The Ethics Blog

A blog from the Centre for Research Ethics & Bioethics (CRB)

Tag: neuroscience (Page 3 of 5)

Neuroethics goes global (By Karen Rommelfanger)

12 February, 2019 / / 0 Comments

The complicated meaning, powerful assumptions, and boundless hopes about what can be revealed through neuroscience have made this discipline a national funding priority around the globe. A growing cohort of large-scale brain research initiatives aim to unravel the mysteries of the basis of feelings, thinking, and ultimately the mind. Questions formerly in the domain of the philosophical world have become part and parcel to neuroscience.

Just as science has so clearly become a global enterprise, ethics must keep pace. Cultural misunderstandings have nontrivial consequences for the scientific enterprise. Gaps in understanding negatively impact opportunities for collaboration and sharing, ultimately slowing scientific advancement. Too narrow of a view on science can limit our ability to reap the benefits of discoveries and, perhaps most damning for science, can result in a failure to anticipate and recognize the full consequences and risks of research.

To date, neuroethics discussions have been dominated by Western influences. However, the rapid neuroscientific development in East Asia in particular and the not-so-gradual relocation of a number of cutting-edge research projects from the West to East Asia, has made it clear that exploration and understanding of the ethics and cultural values informing research will be critical in engaging science as a collaborative global enterprise.

The Neuroethics Workgroup of the International Brain Initiative is comprised of members of each of the existing and emerging large-scale brain research initiatives. Leveraging the fellowship of the IBI and using an intentional culturally aware approach to guide its work, the Neuroethics Workgroup completes rapid deliverables in the near (within one year) and short-term (within two years).

With the inaugural 2017 summit, leading scientists, ethicists, and humanist co-created a universal list of neuroethics questions, Neuroethics Questions for Neuroscientists (NeQN) that should be addressed by scientists in each brain project. These NeQN were published in Neuron in 2018 and can be found here.

The neuroethics questions themselves were not necessarily unfamiliar neuroethics questions; however, these NEQN were designed to be adapted and informed by the cultural values and frameworks of each country.

The 2018 meeting served as a workshop, where each of the brain projects discussed why and how they will integrate neuroethics into their brain projects with particular recognition of the five questions from the 2018 Neuroethics Questions for Neuroscientists (NeQN) featured in Neuron. The product is the first neuroethics special issue in a high impact neuroscience journal.

Each perspective offers topics and context for their engagement with and practice of neuroethics. The issue features the seven existing and emerging large-scale brain research projects organized in alphabetical order.

The Australian Brain Alliance describes how neuroethics has been integrated into their research ethos as featured in their public outreach and advocacy efforts as well as their explorations in the public domains such as neurolaw and industry. A key component for the Australian project is diversity and inclusion, and there is a particular interest in engaging brain health with vulnerable Indigenous populations in Australia.

The Canadian Brain Research Strategy paper illustrates the rich historical efforts in pioneering neuroethics and future plans of a national collaboration to carefully consider public discourse and patient engagement as they pursue deeper knowledge of the how the brain learns, remembers, and adapts. A fundamental recognition of the neuroethics backbone of the Canadian project is that “The powerful ability of the brain to change or rewire itself in response to experience is the foundation of human identity.”

The China Brain Project discusses potential models for important public outreach campaigns and the balance of considering traditional Chinese culture and philosophy, particularly in the areas of brain death, conceptualizations of personhood and individual rights, and stigma for mental illness. The authors describe commitments for integrating neuroethics as the China Brain Project is being designed.

The EU Human Brain Project outlines its bold leadership and addresses the conceptual and philosophical issues of neuroethics and the implementation of philosophical insights as an iterative process for neuroscience research. A project with an extremely sophisticated neuroethics infrastructure, this paper provides examples of managing issues related to the moral status of engineered entities, how interventions could impact autonomy and agency, and dual use.

The Japan Brain/MINDS paper describes plans to reinvigorate historical efforts in neuroethics leadership as it expands the scope of its research and launches Japan Brain/MINDS Beyond. In particular, the project will integrate neuroethics to address issues related to privacy and data collection as well as in considering stigma and biological models of psychiatric disease.

The Korea Brain Initiative paper nicely demonstrates how advocacy for neuroscience and neuroethics at the government and policy levels go hand in hand. As Korea aims to advance its neuroscience community, the Korean government has seen neuroethics as integral to neuroscientists’ development. The Korea Brain Initiative is exploring ethical issues related to “intelligent” brain technologies, brain banking, cognitive enhancement, and neural privacy in the milieu of traditional and contemporary cultural traditions in Korea.

The US BRAIN Initiative outlines its efforts in building an infrastructure for neuroethics in research and policy and for funding research as it plans its roadmap for the next phase of BRAIN to 2025. Example of ethical issues that arise from the project’s goals of understanding neural circuitry include the moral relevance and status of ex vivo brain tissue and organoids as well as unique ethical concerns around informed consent in brain recording and stimulation in humans.

Each project illustrates that neuroethics is important regardless of the scope and methodologies inherent in its research goals and demonstrates the utility of the NeQNs for today’s and future scientists within and beyond the large-scale neuroscience research projects.

Karen Rommelfanger

PhD, Director, Neuroethics Program Emory Center for Ethics, Co-chair International Brain Initiative Neuroethics Workgroup

Drug addiction as a mental and social disorder

4 December, 2018 / / 0 Comments

Michele FariscoCan the brain sciences help us to better understand and handle urgent social problems like drug addiction? Can they even help us understand how social disorder creates disorderly, addicted brains?

If, as seems to be the case, addiction has a strong cerebral base, then it follows that knowing the brain is the key to finding effective treatments for addiction. Yet, what aspects of the brain should be particularly investigated? In a recent article, co-authored with the philosopher Kathinka Evers and the neuroscientist Jean-Pierre Changeux, I suggest that we need to focus on both aware and unaware processes in the brain, trying to figure out how these are affected by environmental influences, and how they eventually affect individual behavior.

There is no doubt that drug addiction is one of the most urgent emergencies in contemporary society. Think, for instance, of the opioid crisis in the US. It has become a kind of social plague, affecting millions of people. How was that possible? What are the causes of such a disaster? Of course, several factors contributed to the present crisis. We suggest, however, that certain external factors influenced brain processes on an unaware level, inviting addictive behavior.

To give an example, one of the causes of the opioid crisis seems to be the false assumption that opioid drugs do not cause addiction. Taking this view of opioid drugs was an unfortunate choice, we argue, likely favored by the financial interests of pharmaceutical companies. It affected not only physicians’ aware opinions, but also their unaware views on opioid drugs, and eventually their inclination to prescribe them. But that is not all. Since there is a general disposition to trust medical doctors’ opinions and choices, the original false assumption that opioid drugs do not cause addiction spread and affected also public opinion, especially at the unaware level. In other words, we think that there is a social responsibility for the increase in drug addiction, if not in ethical terms, at least in terms of public policies.

This is just an example of how external factors contribute to a personal disposition to use potentially addictive drugs. Of course, the factors involved in creating addiction are multifarious and not limited to false views about the risk of addiction associated with certain drugs.

More generally, we argue that in addition to the internal bases of addiction in the central nervous system, socio-economic status modulates, through unaware processing, what can be described as a person’s subjective “global well-being,” raising in some individuals the need for additional rewards in the brain. In the light of the impact of external factors, we argue that some people are particularly vulnerable to the pressures of the political and socio-economical capitalistic system, and that this stressful condition, which has both aware and unaware components, is one of the main causes of addiction. For this reason, we conclude that addiction is not only a medical and mental disorder, but also a social disorder.

Michele Farisco

Farisco M, Evers K and Changeux J-P (2018) Drug Addiction: From Neuroscience to Ethics. Front. Psychiatry 9:595. doi: 10.3389/fpsyt.2018.00595

International brain initiatives need cultural awareness

12 November, 2018 / / 0 Comments

Pär SegerdahlToday, billions of research dollars are being invested in developing huge research collaborations about the human brain. Australia, Canada, Japan, Korea and the United States have their own brain initiatives. In Europe, the Human Brain Project has a total budget of around one billion euros over a ten-year period, 2013-2023.

Scientific research is often seen as an activity that transcends cultural differences. However, research about the brain touches such fundamental aspects of human existence that it cannot ignore cultural views. For example, the notion that the brain, as a separate organ, is the locus of human identity, of the self, is not generally embraced. Neuroscientific research touches profound cultural ideas about human life which require careful philosophical and ethical attention.

The international brain initiatives also touch other culturally sensitive issues, in addition to questions about human identity. Ideas about death and brain death, about the use of nonhuman primates in research, about privacy and autonomy, and about mental illness, differ across cultures. For example, a diagnosis that in one culture can be seen as an opportunity to get individual treatment can in another culture threaten to condemn a whole family to social isolation.

Neuroethicists from parts of the world that currently make major investments in neuroscientific research met in Korea to highlight ethical questions on cultural differences, which the international brain initiatives need to address. This in order for the research to be conducted responsibly, with awareness of relevant cultural diversity. The questions that the neuroethicists (among them, Arleen Salles) propose should be addressed are summarized in an article in the journal Neuron.

The authors mention questions about how neuroscientific research could cause stigma in individuals or social groups, and about how cultural notions might bias research design and the interpretation of results. They ask how collecting and storing neural tissue can be viewed in different cultures, and about how we should understand the moral status of robots and computer-simulated brains. They mention questions about how new brain interventions (brain devices and drugs) may affect notions of responsibility and autonomy, as well as issues about drawing boundaries between legitimate and illegitimate uses of neuroscientific techniques. Finally, questions are highlighted about fair access to research results.

How can these questions be addressed and discussed in the international brain initiatives? The authors propose education in neuroethics, as well as dialogue with scholars in the humanities and social sciences, and finally improved communication and interaction with the publics.

Within the European Human Brain Project, four percent of the budget is used for ethics and society. Similar emphasis on ethical reflection would be desirable also in other brain initiatives.

Pär Segerdahl

Global Neuroethics Summit Delegates. 2018. Neuroethics questions to guide ethical research in the international brain initiatives. Neuron 100, October 10, 2018.  https://doi.org/10.1016/j.neuron.2018.09.021

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Philosophy in responsible research and innovation

22 August, 2018 / / 0 Comments

Pär SegerdahlThe honorable discipline philosophy is hardly anything we associate with groundbreaking research and innovation. Perhaps it is time we began to see a connection.

To begin with, we can let go of the image of philosophy as an honorable discipline. Instead, let us talk about the spirit of philosophy. People who think for themselves, as philosophers do, rarely find themselves at home within the narrow bounds of disciplines and fields. Not even if they are called philosophical. On the contrary, if such a person encounters boundaries that restrict her thought, she investigates the boundaries. And removes them, if necessary.

Forget the reverent representation of philosophy as an honorable discipline.

The spirit of philosophy is to avoid discipline, submission, tradition and all forms of dependence. Someone who functions as a loyal representative of a philosophical school is hardly a genuine thinker. A philosopher is someone who, in a spirit of absolute independence, questions everything that makes a pretense of being true, right and correct. Therefore, it has been said that one cannot learn philosophy, only to philosophize. As soon as a philosophy crystallizes, the philosophical spirit awakens and investigates the boundaries of what usually turns out to be a fad that attracts insecure intellects who shun independent thinking. No system of thought restricts a freely investigating thinker. Especially not the philosophy that is in fashion.

How does this spirit of philosophy connect to research and innovation? The connection I see is different than you probably guess. It is not about boosting the development by removing all boundaries, but about taking responsibility for the development. Philosophical thinking does not resemble an overheated research field’s fast flow of ideas, or an entrepreneur’s grandiose visions for the future. On the contrary, a philosopher takes a step back to calmly investigate the flow of ideas and visions.

Philosophy’s freedom is basically a responsibility.

Responsible Research and Innovation has become an important political theme for the European Commission. This responsibility is understood as an interactive process that engages social actors, researchers and innovators. Together, they are supposed to work towards ethically permissible research activities and products. This presupposes addressing also underlying societal visions, norms and priorities.

For this to work, however, separate actors cannot propagate separate interests. You need to take a step back and make yourself independent of your own special interests. You need to make yourself independent of yourself! Reflect more open-mindedly than you were disciplined to function, and see beyond the bounds of your fragmentary little field (and self). This spacious spirit of philosophy needs to be awakened: the freedom of thought that is basically the responsibility of thought.

Concrete examples of what this means are given in the journal, Neuroethics. In an article, Arleen Salles, Kathinka Evers and Michele Farisco describe the role that philosophical reflection currently plays in the European Flagship, the Human Brain Project. Here, philosophy and neuroethics are no mere appendages of neuroscientific research. On the contrary, by reflecting on central concepts in the project, philosophers contribute to the overall self-understanding in the project. Not by imposing philosophy as a special interest, or as a competing discipline with its own concepts, but by open-mindedly reflecting on neuroscientific concepts, clarifying the questions they give rise to.

The authors describe three areas where philosophy contributes within the Human Brain Project, precisely through awakening the spirit of philosophy. First, conceptual questions about connections between the brain and human identity. Secondly, conceptual questions about connections between the brain and consciousness; and between consciousness and unconsciousness. Thirdly, conceptual questions about links between neuroscientific research and political initiatives, such as poverty reduction.

Let us drop the image of philosophy as a discipline. For we need the spirit of philosophy.

Pär Segerdahl

Salles, A., Evers, K. & Farisco, M. Neuroethics (2018). https://doi.org/10.1007/s12152-018-9372-9

(By the way, anyone can philosophize. If you have the spirit, you are a philosopher. A demanding education in philosophy as a separate discipline can actually be an obstacle that you have to overcome.)

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Can neuroscience and moral education be united? (By Daniel Pallarés Domínguez)

4 June, 2018 / / 0 Comments

Daniel Pallarés DomínguezPeople have started to talk about neuroeducation, but what is it? Is it just another example of the fashion of adding the prefix neuro- to the social sciences, like neuroethics, neuropolitics, neuromarketing and neurolaw?

Those who remain sceptical consider it a mistake to link neuroscience with education. However, for some authors, neuroscience can provide useful knowledge about the brain, and they see neuroeducation as a young field of study with many possibilities.

From its birth in the decade of the brain (1990), neuroeducation has been understood as an interdisciplinary field that studies developmental learning processes in the human brain. It is one of the last social neurosciences to be born. It has the progressive aim of improving learning-teaching methodologies by applying the results of neuroscientific research.

Neuroscientific research already plays an important role in education. Taking into account the neural bases of human learning, neuroeducation looks not only for theoretical knowledge but also for practical implications, such as new teaching methodologies, and it reviews classical assumptions about learning and studies disorders of learning. Neuroeducation studies offer possibilities such as early detection of special learning needs or even monitoring and comparing different teaching methodologies implemented in school.

Although neuroeducation primarily focuses on disorders of learning, especially in mathematics and language (dyscalculia and dyslexia), can it be extended to other areas? If neuroscience can shed light on the development of ethics in the brain, can such explorations form the basis of a new form of neuroeducation, moral neuroeducation, which studies the learning or development of ethics?

Before introducing a new term (moral neuroeducation), prudence and critical discussion are needed. First, what would the goal of moral neuroeducation be? Should it consider moral disorders in the brain or just immoral behaviours? Second, neuroscientific knowledge is used in neuroeducation to help design practices that allow more efficient teaching to better develop students’ intellectual potentials throughout their training process. Should this be the goal also of moral neuroeducation? Should we strive for greater efficiency in teaching ethics? If so, what is the ethical competence we should try to develop in students?

It seems that we still need a critical and philosophical approach to the promising union of neuroscience and moral education. In my postdoctoral project, Neuroethical Bases for Moral Neuroeducation, I will contribute to developing such an approach.

Daniel Pallarés Domínguez

My postdoctoral research at the Centre for Research Ethics and Bioethics (CRB) is linked to a research project funded by the Ministry of Economy and Competitiveness in Spain. That project is entitled, Moral Neuroeducation for Applied Ethics [FFI2016-76753-C2-2-P], and is led by Domingo García-Marzá.

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New concept of consciousness challenges language

31 January, 2018 / / 0 Comments

Pär SegerdahlA few weeks ago, I recommended an exciting article by Michele Farisco. Now I wish to recommend another article, where Farisco (together with Steven Laureys and Kathinka Evers) argues even more thoroughly for a new concept of consciousness.

The article in Mind & Matter is complex and I doubt that I can do it justice. I have to start out from my own experience. For when Farisco challenges the opposition between consciousness and the unconscious, it resembles something I have written about: the opposition between human and animal.

Oppositions that work perfectly in everyday language often become inapplicable for scientific purposes. In everyday life, the opposition between human and animal is unproblematic. If a child tells us that it saw an animal, we know it was not a human the child saw. For the biologist, however, the idea of ​​the human as non-animal would be absurd. Although it is perfectly in order in everyday language, biology must reject the opposition between human and animal. It hides continuities between us and the other animals.

Farisco says (if I understand him) something similar about neuroscience. Although the opposition between consciousness and the unconscious works in everyday language, it becomes problematic in neuroscience. It hides continuities in the brain’s way of functioning. Neuroscience should therefore view consciousness and the unconscious as continuous forms of the same basic phenomenon in living brains.

If biology talks about the human as one of the animal species, how does Farisco suggest that neuroscience should talk about consciousness? Here we face greater linguistic challenges than when biology considers humans to be animals.

Farico’s proposal is to widen the notion of consciousness to include also what we usually call the unconscious (much like the biologist widens the concept of animals). Farisco thus suggests, roughly, that the brain is conscious as long as it is alive, even in deep sleep or in coma. Note, however, that he uses the word in a new meaning! He does not claim what he appears to be claiming!

The brain works continually, whether we are conscious or not (in the ordinary sense). Most neural processes are unconscious and a prerequisite for consciousness (in the ordinary sense). Farisco suggests that we use the word consciousness for all these processes in living brains. The two states we usually oppose – consciousness and the unconscious – are thus forms of the same basic phenomenon, namely, consciousness in Farisco’s widened sense.

Farisco supports the widened concept of consciousness by citing neuroscientific evidence that I have to leave aside in this post. All I wish to do here is to point out that Farico’s concept of consciousness probably is as logical in neuroscience as the concept of the human as animal is in biology.

Do not let the linguistic challenges prevent you from seeing the logic of Farisco’s proposal!

Pär Segerdahl

Farisco, M., Laureys, S. and Evers, K. 2017. The intrinsic activity of the brain and its relation to levels and disorders of consciousness. Mind and Matter 15: 197-219

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The unconscious deserves moral attention

10 January, 2018 / / 0 Comments

Pär SegerdahlLast autumn, Michele Farisco wrote one of the most read posts on The Ethics Blog. The post was later republished by BioEdge.

Today, I want to recommend a recent article where Farisco develops his thinking – read it in the journal, Philosophy, Ethics, and Humanities in Medicine.

The article will certainly receive at least as much attention as the blog post did. Together with Kathinka Evers, Farisco develops a way of thinking about the unconscious that at first seems controversial, but which after careful consideration becomes increasingly credible. That combination is hard to beat.

What is it about? It is about patients with serious brain injuries, perhaps after a traffic accident. Ethical discussions about these patients usually focus on residual consciousness. We think that there is an absolute difference between consciousness and unconsciousness. Only a conscious person can experience well-being. Only a conscious person can have interests. Therefore, a patient with residual consciousness deserves a completely different care than an unconscious patient. A different attention to pain relief, peace and quiet, and stimulation. – Why create a warm and stimulating environment if the patient is completely unaware of it?

In the article, Farisco challenges the absolute difference between consciousness and unconsciousness. He describes neuroscientific evidence that indicates two often-overlooked connections between conscious and unconscious brain processes. The first is that the unconscious (at least partly) has the abilities that are considered ethically relevant when residual consciousness is discussed. The other connection is that conscious and unconscious brain processes are mutually dependent. They shape each other. Even unconsciously, the brain reacts uniquely to the voices of family members.

Farisco does not mean that this proves that we have an obligation to treat unconscious patients as conscious. However, the unconscious deserves moral attention. Perhaps we should strive to assess also retained unconscious abilities. In some cases, we should perhaps play the music the patient loved before the accident.

Pär Segerdahl

Farisco, M. and Evers, K. The ethical relevance of the unconscious. Philosophy, Ethics, and Humanities in Medicine (2017) DOI 10.1186/s13010-017-0053-9

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When “neuro” met “ethics”

13 June, 2017 / / 0 Comments

Pär SegerdahlTwo short words increasingly often appear in combination with names of professional fields and scientific disciplines: neuro and ethics. Here are some examples: Neuromusicology, neurolaw, neuropedagogy. Bioethics, nursing ethics, business ethics.

Neuro… typically signifies that neuroscience sheds light on the subject matter of the discipline with which it combines. It can illuminate what happens in the brain when we listen to music (neuromusicology). What happens in the brain when witnesses recall events or when judges evaluate the evidence (neurolaw). What happens in children’s brains when they study mathematics (neuropedagogy).

…ethics (sometimes, ethics of…) typically signifies that the discipline it combines with gives rise to its own ethical problems, requiring ethical reflection and unique ethical guidelines. Even war is said to require its own ethics of war!

In the 1970s, these two words, neuro and ethics, finally met and formed neuroethics. The result is an ambiguous meeting between two short but very expansive words. Which of the two words made the advance? Where is the emphasis? What sheds light on what?

At first, ethics got the emphasis. Neuroethics was, simply, the ethics of neuroscience, just as nursing ethics is the ethics of nursing. Soon, however, neuro demonstrated its expansive power. Today, neuroethics is not only the “ethics of neuroscience,” but also the “neuroscience of ethics”: neuroscience can illuminate what happens in the brain when we face ethical dilemmas. The emphasis thus changes back and forth between neuroethics and neuroethics.

The advances of these two words, and their final meeting in neuroethics, reflects, of course, the expansive power of neuroscience and ethics. Why are these research areas so expansive? Partly because the brain is involved in everything we do. And because all we do can give rise to ethical issues. The meeting between neuro… and …ethics was almost inevitable.

What did the meeting result in? In a single discipline, neuroethics? Or in two distinct disciplines, neuroethics and neuroethics, which just happen to be spelt the same way, but should be kept separate?

As far as I understand, the aim is to keep neuroethics together as one interdisciplinary field, with a two-way dialogue between an “ethics of neuroscience” and a “neuroscience of ethics.” This seems wise. It would be difficult to keep apart what was almost predetermined to meet and combine. Neuroethics would immediately try to shed its neuroscientific light on neuroethics. And neuroethics would be just as quick to develop ethical views on neuroethics. The wisest option appears to be dialogue, accepting a meeting that appears inevitable.

An interesting article in Bioethics, authored by Eric Racine together with, among others, Michele Farisco at CRB, occasions my thoughts in this post. The subject matter of the article is neuroethics: the neuroscience of ethics. Neuroethics is associated with rather grandiose claims. It has been claimed that neuroscience can support a better theory of ethics. That it can provide the basis for a universal ethical theory that transcends political and cultural divides. That it can develop a brain-based ethics. That it can reveal the mechanisms underlying moral judgments. Perhaps neuroscience will soon solve moral dilemmas and transform ethics!

These pretentions have stimulated careless over-interpretation of neuroscientific experiments. They have also provoked rash dismissal of neuroethics and its relevance to ethics. The purpose of the article is to support a more moderate and deliberate approach, through a number of methodological guideposts for the neuroscience of ethics. These include conceptual and normative transparency, scientific validity, interdisciplinary methods, and balanced interpretation of results.

In view of this critical perspective on hyped neuroscientific claims, one could define the article as a neuroethical article on neuroethics. Following the linguistic pattern that I described above, the article is an example of neuroethics-ethics. No, this will not do! We cannot use these two expansive words to specify in neurotic detail who currently happens to advance into whose field.

I choose to describe the article, simply, as a neuroethical paper on neuroethics. I want to see it as an example of the dialogue that can unite neuroethics as an interdisciplinary field.

Pär Segerdahl

Racine, E., Dubljevic´, V., Jox, R. J., Baertschi, B., Christensen, J. F., Farisco, M., Jotterand, F., Kahane, G., Müller, S. (2017). “Can neuroscience contribute to practical ethics? A critical review and discussion of the methodological and translational challenges of the neuroscience of ethics.” Bioethics 31: 328-337.

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The New Yorker features resignation syndrome

29 March, 2017 / / 0 Comments

Pär SegerdahlLast year I wrote a post about resignation syndrome in children in families who are denied asylum in Sweden. I described a hypothesis about the syndrome suggested by Karl Sallin, PhD student at CRB in the field of neuroethics and neurophilosophy.

An intuitive explanation is that the syndrome is a reaction to prolonged stress and depression. A reaction that is triggered when the family is denied asylum. However, if the explanation is correct, the syndrome should exist on a similar scale also in other countries that receive refugee families. It seems it does not.

To understand what happens to these children, we should, Karl Sallin suggested, see it as a psychological reaction that occurs in the meeting between certain cultures and Swedish cultural conditions. For another peculiarity is the fact that the syndrome occurs mainly in families from certain parts of the world. We are dealing with a culture bound psychopathology, Sallin proposed in Frontiers in Behavioral Neuroscience.

The New Yorker recently wrote about this “Swedish” syndrome, in a long article in which Karl Sallin interviewed.

The article contains a touching description of how one of these children falls ill when the family is denied asylum. For several months, he is confined to bed, not contactable, and he must be tube fed. When the family gets permanent residence, they try to convey this to the boy. After two weeks, he begins to open his eyes. After a further seven weeks, the nasal tube taped to his cheek falls out. Finally, he can return to school and begin to talk about the disease.

The article in The New Yorker emphasizes that the syndrome is a culture-bound psychopathology. However, the tendency seems to be to point out Sweden’s crumbling self-image as the relevant cultural context for the disease. We see “apathetic refugee children” as symbols of our own moral failure to treat them and their families humanely. Therefore, we tube feed them without further treatment, while waiting for the family to hopefully get their residence permit. This creates a culture where children become sick when their families are denied asylum.

This can hardly be the whole explanation, since it then becomes difficult to understand why mainly children from certain parts of the world are afflicted. Moreover, mainly children who come together with their families, rather than unaccompanied refugee children. The cultural dynamics seems to be more complex than the desire to find scapegoats for the syndrome can handle.

Pär Segerdahl

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