What sparked your interest in economics?
Dan Ariely is the James B Duke Professor of Psychology and Behavioral Economics at Duke University. He is the founder of The Center for Advanced Hindsight and co-founder of BEworks, which helps business leaders apply scientific thinking to their marketing and operational challenges. His books include Predictably Irrational and The Upside of Irrationality, both of which became New York Times best-sellers. as well as The Honest Truth about Dishonesty and his latest, Irrationally Yours.
Ariely publishes widely in the leading scholarly journals in economics, psychology, and business. His work has been featured in a variety of media including The New York Times, Wall Street Journal, Washington Post, Boston Globe, Business 2.0, Scientific American, Science and CNN.
Question: What sparked your interest in economics?\r\n
Dan Ariely: So the starting of . . . For me the starting of this journey on irrational behavior started from actually being in the hospital. So quite a few years ago I got injured in an explosion. I got burned in about 70 percent of my body. And as a consequence I spent about three years in hospital. The first few months in the burn department were particularly painful, and one of the particularly difficult things is what is called the “bath treatment”. So everybody had the bandages on, and they took it off, and it’s always a little bit painful. Imagine there was no skin whatsoever; and it’s not a small bandage, but it’s covering 70 percent of your body. That’s a long process and incredibly painful. So during the procedure the nurses would put me on a stretcher and would lower me into a bath full of iodine water that would sting to start with. And then they would go ahead and rip the bandages off one by one for about an hour. And during that process, I would have debates over weeks about what is the best way to do it. Here I was experiencing this incredible pain, and what I wanted to do was to minimize it. So I would have arguments with them about what was the right way to trade off the intensity at each moment and the duration. So think about it. Should you have a shorter experience with a high momentary intensity? Or should you have a lower momentary intensity – tearing the bandages slower, but having longer duration? Should you start form the least painful and move to the most painful or do the opposite? Does it matter? Should you give people breaks or not breaks? And I had my own intuitions about what’s the best way to give me the least pain. And the nurses had a different intuition. But given the fact that I was the patient and they were the nurses, they were deciding what to do. And when I got out of the hospital and I learned a little bit about the experimental method, I decided to test what’s the right way. So I created lab experiments in which I would bring people in, and I would hurt them for longer durations, and lower intensities, and higher intensities; decreasing, increasing; with breaks, without breaks. And after each experience I would ask people how painful was this? So which one of these two pains would you prefer to repeat again? And so I would try to infer how people actually aggregate this pain. If you had an experience that lasts over time and change the intensity, at the end of it how do you think about the whole experience? And to my surprise the nurses were wrong. What does it mean? That their intuition . . . That having the treatment being relatively short – let’s say an hour – and tearing bandages one after the other was the right approach. They thought that high spikes and high intensity until duration was the way to go. It turns out that it was wrong. It’s much better to have lower intensity and longer duration; not to have spikes. It also turns out it would be better to start from the most painful part and go down (07:01) over time. And it would have been good to have breaks. And when I came back to present this to them, it struck me that these were really kind, wonderful people. They gave their life to their patients. I mean this is not something that you would . . . Unless you felt like it was your mission, this is not a job that you would choose. And at the same time they were wrong. And even though they had vast experience and the best intentions in the world, they were still very wrong. And I started wondering about what other cases are there where people have experience and good intentions, but are still fundamentally wrong? And that kind of opened my eyes to look at many things in which people are good, well meaning, but still fundamentally wrong.\r\n
Recorded on: Feb 19 2008\r\n
Ariely's fascination with rationality started in the burn unit.
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Researchers hope the technology will further our understanding of the brain, but lawmakers may not be ready for the ethical challenges.
- 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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