Why Trust (Or Lack of It) Can Mean Poverty or Prosperity

Question: Is there a link between trust and poverty?

Paul Zak:  So the kind of key issue that drove me into neuroeconomics was something I found in the late 1990’s, that trust at the level of a country was the big gun to explain why countries are rich or poor.  So economists have for 50 years or more, looked for the factors that cause a country to grow and become prosperous or those factors are missing and countries are mired in poverty.  And trust really was this huge factor.  High-trust countries are by and large rich countries, or certainly fast-growing countries, and poor countries are countries with low trust.  And the variation of this data is substantial. 

So the last data I saw, 2% of Brazilians said they trust each other, whereas in the United States around 45% of Americans said they trust each other and two-thirds of Norwegians trust each other. 

So we characterized why trust would be higher or lower across different environments.  And the payoff to raising trust, which can be done through public policy, is substantial in terms of improving people’s lives. 

Countries in which trust is high have effective governments, they have very tight social structures, people interact very nicely with each other, they don’t have a lot of divisions, and there’s a positive feedback loop.  They have higher incomes which further accentuates greater growth.  So trust is this kind of great summary measure of a society in which things are working well.  And lack of trust therefore is a measure of how things do not work well in society. 

Question: What does this mean for a nation’s potential?

Paul Zak:  So there’s kind of an upside and a downside to this cross-country trust where one is that we find that there is a threshold level of trust in other people below which you get very little growth at all.  And that threshold depends on the environment of that country being in.  But if trust is too low, it’s just too hard to engage in transactions.  There’s too many, what economists call, transaction costs.  I need lawyers and judges and the cops to enforce all of these agreements.  And so therefore, the number of people I interact with economically gets very small.  I am only going to interact with my family or my clan or someone who is really trusted because I can’t count on the government to enforce these contracts.  That limits the size of the market and therefore the number of transactions that can occur that increase prosperity. 

So for the developing countries, this is particularly critical that you need to have solid institutions that will facilitate economic transactions.  So trust, for example in China is quite high.  China has a very effective government; even though it is authoritarian, it's market oriented. And other work I’ve done we’ve shown that with sufficient growth, all authoritarian governments eventually become democracies.  So personally, I’m less concerned with China as an authoritarian system—although I think the human rights abuses are horrendous.  That will resolve itself as economic growth proceeds, because it moves power away from the center and towards the individual.  And when individuals have economic power, they can press a government to be better. 

And so I think that’s the way to make progress in developing countries.  In other developing countries, largely in sub-Saharan Africa and some in South America, you see trust levels that are so low that you see no or little economic growth. And so in some of these countries, Haiti comes to mind, Venezuela, you have such corrupt governments that there’s no reason to even undertake transactions.  You do what you need to eat and then most of the money flows out of that country into the United States or into the West, where the money is safer.  So that’s a huge problem and I think the way to solve that is not necessarily internally; it may require international focus on improving institutions in these countries.  So the World Bank has a program that has done some work in this area, but it’s awfully hard to move a country that has very poor institutions into one that’s got very good institutions absent something catastrophic.
 
Question: Is there another option?

Paul Zak:  The alternative approach is to start from the ground up.  So if things like microfinance and micro-entrepreneurship are a way to take economic power and bring it back to the individuals even at the lowest levels; weaving cloth, making pottery.  And the way to do this now I think is through the Internet, where you can have collectives that sell to someplace that gets this to a larger market and that allows small farmers, small weavers, these individuals to actually earn a living that doesn’t depend or even outside of a purview of a corrupt government.  And as they do that they build this ground swell of support of better institutions because they have enough capacity to do that. 

So if your belly is empty, you’re worried more about getting enough calories onboard than about whether your government is inflating the currency.  But once you actually have some economic base, then there can be a role for ground level change in governments.  And I think this is one reason why the United States had these brilliant framers, but the decentralized power and so there’s a constant feedback between keeping power from centralizing in the United States and allowing it to disperse, which creates better government.

Recorded October 27, 2010
Interviewed by John Cookson

Nations where trust is high have effective governments, very tight social structures, and better interactions among people—they also have higher incomes and greater growth.

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Time of death is considered when a person has gone into cardiac arrest. This is the cessation of the electrical impulse that drive the heartbeat. As a result, the heart locks up. The moment the heart stops is considered time of death. But does death overtake our mind immediately afterward or does it slowly creep in?

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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.

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  • 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. Think a dialysis machine for the mind. 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.