The Moral Costs of Prophylactic Propranolol

Hurley, Elisa A.

doi:10.1080/15265160701518607

Cited by 19 publications

(5 citation statements)

References 6 publications

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“…For this reason, philosophers have worried that the use of propranolol to treat PTSD may threaten goods we have reason to value. For instance, Hurley (2007) worries that erasing trauma blocks our epistemic access to the meaning of traumatic events, and Evers (2007) suggests that propranolol might promote what she calls mendacity: even if users recall what happened, because they have been inoculated against the emotional effects of trauma, they will live as though the traumatizing events had not occurred.…”

Section: Propranololmentioning

confidence: 99%

Are You Morally Modified?: The Moral Effects of Widely Used Pharmaceuticals

Levy¹,

Douglas²,

Kahane³

et al. 2014

ppp

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A number of concerns have been raised about the possible future use of pharmaceuticals designed to enhance cognitive, affective, and motivational processes, particularly where the aim is to produce morally better decisions or behavior. In this article, we draw attention to what is arguably a more worrying possibility: that pharmaceuticals currently in widespread therapeutic use are already having unintended effects on these processes, and thus on moral decision making and morally significant behavior. We review current evidence on the moral effects of three widely used drugs or drug types: (i) propranolol, (ii) selective serotonin reuptake inhibitors, and (iii) drugs that effect oxytocin physiology. This evidence suggests that the alterations to moral decision making and behavior caused by these agents may have important and difficult-to-evaluate consequences, at least at the population level. We argue that the moral effects of these and other widely used pharmaceuticals warrant further empirical research and ethical analysis.

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Section: Propranololmentioning

confidence: 99%

Are You Morally Modified?: The Moral Effects of Widely Used Pharmaceuticals

Levy¹,

Douglas²,

Kahane³

et al. 2014

ppp

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“…Unfortunately, previous authors have often overlooked the distinction between normal and pathological responses to trauma and have discussed the perils of chemoprophylaxis in the context of the former [35]. It is reasonable to argue that attenuating such feelings as embarrassment [25,36], loss after a friend's betrayal [37] or disappointment on missing out on a job opportunity [38] is inadvisable and the risks are likely to outweigh any potential benefits. The debilitating effects of severe PTSD, on the other hand, should be prevented if at all possible.…”

Section: Pathological and Normal Reactionsmentioning

confidence: 99%

Preventing Post Traumatic Stress Disorder: Are Drugs the Answer?

Fletcher

Creamer

Forbes

2010

Aust N Z J Psychiatry

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In the field of traumatic stress, chemoprophylaxis is a term that is often used but rarely well understood. There has been no shortage of debate on the issue, but few rigorous studies to ground the discussion. The purpose of the current paper is to explore the issues surrounding this contentious area. Databases including PubMed, PsychArticles and Web of Knowledge were searched using the key words 'chemo or pharmaco', 'prevention or prophylaxis', and 'PTSD or post-traumatic stress'. Relevant journals and reference lists of the papers obtained through this search were scanned for additional references. Studies that investigated the use of pharmacotherapy to prevent the onset of post-traumatic stress disorder were considered for this paper. Studies that examined the treatment of established PTSD were excluded. A total of 15 empirical studies were included in the review (including five randomized controlled trials), and twice as many non-data-driven papers. Evidence for the prophylactic use of alcohol, morphine, propranolol, and hydrocortisone is presented, followed by a discussion of the many challenges of using pharmacological interventions in this context. While attention to this issue has increased in recent times, the dearth of empirical data has done little to further the field. Larger studies are indicated following small trials with medications such as propranolol and hydrocortisone. There remain a number of ethical and practical questions to be answered before the widespread use of chemoprophylaxis can be recommended.

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“…Furthermore, it viewed memory loss as affecting one's personal identity and sense of responsibility, which could possibly thwart the adaptive value of emotionally charged memories. Harmful consequences could include: (1) the possible blunting of a natural fear response that subsequently hampers perception of a real subsequent threat (Glannon 2006;Henry, Fishman, and Youngner 2007); (2) impact on cognition in ways that adversely affect practical decision making (Craigie 2007); (3) unwanted blunting of beneficial memories in addition to traumatic ones (Glannon 2006); (4) misuse of such medication to lessen the impact of merely inconvenient experiences (Dossey 2006;Evers 2007), resulting in the overmedicalization of a normal stress response (Bell 2007); (5) potential loss of an opportunity for posttraumatic psychological growth (Warnick 2007); and (6) losing touch with moral injuries to which trauma exposes its victims-injuries that might be important for holding others accountable for moral wrongdoing (Hurley 2007). …”

Section: Beneficence and Nonmaleficencementioning

confidence: 99%

Overview of Bioethical Issues in Contemporary PTSD Treatment and Research: Considering Priorities for Future Empirical Ethics Investigation

Jain

Nazarian

Weitlauf

et al. 2011

AJOB Primary Research

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The last decade has seen a surge in biomedical research advancing the evidence base for the effective clinical management and study of posttraumatic stress disorder (PTSD). The authors review the literature describing ethical issues in conducting PTSD research; controversies over the role of preventive pharmacotherapy for PTSD; and ethical quandaries in the identification, treatment, or empirical investigation of PTSD in postdisaster settings. Findings are synthesized within an ethics framework that utilizes major constructs in the biomedical literature: beneficence/nonmaleficence, informed consent, and autonomy. Gaps and weaknesses in the current evidence base are highlighted. The authors conclude by considering priorities for future empirical ethics investigation in this field.

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The Moral Costs of Prophylactic Propranolol

Cited by 19 publications

References 6 publications

Are You Morally Modified?: The Moral Effects of Widely Used Pharmaceuticals

Are You Morally Modified?: The Moral Effects of Widely Used Pharmaceuticals

Preventing Post Traumatic Stress Disorder: Are Drugs the Answer?

Overview of Bioethical Issues in Contemporary PTSD Treatment and Research: Considering Priorities for Future Empirical Ethics Investigation

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