Can We Afford the Iraq War?

Card: Can we afford the Iraq War?

Stiglitz:    What we have been doing, as I say, is been borrowing totally to finance this war.  In our book with Linda Bilmes, we estimated that the cost of the Iraq war will be over 3 trillion dollars.  Some of these are budgetary costs, one and half two trillion dollars, some of it is cost born to our economy that goes beyond the budget.  Cost of families and about a fifth of the families in which somebody has been seriously injured, somebody has to give up a job to care for the person who has been injured.  And this war, has had a large number of very serious injuries.  We estimate that over 40% of those returning from Iraq are coming back with disabilities and we will have to finance that.  We have to pay for the healthcare, we have to pay for disability benefits, these… this is… these are numbers that are not yet included in our national deficit and our national debt.  These are bills that are yet due.  We estimate that that bill itself is in excess of 600 billion dollars.  Since we did our book, since it went to press, new numbers are coming out from the [IB] study that shows that a third of the returning veterans are coming back with what I call invisible wounds, traumatic brain injury, post-traumatic stress syndrome, serious depression.  Again, huge costs that are going to be born by our society, by our economy, by our taxpayers so these are large costs.  Now, the concern is that while the war is been very expensive and the President… the administration was not honest to us, when we went to war… Larry Lindsey was the Chief Economic Adviser at that time said it might cost a 100 or 200 billion dollars.  He was rewarded for that [IB], you might say part honesty because, of course, it was a vast underestimate by being fired.  The administration said, “Baloney, the total cost would be 50, 60 billion dollars,” we’re now spending that amount of money every three to four months up front, not including the cost of paying for the veterans, the disability benefits, not including the cost of resetting the military because we’ve been using up equipment much more rapidly than we’ve been replacing it.  But the saddest part of all of this is that while we’ve been spending so much money, while this huge debt has reduced our room for maneuver to address, not only the economic crisis but a whole set of other social problems that we face, we haven’t even got security.  What do we buy for this?  Now, economists talk the economic opportunity cost.  What we could have done with 3 trillion dollars, 2 trillion dollars, 4 trillion dollars, the mind boggles.  The President talked about the problem, “Social Security might bankrupt our country,” he said.  Well, the fact is, for about a sixth of the cost of the Iraq war, we could have put the Social Security System on sound financial grounds for the next 75 years or more.  And we’ve created a gap, [IB] on disability that is equal to the gap that we had in Social Security.  So, that’s just one example.  The President said that, you know, America is one of the few countries that does not have financed healthcare for all its citizens… view that healthcare is our basic right and Congress passed a bill to provide healthcare for poor children who don’t have insurance, if they don’t get healthcare, they could be scarred for life.  The President said that we could not afford them.  We were talking about a few days of fighting in Iraq and we were willing to sacrifice our children for a few days of fighting in Iraq.  But that’s the economic opportunity cost but there’s beyond that, the security opportunity cost.  We aren’t buying security.  The world is a big world out there, Iraq is a little small place in that global map.  Even if we got security in Iraq, it doesn’t mean that we have global security and we’ve seen that.  Things have been going worse in Afghanistan which was related to 9/11, Iraq was not related to 9/11.  The death rate in Afghanistan is sure… is increasing.  In fact, given the number of troops we have, the death rate now is actually greater than that in Iraq, the… adjusted for the number of troops.  The… things are going badly in Pakistan.  Conflict is expanding.  So the point is that… that we haven’t bought the security that Americans want.  The bottom line… you asked the question, can we afford the war?  We can afford security, we can’t afford wasting money.  We’ve been wasting money in Iraq, we’ve not been getting the security that we need, we’ve been wasting money more broadly in our military expenditures, and we’ve been spending with weapons that don’t work against enemies that don’t exist.  We still are… we’ve started fighting the war on terrorism, we didn’t cut back on the cold war expenditures.  So, the fact that, you know, in the last 5 years, expenditures on military beyond the war on terrorism has increased half a trillion dollars.  Now, the answer is can we afford this kind of [IB]?  Well, some people are doing very well, [IB] stock has soared but can we as a country afford it?  I don’t think so.  I think we have to husband our resources, both if we want security and if we want a strong economy.  If we don’t have a strong economy, we won’t have the resources to address, not only our security needs, but all our other needs.

Nobel prize winning economist Joseph Stiglitz on how the Iraq War contributed to the global economic meltdown.

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Yale scientists restore brain function to 32 clinically dead pigs

Researchers hope the technology will further our understanding of the brain, but lawmakers may not be ready for the ethical challenges.

Still from John Stephenson's 1999 rendition of Animal Farm.
Surprising Science
  • Researchers at the Yale School of Medicine successfully restored some functions to pig brains that had been dead for hours.
  • They hope the technology will advance our understanding of the brain, potentially developing new treatments for debilitating diseases and disorders.
  • The research raises many ethical questions and puts to the test our current understanding of death.

The image of an undead brain coming back to live again is the stuff of science fiction. Not just any science fiction, specifically B-grade sci fi. What instantly springs to mind is the black-and-white horrors of films like Fiend Without a Face. Bad acting. Plastic monstrosities. Visible strings. And a spinal cord that, for some reason, is also a tentacle?

But like any good science fiction, it's only a matter of time before some manner of it seeps into our reality. This week's Nature published the findings of researchers who managed to restore function to pigs' brains that were clinically dead. At least, what we once thought of as dead.

What's dead may never die, it seems

The researchers did not hail from House Greyjoy — "What is dead may never die" — but came largely from the Yale School of Medicine. They connected 32 pig brains to a system called BrainEx. BrainEx is an artificial perfusion system — that is, a system that takes over the functions normally regulated by the organ. The pigs had been killed four hours earlier at a U.S. Department of Agriculture slaughterhouse; their brains completely removed from the skulls.

BrainEx pumped an experiment solution into the brain that essentially mimic blood flow. It brought oxygen and nutrients to the tissues, giving brain cells the resources to begin many normal functions. The cells began consuming and metabolizing sugars. The brains' immune systems kicked in. Neuron samples could carry an electrical signal. Some brain cells even responded to drugs.

The researchers have managed to keep some brains alive for up to 36 hours, and currently do not know if BrainEx can have sustained the brains longer. "It is conceivable we are just preventing the inevitable, and the brain won't be able to recover," said Nenad Sestan, Yale neuroscientist and the lead researcher.

As a control, other brains received either a fake solution or no solution at all. None revived brain activity and deteriorated as normal.

The researchers hope the technology can enhance our ability to study the brain and its cellular functions. One of the main avenues of such studies would be brain disorders and diseases. This could point the way to developing new of treatments for the likes of brain injuries, Alzheimer's, Huntington's, and neurodegenerative conditions.

"This is an extraordinary and very promising breakthrough for neuroscience. It immediately offers a much better model for studying the human brain, which is extraordinarily important, given the vast amount of human suffering from diseases of the mind [and] brain," Nita Farahany, the bioethicists at the Duke University School of Law who wrote the study's commentary, told National Geographic.

An ethical gray matter

Before anyone gets an Island of Dr. Moreau vibe, it's worth noting that the brains did not approach neural activity anywhere near consciousness.

The BrainEx solution contained chemicals that prevented neurons from firing. To be extra cautious, the researchers also monitored the brains for any such activity and were prepared to administer an anesthetic should they have seen signs of consciousness.

Even so, the research signals a massive debate to come regarding medical ethics and our definition of death.

Most countries define death, clinically speaking, as the irreversible loss of brain or circulatory function. This definition was already at odds with some folk- and value-centric understandings, but where do we go if it becomes possible to reverse clinical death with artificial perfusion?

"This is wild," Jonathan Moreno, a bioethicist at the University of Pennsylvania, told the New York Times. "If ever there was an issue that merited big public deliberation on the ethics of science and medicine, this is one."

One possible consequence involves organ donations. Some European countries require emergency responders to use a process that preserves organs when they cannot resuscitate a person. They continue to pump blood throughout the body, but use a "thoracic aortic occlusion balloon" to prevent that blood from reaching the brain.

The system is already controversial because it raises concerns about what caused the patient's death. But what happens when brain death becomes readily reversible? Stuart Younger, a bioethicist at Case Western Reserve University, told Nature that if BrainEx were to become widely available, it could shrink the pool of eligible donors.

"There's a potential conflict here between the interests of potential donors — who might not even be donors — and people who are waiting for organs," he said.

It will be a while before such experiments go anywhere near human subjects. A more immediate ethical question relates to how such experiments harm animal subjects.

Ethical review boards evaluate research protocols and can reject any that causes undue pain, suffering, or distress. Since dead animals feel no pain, suffer no trauma, they are typically approved as subjects. But how do such boards make a judgement regarding the suffering of a "cellularly active" brain? The distress of a partially alive brain?

The dilemma is unprecedented.

Setting new boundaries

Another science fiction story that comes to mind when discussing this story is, of course, Frankenstein. As Farahany told National Geographic: "It is definitely has [sic] a good science-fiction element to it, and it is restoring cellular function where we previously thought impossible. But to have Frankenstein, you need some degree of consciousness, some 'there' there. [The researchers] did not recover any form of consciousness in this study, and it is still unclear if we ever could. But we are one step closer to that possibility."

She's right. The researchers undertook their research for the betterment of humanity, and we may one day reap some unimaginable medical benefits from it. The ethical questions, however, remain as unsettling as the stories they remind us of.

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