Defining brain death and the controversies of existence

The Boston Globe has an interesting article on the concept of ‘brain death’. The criteria for brain death are being contested and it’s become a hot issue, partly because the US allows organs from consenting donors to be removed when brain death has been diagnosed.

The ‘dead donor rule’ stipulates that it’s only possible to remove organs in cases where a person has died, and this can either be after cardiac death, where the heart and lungs stop functioning, or after brain death, where the brain suffers irreversible damage which causes coma where the patient is kept alive solely by life support.

Most organs donated from the deceased come from people who have been diagnosed as brain dead. Organs remain viable for only about an hour or two after a person’s last heartbeat. Brain dead patients are ideal candidates for organ donation, then, because they are kept on ventilators, which means their heart and lungs continue to work, ensuring that a steady flow of oxygen-rich blood keeps their organs healthy. Surgeons remove the donor’s organs, then shut off the ventilator. The patient’s heart eventually stops.

Yet a small but vocal minority in the medical community has always insisted that some brain dead patients may not be dead. For instance, one study documented some kind of brain activity in up to 20 percent of people declared brain dead, suggesting to some critics that doctors sometimes misdiagnose the condition. Although some neurologists contend the claim, University of Wisconsin medical ethicist Dr. Norman Fost points to research showing that many “brain dead” patients have a functioning hypothalamus, a structure at the base of the brain that governs certain bodily functions, such as blood pressure and appetite.

It’s an challenging that speaks directly to our idea of what divides life and death. There is no question that any of the patients will recover, regardless of any residual activity detected in their brain.

But it prompts the question of what sort of brain activity we consider human enough to constitute life.

Of course, the issue is compounded by the importance of life-saving organ donation operations, for which suitable organs are almost always in short-supply.

Link to Boston Globe article ‘Fatal flaw’.

Pavlov: the name that rings a bell

Mental Floss, an emporium of thought-themed merchandise, do this witty Pavlov t-shirt in either a long or short-sleeved version.

Actually, they do quite a few psychology themed t-shirts although they have a distinctly early 19th century feel to them.

For those still on a behaviourist tip, Advances in the History of Psychology have an interesting piece on common errors in psychology textbooks, with one about an oft-repeated legend concerning the bearded Russian dog harasser:

…a wide array of textbooks seem to repeat a version of the story of Pavlov‚Äôs mugging in which he laid his wallet beside him on a seat at New York‚Äôs Grand Central Station and, upon discovering it missing after an extended intellectual reverie, philosophically mused ‚Äúone must not put temptation in the way of the needy.‚Äù

In fact, according to the contemporary New York Times account of the event, Pavlov and his son were confronted by a three men after having boarded a train and had their money forcibly taken from them.

Link to Mental Floss t-shirts.

2008-03-21 Spike activity

Quick links from the past week in mind and brain news:

Medication is the least effective way of treating children with conduct problems, according to a recent review.

Truth serum art chaos! The Arts Catalyst has a secret psychology art-science project you can participate in on March 29th in Liverpool.

The New York Times has a rather timely election themed article on the psychology of rumours.

“You know, just the other day, on this very blog, I swore I would never read another imaging paper again…” Evidence we are helpless to resist (the colours! the colours!) as Mixing Memory discusses a recent brain imaging study on the influence of language on colour perception.

Child-like intelligence created in Second Life. Surely this isn’t news?

Treatment Online examines a study which has found differences in a gene linked to neural connectivity in people with autism spectrum diagnoses.

The New York Times has an article on the popularity of sewing wild oats throughout the animal kingdom.

The key Freudian concept of transference captured in the lab, and reported by Cognitive Daily. See an earlier Mind Hacks post for more on the science of transference.

The Guardian reports that the Pentagon delayed mild brain injury screening in an attempt to prevent medicalisation of psychogenic problems.

<a href="Tiredness 'raises sleepwalk risk'
http://news.bbc.co.uk/1/hi/health/7300527.stm”>Sleepwalking is more likely to occur when people are recovering from sleep deprivation, reports BBC News.

As a nice complement to our recent post on authenticity, Psychology Today’s Matthew Hutson discusses the psychology of authenticity in the art world.

Is someone at New Scientist trying to win a bet over how many times they can get the word ‘telepathy’ into print? This time an article about a possible US military ‘telepathic’ ray gun‘ that has nothing to do with telepathy. Sadly.

Imminent gnome attack! Wired report on how World of Warcraft could be used to study terror tactics.

Channel N has a remarkably well-explained video introduction to body dysmorphic disorder.

It is better to give than receive. At least in terms of your happiness, reports Not Exactly Rocket Science.

Better living through reckless self-experimentation

Scientific American have just concluded its series on scientists who have experimented on themselves in an effort to better understand the mind, brain and body.

The first piece is about Kevin ‘Captain Cyborg’ Warwick, who seems mainly to have been experimenting with the media rather than himself.

I’ve always considered him the poor man’s Stelarc to be honest, but then again, Stelarc hasn’t had a distinguished research career in robotics so swings and roundabouts I guess.

A further story discusses Olivier Ameisen, a cardiologist who became alcoholic and treated himself with baclofen, a drug then untested for the condition.

There’s a couple of people who experimented on their children, which doesn’t really count as self-experimentation in my book, but they make for good reads nonetheless.

One covers Deb Roy’s recording of the entire first two years of his child’s vocalisations and speech to help understand how language develops.

The other describes Jay Giedd’s project to brain scan his daughter every three months from the age of four upwards. Interestingly, it got stopped by the ethics committee because she might feel pressured to take part. Surely bribery by Pokemon cards would have solved that problem?

While there are several other scientists discussed, the only other one of psychological interest in the legendary Alexander Shulgin who has spent most of his life synthesising new hallucinogenic drugs and trying them on himself. He’s now 83. There’s a moral in that story somewhere.

Link to SciAm’s self-experimenters series.

Will Working Mothers‚Äô Brains Explode?

A new journal, Neuroethics, has just launched and among the freely available articles is an engaging piece on ‘neurosexism’, the increasing trend to portray sex differences as ‘hard wired’ into the brain.

The piece is by psychologist Cordelia Fine who argues that some recent popular science books and articles are simply restating old stereotypes but making them sound more modern with an appeal to neuroscience.

Neuropsychiatrist Louann Brizendine’s book The Female Brain comes in for particular criticism, as it has in the scientific literature. But despite the fact it seems to play fast and loose with the scientific evidence, it has become an international best-seller.

Then, too, with the buzz-phrase ‘hard-wiring’ comes an extraordinary insistence on locating social pressures in the brain. In The Female Brain, for example, the working mother learns that she is struggling against “the natural wiring of our female brains and biological reality” (p. 161). According to Brizendine, combining motherhood with career gives rise to a neurological “tug-of-war because of overloaded brain circuits” (p. 160). Career circuits and maternal circuits battle it out, leading to “increased stress, increased anxiety, and reduced brainpower for the mother’s work and her children.” (p. 112).

But Brizendine promises her female readers that “understanding our innate biology empowers us to better plan our future.” (p. 159). It may startle some readers to learn that family friendly workplace policies are not the solution to reduced maternal stress and anxiety, and that fathers who do the kindergarten pick-ups, pack the lunch-boxes, stay home when the kids are sick, get up in the night when the baby wakes up, and buy the birthday presents and ring the paediatrician in their lunch hour are not the obvious solution to enhanced maternal ‘brainpower’.

No, it is an appreciation of female brain wiring that will see the working mother through the hard times. (Predictably, Brizendine never even hints that the over-wired working mother consider the simplest antidote to the ill-effects of going against her ‘natural wiring’: namely, giving her partner a giant kick up the neurological backside.)

Fine’s argument is not that that sex differences don’t exist in the mind and brain. Indeed, there are numerous scientific studies which have reported these.

The problem is that they are often portrayed in the popular literature as being ‘hard wired’ – an ugly analogy taken from computers that suggests that the difference is an innate and permanent feature.

Apart from ignoring the fact sex differences are typically only stable at the group level (meaning that this difference is not significant in any single male-female comparison) most of these claims about ‘hard wiring’ are not based on evidence about the innateness of the difference.

Actually, I’ve never been clear what ‘hard-wired’ is supposed to mean. Even if we presume that a particular behaviour or feature is coded in the DNA, the brain develops only through interaction with its environment – be this after birth, or in the womb.

In other words, most claims about a human ability being ‘hard wired’ ignore the history of how these develop through our lives.

The rest of the first issue of Neuroethics also looks fascinating, with article on neuroenhancement of love and lust, nanotech, neuroimaging and understanding others’ mind, to name but a few.

pdf or web version of Fine’s article ‘Will Working Mothers‚Äô Brains Explode?’.
Link to Neuroethics 1st issue table of contents (via Neurophilosophy).

The northern lights of neural stem cells

The beautiful image on the right is a collection of neural stem cells stained with fluorescent die, taken from the finalists of the Wellcome Image Awards.

A wonderful image of the bacteria that cause a type of meningitis is another brain-related image in the finalists’ gallery.

There are plenty more images of course, but don’t miss the audio interviews that accompany each image where the scientist discusses their work.

All of the pictures are quite stunning so well worth a look.

Link to 2008 Wellcome Image Awards gallery.

Internet addiction nonsense hits the AJP

While we’ve got used to ‘internet addiction’ popping up in the media from time to time, it has inexplicably been the subject of an editorial in this month’s American Journal of Psychiatry arguing it should be included in the DSM-IV – the next version of the diagnostic manual for psychiatry.

The editorial suggests that we should make ‘internet addiction’ a serious public health issue despite the fact that no-one yet has suggested anything that uniquely distinguishes it from its use as a tool or a source of entertainment.

For example, here are the components that the author, psychiatrist Jerald Block, cites as evidence that someone can become addicted to the internet:

1) excessive use, often associated with a loss of sense of time or a neglect of basic drives, 2) withdrawal, including feelings of anger, tension, and/or depression when the computer is inaccessible, 3) tolerance, including the need for better computer equipment, more software, or more hours of use, and 4) negative repercussions, including arguments, lying, poor achievement, social isolation, and fatigue

Apart from the fact that these and most other supposed criteria make no distinction between using the internet and what the person is using the internet for, it’s easy to see that they don’t describe anything unique to the net.

For example, here are my criteria for ‘sports team addiction’:

1) excessive time following games, often associated with a loss of sense of time or a neglect of basic drives, 2) withdrawal, including feelings of anger, tension, and/or depression when team news or matches are inaccessible, 3) tolerance, including the need for better match viewing equipment, more news, or more hours of team-related activity, and 4) negative repercussions, including arguments, lying, poor achievement, social isolation, and fatigue

As more people in the world follow sports teams than have access to the internet, surely this is the more serious problem, especially considering the high levels of violence and alcohol abuse associated with this tragic affliction.

You may, of course, substitute whatever interest you want into the criteria to capture people who are the most motivated to pursue their favourite interest, or who are workaholics who rely on the technology (if you want a retro version, substitute the ‘postal system’ for the internet for a 1908 style communication addiction).

Rather curiously, the editorial mentions the figure that 86% of people with ‘internet addiction’ have another mental illness. What this suggests is that heavy use of the internet is not the major problem that brings people into treatment.

In fact, ‘internet addiction’, however it is defined, is associated with depression and anxiety but no-one has ever found this to be a causal connection.

Recent research shows that shy or depressed people use the internet excessively to (surprise, surprise) meet people and manage their shyness.

And in fact, as I mentioned in an earlier article, one of the only longitudinal studies [pdf] on the general population found that internet use is generally associated with positive effects on communication, social involvement, and well-being, although interestingly, those who were already introverts show increased withdrawal.

In other words, the internet is a communication tool and people use it manage their emotional states, like they do with any other technology.

Of course there are some people who are depressed and anxious who use the internet (or follow sports teams, or read books, or watch TV…) to excess, but why we have to describe this as an addiction still completely baffles me.

Link to AJP editorial. Don’t click! You’re feeding your addiction!
Link to previous post ‘Why there is no such thing as internet addiction’.