01:08:17someone who's a donor and hook them
• 01:08:19up to a a perfusion machine that's
• 01:08:21been customized for that kind of
• 01:08:23organ and fly it across the country,
• 01:08:25fly it around the world and use
• 01:08:27it for transplant exists.
• 01:08:28You do that for kidneys,
• 01:08:30you do that for livers and so on.
• 01:08:32And that's how these guys derive
• 01:08:34the solution to food.
• 01:08:36There's a derivation of the
• 01:08:39previous solution that had for
• 01:08:41kidneys and livers and so on that has
• 01:08:45been around for long. I'll have
• 01:08:46to take your word for that.
• 01:08:50Although I do know that we had a
• 01:08:52study of whole body perfusion with our
• 01:08:55perfusate that compared it to ECMO and
• 01:08:57it performed better than ECMO at support
• 01:09:01of organs across a whole deceased pig.
• 01:09:07But right it might have
• 01:09:09applications for for transplant.
• 01:09:11And also the perfusate is a cellular so it
• 01:09:14carries oxygen without any red blood cells.
• 01:09:17And that means if somebody's had a stroke,
• 01:09:20which is in in the form of, you know,
• 01:09:22a sieve in a capillary in the brain,
• 01:09:25Perfuse 8 might be able to carry
• 01:09:27oxygen through the sieve to the
• 01:09:28downstream parts of the brain.
• 01:09:30There are many possible medical applications,
• 01:09:34but those don't require consciousness
• 01:09:38and they're being licensed out.
• 01:09:40Yale owns the intellectual property
• 01:09:42to the Perfuse 8 and machinery and
• 01:09:45the the labs here and also Bexorg are
• 01:09:48partnering with research universities
• 01:09:50around the world to try to work on
• 01:09:52developing those clinical applications.
• 01:09:54Including, you know,
• 01:09:55trying to bring someone back who's had,
• 01:09:57who's not breathed 'cause they had
• 01:09:59a heart attack in a swimming pool
• 01:10:011/2 hour ago that that kind of
• 01:10:03stuff is definitely on the table.
• 01:10:05But, but specifically,
• 01:10:07restoration of consciousness after 10
• 01:10:10minutes or an hour of death would be,
• 01:10:14you know, a medical miracle, right?
• 01:10:18Like that.
• 01:10:18That seems to me like something
• 01:10:20worth investigating.
• 01:10:29Yeah. I think the way that you
• 01:10:32would investigate it would be via
• 01:10:34emergency room applications because
• 01:10:38we know that it can do some reversal
• 01:10:42of ischemic damage in the brain
• 01:10:44and restore metabolic function.
• 01:10:46And I think the way you would
• 01:10:49do it is you would try it out in
• 01:10:51people who otherwise would die
• 01:10:53and see if it restores function.
• 01:10:56And then you run into the thing
• 01:10:57that I already mentioned, the talk,
• 01:10:59which is that you could have a
• 01:11:01therapy that restores function but
• 01:11:03doesn't restore great quality of life.
• 01:11:05I'm not sure what would what the
• 01:11:08additional gain would be to show that
• 01:11:10it it wakes up the brain in the VAT.
• 01:11:13Why that?
• 01:11:13Why you would want to do that before
• 01:11:16you try to apply it to someone whose
• 01:11:18other option is death in the ER,
• 01:11:24Yeah, no, sorry.
• 01:11:24My question was just making sure that
• 01:11:26you were saying a little bit louder,
• 01:11:27a little bit closer, if you would.
• 01:11:28My question was just making
• 01:11:29sure that you were saying that
• 01:11:31you would go like straight
• 01:11:33from brain about not not like awake
• 01:11:36to testing on humans to see if that
• 01:11:40would awake. And you don't see
• 01:11:42a benefit to like trying out
• 01:11:45that on a like, pig brain before
• 01:11:47heading over to like 'cause like,
• 01:11:50I guess I I I don't know,
• 01:11:52I don't know enough.
• 01:11:53But wouldn't you be able to
• 01:11:55sort of tell if you aren't
• 01:11:58regaining function that is
• 01:12:00conducive to any quality of life
• 01:12:03in a brain of that before you got to
• 01:12:07doing that in life, like live humans?
• 01:12:11I'd say I don't know the answer to that.
• 01:12:16So yeah, I I I don't know how much,
• 01:12:22how well, again, the brain is
• 01:12:27disembodied on the perfusion machine.
• 01:12:30It is not getting any sensory information.
• 01:12:34It's not clear to me that the awake
• 01:12:37brain in the machine is a decent
• 01:12:40model for somebody who's lying there
• 01:12:42in a whole body with arms and legs
• 01:12:45and eyes and ears and a nose, right?
• 01:12:48It's not clear to me that whatever you
• 01:12:52would see in the perfusion context
• 01:12:54would be a decent map of what you
• 01:12:57would see in the emergency department
• 01:12:59if you restored metabolic function to
• 01:13:00the brain of someone who was injured.
• 01:13:05It's not clear to me how great
• 01:13:08the value would be of adding
• 01:13:11that step before trying it out,
• 01:13:14especially with patients who
• 01:13:16otherwise we would give up on.
• 01:13:20Steve, a question and this
• 01:13:23is this is on some Physiology
• 01:13:26going on here. I think in
• 01:13:27reference to your description
• 01:13:28perhaps of some of the potential,
• 01:13:29how is the connectivity of the
• 01:13:30brain maps without neurons firing?
• 01:13:38Because neurons are connected
• 01:13:40in permanent pathways,
• 01:13:41even if they're not firing.
• 01:13:43There is something like you can
• 01:13:45imagine the Google Maps of the brain,
• 01:13:47and there are certain kinds of markers,
• 01:13:51viral markers mainly,
• 01:13:52that if you put them in a brain
• 01:13:55that is metabolically functioning,
• 01:13:57will spread from cell to cell in the
• 01:14:00pathway that those cells are connected to.
• 01:14:02So for example, you you can
• 01:14:06do that
• 01:14:09not in the same way and not at this
• 01:14:12single cell to single cell level.
• 01:14:14But I believe that in the next six
• 01:14:18months you will see a publication
• 01:14:20that shows that the kind of brain
• 01:14:22mapping I'm talking about is not
• 01:14:24currently available anywhere.
• 01:14:28Thank you. Yeah, this gentleman.
• 01:14:29It does seem to me that there
• 01:14:31are some potential clinical
• 01:14:33applications of this technology that
• 01:14:35would require inducing consciousness.
• 01:14:40It seems to me that we might
• 01:14:41be able to make some advance.
• 01:14:43And I'm not a I'm not a psychiatrist,
• 01:14:45I'm not a neurologist.
• 01:14:45But it does seem to me that we can make some
• 01:14:47advances in the field of,
• 01:14:48for example, mental health care
• 01:14:50if we are able to
• 01:14:54somehow experiment on these brains in a VAT,
• 01:14:57so to speak, that are conscious
• 01:15:00now without any sensory input.
• 01:15:04But could we? Could we not?
• 01:15:08I mean, yeah, I think so.
• 01:15:10When these people say to me,
• 01:15:11I want to upload my brain into a computer,
• 01:15:15I part of my response to them is,
• 01:15:18what's your plan for Tuesday
• 01:15:20morning with no body?
• 01:15:22Yeah, right. I I, I really,
• 01:15:25I I feel like the disembodied,
• 01:15:27like one of the things
• 01:15:28that I mean when I say,
• 01:15:30hey, the pig is dead,
• 01:15:32even though we've got its brain
• 01:15:35metabolically going in our lab,
• 01:15:37that pig is dead, right.
• 01:15:39I think we are much more
• 01:15:44embodied
• 01:15:47than we than people who are very
• 01:15:50concerned with brains often reckon on
• 01:15:55anyway. But I, I interrupted you.
• 01:15:56Yeah. No, I I, I, you know,
• 01:15:59I don't know if we need sensory
• 01:16:00input per SE to look at
• 01:16:02those things. Because in,
• 01:16:03I mean in in theory, right.
• 01:16:04A a conscious disembodied
• 01:16:06brain will still carry with
• 01:16:07it its memories, right.
• 01:16:09And its experiences. And I don't
• 01:16:11know I'm making this up, right.
• 01:16:13This is all science fiction.
• 01:16:14We have to, I don't know,
• 01:16:15talk to them about them,
• 01:16:17figure out what they were,
• 01:16:19stimulate particular memories,
• 01:16:21all in a completely disembodied model.
• 01:16:24I I, I don't, I don't really see it.
• 01:16:28So depending
• 01:16:29on how much of the brain you
• 01:16:30take out, of course it's it's
• 01:16:32quite possible to get
• 01:16:34stimuli into a brain just through
• 01:16:38cranial nerves, for example,
• 01:16:41or auditory. I mean there are,
• 01:16:42there are people who are building
• 01:16:45brain organoids that they're trying
• 01:16:47to connect to sensory organs.
• 01:16:53Your interface is that that input
• 01:16:55visual stimuli into the right.
• 01:16:56The the pong playing brain
• 01:16:58computer interface that just
• 01:16:59was written about last month or
• 01:17:00cochlear implants that
• 01:17:01send electrical signals
• 01:17:02directly to the auditory nerve and and
• 01:17:04you know you you think and you move a
• 01:17:07joystick so you can drive your wheelchair,
• 01:17:09those kinds of things there.
• 01:17:10No, there's a lot of there's a lot of
• 01:17:12human brain mechanical interface available.
• 01:17:18No, there's sensory input. There's
• 01:17:19what I'm saying is there's there's
• 01:17:21actually sensory input available as well.
• 01:17:25Yeah. And you'd have to explain to
• 01:17:26me why it would be better to do that
• 01:17:28in a model that was disembodied than
• 01:17:30you know a volunteer human subject
• 01:17:32that that's a fairpoint that that that
• 01:17:35I agree with. But
• 01:17:37I do think that you know
• 01:17:39there there is potential benefit
• 01:17:41across that event horizon
• 01:17:42of consciousness as well.
• 01:17:44And if we're, you know,
• 01:17:45we're just doing the math
• 01:17:46in our head right now, we say, all right,
• 01:17:47that that benefit's not worth it.
• 01:17:51I think that's a reasonable
• 01:17:52conclusion to draw,
• 01:17:54but that could be, that could be.
• 01:17:59I've got one question here.
• 01:18:02This is a follow on from the
• 01:18:03first question I asked you which
• 01:18:05was that when you spoke of a a
• 01:18:07traumatized brain in a living animal,
• 01:18:09this is a quote or a traumatized,
• 01:18:12traumatized brain in a living animal
• 01:18:14is to control a brain or an animal.
• 01:18:18I'm not quite sure what that question is.
• 01:18:20I have to apologize to the
• 01:18:21question of your well,
• 01:18:22I think when I was talking
• 01:18:24about traumatized brains,
• 01:18:24I was I was trying to compare
• 01:18:31suppose we were to bring a pig
• 01:18:34brain to consciousness in the lab.
• 01:18:39What could what could the negative experience
• 01:18:42of that pig brain possibly amount to?
• 01:18:45And I was making a point that's sort of
• 01:18:48parallel to the point that you made about
• 01:18:50the fact that we all eat pork in other
• 01:18:53parts of our medical research complex.
• 01:18:56We bash pigs in the head in order to make
• 01:19:00judgments about the effects of brain trauma.
• 01:19:03And I can't imagine that the ill
• 01:19:06effects of a pig of having its brain
• 01:19:08come to life in a VAT in the lab,
• 01:19:11could be worse than the ill effects on
• 01:19:14the pig who has his head bashed in as
• 01:19:16part of a brain trauma experiment and
• 01:19:18or a pig who is part of a cancer study
• 01:19:21where death is the end point and so on.
• 01:19:23Right. We do lots of things to pigs
• 01:19:27that strike me as worse than what
• 01:19:30we would be doing to the pig brain
• 01:19:32in our research studies. So
• 01:19:34but let me ask you this, but
• 01:19:37that's not enough to say that we could
• 01:19:38go ahead and do our research studies
• 01:19:40because it might be really wrong that
• 01:19:42we're doing all those terrible things.
• 01:19:43But let me ask this question I I get that.
• 01:19:46But but to me it's a cannonball and a
• 01:19:48BB to some extent to say we're really
• 01:19:50going to worry about this BB because but
• 01:19:52we're going to ignore the cannonball.
• 01:19:53But the other aspect of this is that
• 01:19:55there's a lot of concern about the pigs,
• 01:19:58because pigs, as you point out,
• 01:20:00are very intelligent,
• 01:20:01very social animals, etcetera.
• 01:20:02And from an ethicist point of view.
• 01:20:05And again, I know you don't call
• 01:20:07yourself an animal ethicist,
• 01:20:07but this is a question
• 01:20:08we can all ask ourselves
• 01:20:09is does that make this work more or less
• 01:20:12permissible than if this were the brain
• 01:20:15of a a mouse, or the brain of
• 01:20:18something much smaller and and and
• 01:20:21less intelligent, less social?
• 01:20:24Yeah, I mean this is controversial,
• 01:20:25controversial view in philosophy.
• 01:20:27But I accept what is widely accepted in the
• 01:20:32kind of in some parts of animal ethics,
• 01:20:34including Shelley Kagan here at Yale
• 01:20:38and in in a lot of the debate about
• 01:20:42the use of animals in medical research,
• 01:20:45The the refine and reduce and replace
• 01:20:49kind of mantra that iacooks obey when
• 01:20:53their institutional animal care and
• 01:20:54use committees obey when they're trying
• 01:20:57to figure out what kinds of animals
• 01:20:58you can use for what kind of research.
• 01:21:01They will always say that it's preferable
• 01:21:04to climb down the species ladder.
• 01:21:07If you can get the result in your
• 01:21:09study from a zebrafish,
• 01:21:10don't get it from a mouse.
• 01:21:11If you can get it from a mouse,
• 01:21:13don't get it from a marmoset, right.
• 01:21:16I get
• 01:21:16it if they say that what I'm asking
• 01:21:18is the ethical justification for it.
• 01:21:21Because the thought is that
• 01:21:23the amount of suffering you're
• 01:21:25inducing in the animal inversely
• 01:21:28varies with their mental capacity.
• 01:21:33Humans exposed to a certain
• 01:21:35kind of experimental
• 01:21:39intervention might have enhanced capacity
• 01:21:42to suffer during that intervention.
• 01:21:45Even Peter Singer, right Mr.
• 01:21:47Animal Rights Guy says.
• 01:21:48Like one of the one of the primary
• 01:21:52inventors of modern era animal
• 01:21:55rights rhetoric and philosophy.
• 01:21:57He says if there are 590 LB animals
• 01:22:02in a boat, four of them are people
• 01:22:04and one of them is a large dog,
• 01:22:06and only four can survive with
• 01:22:08the provisions in the boat.
• 01:22:10He says you should throw the dog overboard,
• 01:22:13not one of the people. Why?
• 01:22:15Because he's being a good utilitarian.
• 01:22:17He thinks the dog, like us,
• 01:22:20will roam around in the water
• 01:22:21for a long time in the cold
• 01:22:22water until it gets too cold,
• 01:22:24and then it's going to drown and die.
• 01:22:25But the dog is going.
• 01:22:28I'm getting tired and having
• 01:22:30various physical bodily sensations,
• 01:22:31but he's not thinking I'm going to
• 01:22:34miss my granddaughter's birthday.
• 01:22:35Oh, how will my wife find out
• 01:22:37what happened to me? Right.
• 01:22:39We are capable of much more
• 01:22:41sophisticated levels of suffering
• 01:22:42in that kind of circumstance.
• 01:22:45So toss the dog, OK?
• 01:22:47That's what the Peter Singer example is.
• 01:22:49Well,
• 01:22:49something like that is going
• 01:22:50on when you say it's worse to
• 01:22:52experiment on a pig than it is
• 01:22:54to experiment on on a mouse.
• 01:22:55We just sort of feel that pigs
• 01:22:58have more sophisticated capacity
• 01:23:01for suffering than mice have.
• 01:23:04You're leaving that assumption
• 01:23:09of what it's it's a different. It's not it,
• 01:23:13it's a different guy. Yeah. Well, but
• 01:23:17yeah, on evidence of the mental
• 01:23:20capacities of different kinds of animals
• 01:23:23as demonstrated in their behaviors,
• 01:23:25their degree of sociality.
• 01:23:28Oysters, for example.
• 01:23:32Yeah.
• 01:23:35So hang on. It's.
• 01:23:36Well that. Yeah, that go
• 01:23:38ahead. If brain, brain,
• 01:23:41the microphone is going to
• 01:23:42be among many other things.
• 01:23:43But at this point the last let me
• 01:23:44just say so this this will be.
• 01:23:46So the question was about you've
• 01:23:48made a comment and then this
• 01:23:49will this will be the last one.
• 01:23:50So let me just be it has to do with
• 01:23:52comparing the suffering of different
• 01:23:54species as and and and what is there
• 01:23:56evidence for that and you were about
• 01:23:59to discuss the evidence for that.
• 01:24:02As far as I understand it
• 01:24:03and this is not my field.
• 01:24:05I'm quoting people who are more
• 01:24:08expert in animal ethics than I am.
• 01:24:10But it has to do with brain size,
• 01:24:12brain capacity, evidence of sociality,
• 01:24:14evidence of the degree of memory
• 01:24:17the different animals possess when
• 01:24:19they're tested in different ways.
• 01:24:22There are, there are lots of people
• 01:24:24who spend a lot of time worrying
• 01:24:26about the comparative mental
• 01:24:28capacities of different animals now.
• 01:24:30A capacity to sell, Sure.
• 01:24:32And, and I will say,
• 01:24:34it's been a huge trend in recent
• 01:24:37years for for people to come out with
• 01:24:40lots of surprising evidence about how
• 01:24:43extraordinary the capacities of animals,
• 01:24:45how extraordinarily greater than
• 01:24:46we used to think the capacity
• 01:24:49of certain animals are.
• 01:24:50Like birds, for example,
• 01:24:52can remember the faces of people
• 01:24:54who've been mean to them,
• 01:24:56and fish can learn to avoid painful stimuli,
• 01:25:00and they can learn from experience
• 01:25:01and change their swimming patterns
• 01:25:03in response to things.
• 01:25:05So there's been a huge theme in recent
• 01:25:08animal ethics literature about how
• 01:25:10much more mental capacity different
• 01:25:13kinds of animals have than we have
• 01:25:16commonly given them credit for.
• 01:25:18But that is not at all the same thing
• 01:25:21as to say their mental capacities
• 01:25:23are so identical that they all
• 01:25:25deserve the same level of moral
• 01:25:27regard or the same level of rights.
• 01:25:29There are people like Tom Regan who
• 01:25:31think that any animal that is the
• 01:25:33subject of a life that leads a life
• 01:25:35and makes choices about what it's
• 01:25:37going to do next has an absolute
• 01:25:40right not to be interfered with by us.
• 01:25:43But most animal ethicists acknowledge
• 01:25:45some kinds of degrees of priority
• 01:25:48between different kinds of animals,
• 01:25:51and we spend a lot of time
• 01:25:53agonizing and discussing the
• 01:25:54different degrees of of moral status
• 01:25:57and priority among our own species.
• 01:25:59People with dementia,
• 01:26:02newborns, fetuses, right.
• 01:26:06This is absolutely fascinating stuff.
• 01:26:07Steven, we're going to follow
• 01:26:08this work with interest and we I,
• 01:26:10I really appreciate your coming and
• 01:26:12sharing this with us and working
• 01:26:13this through this has been terrific.
• 01:26:15Thank you so much.
• 01:26:15Thank you so much for having me.
• 01:26:16And thank you for all the great questions.
• 01:26:22All right. We'll see you next week.