Sunday, December 21, 2003

This is the fifth part in a series of editorials on the challenges raised by the October report of the President’s Council on Bioethics.

This joyful season has many moments of aggravation and frustration, ranging from the instant someone swipes a precious parking space at the mall to the lengthy periods of preparation and cleanup that bookend holiday parties. Yet despite those trying times, holiday moods and memories are usually so happy that many wish they could stay in the seasonal spirit all year.

In the future, the products of biotechnology might provide that opportunity. Tailor-made medicines might give both the momentary brightening of mood and the longer-term palliation — and possibly even total obliteration — of painful memories. However, pharmacologically induced happiness could be costly to both the individual and the society. By diminishing the capacity to feel, mood-brighteners might diminish the ability to grow; by reducing the sting of the past, memory-modifiers might compromise one’s moral agency and even sense of self.

Mood-altering agents like alcohol have been used for millennia. However, newer pharmaceuticals — selective serotonin reputake inhibitors (SSRIs) such as Prozac and Zoloft — are more subtle in effect and perhaps greater in peril. Under some circumstances, SSRIs can be life-savers, lifting deeply depressed individuals to functional levels. However, those medicines may also be used to lift the moods of individuals who are simply melancholy. At some point, healing the psyche might be confused with the pharmacological pursuit of happiness.

That possibility is worrisome, since numbing experience can estrange one emotionally, reducing the capacity to feel disappointment and delight. Some moments should not be dulled, lest the lessons they teach be lost. Dissatisfaction can be a spur, discontent a motivator. Such pharmaceuticals, the Council said, “may fracture the relationship between passion and action, inducing calm, apathy and easy self-satisfaction where energy, engagement, and the desire for self-improvement might be called for.”

Moreover, identity is intimately intertwined with memory. Experiences blurred or dulled by mood-altering drugs might produce a shrunken self — an individual whose life is lived out of his “right mind,” and whose ability to cope with the real world is limited by chemical crutches. Such medicines might also silence the voice of conscience, which sometimes reminds of shames that should not be repeated. According to the Council, eliminating the mental sting of memories “risks eroding the responsibility we take for our own actions.”

In addition, some events — such as the Holocaust — must be remembered fully and completely so that their horror is not repeated. While some detachment may salve survivors of crippling emotional experiences, those are terrible exceptions to the larger concerns.

Ultimately, the fullest life may not necessarily be the happiest one. Rather, it is one in which the fingertips of the psyche feel perfectly instants of pleasure and periods of pain; in which each moment is experienced truly and lived fully. Medicines that lift moods and cover memories could increase happiness, but only at the cost of reduced humanity.

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