“I would be the first patient!” exclaimed the Dalai Lama before 14,000 neuroscientists who flocked to hear him speak at the Society for Neuroscience's annual meeting in November 2005 in Washington, D.C. The Buddhist spiritual leader's promise followed his comment that hospitals not only should aid the mentally ill but also should provide mind-altering brain surgery and drugs to control anger, hate or jealousy in everyday people. He added—only half-jokingly—that if a small electrical jolt to his brain could free him of negative emotion, he would have no need to spend hours meditating each day to reach a trouble-free state of mind.
The audience members responded to the Dalai Lama's proposal with nervous laughter, because they knew that the means already exist to tweak emotions. The checkered history of prefrontal lobotomy flashed collectively through their minds. But the high priest had already moved ahead to other similarly difficult questions. Is it ethical to take drugs such as antidepressants to find happiness? Yes, he replied, as long as critical faculties are not numbed. But should a patient in dire need be forced to take antidepressants? “Never forced,” he said, although he quickly added that he thought troubled individuals could be persuaded. Where does a caretaker draw the line? “Some have the view that [ethics] must be based on religious beliefs. I don’t believe that.”
In this direct fashion, the Dalai Lama confronted the most critical issue of neurobiological research: How are scientists, and society, going to handle the explosion of information on the machinery of our thoughts? While scientists grapple with their own ethical dilemmas of applying brain research to treat the mentally ill, the Dalai Lama is probing an even greater philosophical challenge: how to utilize this science to make a healthy mind better.
Rising above the Controversy
Science and society have drifted back and forth on ethical dilemmas presented by new treatments for brain disorders. For decades after its inception, prefrontal lobotomy was lauded as a breakthrough in easing the suffering of hopelessly ill schizophrenics. Egas Moniz was awarded the Nobel Prize in 1949 for introducing the surgical procedure. But later the technique was stigmatized as an unethical remedy, because it crippled parts of the patient's mind and personality in exchange for fewer horrifying delusions or catatonia. The treatment was also sometimes abused as an expedient method to control difficult individuals. More recently, the use of electroconvulsive (shock) therapy for treating depression has suffered similar swings in acceptance. Today psychotropic drugs, mood stabilizers, and antianxiety and antidepressant pharmaceuticals abound, and the same issue arises: When should they be used?
According to the Dalai Lama, securing human well-being and happiness is paramount. Audience members pressed the spiritual leader to elaborate on what appeared to be a prescription for abuse. They raised the specter of a society addicted to pills to treat nonexistent ailments, as many people now are addicted to alcohol and other drugs. He offered no simple answers, dogma, or “just say no” platitudes.
The monk's scheduled appearance at the meeting had been highly controversial. A petition demanding that the invitation be rescinded had been circulating for months and was ultimately signed by 500 neuroscientists. “What can the Dalai Lama teach me about neuroscience?” asked one of the petition movement's leaders. The co-signers stated that they objected to using science, or pseudoscience, to validate the Buddhist method of enlightenment through meditation. Many of them felt it was inappropriate for a spiritual leader to espouse his views at a scientific meeting, particularly in this time of heated debate over the government mandate in certain states that the religious concept of “intelligent design” be taught in science classes as an equivalent alternative to evolution.