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Eradicating war memories: Neuroscientific reality and ethical concerns

Published online by Cambridge University Press:  20 December 2018

Marijn C. W. Kroes  and
Rain Liivoja
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Abstract

Traumatic memories of war can result in mental disorders such as post-traumatic stress disorder (PTSD). PTSD is characterized by intrusive trauma memories and severe stress responses with devastating personal and societal consequences. Current treatments teach patients to regulate trauma memories, but many experience a return of symptoms even after initially successful treatment. Neuroscience is discovering ways to permanently modify trauma memories and prevent the return of symptoms. Such memory modification techniques (MMTs) have great clinical potential but also important ethical, legal and social implications. In this article, the authors describe PTSD, the role of memory in PTSD, its effects on the brain, and the limitations of current treatment methods. Then, the state of the art of the neuroscience of MMTs is presented. Within this realistic scientific framework the authors will discuss the ethical, legal and social implications of MMTs for the treatment of war-induced PTSD, especially in a military population. Three major sets of issues will be focused on: safety and social justice concerns, concerns about threats to authenticity and identity, and the possible legal and moral duties to retain certain memories. Finally, the article concludes that within scientific reality, concerns are limited and do not outweigh the potential benefits of developing treatments for patients.

Keywords

warpost-traumatic stress disordermemory modificationneuroscienceethics
Type
Ethical challenges: Whether to remember
Information
International Review of the Red Cross , Volume 101 , Issue 910: Memory and war , April 2019 , pp. 69 - 95
Copyright
Copyright © icrc 2018 

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Footnotes

*

While writing this article, both authors were supported by Branco Weiss Fellowships. Marijn C. W. Kroes was also supported by an H2020 Marie Skłodowska-Curie Fellowship.

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114 E. Donovan, above note 87, p. 70.

115 D. L. Schacter, above note 108, p. 183.

116 A. J. Kolber, above note 105, p. 1600 (emphasis in original).

117 E. Donovan, above note 87, p. 70.

118 J. E. Warnick, above note 110, p. 37.

119 E. A. Holmes, A. Sandberg and L. Iyadurai, above note 108.

120 President's Council on Bioethics, above note 80, p. 231.

121 C. R. A. Aoki, above note 90, p. 357.

122 Robin Marantz Henig, “The Quest to Forget”, New York Times Magazine, 4 April 2004; D. Wasserman, above note 107, p. 12; C. R. A. Aoki, above note 90, pp. 356–357.

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131 E. Parens, above note 80, p. 106.

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135 There is broad support for the “principle of equivalence of care”, which requires prisoners to be provided health care equivalent in quality to that provided to the general public. For critical discussions of this concept, see Niveau, Gérard, “Relevance and Limits of the Principle of ‘Equivalence of Care’ in Prison Medicine”, Journal of Medical Ethics, Vol. 33, No. 10, 2007CrossRefGoogle Scholar; Jotterand, Fabrice and Wangmo, Tenzin, “The Principle of Equivalence Reconsidered: Assessing the Relevance of the Principle of Equivalence in Prison Medicine”, American Journal of Bioethics, Vol. 14, No. 7, 2014CrossRefGoogle ScholarPubMed.

136 For a discussion of associated human rights issues in a different context, see Amon, Joseph and Lohman, Diederik, “Denial of Pain Treatment and the Prohibition of Torture, Cruel, Inhuman or Degrading Treatment or Punishment”, Interights Bulletin, Vol. 16, No. 4, 2011Google Scholar.

137 Paul McHugh, quoted in Giles, Jim, “Beta-Blockers Tackle Memories of Horror”, Nature, Vol. 436, No. 7050, 2005CrossRefGoogle ScholarPubMed.

138 For a brief discussion, see René Provost, “Targeting Child Soldiers”, EJIL: Talk!, 12 January 2016.

139 Booth-Kewley, Stephanie et al. , “Factors Associated with Antisocial Behavior in Combat Veterans”, Aggressive Behavior, Vol. 36, No. 5, 2010Google ScholarPubMed.

140 C. R. A. Aoki, above note 90, p. 356.

141 See, for example, E. Donovan, above note 87, pp. 70, 72.