About Docters Young and Old: Decisions and Drones

Moving my activity from Medical forum mailing list (mainly topics on syndicalism and politics) towards more intensive neuroscience activities, has been a most rewarding strategy for me. Taking some distance and neuroscientific goggled perspective has offered me new and fruitfull insights on human psychology and decision processes. I have not completely left the Medical forum though and will keep lurking a lot of the time but interventions and comments are already sparse although they sometimes keep irritating some syndicalist powers to be. That's a good thing as it stirs the debate. Recently I got fascinated by an animated ongoing discussion about the obligation of docters over 60 to participate in weekend gards. Apart from all arguments large and small that were deployed with great taste of debate and advocacy by many talented collegues I strikes me again how our decision processes are at work without us actors on the stage being fully aware of the underlying processes. In neuroscience we know that decision making networks are very hardwired in the brain. There is the "logical reasoning channel" mostly with network activity converging towards the prefrontal cortex while there is another more "personal and emotional" decision making neuronal highway where superior temporal cortex, gyrus cinguli posterior and frontomedial cortex are involved. Was it not Freud who stated: when reason and emotion are in conflict , emotion often wins. But everybody labels his decision as "rational and logical" what is of course far from painting the complete picture. Both ways are valid as the independent output of different weighting systems. Younger docters who broadcast their pure rationallity (:-) "we are young, we are scientifically sound and we are logical" come up with pure rational and very logical sounding sets of arguments why older docters should continue to help them out doing weekend , while older docters who broadcast their wisdom, experience and rationality (;-) will try to convince the audience why this should not be. How often are we not judged by people who cannot (or refuse) to activate their "empathic system" just to win the debate with unilateral rational logical sounding arguments ?

Every good decision process is characterised by posting the output of both systems side by side "sui generis" and decide by weighted concensus. Clearly not an easy task at all.

To get an idea about the implication of this remote versus close decision process it is good to read the blog of at Frontal Cortex about the "Morality of the Drones". Young docters should know what drones are and older docters who do not should be exempted from weekend gards until their Starwars knowledge base has been updated ;-)

Here a situation is sketched where army personel housed in trailers somewhere in Arizona are steering unmanned (but heavily armed) light aircraft "drones" on information gathering missions (somewhere around the pakistan border) in taliban country and also from time to time "take out" the foes. This is a very mechanical decision: is it an ennemy ? is he/she harmfull or dangerous for our troops (fi preparing a road bom): if yes on all questions.. press button. Bye bye sweet ennemy. Flight goes on. Conscience can easily come to rest knowing prefrontally that one has saved the lives of many innocent soldiers or personel that were targetted by that nasty bom or landmine. So far so good but what would conscience say if one could only reach that same life saving effect (rational) by physically sticking a nife into that TTT (terrible Taliban terrorist). Logically that should make no difference.. should it. In his blog another classical example is given about the railroad tender that gets loose. Read it there . It sure can make You reflect. Ethics are everywhere. Even posted on an innocent medical mail list to be read by young and old, from 7 to 77.

Georges Otte