Vol 7 Spring 2010 | Brown A Production of The Triple Helix

THE SCIENCE IN SOCIETY REVIEW The International Journal of Science, Society and Law

Neuromarketing
Who Decides What You Buy?

The Science of Love

Music Facilitating Speech:

Melodic Intonation Therapy for
Patients with Speech Deficits

ASU • Berkeley • Brown • Cambridge • CMU • Cornell • Dartmouth • Georgetown • Harvard • JHU • LSE •
Northwestern • NUS • Oxford • Penn • UChicago • UCL • UNC Chapel Hill • University of Melbourne • UCSD • Yale
 THE TRIPLE HELIX
EXECUTIVE MANAGEMENT
TEAM Managing Production Editor
Darwin Chan
Chief Executive Officer
Julia Piper Senior Production Editors

Executive Editor-in-Chief
Luna Chen
Jessica Lee
A global forum for science in society
Bharat Kilaru Jasmine Chuang

Executive Editor-in-Chief, Production Editors

E-Publishing Becca Liu
Zain Pasha Baher Guirguis The Triple Helix, Inc. is the world’s largest completely student-run organization
Annie Chiao
Executive Production Editors Nancy Li
dedicated to taking an interdisciplinary approach toward evaluating the true
Chikaodili Okaneme Zhihan Ye impact of historical and modern advances in science.
Yang Zhang Reshmi Radhakrishnan

Chief Operating Officer, BOARD OF DIRECTORS Work with tomorrow’s leaders

North America
Daniel Choi Kalil Abdullah Our international operations unite talented
Manisha Bhattacharya
Chief Operating Officer, Joel Gabre
undergraduates with a drive for excellence at
Europe Kevin Hwang over 25 top universities around the world.
Hannah Price Melissa Matarese
Erwin Wang
Chief Operating Officer, Asia Imagine your readership
Kevin Pye Phyo Nay Yaung TRIPLE HELIX CHAPTERS
Bring fresh perspectives and your own analysis
Chief Operating Officer, North America Chapters
Australia Arizona State University
to our academic journal, The Science in Society
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Policy Northwestern University
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The E-publishing division showcases the
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University of North Carolina,
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Affairs University of Pennsylvania
Jennifer Yang Yale University
Catalyze change and shape the future
Our new Science Policy Division will engage
INTERNATIONAL DIRECTORS Europe Chapters
Cambridge University students, academic institutions, public leaders,
Annual Meeting Planning and the community in discussion and debate
Committee Asia Chapters
Jennifer Ong National University of about the most pressing and complex issues
Roza Anbari Singapore
Alexander Han
that face our world today.
Steven He Australia Chapters
University of Melbourne
Business and Marketing
Division All of the students involved in The Triple Helix understand that the fast pace of
Alexander Han
scientific innovation only further underscores the importance of examining the
Member Resources Division
Nikhita Parandekar
ethical, economic, social, and legal implications of new ideas and technologies
— only then can we completely understand how they will change our everyday
Science Policy Division
Paul Shiu lives, and perhaps even the norms of our society.
Hann-Shuin Yew

GLOBAL LITERARY & Come join us!

PRODUCTION

Senior Literary Editors

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E-Publishing Editors
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BROWN.indb 2 5/25/2010 1:33:07 PM

 TABLE OF CONTENTS
Medical Neuroscience of
Science of Love:
Meditation:

12 30
Malpractice: A closer look at a

8
carefully orchestrated Perspectives,
No-fault reforms as a
process conversations and
solution
controversy

Cover Article
4 Neuromarketing: Who Decides What You Buy? Victoria Phan, UCSD

Local Articles
6 Williams Syndrome: Perhaps the Missing Link in the Nature-Nurture Aviel Ettin
Debate for the Presence of Absolute Pitch

8 A Faultless Fix for Medical Malpractice? Douglas Jacobs

10 Corporate Medicine: The Economics of Physician-Owned Specialty Mangaladevi Patil

Hospitals

12 The Science of Love Sofia Castello Tickell

14 Music Facilitating Speech: Melodic Intonation Therapy for Patients MariaLisa Itzoe
with Speech Deficits

BROWN
17 From Bench to Bedside: The Ongoing Controversy of Adult vs. Lakir Patel
Embryonic Stem Cells

20 “Re-Evolution”: One Receptor’s Impact on Evolutionary Theory Lauren Pischel

International Features

ROW
23 From Bacon to Human Babies: Ethical Conflict in Pigs as Surrogate Daniel Brewer, ASU
Mothers

26 Romantic Roots: Shelley’s Deep Ecology Elizabeth Koebele, ASU

28 E. coli: The Cure for Cancer? Kenneth Gao, Berkeley

30 The Neuroscience of Meditation: Perspectives, Conversations, and Cynthia Peng, CMU

Controversy

32 A New Age of Water Politics Dan Plechaty, UChicago

34 Fighting Disease: Are Global Funds Misallocated? Chana Messinger, UChicago

BR
Cover design courtesy of Victoria Phan, UCSD

BROWN.indb 1 5/25/2010 1:33:09 PM

 INSIDE TTH

Message from the Chapter President

Dear Reader,

Congratulations on picking up the eighth edition of The Triple Helix publication at Brown
University! Whether you are familiar with our journal, The Science in Society Review, or
whether this is your first exposure, I am sure you will be enthralled and invigorated by the
spread of articles you find in the following pages.

Established in October 2004 at Cornell University, The Triple Helix is a completely

student run organization that seeks to bridge the gap which often exists between the
three major realms of science, society, and law. Over the past six years, students world-
wide have formed TTH chapters at their own universities, with involvement reaching
STAFF AT BROWN
from University of California, San Diego to National University of Singapore. Taking
an interdisciplinary approach, we strive to further the community’s understanding and
Incoming President
MariaLisa Itzoe appreciation for the intersections of knowledge. Providing an open forum for question and
debate on subjects ranging from business to globalization to ethical concerns of research,
Outgoing President
Konstantin Kashin our journal aims to foster undergraduate communication and dialogue.
Vice President
Raj Vaghjiani However, were we only to promote discussion among fellow university students, our
Editor-in-Chief mission would be only partly achieved. It is my wish that the topics covered, questions
Catherine McCarthy asked, and realities revealed in these articles challenge each of our readers, regardless of
Managing Editor your age or stage in life, to express and exchange your own ideas.
MariaLisa Itzoe

Marketing Co-Directors
Nicole Noronha
Theresa Lii Dedication, diligence, and independence of thought are hallmark characteristics of all
students and faculty who breathe life into The Triple Helix. To all involved: thank you for
Treasurer
Aaron Foo making this possible.
Science Policy Director
Cathy Li Sincerely,
Associate Editors
Mikalei Gordon MariaLisa S.M. Itzoe
Catherine McCarthy
Cody Simmons President 2010-2011, The Triple Helix at Brown University
Jaclyn Teixeira
Laura Tiedemann

Writers
Sofia Castello y Tickell
Aviel Ettin
Doug Jacobs
MariaLisa Itzoe
Lakir Patel
Mangala Patil
Lauren Pischel

Faculty Review Board

Andrea Megela Simmons, Ph.D.
Professor, Departments of
Psychology & Neuroscience

Daniel Weinreich, Ph.D.

Assistant Professor of Biology,
Department of Ecology and
Evolutionary Biology

Gary Wessel, Ph.D.

Professor of Molecular, Cellular
Biology & Biochemistry

2 THE TRIPLE HELIX Spring 2010 © 2010, The Triple Helix, Inc. All rights reserv
reserved.

BROWN.indb 2 5/25/2010 1:33:11 PM

 INSIDE TTH

Message from the CEO

Dear Reader,

Once again, we are at a time of change. This year, in tandem with the American Association for the
Advancement of Science (AAAS) conference in San Diego, The Triple Helix hosted its Leadership
Summit and Membership Workshop to bring together students throughout the world and plan
our future. However, despite their startling creativity and surprising expertise, the most striking
discovery was their raw passion for what lies ahead. Hours and days go by just in discussion. With
such enthusiasm behind every idea, it is difficult to envision anything but overflowing success.

Before you look through The Science in Society Review issue awaiting you, I hope to share with you
my insight into the level of work behind every word. The articles in the following pages are derived
from an outstanding level of editorial and literary commitment. Each piece represents not only the work of the writer, but
also the work of one-on-one associate editors, a highly effective editorial board, astute international senior literary editors, an
impressive faculty review board, and an imaginative production staff that reinvents the journal with every issue. As you read
the following pieces, we hope you will come to appreciate the truly professional level of work that goes into every paragraph.
And it is with that same dedication to improvement that every division of The Triple Helix creates progress everyday.

Over the last year, Julia Piper and TTH leadership redefined the limits of the organization yet again with our amazing progress
in the Electronic Publishing, Internal Affairs, and Science Policy divisions. We have truly come a long way. However, our
greatest accomplishment has been the new wave of global connectedness and communication. As we enter the next cycle, I
hope to witness the next surge of interest and passion from every member as we strive to achieve the dreams we have always
had for the organization. We invite you as readers and supporters to come forward and develop new visions that will push us
to the next level. The opportunity is upon us.

Sincerely,
Bharat Kilaru, Incoming CEO , The Triple Helix, Inc.

Letter from the Outgoing CEO

Even after a year as The Triple Helix’s CEO, I find myself struggling to successfully communicate
the singularity of TTH’s management approach. I think the concept of a completely undergraduate-
run international non-profit corporation is baffling to many because its depends completely on the
effectiveness of 20 and 21 year olds with little free time and even less experience. But it works. It
works because TTH takes the inexperience that other organizations consider limiting and turns it
into an advantage. It is through the annual refreshment of our international leadership that TTH
stays engaged and innovative. With this in mind, I’d like to welcome our new Executive Management
Team, individuals who without bachelor’s degrees are poised to lead an international team. In true
TTH form, however, this inexperience allows them a fresh perspective, a fresh enthusiasm, and a
fresh start to build a new team and a new future. Readers, stay tuned, as I think we will see great
things to come.

Sincerely,

Julia Piper
Outgoing Chief Executive Officer
The Triple Helix, Inc.

© 2010, The Triple Helix, Inc. All rights reserved. THE TRIPLE HELIX Spring 2010 3

BROWN.indb 3 5/25/2010 1:33:11 PM

 UCSD

Neuromarketing:
Who Decides What You Buy?
Victoria Phan

P
eople who have found themselves indulging in clothing popular brands and catchy slogans—tools crafted purposely
trends, jiving to mainstream music, or frequenting the local by marketing executives to catch our attention. This tendency
Starbucks can see that companies spend billions a year to gravitate toward familiar symbols and phrases is the driv-
researching how to perpetuate such conformity. What people ing force behind the concept of neuromarketing. Scientists are
may not know is that the advertising itself is becoming far more focusing on these natural inclinations, using brain imaging
scientifically advanced. Neuromarketing is an emerging branch techniques to gauge consumer reactions and expand upon
of neuroscience in which researchers use medical technology more common, traditional methods, such as surveys and focus
to determine consumer reactions groups [3].
to particular brands, slogans, There are multiple types of
and advertisements. By observ- Despite the ongoing brain-imaging technologies used
ing brain activity, researchers in debate about the ethics of in current neuromarketing stud-
lab-coats can predict whether you ies: fMRI (functional magnetic
prefer Pepsi or Coke more accu- neuromarketing, ...results resonance imaging), QEEG (quan-
rately than you can. Critics have are leading researchers to titative electroencephalography),
already begun to denounce the and MEG (magnetoencephalogra-
idea for its intrusiveness; however, believe that nobody currently phy). However, the fMRI method
though the field is already highly has the power to fully alter is currently the most popular
controversial, there is no doubt amongst marketing companies,
that its continuing development our personal opinions and since it utilizes mainstream tech-
will ultimately have a profound preferences. nology to produce clear images of
impact on consumerism and the real-time brain activity [4]. As an
overall study of human behavior. imaging technique, the process
In America’s capitalist society, advertisements drive our also translates results more easily into layman’s terms: rather
everyday lives. While the idea of actual ‘mind control’ may seem than presenting data in strings of incomprehensible numbers,
far-fetched and unrealistic, the fact remains that the marketing fMRI technology gives people the opportunity to actually vi-
industry has had a firm grasp over the American perception sualize the activity patterns in their brains [5].
of everything from smoking to sex education. Our current fMRI works by gauging amounts of hemoglobin, the
concept of marketing, with its image-based ads, department oxygen-carrier on red blood cells, in certain parts of the body.
store window displays, and catchy TV jingles, actually did For mental imaging, the machine “measures the amount of
not exist before the mid-1900s. Starting in the 1950s, fast food oxygenated blood throughout the brain and can pinpoint an
industries teamed up with processed food companies to shape area as small as one millimeter” [6]. The harder a specific area
the concept of what we now understand to be McDonald’s and of the brain is working, the more oxygen it requires; so when
Burger King ‘cuisine’ [1]. In the 1980s, the invention of cable the fMRI machine scans the brain, it picks up on the areas with
TV, VCRs, and remote controls revolutionized the advertising concentrated amounts of hemoglobin and displays them as
world, as it allowed the media to become much more easily regions of high mental activity on the computer screen. These
accessible to average families [2]. These developments soon computer images are what researchers use to identify the parts
allowed advertising executives to cater to the public’s general of the brain being utilized.
interests and subconscious desires. For neuromarketing, scientists use fMRI to observe areas
Over time, the marketing industry has learned to exploit of the brain that respond to consumer-based stimuli, such as
our responses to a wide variety of images and concepts. It is not particular brands, price ranges, and even taste preferences
difficult, however, to recognize and understand the methodology [4]. The researchers have found that the regions in the brain
behind these marketing campaigns. The strategic placement of corresponding to the prediction of gain and loss (the nucleus
Victoria’s Secret models into Super Bowl halftime commercials accumbens and the insula, respectively) are indicators of behavior
has an obvious sexual appeal. Celebrities are paid to endorse and reaction to finances and economics [3]. In other words, we
particular products, since their personal testimonies make make our decisions based on cursory judgments of whether
any company just seem better. Even the catchiness of a jingle we will gain or lose money when purchasing a product.
makes us more likely to pause when we see a bag of Kit Kats Though fMRI technology was first used for marketing
or Goldfish crackers. But somehow, despite the almost laugh- purposes in the late 1990s, the actual term “neuromarketing”
ably obvious marketing methods, we still respond positively to was only just coined by Erasmus University’s Professor Ale

4 THE TRIPLE HELIX Spring 2010 © 2010, The Triple Helix, Inc. All rights reserved.

BROWN.indb 4 5/25/2010 1:33:11 PM


Smidts in 2002, and the general premise of the research was
not widely recognized until the first neuromarketing confer-
ence in 2004. However, the potential results and subsequent
discoveries about human responses to the media are causing
this infant branch of science to rapidly gain popularity [4].
The infamous “Pepsi vs. Coca-Cola” experiment, in which
scientists studied the motivation behind brand preferences,
was what first put early neuromarketing in the spotlight. The
researchers observed that although Pepsi and Coke are es-
sentially identical, people often favor one over the other. They
subsequently sought to investigate how cultural messages work
to guide our perception of products as simple as everyday
beverages [7].
The experiment was simple: there were two taste tests—one
blind and one in which subjects knew which beverage was
which—and the researchers observed the corresponding brain
activity. When volunteers were unaware of which brand they
were drinking, the fMRI showed activation in the ventromedial
prefrontal cortex, a basic “reward center,” when they drank Pepsi.
However, when the subjects knew which soda was which, the
scans showed brain activity in the hippocampus, midbrain, and
dorsolateral prefrontal cortex (which are centers for memory
and emotion), in favor of Coke. So essentially, people actually
liked the taste of Pepsi, but they were more inclined to believe
that they preferred Coke, based off of nostalgia and emotional
connections. From these results, the researchers determined
that “a preference for Coke is more influenced by the brand
image than by the taste itself” [4].
The outcome of these studies is intriguing and even a
bit entertaining; however, upon a second glance, it can also
be alarming. The fact that a series of ads could actually cause
your brain to believe something that contradicts what the rest
of your body thinks is unnerving, to say the least. Because of
this, there is a growing amount of controversy surrounding
the subject of neuromarketing.
One of the more paranoid views on this subject is that
people may eventually fall victim to an uncontrollable force
compelling them to think or act a certain way. While it is still
too early for anyone to make definitive legal restrictions on the
technology, people are already anxious about its subliminal
undermining of free will. Commercial Alert, an organization
protesting the development of neuromarketing, has expressed
concern over the use of medical technology for advertising
purposes, claiming that brain scans “subjugate the mind and
use it for commercial gain” [6]. The group has argued that
any power-hungry neuroscientist could use these studies to
manipulate the public’s desire for specific products, or that the
research could be used in the realm of politics and propaganda,
dragging us down a slippery slope toward totalitarianism and
war [6].
References:
1. Spring, J. Educating the consumer-citizen: a history of the marriage of schools,
advertising, and media. Mahwah: Lawrence Erlbaum Associates, Inc.; 2003.
2. Fox, S. The mirror makers: a history of American advertising and its creators.
Edition 1997. New York: Morrow, 1984.
3. Schnabel, J. Neuromarketers: the new influence-peddlers? The Dana Foundation.
25 Mar 2008 [cited 2009 Oct 26]. Available from: http://www.dana.org/news/features/
detail.aspx?id=11686.
4. Bridger D, Lewis D. Market researchers make increasing use of brain imaging.
© 2010, The Triple Helix, Inc. All rights reserved.
BROWN.indb 5
UCSD
On the other hand, more optimistic observers contend
that the studies could in fact be beneficial for our society. For
example, neuromarketing has the potential to be a great boon
to public service industries by helping them understand how to
improve anti-drug or anti-smoking campaigns [3]. By utilizing
these new advancements in neuroscience, we could educate the
public more effectively; we would know how to better present
information to inattentive children, how to best impact teenagers
having unprotected sex, and how to inform the public about
conserving energy. The road toward understanding consumer
responses opens paths to understanding human behavior in
general, which could be invaluable to the development of our
global community.
Despite the ongoing debate about the ethics of neuromar-
keting, the amount of research we have today is still minimal,
and the results are leading researchers to believe that nobody
currently has the power to fully alter our personal opinions
and preferences. Most professionals are presently under the
impression that this field is underdeveloped and that research-
ers are hyping it up using neuroscience, a current ‘hot topic,’
to elicit extra funding [3]. However, though there isn’t much
evidence so far to prove that the imaging studies will have a
drastic effect on consumers, researchers agree that even a slight
edge in the competition to win the public’s attention would be
worth the cost for many advertisers.
Like all new scientific advancements, neuromarketing is
thus far merely a research tool. Marketing expert Martin Lind-
strom views the area of study as “simply an instrument used
to help us decode what we as consumers are already thinking
about when we’re confronted with a product or a brand” [6].
In either case, the studies would reveal more intimate details
about human thought-processing and decision-making on a
broader scale.
So the question remains: Is neuromarketing a step forward
in understanding the human mind, or is it an invasive marketing
ploy geared toward demolishing privacy and personal opinion?
As of right now, nobody seems to be sure. Though there is
always the possibility that this technology could be exploited for
immoral purposes, one could say that any scientific discovery
has the same potential for misuse in the wrong hands. The best
way to limit the media’s influence is to educate ourselves about
the science and to be more deliberate with our decisions; a
well-educated consumer is less likely to make rash judgments
based on unfounded claims. Still, knowing that companies have
people researching how our minds work probably won’t stop
most of us from pining after all of the latest products —we will
always have commercialism to thank for that.
Victoria Phan is an undergraduate at the University of California,
San Diego.
ACNR. 2005; 5(3): 36-7.
5. Bloom, P. Seduced by the flickering lights of the brain. Seed Magazine. 2006 Jun 27
[cited 2010 Jan 7]. Available from: http://seedmagazine.com/content/article/seduced_
by_the_flickering_lights_of_the_brain/
6. Lindstrom, M. Buyology: Truth and Lies about Why We Buy. New York:
Doubleday; 2008.
7. McClure, SM, Li J, Tomlin D, Cypert KS, Montague LM, Montague PR. Neural
Correlates of Behavioral Preference for Culturally Familiar Drinks. Neuron. 2004; 44:
379-387.
THE TRIPLE HELIX Spring 2010 5
5/25/2010 1:33:12 PM
 BROWN

Williams Syndrome:
Perhaps the Missing Link in the Nature-Nurture
Debate for the Presence of Absolute Pitch
Aviel Ettin

T
here has been a long-standing debate over whether the musicians accepted to Juilliard and upwards of 20 percent of
phenomenon of absolute pitch is an ability that can be individuals in professional symphony orchestras show perfect
learned or whether someone is just born with it. While pitch ability [3]. On the other hand, Nicolas Slonimsky, a 20th-
there is a variety of rather expensive software on the market, century Russian-American composer and musician, writes in
such as “The Ear Training Companion” and “Pure Pitch,” his autobiography Perfect Pitch that ”to lack it does not exclude
which promise to give even the most tone-deaf of us a perfect musical talent or even genius. Neither Wagner nor Tchaikovsky
ear, I remain skeptical that absolute pitch can be learned. had absolute pitch, while a legion of mediocre composers have
Howard Lenhoff, a professor emeritus of microbiology at the been known to possess it to the highest degree” [4].
University of California at Irvine, began studying brain science
after his daughter was diagnosed with Williams syndrome. Williams Syndrome
He found evidence that absolute pitch may be much more Williams syndrome is a rare neurodevelopmental disorder
prevalent among those with this special condition than among caused by the microdeletion of approximately 26 genes on
the general population [1]. This provides us with an interesting the long arm of chromosome 7. This disorder occurs in one
insight into the nature-nurture out of about 20 thousand births
debate of trait acquisition, be- and is the result of a mistake
cause if there is link between in genetic transcription that oc-
absolute pitch and Williams
Absolute pitch (AP), found curs in the early stages of fetal
syndrome, auditory acuity and in approximately one in development [5]. People with
maybe even musical ability can Williams syndrome have pro-
be labeled as something heavily
10 thousand people, is the found intellectual impairment
pre-determined by one’s genes. ability to accurately identify and demonstrate IQ scores that
average around 60. Few learn
Absolute Pitch
and reproduce a given pitch to count, tell time, or even read,
Absolute pitch (AP), found in without relying on any form yet interestingly, most possess a
approximately one in 10 thou- great memory for songs and an
sand people [2], is the ability
of external pitch reference. uncanny sense of rhythm. Some
to accurately identify and re- individuals even have the kind
produce a given pitch without of auditory acuity that enables
relying on any form of external them to distinguish different
pitch reference. This ability is often likened to the familiar- kinds of vacuum cleaner brands by the sounds they make [6].
ity with which most adults are able to associate a color and Despite having whole brain volumes of about 15 per-
its name. Throughout early childhood we are exposed to all cent smaller than normal, the temporal lobes—the area of
the basic colors and learn their names; as we grow older, we the brain responsible for auditory processing—of those with
no longer need a labeled color wheel to correctly identify a Williams syndrome are of normal or supernormal size [7].
specific color—we are able to intuit it. This is similar to the Further evidence of cortical disparity came from Bellugi et
ease and accuracy with which an individual with AP can al. (1989), who found that there is a reduction in size and
recognize pitches. Unfortunately the color analogy only goes weight in the occipital and parietal lobes—regions that are
so far because it assumes that absolute pitch, like “absolute concerned with visual processing and integration of sensory
color,” can be learned during one’s upbringing. This has yet information, respectively [8]. Recent research has produced
to be proven. data to support this theory, finding that lesions to particular
Oliver Sacks, a British neurologist and professor of neu- areas in the cerebellum can cause Williams syndrome-like
roscience at Columbia University, mentions in his journal symptoms, whereby people suddenly become too outgoing
article Musical Ability that absolute pitch, while rare in the and overly familiar with strangers [9].
general population, “is relatively common among professional
musicians, and to a limited extent may serve as a marker The Theory of Causation
for musicality” [3]. It has been estimated that 10 percent of Because of the tendency of individuals with Williams syndrome

6 THE TRIPLE HELIX Spring 2010 © 2010, The Triple Helix, Inc. All rights reserved.

BROWN.indb 6 5/25/2010 1:33:12 PM

 BROWN

to show some gift for musical expression and to possess absolute talent and that absolute pitch has an underlying genetic basis
pitch, the possibility was considered that this connection was [2], and while evidence of a genetic locus has recently been sug-
not so much a correlation but rather one of causation, whereby gested [13], most believe that the acquisition of absolute pitch
the genetic mutations that caused Williams syndrome precisely requires early training during a critical period of development
endowed that individual with absolute pitch. Lenhoff was regardless of any sort of genetic predisposition [14]. Lenhoff’s
the first to make this observation, and was able to prove it discovery of the prevalence of absolute pitch in Williams syn-
true in his paper in Music Perception entitled “Absolute Pitch drome provides an interesting insight into this debate, since it
in Williams Syndrome.” His theory was later supported by suggests that absolute pitch is an innate talent that is fostered
the fact that the region during development—
of elevated growth in something brought
the temporal lobe of about by a combination
Williams individuals of nature- and nurture-
is the planum tem- related causes. He be-
porale [10]—an area lieves that “the normal
responsible for a vari- mechanism of closing
ety of auditory tasks, that developmental win-
including acquisition dow for AP somehow
of absolute pitch [11]. gets jammed when other
The rarity of ab- cognitive functions get
solute pitch within the jammed. That window
population, its relative for some reason seems
isolation from general to stay open for longer
musical ability and en- periods in Williams
joyment, and its high syndrome” [1].
prevalence among As with language
individuals with neu- acquisition, some
rodevelopmental disor- people have an innate
ders such as Williams skill for distinguishing
syndrome all suggest sounds and are drawn
that absolute pitch is to music training as a
a talent of what Sacks Reproduced from [15] result, while others have
dubs “savant” nature [3]. In Musical Ability, Sacks describes trouble humming even the simplest tune. The diathesis-stress
these “savant” talents as characterized by “functional isolation, model provides the foundation for an understanding of be-
autonomy and an independence of training or practice,” [3] havior as a result of both genetic factors (“nature”), and life
which make them rather different in character from “normal” experiences (“nurture”), and so I wonder, why this can’t be
talents. Lynn Waterhouse et al. proposed that such savant applied to absolute pitch? Maybe those few individuals with
talents may be dependent on the development of a “special- absolute pitch have been fortunate enough to possess the genes
ized neural network” [12]. It seems that the phenomenon for absolute pitch and also be brought up in an environment
of AP may not be the result of higher cognition or of vastly that allows them to fully realize this gift. This is unfortunately
impressive memory, but rather of a different type of cogni- still a hypothesis that has yet to be experimentally determined,
tion altogether. so until then, absolute pitch remains a mythologized musical
phenomenon enjoyed by a fortunate minority.
Nature vs. Nurture
A number of scientists believe that musical ability is an inborn Aviel Ettin is an undergraduate at Brown University.

References
1. Lenhoff H. et al., Absolute Pitch in Williams Syndrome, Music Perception, Volume
18, pp 491–503 (2001)
2. Drayna D et al., Genetic Correlates of Musical Pitch Recognition in Humans,
Science, Volume 291, pp 1969-1972 (2001)
3. Sacks O., Musical Ability, Science, Volume 268, pp 621 -622 (1995)
4. Slonimsky N., Perfect Pitch: A life story, Oxford University Press, pp 5-9 (1988)
5. Bellugi et al., Bridging cognition, the brain and molecular genetics: evidence from
Williams syndrome, Trends in Neurosciences, Volume 22, pp 197-207 (1999)
6. Salk Institute, Williams Syndrome, The Brain And Music. ScienceDaily
(2006). Retrieved April 24, 2008, from http://www.sciencedaily.com¬ /
releases/2006/10/061003191006.htm
7. Schmitt J. et Al., Analysis of Cerebral Shape in Williams Syndrome, Arch
Neurology, Volume 58, pp 283-287 (2001)
8. Bellugi etl al., Neuropsychological, neurological, and neuroanatomical profile of
Williams syndrome, American Journal of Medical Genetics, Volume 37, pp 115 – 125
(1989)
9. Levitin D., This is Your Brain on Music, Penguin, pp 186 – 187 (2006)
10. Reiss A., An Experiment of Nature: Brain Anatomy Parallels Cognition and
Behavior in Williams Syndrome, The Journal of Neuroscience, Volume 24, pp 5009-
5015 (2004)
11. Keenan J., Absolute Pitch and Planum Temporale, NeuroImage, Volume 14, pp
1402-1408 (2002)
12. Obler L. er al., The Exceptional Brain: Neuropsychology of Talent and Special
Abilities, Guilford, pp 493-512 (1988)
13. Theusch E. et al., Genome-wide Study of Families with Absolute Pitch Reveals
Linkage to 8q24.21 and Locus Heterogeneity, The American Journal of Human
Genetics, Volume 85, Issue 1, Pages 112-119 (2009)
14. Chin C., The Development of Absolute Pitch: A Theory Concerning the Roles
of Music Training at an Early Developmental Age and Individual, Cognitive Style
Psychology of Music, Vol. 31, No. 2, 155-171 (2003)
15. http://weboflife.nasa.gov/images/earRevAFlat.jpg

© 2010, The Triple Helix, Inc. All rights reserved. THE TRIPLE HELIX Spring 2010 7

BROWN.indb 7 5/25/2010 1:33:12 PM

 BROWN

A Faultless Fix for Medical Malpractice?

Douglas Jacobs

L
aurie Johnson woke up and went to her scheduled dila- ranks physician errors as one of the leading causes of death
tion and curettage procedure. During the operation, the in America today [4].
physician unknowingly perforated Ms. Johnson’s uterus In addition, malpractice trials often place an unneces-
and lacerated her colon. Despite reporting severe pain, she sary burden on physicians who have done nothing wrong:
was sent home without further evaluation. One hour later, of those physicians who are sued, 83 percent have not acted
she returned to the emergency room reporting persistent pain negligently. In fact, a recent study demonstrated that the
and internal bleeding as a result of this medical injury. After number of malpractice suits brought against different physi-
the traumatic affair, she contemplated suing her physician cians could be predicted entirely by the patients’ reactions to
for malpractice [1]. intonations in physicians’ voices—nothing to do with medical
In the United States, we have a set of legal institutions to deal errors whatsoever [5].
with issues of negligence: a tort-based medical malpractice sys- The tort malpractice system has also proven to be unfair
tem. Broadly defined, a tort in terms of representation.
is an act that injures someone Individuals who can claim
in some way. In the case of high economic losses from
medical malpractice, this an injury are invariably
injury is due to negligence, from higher income strata
which is defined by law as and are therefore lucrative
“a wrong which constitutes targets for malpractice law-
a ground of legal liability yers. On the opposite end of
even though the fault upon the spectrum, poor people,
which it is predicated is at- the elderly, and even women
tributable to imprudence or often have trouble getting
to a lack of skill rather than legal representation because
to a conscious design to do they cannot claim as much
wrong and notwithstanding economic damage from their
the lawfulness of the enter- injuries as younger, wealthi-
prise in the conduct of which er, male persons can. If in our
the negligence occurs” (57 example Ms. Johnson did not
A. am. Jur.2nd. No.32) [2]. have a high-paying job, she
In other words, a doctor is would have more difficulty
liable to be found negligent finding a lawyer to try her
when he or she has failed to case. Individuals with minor
provide the standard of care injuries find it even harder
that the law requires. In our Reproduced from [12] to receive compensation: the
current system, Ms. Johnson has the right to find a trial lawyer high cost of a trial outweighs the relatively small payout for
to represent her, sue the practicing physician, and hope that a minor injury.
the jury awards her compensation.
The tort-based malpractice system has two goals: to com- No-Fault Medical Malpractice as a Solution
pensate patients who are injured due to negligence and to act as The question arises as to what our course of action should be
a deterrent for physicians to provide negligent care. However, to remedy these problems. An alternative malpractice system,
on both fronts, the current medical malpractice system is fail- dubbed the “no-fault malpractice system,” has been gaining
ing badly. Only about one percent of those injured as a result global popularity and has been adopted by Sweden, Finland,
of a medical mistake receive any compensation at all [3]. This New Zealand, Canada, Australia, and Denmark. Unlike the
is because patients may not know that their injury was the tort-based system, this no-fault approach does not require
result of a mistake, and the litigation process is complex. Thus, proof of provider negligence. Instead, injured patients are
only a small fraction of patients are compensated (failing the compensated if their injury is deemed avoidable in the normal
first goal), which means that physicians who act negligently course of medical treatment, even if the physician is not at
aren’t sued (failing the second goal). Since physicians aren’t fault. Governmental agencies and boards are created with
usually held liable, it is difficult to assume that the 100,000 three purposes in mind: to collect the funds necessary to allow
annual deaths in the United States due to medical mistakes compensation to injured patients, to quickly review claims
will decrease. This frighteningly high number of mortalities and reach a verdict regarding compensation, and to ensure

8 THE TRIPLE HELIX Spring 2010 © 2010, The Triple Helix, Inc. All rights reserved.

BROWN.indb 8 5/25/2010 1:33:12 PM


that the correct steps are taken to prevent the medical error
from happening again.
It seems that the no-fault malpractice system would ad-
dress some of the problems realized in our current system. In
no-fault medical malpractice, many more patients file claims
and are compensated. For example, in Sweden during 1992, the
claims frequency was 50 percent higher than the correspond-
ing claims frequency against physicians in the United States
[6]. In a no-fault system all injuries, no matter the severity or
the incurred economic damage, can be compensated, thereby
offering a “fairer” alternative to our current discriminatory
tort system. Because a higher percentage of patients are com-
pensated, the two goals of reimbursing patients and deterring
negligent care become achievable. Because more claims are
filed as more patients are rewarded, the agency overseeing
claims can facilitate the correction of patterns of negligent
care, through retraining programs or even punitive measures.
In countries with no-fault systems, physicians actually help
injured patients fill out the forms for compensation rather
than try to veil mistakes for fear of being sued [7].
Efficiency and speed characterize the no-fault alternative.
More than 50 percent of the cost of today’s malpractice system
is wasted on litigation and administration [8]. With a no-fault
system, the high cost of lawyers and trials is avoided, and only
10 percent is allocated to administrative purposes [7]. It is also
possible that a no-fault malpractice system could be funded
entirely through the exorbitant malpractice premiums that
doctors pay today [7]. This, of course, means that there would
be no tax increases, which so often thwart potential reform.
Speedier results are also commonplace; a verdict is reached
in a time span of weeks to months rather than the years of
litigation that often marks malpractice trials [2].
Attempts at No-Fault Reform
If a no-fault medical malpractice system would solve many
of our current malpractice system’s problems, why has it not
been enacted? The fact remains that no-fault malpractice has
proven to be a difficult political sell. Such a system would es-
sentially expunge malpractice lawyers and malpractice insurance
companies from their unique niches in today’s society. Any
legislation altering or affecting the job of an attorney or insur-
ance company is sure to be met with fierce opposition. When
Sen. Michael Enzi (R-Wyo.) and Sen. Max Baucus (D-Mont.)
introduced the “Fair and Reliable Medical Justice Act” (S. 1337),
References
1. This is a fictional story.
2. Medical Malpractice Systems around the Globe: Examples from the US- tort
liability system and the Sweden- no fault system [Online]. [2009?] [cited 2009
December 14]; Available from: URL:http://194.84.38.65/files/esw_files/malpractice_
systems_eng.pdf
3. Brennan TA, Leape LL, Laird NM, Hebert L, Localio AR, Lawthers AG et al.
Incidence of adverse events and negligence in hospitalized patients. Results of the
Harvard Medical Practice Study I. N Engl J Med 1991 Feb 7;324(6):370-6.
4. Starfield B. Medical Errors- A Leading Cause of Death. JAMA 2000 Jul 26;284(4).
5. Ambady N, Laplante D, Nguyen T, Rosenthal R, Chaumeton N, Levinson W.
Surgeon’s tone of voice: a clue to malpractice history. Surgery 2002 Jul;132(1):5-9.
6. Danzon P. The Swedish Patient Compensation System: Myths and Realities. 1994
[cited 2009 December 14]; Available from: URL:http://hc.wharton.upenn.edu/danzon/
PDF%20Files/Swedish%20Patient%20Comp%20System%20Myths%20-%20Intl%20
%20Review%20of%20Law%20&%20Econ%201994.pdf
7. Bismark M, Patterson R. No-fault compensation in New Zealand: harmonizing
© 2010, The Triple Helix, Inc. All rights reserved.
BROWN.indb 9
BROWN
which would provide money for demonstration projects on
alternative methods to address malpractice, the bill did not
even pass out of committee [9]. The right to a jury trial is a
sacred part of American history and culture, which makes the
implementation of alternative dispute resolution mechanisms
difficult, even if consumer rights and justice would benefit.
Nevertheless, despite these hurdles, some no-fault mecha-
nisms have already been adopted. In 1987 and 1988, Virginia
and Florida, respectively, assumed no-fault programs for com-
pensating serious birth-related neurological injuries. As the
first no-fault malpractice programs in the United States, they
represent a “trial run” for further malpractice reform. A research
team analyzed the two programs and reported a number of
positive findings. First, obstetrical malpractice premiums for
physicians decreased because the most expensive obstetrical
cases were taken out of tort litigation. Additionally, these no-
fault programs followed through with perceived increases in
efficiency. “No-fault delivers benefits quite similar in value to
tort, but much faster and with far lower administrative costs,”
reports a member of the project staff [10]. Finally, claimants
generally expressed satisfaction with the programs, a notable
result considering their right to a trial was taken away [10]. But
as promising as these results are, this project was too limited
in scope to vouch for a no-fault system’s ability to increase
compensation and decrease medical errors across the country.
Looking Ahead
No-fault solutions to our nation’s growing malpractice prob-
lems are gaining momentum. President Barack Obama has
stated in his healthcare plan that he and Vice President Joe
Biden will “promote new models for addressing physician
errors that improve patient safety, strengthen the doctor-patient
relationship, and reduce the need for malpractice suits” [11].
Clearly, the shortcomings of our current tort-based malpractice
system can no longer be ignored. Further malpractice reforms
need to take the failure of Senators Enzi’s and Baucus’ pro-
posal into consideration and include malpractice lawyers and
insurance companies in the process. If a no-fault alternative
is indeed implemented, even at a statewide level, it could
offer a poignant example of the benefits of a faultless fix to
America’s malpractice problem. Until then, Laurie Johnson
will just have to try her luck in court.
Douglas Jacobs is an undergraduate at Brown University.
injury compensation, provider accountability, and patient safety. Health Aff 2006
Jan-Feb;25(1):278-83.
8. Studdert DM, Mello MM, Gawande AA, Gandhi TK, Kachalia A, Yoon C et al.
Claims, errors, and compensation payments in medical malpractice litigation. N Engl
J Med 2006 May 11;354(19):2024-33.
9. S. 1337: Fair and Reliable Medical Justice Act [Online]. 2006 [cited 2009 December
14]; Available from: URL:http://www.govtrack.us/congress/bill.xpd?bill=s109-1337
10. Sloan FA, Bovbjerg RR. The Road from Medical Injury to Claims Resolution: How
No-Fault and Tort Differ. Administrative Performance of ‘No-Fault’ Compensation
for Medical Injury. Proceedings of the IMPACS/Duke Medical Malpractice
Conference; 1997 Sep 12-13; Durham, NC.
11. Barack Obama and Joe Biden’s Plan to Lower Health Care Costs and Ensure
Affordable, Accessible Health Coverage for All [Online]. [2008?] [cited 2009
November 30]; Available from: URL:http://www.barackobama.com/pdf/issues/
HealthCareFullPlan.pdf
12. http://www.co.gloucester.nj.us/Bodyimages/Clerkboard/tortClaim_lg.jpg
THE TRIPLE HELIX Spring 2010 9
5/25/2010 1:33:13 PM
 BROWN
Corporate Medicine: The Economics of
Physician-Owned Specialty Hospitals
Mangaladevi Patil
I
magine a world where the CEOs of Fortune 500 companies
and the directors of hedge funds are running our hospitals.
The resulting improvements in management and efficiency
may prove beneficial. However, these CEOs and directors will
be driven by financial benefits. Recall the collapse of the banking
industry that plunged our na-
tion into recession. Business
executives made decisions
driven primarily by finan-
cial gain rather than for the
betterment of the American
people. Can you imagine a
world where doctors’ incen-
tives to make profits and to
attract business overpowers
their incentive to provide
quality healthcare? We may
not have to imagine much
longer. Physician-owned
specialty hospitals provide
an environment that encour-
ages physician profit-seeking
behavior. As the number of
these institutions continues
to rise in the United States,
debate over the impact of
physician-owned specialty hospitals on the healthcare field
and patient welfare becomes increasingly important.
Background & Controversy
A specialty hospital is a health care facility that channels re-
sources and expertise into one particular area of medicine.
Proponents of specialty hospitals argue that these “focused
factories” allow for an increase in quality of care as they allow
physicians to concentrate efforts on treating specific illnesses.
In addition they result in greater cost efficiency by providing
for a narrower range of services [1]. The majority of specialty
hospitals are cardiac care facilities; however, women’s, ortho-
pedic, surgical, and other subspecialty facilities exist as well
[1]. The first specialty hospital dates back to as early as mid-
19th-century England, with the opening in 1857 of London’s
National Hospital for Diseases of the Heart and Paralysis [2].
Currently there are over 100 specialty hospitals in America [3].
The main controversy that arises in regards to specialty
hospitals is that many of these facilities have physician share-
holders. In the mid-1900s, Congress lifted a ban preventing
physicians from self-referring patients to institutions in which
they had financial investments. In 2008, a study was con-
ducted at the Georgetown Public Policy Institute to explore
10 THE TRIPLE HELIX Spring 2010
BROWN.indb 10
whether financial incentive motivated shareholding physicians
at specialty hospitals to alter patient care in any manner. The
results showed that physicians holding a financial stake in the
hospital were more likely to self-refer patients to the hospital
and prescribe a greater number of diagnostic, surgical, and
secondary procedures. This
practice results in a signifi-
cantly greater healthcare
cost for patients treated at
physician-owned specialty
hospitals as opposed to at
a non-self-referring facility
[4]. However, supporters of
physician-owned specialty
hospitals attest that allowing
physicians to direct control
over management decisions
results in improved results
for patients [4]. Nonetheless,
physician-owned specialty
hospitals inherently encour-
age profit-seeking behavior
from its doctors. This practice
is contributing greatly to the
increasingly corporate nature
Reproduced from [7]
of healthcare management.
Doctors are altering care unnecessarily to increase revenue.
The notion that doctors are seeking increased profits is not
alarming itself, but the consequences this behavior has on
patient care is cause for serious concern.
Ethical Concerns
It is undoubtedly unethical that doctors are altering methods
of treatment for financial gain. A joint study by the University
of Iowa Center Carver College of Medicine, Center for Study-
ing of Health System Change, and the Center for Research
in the Implementation of Innovative Strategies for Practice
found that physician-owned specialty hospitals tended to
treat patients with greater insurance coverage and patients
at lower risks for complications. It concluded that patients
admitted to the examined specialty hospitals were less likely
to be female, Hispanic, or Black and had significantly lower
rates of comorbid illnesses such as diabetes with complications
or renal failure than patients admitted to general hospitals.
However, despite having lower rates of comorbid illness, pa-
tients at specialty hospitals were more likely to undergo drastic
interventional procedures. For example, patients with acute
myocardial infarctions [AMI] at specialty hospitals were more
likely to undergo cardiac catheterization than AMI patients
© 2010, The Triple Helix, Inc. All rights reserved.
5/25/2010 1:33:13 PM
 BROWN

at general hospitals [5]. physician-owned specialty hospitals offer burdened doctors a

Nonetheless, proponents of specialty hospitals continue financial alternative, they inadvertently cause general hospitals
to argue that by focusing resources and expertise, these facili- to lose valuable financial resources. Although politicians have
ties are able to treat particular recognized the need to address
ailments more effectively. For Consequently, we must the emergence of self-referring,
instance, a study conducted by physician-owned specialty hos-
the Department of Rheumatol- acknowledge that physician- pitals, they have taken various
ogy at Brigham Young Hospital, owned specialty hospitals are positions on the issue. In general,
Harvard Medical School found Republicans promote market-
that patients requiring total knee contributing to the increasingly based solutions, unfettered by
replacement saw higher rates of corporate, profit-seeking nature government constraints, whereas
success at specialty orthopedic Democrats and the general hos-
hospitals, particularly if they had of medicine, evidenced by pital community share the belief
complications [6]. the damaging self-promoting that the self-referral of patients
However, it has been shown by physician-owners to specialty
that in efforts to increase success practices of specialty hospitals. hospitals represents unfair com-
rates and attract more business, petition and should be strictly
these “focused factories” have resorted to “cherry-picking” the limited and controlled, if not prohibited [2].
best patients. Investigations have shown that while healthier The dominance of specialty hospitals will not affect the
patients receive comparable treatment from specialty and gen- wealthy physician’s family with excellent insurance cover-
eral hospitals, patients with higher age, but it will affect the 45.7 mil-
incidences of comorbid disease expe- lion Americans without any health
rience worse 30-day post-discharge insurance and the millions more
mortality rates at specialty hospitals with inadequate coverage. These
[1]. Americans will not have the luxury
For argument’s sake, let us as- of acquiring treatment at a specialty
sume that specialty hospitals do, hospital. They will have to rely on
however marginally, provide better general hospitals already deprived of
treatment for certain illnesses—but financial resources. Furthermore, not
does the improvement outweigh the only do specialty hospitals jeopardize
substantially greater cost incurred? the financial stability of the healthcare
Specialty hospitals must fund an industry by attracting resources away
increased number of diagnostic, from general hospitals, but also, as the
interventional, and secondary pro- aforementioned studies have shown,
cedures. A study published in the specialty hospitals provide a decreased
Journal of the American Heart As- quality of healthcare for the average
sociation argues that the benefit is patient requiring non-specialized care.
therefore negligible. Consequently, we must acknowl-
edge that physician-owned specialty
Future Impact hospitals are contributing to the in-
Consequently, physician-owned creasingly corporate, profit-seeking
specialty hospitals not only fail to nature of medicine, evidenced by the
significantly increase the quality of damaging self-promoting practices
patient care, but also may negatively of specialty hospitals. Ultimately,
Reproduced from [8]
affect the surrounding community. decisions must be made to protect
When these facilities “cherry-pick” the most profitable pa- the rights of the millions of Americans that rely daily on the
tients, funds are driven away from neighboring general hos- healthcare industry.
pitals. The situation has worsened as the economic recession
forces many states to further lower healthcare budgets. While Mangaladevi Patil is an undergraduate at University of Chicago

References
1. Hwang CW, Anderson GF, Diener-west M, Powe Nr. Comorbidity and Outcomes
of Coronary Artery Bypass Graft Surgery at Cardiac Specialty Hospitals Versus
General Hospitals. Medical Care 2007; (45]:720-728.
2. Brindis RG, Spertus JA. Specialty Cardiac Hospitals: How Special Are They?
American Heart Association 2007; (116]:2238-2240.
3. Schmidt K, Meagher TM. Specialty Hospitals: Positive Contributors to Healthcare
Delivery. JONA 2005; 35(7/8]:323-325.
4. Mitchell JM,, Do Financial Incentives Linked to Ownership of Specialty Hospitals
Affect Physicians’ Practice Patterns? Medical Care 2008; (46]:732-737
5. Cram P, Pham HH, Bayman L, Vaughan-sarrazin Ms. Insurance Status of Patients
Admitted to Specialty Cardiac and Competing General Hospitals: Are Accusations of
Cherry Picking Justified? Medical Care; 46(5]:467-475.
6. Katz JK, Bierbaum BE, Losina E. Case Mix and Outcomes of Total Knee
Replacement in Orthopaedic Specialty Hospitals. Medical Care 2008; (46]:476-480.
7. http://www.houston.va.gov/images/pressrel/heart22.jpg
8. http://www.lexingtonky.gov/Modules/ShowImage.aspx?imageid=3534

© 2010, The Triple Helix, Inc. All rights reserved. THE TRIPLE HELIX Spring 2010 11

BROWN.indb 11 5/25/2010 1:33:13 PM

 BROWN
The Science of Love
Sofia Castello Tickell
“And therefore is winged Cupid painted blind.”
- William Shakespeare, A Midsummer Night’s Dream
P
assionate love has more than once been painted as irra-
tional—subject to only the laws of chance and destiny. Its
presence has pervaded human life for thousands
of years, and we have all been exposed to it in some
way or other. A recent survey found evidence for
romantic love in 147 of 166 countries and no significant
evidence against it in the remaining 19 [1]. It would
appear that love is anthropologically universal.
And yet, there are also certain boundaries to
love—most often, attractive people are paired off
together, men and women form couples, and mo-
nogamy is the standard. There are also cultural ideals
of attractiveness.
With the progression of brain-scanning techniques
and the development of evolutionary theory, another
side of love has begun to be unveiled—and it seems
that love may not be as accidental as some think. In
fact, it is a carefully orchestrated process: there are
hormones behind the fever and evolutionary drives
behind the magnetism.
It is up to science to decode them.
The Neuroscience of Love
The “symptoms” of romantic love are well known: an obsessive
focus on the object of affection; euphoria; excess energy; sleep-
lessness; possessiveness; “frustration attraction” (an increase
in the intensity of feelings following rejection); separation
anxiety; rage at abandonment; pounding heart and sweaty
palms; and in extreme cases, a willingness to die for the object
of affection [2].
In 1986, psychologist Elaine Hatfield and sociologist Su-
san Sprecher set out to quantify romantic love. They devised
a questionnaire known as the Passionate Love Scale, which
consists of 15 statements, such as the following (the blank
represents the object of affection) [3]:
2. Sometimes I feel I can’t control my thoughts; they
are obsessively on __________.
5. I’d get jealous if I thought __________ were falling
in love with someone else.
9. For me, __________ is the perfect romantic partner.
10. I sense my body responding when __________
touches me.
12. I want __________ to know me—my thoughts,
my fears, and my hopes.
15. I get extremely depressed when things don’t go
right in my relationship with __________.
Subjects correlate their feelings with the statements on a
12 THE TRIPLE HELIX Spring 2010
BROWN.indb 12
nine-point scale, one being “not at all true” and nine being “defi-
nitely true.” The final result is a score out of 135 points, which
is placed into one of five categories ranging from “extremely
passionate” to “extremely cool” [3]. Understandably, there are
various arguments against using a quantitative test to determine
“levels” of love, but the
very fact that it provides
a solid number makes
it a useful candidate in
scientific studies.
In 2005, research-
ers Helen Fisher, Arthur
Aron, and Lucy L. Brown
made an attempt at un-
derstanding the effects
of early stage intense
romantic love on the
brain. Their subjects, 10
women and seven men
between 18 and 26 years
old, all claimed to have
been intensely in love
for a length of time between one and 17 months. They filled
out the Passionate Love Scale and underwent an interview to
determine the range and intensity of their feelings [2].
Once it had been determined how besotted subjects were,
they were shown a picture of their beloved, and their brains
were monitored using magnetic resonance imaging (MRI) [2].
Full brain scans revealed activation of the ventral tegmental
area and the caudate nucleus, both of which are small groups
of dopaminergic cells in the midbrain. They have been linked
to the reward system, which positively reinforces adaptive
behaviors [3,4].
Due to its role in the reward system, dopamine has been
associated with “drives,” goal-oriented behaviors associated
with dopamine. The prevalence of dopamine in the romantic
process suggests that romantic love is a primal drive, rather
than the more complex emotion we often consider it to be.
Interestingly, unlike most emotions, passionate love is not
associated with any particular facial expression [2].
The use of words such as “rush” and “high” in describing
a romantic experience is surprisingly accurate. Cocaine, which
leads to a surge in dopamine, has also been found to activate
the ventral tegmental area. Cocaine causes similar behaviors to
intense romantic love, such as exhilaration, excessive energy,
sleeplessness, and loss of appetite [1].
Stages of Love
Biological anthropologist Helen Fisher has broken down the
mammalian system of mating into three stages: lust, attraction,
and, in monogamous species, attachment [5]. The romantic love
© 2010, The Triple Helix, Inc. All rights reserved.
5/25/2010 1:33:13 PM

found in humans can be seen as an extension of the “attraction”
phase. Essentially, lust is “sex drive,” the urge to seek out a
variety of potential mates; attraction helps the organism to
single out and choose the fittest potential mates from the pool;
and attachment leads the pair to stay together long enough
to successfully raise their offspring [5]. Sex activates different
areas of the brain than does passionate love, suggesting the
two drives are distinct, though certainly related [2].
Lust powers the mating process – it alone could lead to
progeny, but these would not necessarily be the most likely
to survive.
Attraction facilitates the creation of the best possible
offspring by selecting for traits that will ensure survival. Ac-
cording to the following studies, these traits include genetic
variation, reproductive potential, and material resources. The
Major Histocompatibility Complex (MHC) is a highly poly-
morphic series of genetic markers key to the immune system
and, specifically, important in self-recognition. In one study,
44 men wore a T-shirt for two nights. Then, 49 women were
each asked to smell six of the T-shirts and rate the owner by
attractiveness. Consistently, women gave the highest ratings
to men with dissimilar MHCs. This trend was reversed when
they were on the contraceptive pill [6]. The “inbreeding hy-
pothesis” provides one possible explanation: the partnering
of organisms who are too similar is generally unfavorable,
for a variety of reasons. As a population loses variation, it
becomes vulnerable to the same stresses, which means a single
event could wipe out the population. The couple’s children
will more likely express recessive mutations and defects—for
example, inbreeding in European royal families led to a high
prevalence of hemophilia. Sex-specific factors also exist: males
mostly seek reproductive potential, while females seek both
genetic and material resources. In 1995, Singh and Young
found that the combination of a low waist-to-hip ratio—a
curvy shape—and large breasts are particularly “attractive,
feminine and desirable” to men [7]. Waist-to-hip ratio ap-
proximately indicates a woman’s level of nourishment and
therefore how well she will be able to carry and care for a
child. A high waist-to-hip ratio has also been associated with
menstrual irregularity and reduced fertility. Indicators of age
such as wrinkles are examples of traits that males may use in
order to indirectly gauge a female’s reproductive potential.
Age matters because females have a limited reproductive span
in comparison to males, who could potentially sire offspring
throughout their lives [8].
While characteristics such as size, strength, and intelli-
gence may aid her offspring in the future, a dependent female
References
1. Aron A, Fisher H, Brown L. Reward, motivation, and emotion systems associated
with early-stage intense romantic love. Journal of Neurophysiology 2005; 94: 327-37.
2. Fisher H, Aron A, Brown L. Romantic love: an fMRI study of a neural mechanism
for mate choice. The Journal of Comparative Neurobiology 2005; 493: 58-62.
3. Hatfield E, Sprecher S. Passionate love scale. Available at: URL: http://www.
elainehatfield.com/Passionate%20Love%20Scale.pdf. Accessed Jan 2, 2010.
4. Bear M, Connors B, Paradiso M. Neuroscience: Exploring the Brain. 2nd ed.
Lippincott Williams and Wilkin; 2001.
5. Fisher H. Lust, attraction, attachment: Biology and evolution of the three primary
emotion systems for mating, reproduction and parenting. Journal of Sex Education
and Therapy 2000; 25: 413-419.
6. Wedekind C, Penn D. MHC genes, body odors, and odor preferences. Nephrology
© 2010, The Triple Helix, Inc. All rights reserved.
BROWN.indb 13
BROWN
will first seek resources with which to nourish both herself
and her offspring. Therefore, a male will be judged on his
genetic prowess as well as his material belongings, and there
is a chance for an unattractive male to make up for his lack
of dazzling genes with resources. Interestingly enough, one
cross-cultural study performed in 1952 by Ford and Beach
found that men are permitted to have more than one mate
at a time in 84 percent of 185 societies so long as they can
provide for them [8].
Attachment applies in the rare case that a mammal is
monogamous. Exclusivity can be advantageous to both par-
ties—for males, it guarantees paternity, whereas for females,
it ensures that all the resources the male has to provide will
go to the female and her offspring.
Clues to the neuroscience of monogamy lie in two key
hormones: oxytocin and vasopressin. Monogamous prairie
voles have a dense concentration of oxytocin and vasopressin
receptors, whereas their close cousins, promiscuous montane
voles, have them in much lower concentrations. Upon mating
for the first time, for up to 16 hours, prairie voles are completely
monogamous and become extremely aggressive toward oth-
ers of their species [9]. In humans, oxytocin levels increase in
both men and women during sexual activity and orgasm [10].
Conclusion
The future of love is somewhat perplexing—as we learn more
about it, the potential for manipulation increases. After a study
found that the use of an oxytocin nasal spray boosted trust
when subjects exhibited nonthreatening signals, one website
is advertising “Liquid Trust”—oxytocin in a bottle [11,12]. It
also sells pheromones, “guaranteed” to boost one’s love life
[12]. Though these specific remedies are likely to be of little
use, there is potential for love to become less blind and more
orchestrated.
Science is advancing at a rapid rate, dissecting love into
stages and reducing attraction to its bare bones. It is now
possible to quantify love, in the form of a number out of 135.
We even know some of the genes and hormones that cause
us to be attracted to one person rather than another—or, for
that fact, attracted to anyone at all. Every organism on earth
comes from a long line of reproductively successful ancestors,
geared to love because it perpetuates the goal of existence.
Love may indeed be a “drive”—a goal-driven behavior—but
is that all it is? One argument remains for hopeless romantics:
the purpose is not the experience.
Sofia Castello Tickell is an undergraduate at Brown University.
Dialysis Transplant 2000; 15: 1269-1271.
7. Singh D, Young RK. Body weight, waist-to-hip ratio, breasts, and hips: role in
judgments of female attractiveness and desirability for relationships. Ethology and
Sociobiology 1995; 16: 483-507.
8. Dixson A. Primate sexuality comparative studies of the prosimians, monkeys, apes
and human beings. New York: Oxford UP; 1999.
9. Judson O. Dr. Tatiana’s sex advice to all creation: the definitive guide to the
evolutionary biology of sex. 1st ed. Holt Paperbacks: 2003.
10. Carmichael M, Warburton V, Dixen J, Davidson J. Relationships among
cardiovascular, muscular and oxytocin responses during human sexual activity.
Archives of Sexual Behavior 2005 April 23; 23(1): 59-79.
11. Zak P. The neurobiology of trust. Scientific American 2008 June; 298: 88-95.
12. Love Scent. Available at: URL: http://www.love-scent.com/
THE TRIPLE HELIX Spring 2010 13
5/25/2010 1:33:14 PM
 BROWN

Music Facilitating Speech:

Melodic Intonation Therapy for Patients with
Speech Deficits
MariaLisa Itzoe
Figure 1. Locations of the two primary language areas in the brain [6].
Broca’s area (anterior) is implicated in speech production; it is patients with
damage to this region that have shown improved fluency after completing
MIT.
with production deficits in conversational or spontaneous
language are able to achieve almost perfect fluency when
asked to sing, not speak, the words of previously learned
songs [2]. Unlike actual singing, MIT uses a limited range
of notes, usually consistent across three or four whole notes
that are more similar to the actual variation of melody within
conversational speech. This type of melodic intonation varies
its pattern based on the type of phrase being targeted; for
example, a declarative sentence will have a different pattern
of intonation than an interrogative sentence. Overall, the three
elements of melodic line, rhythm, and points of stress help
the patient to build up a musical representation of a phrase,
perhaps allowing them to recruit undamaged neural areas
for an alternative way of accessing, as well as producing,
the words themselves [3]. Another key component of MIT is
its emphasis on slow speed and precision throughout each
of the exercises. By using a slow tempo for the intonation
and then precisely isolating rhythm and stress, the therapy
prevents the patients from becoming overwhelmed by the
task because it demands that they direct their attention to
individual word fragments-the necessary building blocks for

I
magine knowing what you want to say but not being able
to put your thoughts into words. Each conversation be- successful production of prosody (intonation) and speech. The
comes a struggle, not only for yourself but also for those particularly innovative aspect of MIT is its incorporation of
around you who attempt to discern the broken fragments physical movement into the patient’s speech therapy. By having
of speech that you manage to enounce. This frustration is a the patient slowly tap beats of a sentence, MIT emphasizes
daily experience for patients with Broca’s aphasia, a speech the syllables that need stronger articulation while assigning
production deficit usually resulting from brain damage to the
anterior areas of the left hemisphere (particularly the infe-
rior frontal area (IFG), often referred to as “Broca’s area;” see
Figure 1). Although thoughts and verbal comprehension are
relatively well-preserved, it has been suggested that Broca’s
patients struggle in being able to select from competing alter-
natives within the lexical and semantic networks (i.e. on the
levels of both words and meanings), which results in slow,
monotonous speech [1]. For many years, limited knowledge
on the source of the deficit has limited effective therapy for
these patients. In recent decades, however, the application
and incorporation of music into more traditional methods
of speech therapy has become a key development in helping
to improve Broca’s aphasics’ speech production, articulation,
and rhythmic intonation.

Melodic Intonation Therapy: A Brief History

First proposed in 1973 by researchers Robert Sparks and Audrey Figure 2. fMRI showing the chief language areas involved during lexical task
of picture naming [7].
Holland, Melodic Intonation Therapy (MIT) is a hierarchical
treatment program founded upon the observation that patients

14 THE TRIPLE HELIX Spring 2010 © 2010, The Triple Helix, Inc. All rights reserved.

BROWN.indb 14 5/25/2010 1:33:14 PM

 BROWN

MIT Level Elementary Intermediate Advanced

Phrase with Lunch -- Ham and I want a ham and cheese sand-
syllables indicated time Cheese wich.
Specific Tone
A – B A - B- A A- B- A – B- B - B -B -A
Assigned
Figure 3. An example of how MIT therapists might apply melody to phrase; notice that as level increases, the phrases increase in length and the
tones become more steady in order to transition the patient towards more normal speech prosody.

a musical note to each word in the phrase. This simultaneous
use of physical stress of rhythm and application of melody
has been shown to aid the patient’s ability to communicate
with rhythmic fluency and articulation.
Keys to Success? Possible Reasons Why MIT Works
The treatment program consists of four basic levels, each
progressively encouraging the patient’s independent produc-
tion while relying on the foundation of a distinct melody and
rhythm. The guided sequence gradually grows to include
longer phrases, decreasing the therapist’s involvement and
the patient’s dependence on melodic intonation (see Figure
3). Before a patient graduates to the next level, s/he must
correctly produce 90 percent of the phrases presented. Any
struggle in articulation or any type of phonemic paraphasia
results in “incorrect production,” decreasing the patient’s final
score and increasing the length of time spent at that level.
Because patients may exhibit weaknesses in different areas
of production, which may cause them to spend more time on
a specific section of MIT, the procedures within the various
levels are meant to be modified to best aid the success of each
individual. For example, a patient who struggles particularly
with articulation may need more practice emphasizing accen-
tuated beats or staccato-like tones in a slow tempo so s/he has
the time needed to process the sound and form the production.
This may cause him to spend more time focusing on the hand-
tapping of beats in a melody (Level I) in order to recognize
where stress should be placed
before applying that rhythm
and melody to a short phrase
(Level II). However, if the pa-
tient struggles more with over-
all fluency once the phrase is
articulated, s/he might benefit
more from practiced melodic
intoning of the whole phrase.
Perhaps this repetition over
time strengthens the neural
representation of the phrase
as the patient becomes more
familiar with the rhythmic
flow of the words. The patient
might then be able to apply
that fluency in spoken context
and facilitate his expression
of the rhythmic association
between words in speech. In either situation, the leadership
and guidance of the therapist or clinician who sets an example,
which the patient then follows, is a critical aspect of Melodic
Intonation Therapy. This is especially important at the initial
levels.
Hierarchical Organization: A Step-by-Step Process for
Treatment
The preliminary level of MIT requires the patient simply to
practice discerning individual beats of a melody (within a small
range of 3-4 notes). The therapist first hums the pattern to the
patient while physically tapping the stressed beats, and the
patient repeats the example with the therapist, who serves as
reinforcement of the rhythm. It is perhaps this reinforcement
and repetition that help strengthen the patient’s connection
between the melody (a primarily right hemisphere function)
and rhythm (in which the patient is expressing a deficit, pos-
sibly due to left hemisphere damage). Level I seems to require
bilateral activation by combining melody with rhythm, possibly
working to exercise and strengthen undamaged left hemispheric
regions as they are required to parse the beats in the phrase.
This preliminary foundation establishes the technique used
in the subsequent stages of therapy.
Level II consists of five separate steps that each retain the
tapping of the rhythm, perhaps serving as a motor task that
helps the patient recognize when certain beats of a phrase should
be articulated. This continual physical stressing of the beats
seems to be a crucial component
of MIT because hand-tapping
may solidify motor memory
while simultaneously creating a
memory of rhythmic sound and
words. Thus, as the patient taps
the rhythm of the words with
reinforcement from the clini-
cian and sings the melody, s/
he may be creating multimodal
memories that will help him
to later access the words dur-
ing conversation. During this
segment of therapy, the phrase
begins to be placed in a more
conversational context as the
patient is required to repeat the
intoned phrase in response to
Reproduced from [10] the therapist’s question. When

© 2010, The Triple Helix, Inc. All rights reserved. THE TRIPLE HELIX Spring 2010 15

BROWN.indb 15 5/25/2010 1:33:14 PM

 BROWN
Reproduced from [11]
one of the short phrases has been taken through each of the
above steps, the same process is followed for the other phrases
in the set. For example, one set may contain phrases concerned
with lunchtime, such as “time to eat” and “ham and cheese
sandwich.” This method helps to improve a patient’s fluency
and production of speech within a general domain.
Levels III and IV become increasingly difficult because of
the greater time latency between the therapist’s presentation
of a question and when the patient is instructed to intone
his response. Additionally, the patient is now challenged to
choose the appropriate phrase with which to answer the ques-
tion and to correctly respond while including the rhythmic
and melodic patterns. Together, these two changes greatly
decrease the aphasic’s reliance on repetition by decreasing
References:
1. Yorkston KM, Beukelman DR. Communication efficiency of dysarthric speakers
as measured by sentence intelligibility and speaking rate. J Speech Hear Discord.
1981;46:2296-2301.
2. Sparks RW, Holland Al. Method: melodic intonation therapy for aphasia. J Speech
Hear Discord. 1976;41:287-297.
3. Belin P, Van Eeckhout P, Zilbovicius M, et al. Recovery from nonfluent aphasia
after melodic intonation therapy: A PET study. Neurology. 1996;47(6):1504-1511.
4. Kim M, Tomaino C. Protocol evaluation for effective music therapy for persons
with nonfluent aphasia. Topics in Speech Rehabilitation. 2008;15(6):555-569.
16 THE TRIPLE HELIX Spring 2010
BROWN.indb 16
the role of the therapist as the patient is required to be more
independent in his speech production.
The final level of Melodic Intonation Therapy, Level IV,
introduces a technique known as sprechgesang, in which
the melodic pitches of previous intoning are transitioned to
pitches used in conversational speech. After the practice in
repetition from the previous levels, the patient is expected,
and generally able, to repeat the normally intoned phrase. At
the completion of the Melodic Intonation Therapy process,
the successful patient can fluidly produce the set of 12-20
phrases with which s/he worked at each level in response to
questions asked by the therapist.
Implications for Music As Speech Therapy
Despite convincing neurological and clinical evidence, much
debate still exists in current literature of the true effectiveness
of music therapy on speech production. All forms of therapy
incorporating music depend on the patient’s ability to understand
rhythms and melodies and the ability to access memory of
familiar songs or hymns [4]. Where traditional speech thera-
pies have previously failed, much success has been seen so
far with Melodic Intonation Therapy. A possible explanation
is that music activates numerous neural structures bilater-
ally, so melody and rhythm may actually reengage language
processing areas or take advantage of neural plasticity of other
areas within the left hemisphere in non-fluent aphasics [5].
Perhaps MIT provides the key with which Broca’s aphasics
may unlock their own speech production.
MariaLisa Itzoe is an undergraduate at Brown University.
Reproduced from [8] and [9]
5. Naesar MA, Helm-Estabrooks N. CT scan localization and response to melodic
intonation therapy in nonfluent aphasia cases. Cortex. 1985;21 (2):203-223.
6. http://www.nidcd.nih.gov/staticresources/health/images/aphasia_broca.jpg
7. http://www.nidcd.nih.gov/staticresources/research/scientists/images/ABraun_
image2.jpg
8. http://www.dhs.gov/xlibrary/graphics/st_brain_music_photo.jpg
9. http://www.franklincountyohio.gov/probate/images/music_notes.jpg
10. http://www.vesid.nysed.gov/specialed/nyssb/images/music/joe.jpg
11. http://www.vesid.nysed.gov/specialed/nyssb/images/music/stephanie.jpg
© 2010, The Triple Helix, Inc. All rights reserved.
5/25/2010 1:33:15 PM

From Bench to Bedside:
The Ongoing Controversy of Adult vs.
Embryonic Stem Cells
Lakir Patel
T
he key to regenerative medicine lies in stem cells. Scientific
developments, ethics, and policy have directed current
research to focus on two cell types: adult stem cells and
embryonic stem cells. Generally, stem cells demonstrate two
cardinal characteristics: self-renewing cell division and potency.
The former refers to the cell’s ability to undergo mitosis, the
process of cell division, and produce daughter cells that retain
an undifferentiated state. The latter describes the differentiation
potential of the stem cell: whether the stem cell can differentiate
into embryonic and extraembryonic cells (totipotent), cells of any
of the three germ layers (pluripotent), or cells of only a specific
tissue type (multipotent). The emphasis on the role of stem
cells for regenerative medicine has resulted in a third defining
characteristic for stem cells: the ability to regenerate a tissue in
vivo [1]. Scientific and political factors affect the direction of
© 2010, The Triple Helix, Inc. All rights reserved.
BROWN.indb 17
BROWN
stem cell research, but ultimately, research follows the path
of greatest promise for regenerative medicine.
Embryonic Stem Cells
Embryonic stem cells are derived from the inner cell mass
(ICM) of the blastocyst and have the potency to differentiate
into the three germ layers and eventually into specific tissues
[1]. In order to obtain embryonic stem cells that have a high
level of pluripotency, cells must be obtained from very early
embryos in the blastocyte stage. Embryonic stem cells can be
obtained from “surplus” embryos grown from eggs fertil-
ized in vitro (never intended to be implanted into a uterus
for gestation) [2]; such embryos represent a viable source for
stem cell research. However, the ethical debate of using an
embryo that could develop into a human (despite its status as a
Reproduced from [25]
THE TRIPLE HELIX Spring 2010 17
5/25/2010 1:33:19 PM
 BROWN

“surplus” embryo) limits the potential of such a cell source [2]. would not induce an immune response upon transplantation.
Research within the past decade has validated the plu- The main role of stem cells within the body is for renewal and
ripotency of human embryonic stem cells and has seen the repair, so it follows that the primary source of adult stem cells
differentiation of embryonic stem cells is tissues that frequently produce
into many specialized cell types [5]. new cells through division such as
More recent research has identified bone marrow, skin, and intestine
human embryonic stem cell lines [9]. However, although adult stem
that differentiate into cardiovascular cells can be found in various tissues,
progenitor cells that display cardiac, the number is limited because only
endothelial, and vascular smooth a few stem cells exist within each
muscle potential both in vitro and tissue [9]. With the advent of iPSCs,
in vivo [6], into natural killer (NK) the functionality of adult stem cells
cells for use in effective antitumor may rival that of embryonic stem
and anticancer immunotherapy [7], cells. Through retroviral induction,
and stable, self-renewable neural cells researchers are able to reprogram
that enable functional recovery after adult stem cells into pluripotent stem
stroke in mice [8]. cells that are similar to embryonic
In terms of function, embryonic stem cells in many aspects that deter-
stem cells, although pluripotent, are mine cell function [11]. Despite the
not universally useful. Pluripotent fact that iPSCs are only similar, and
embryonic stem cells can differenti- not equivalent, to embryonic stem
ate into any tissue type and are thus cells, the prospect of autologous cell
useful for tissue regeneration, but transplantation with iPSCs makes
since the cells are obtained from a Reproduced from [26] iPSC research advantageous.

foreign embryo, they will not be immunologically compatible Nonetheless, iPSCs are not free from risk. Adult cells
with the patient receiving transplantation (unless the two are are reprogrammed into iPSCs through retroviral induction.
genetically identical) because of the presence of non-native This technique introduces risk because it uses viral vectors
major histocompatibility complex (MHC) proteins, resulting that are oncogenic (cancer-causing). Recently, a research team
in graft rejection [3]. In order to prevent graft rejection, an has circumvented this problem by inducing pluripotency in
embryonic stem cell bank, with adult stem cells using a small
many MHC protein profiles to chemical molecule instead of
ensure accurate matching with In order to obtain the oncogenic viral vectors [9].
patients, would need to be cre- As adult stem cells demonstrate
ated and used in conjunction with embryonic stem cells more promise and fewer obsta-
immunosuppressant drugs [4]. that have a high level of cles, iPSC research continues to
Although transplantation of em- increase [12]. In the last couple
bryonic stem cells is possible, this pluripotency, cells must be of years, researchers have im-
would require a patient to follow obtained from very early proved symptoms in a rat model
a regimen of immunosuppressant of Parkinson’s disease through
drugs for the rest of his or her embryos in the blastocyte neurons from reprogrammed
life, which subjects the patient to stage. adult mouse skin cells [13],
risks associated with a compro- have proven the pluripotency
mised immune system. Despite of iPSCs through the produc-
the recent successes in human embryonic stem cell research, tion of live mice (the gold standard test for pluripotency)
the problem of immunocompatibility in cell transplantation [14], and have grown heart muscle cells (cardiomyoctyes)
has driven scientific research towards adult stem cells. from induced pluripotent stem cells [15]. Arguably, the most
important advancement has been the clinical transplantation
Adult Stem Cells of a trachea colonized by stem-cell derived epithelial cells
Initially, adult stem cells were believed to be involved in only and chondrocytes [16], which exemplifies the potential of
the maintenance of homeostasis (the body’s stable internal iPSCs. The recent advances in induced pluripotent stem cell
condition) and the repair of the organ tissue from which they research may establish iPSCs as superior to embryonic stem
were derived [9]. Recent research has revealed that adult stem cells because of similar potency and immunocompatibility.
cells not only can differentiate into cell types other than that Nevertheless, continued research in embryonic stem cells is
of the origin tissue but also can be genetically and chemically necessary to fully realize the potential of iPSCs [7].
reprogrammed into pluripotent stem cells, more commonly
known as induced pluripotent stem cells (iPSCs) [10]. Such Influence of Public Policy
stem cells originate from the patient’s own tissue cells and Public policy has a profound effect on stem cell research. Policy

18 THE TRIPLE HELIX Spring 2010 © 2010, The Triple Helix, Inc. All rights reserved.

BROWN.indb 18 5/25/2010 1:33:20 PM

 BROWN

frameworks and government regulations impact procurement, the research of human embryonic stem cells is permissible,
derivation, and use of stem cell lines (a family of cells derived global access to and implementation of stem cell treatment
from a single parent group of stem cells) [17]. In the United may transcend policy differences. Differences in the structure
States, the Bush administration limited the number of em- of health insurance could also influence clinical use of stem
bryonic stem cell lines that could be researched with federal cell therapies. When the transition from research to treatment
funding. The limited resources available to researchers caused comes, it will be interesting to observe how governments deal
a bottleneck effect that resulted in human embryonic stem with the question of “whether it is morally consistent for a
cell research being stuck government to provide
on two early lines [18]. In treatments derived from
fact, it is possible that the Major policy directives, such human embryonic stem
limited governmental sup- cells (hESCs) if the re-
port of embryonic stem cell
as the Obama administration’s search is not permitted in
research during the Bush support of embryonic stem cell the country” [21]. In light
administration is what of such moral dilemmas,
drove the scientific com-
research and the goal of the motions to unify stem cell
munity to further investi- EU to unify stem cell policy, research policy on a global
gate adult stem cells and scale would seem most
induced pluripotency [19].
could galvanize the scientific conducive to implement-
Recently, President Obama community to bring stem cells ing regenerative medicine
lifted the embryonic stem around the world.
cell ban and encouraged
and regenerative medicine
the scientific community closer to clinical use. Conclusion
to conduct basic research The ideal stem cell treat-
[20]. Since research has re- ment would demonstrate
lied on only two early lines, the effects of President Obama’s immunocompatibility and true pluripotency. Adult stem cells
action can only be truly assessed after research teams have have demonstrated the former while embryonic stem cells
had the time to develop more stem cell lines. The study of remain the paragon of the latter. In order to transition from
more embryonic stem cell lines would elucidate the genetic the lab bench to the clinical setting, both adult stem cell and
differences between lines, potentially leading to more effec- embryonic stem cell research is needed. Public policy also
tive therapies [20]. plays a key role in advancing stem cell research. Major policy
Among the nations of the European Union, human em- directives, such as the Obama administration’s support of
bryonic stem cell policy varies from permissive to restrictive; embryonic stem cell research and the goal of the EU to unify
the EU’s goal of unifying the different systems has yet to be stem cell policy, could galvanize the scientific community to
accomplished [21]. As stem cell research continues to grow into bring stem cells and regenerative medicine closer to clinical
a global endeavor, the issues within the EU become representa- use.
tive of the issues that global differences in policy can cause.
Whereas differences in policy entail regulations of whether Lakir Patel is an undergraduate at Brown University.

References
1. Verfaillie C. Pluripotent stem cells. Transfus Clin Biol 2009 May 12;16:65-9.
2. Orkin S, Morrison S. Stem-cell competition. Nature 2002 Jul 4;418:25-7. 3. Drukker
M, Katz G, Urbach A et al. Characterization of the expression of MHC
proteins in human embryonic stem cells. Proc Natl Acad Sci U S A 2002 Jul
23;99(15):9864-9.
4. Passier R, Mummery C. Origin and use of embryonic and adult stem cells in
differentiation and tissue repair. Cardiovasc Res 2003;58:324-335.
5. Darabi R, Santos F, Perlingeiro R. The Therapeutic Potential of Embryonic and
Adult Stem Cells for Skeletal Muscle Regeneration. Stem Cell Rev 2008 Jul 8;4(3):217-
225.
6. Yang L, Soonpaa M, Adler E et al. Human cardiovascular progenitor cells develop
from
a KDR1 embryonic-stem-cell-derived population. Nature 2008 May 28;453:524-9.
7. Woll P, Grzywacz B, Tian X et al. Human embryonic stem cells differentiate into
a homogeneous population of natural killer cells with potent in vivo antitumor
activity. Blood 2009 Jun 11;113(24):6094-6101.
8. Daadi M, Maag A, Steinberg G. Adherent Self-Renewable Human Embryonic Stem
Cell- Derived Neural Stem Cell Line: Functional Engraftment in Experimental Stroke
Model. PLoS ONE [serial online] 2009 Feb [cited 2009 Oct 26];3(2):1-9. Available from:
URL:www.plosone.org
9. Presnell S, Petersen B, Heidaran M. Stem cells in adult tissue. Semin Cell Dev Biol
2002 Oct;13(5):369-376.
10 Ichida J et al. A Small-Molecule Inhibitor of Tgf-b Signaling Replaces Sox2 in
Reprogramming by Inducing Nanog. Cell Stem Cell 2009 Nov;5:1-13.
11. Takahashi K, Tanabe K, Ohnuki M et al. Induction of Pluripotent Stem Cells from
Adult Human Fibroblasts by Defined Factors. Cell Stem Cell 2007 Nov 30;131:861-
872.
12. NIH. Highlights of Stem Cell Research. Available at: URL:http://stemcells.nih.
gov/research/scilit/highlights/. Accessed Oct 24, 2009.
13. Wernig M et al. Neurons derived from reprogrammed fibroblasts functionally
integrate into the fetal brain and improve symptoms of rats with Parkinson’s disease.
Proc Natl Acad Sci U S A 2008 Apr 15;105(15):5856-5861.
14. Kang L, Wang J, Zhang Y et al. iPS Cells Can Support Full-Term Development of
Tetraploid Blastocyst-Complemented Embryos. Cell Stem Cell 2009 Aug 7;5:135-138.
15. Zhang J et al. Functional Cardiomyocytes Derived From Human Induced
Pluripotent Stem Cells. Circ Res 2009;104:30-41.
16. Macchiarini et al. Clinical transplantation of a tissue-engineered airway. Lancet
2008 Dec 13;372:2023-30.
17. Caufield T, Zarzeczny A, McCormick J et al. The Stem Cell Research
Environment: A Patchwork of Patchworks. Stem Cell Rev and Rep 2009 May;5:82-8.
18. Scott C, McCormick J, Owen-Smith J. And then there were two: use of hESC lines.
Nat Biotechnol 2009 Aug;27(8):696-7.
(19) Loike J, Fischbach R. Benefits of the stem cell ban. The Scientist
[serial online] 2009 June [cited 2009 Dec 29]. Available from: URL: http://www.
the-scientist.com/templates/trackable/display/news.jsp?type=news&o_url=news/
display/55752&id=55752
20. Truonson A. New perspectives in human stem cell therapeutic research. BMC
Med [serial online] 2009 Jun 11 [cited 2009 Oct 26];7(29):1-5. Available from:
URL:http://www.biomedcentral.com /1741-7015/7/29
21. Druml C. Stem Cell Research: Toward Greater Unity in Europe? Cell 2009 Nov
13;139(4):649-651.
22. http://www.stemcell.ny.gov/slideshow/images/Fasano_500.jpg
23. http://stemcells.nih.gov/StaticResources/info/scireport/images/figure31.jpg

© 2010, The Triple Helix, Inc. All rights reserved. THE TRIPLE HELIX Spring 2010 19

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“Re-Evolution”:
One Receptor’s Impact on Evolutionary Theory
Lauren Pischel
W
ith the 200th anniversary of Darwin’s birth and the
150th anniversary of his publication of On the Origin
of Species in 2009, the theory of evolution and how
its forward march creates new species has received a good
deal of attention. However, a novel study questioned not how
evolution moves forward, but rather if it could move in reverse.
Jamie Bridgham in Joe Thompson’s lab at the University of
Oregon examined if evolution can move equally well both
forward and backward to gain a better understanding evolu-
tion’s underlying mechanisms. In a recent letter published in
Nature, Bridgham et al. showed that the evolutionary path of
the glucocorticoid receptor, which mediates an organism’s stress
response, is not easily reversible even if evolutionary pressure
is applied for the receptor to return to its ancestral state [1].
In this instance, it appears that the probability of evolution
reversing itself is very low. This study has subsequently been
lauded by Intelligent Design (ID) theorists and generated a
debate between those for and those against evolution.
Dollo’s Law
The concept of reverse-evolution, or “re-evolution,” is the
ability of an organism to regain an ancestral trait, and it has
been examined by a plethora of renowned scientists including
Louis Dollo, Hermann Joseph Muller, George Gaylord Simp-
son, and Stephen Gould [1,2]. The debate over re-evolution
Reproduced from [14]
20 THE TRIPLE HELIX Fall 2010
BROWN.indb 20
is then nearly as old as the theory of evolution itself. In 1893,
Dollo proposed a theory that later became known as Dollo’s
Law: the “inability of [single] complex characteristics to re-
evolve once lost” [3]. This “law” provides the basis for the
postulate that evolution is irreversible. However, recently
experiments have shown that at least certain steps in evolu-
tion may be more reversible than previously thought. For
example, experiments have shown that chickens may regain
their teeth, lizards their digits and stick insects their wings
Experiments have shown that
chickens may regain their teeth,
lizards their digits and stick insects
their wings.
[4]. However, it can be argued that for hens to regain teeth,
only transcription factors that are already present need to
be activated. Loss and reacquisition of gene expression is a
relatively easy evolutionary feat compared with changing the
function and binding specificity of a protein.
Traditionally re-evolution has been studied by compar-
ing traits that were gained or lost over time to an organism’s
placement on the evolutionary tree. This method’s accuracy is
limited by the proper placement of species in the phylogenic
tree, how complete the knowledge of the taxon is, how well
characteristics are identified, and data on ancestral states [4,5].
The recent rise of molecular and genetic techniques bypasses
these constraints and allows for a more detailed examination
of how evolution occurs on a molecular level and provides
more insight into the mechanisms of phenotype acquisition
and alteration.
Bridgham’s results stem from a several-year-long project
studying the evolution of the glucocorticoid receptor. The
glucocorticoid receptor binds cortisol in teleosts (ray finned
fish) and tetrapods (vertebrate animals that have four limbs
and which evolved from teleosts). It coordinates the organ-
ism’s long-term response to stress [6]. In previous studies,
the Thompson lab showed that the glucocorticoid receptor
and the aldosterone receptor evolved from the same ancestral
mineralocorticoid receptor, which responds to aldosterone [7].
This paleoprotein existed some 450 million years ago. Through
statistical analysis of these receptors across the phylogenic
tree, this lab was able to deduce and re-create the ancestral
protein and test its sensitivities to various ligands. They found
that this old protein could bind to aldosterone, an ancient
vertebrate hormone deoxycorticosterone (DOC) and could also
weakly bind cortisol making it a “promiscuous receptor.” The
© 2010, The Triple Helix, Inc. All rights reserved.
5/25/2010 1:33:20 PM
 BROWN

Reproduced from [13]

type B and vice versa. Bridgham’s results do not follow this
pattern [8]. One way to explain this is that there are several
intermediate phenotypes. A goes to an intermediate stage I
and then from stage I to B. Because I does not bind A’s ligand,
the situation is much more difficult to reverse. By the same
reasoning, if B and I were two phenotypes in equilibrium and
phenotype I were selected for first (such as by selecting for a
weakly binding cortisol receptor), then re-evolving from I to
A could follow as a second step.

scientists found that 37 amino acids differ from the ancestral
and the current glucocorticoid receptor. Two mutations were
necessary and sufficient for the paleo-protein to prefer cortisol
over mineralcorticoids. Three other substitutions caused the
protein to lose specificity for the mineralcorticoids and two
more substitutions stabilized the new, cortisol-specific protein.
Reversal Experimentation
In this current study, Bridgham et al. studied whether the
same mutations could work in reverse. They found that di-
rectly reversing the seven key mutations in the glucocorticoid
receptor by themselves did not produce a functional ancestral
protein. Surprisingly, this protein could not bind any of the
three ligands. To recover ancestral function, several other
“epistatic” mutations were needed [1]. By several sequential
substitutions, they followed protein stability and functional
abilities and were able to infer the order of the mutations in
both forward and reverse-evolution. When proceeding from
the ancestral protein to the current protein, these epistatic
mutations occurred after the protein started to preferentially
bind cortisol and they made the protein more efficient.
The central finding of Bridgham’s paper was that if selec-
tive pressure were applied to the current receptor to return to
its ancestral state that bound aldosterone, DOC, and cortisol,
the receptor could not, because it would have to pass through
several neutral intermediates that would not increase binding
Reverse Design
One of the central questions of re-evolution is: does evolu-
tion occur in a contingent or deterministic manner? In other
words, is the current make-up of an organism or the force of
selection more important in determining future evolutionary
outcomes? As Bridgham argues, “If selection is limited in its
ability to drive the reacquisition of ancestral forms, then the
future outcomes available to evolution at any point in time
must depend strongly on the present state and in turn the
past” [1]. In contrast, if a process is readily reversible then
“the forms of functional proteins can evolve deterministi-
cally, irrespective of contingent historical events” [1]. Since
this study showed the former, historical contingency at least
here trumps natural selection.
This apparent limitation of evolution was noticed by those
in favor of intelligent design. Michael Behe, a professor of
biology at Lehigh University, wrote a series of blog entries on
the Discovery Institute website in September 2009 concerning
the study. Behe primarily stressed how this study shows the
limitations of “unguided evolution” because evolution was

Is the current make-up of an

organism or the force of selection
more important in determining
future evolutionary outcomes?
to these three mineralcorticoid ligands. These epistatic modi-
fiers then act as a “ratchet,” making it very unlikely that the
protein will return to its ancestral state via this pathway [1].
Thus, evolution here is not readily reversible. The amino acids
that were necessary for ancestral structure and function had
been degraded to improve the current function of the protein.
In order to return to the ancestral state, the protein would
need to pass through several intermediate stages that did not
increase ancestral function. This differs from a straightforward
reversible model of evolution where there are two phenotypes;
mutations that promote phenotype A detract from pheno- Reproduced from [12]

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BROWN.indb 21 5/25/2010 1:33:21 PM

 BROWN
unable to perform such a simple reversal [9]. He then makes
a leap and concludes that since evolution cannot accomplish
such a simple task, it would be “highly unlikely” that evolu-
tion could have “built the complex molecular machinery of
the cell” [9]. This in turn set off a heated discussion between
Behe and Carl Zimmer, a science writer for the New York
Times on his blog “The Loom” [10].
Stepping Forward or Backward?
Why so much writing about the evolutionary path of one pro-
tein? Perhaps with the yearlong celebration of both Darwin’s
birthday and his publication of On the Origin of Species, those
who believe in ID were looking for an opening to limit the scope
of evolution. Or perhaps, it is because research in evolution
can be wrought with political overtones? It also should be
noted that the 2004 study published by Thompson’s lab, the
origin of the glucocorticoid and mineralcorticoid receptors
was used as evidence against the ID theory of irreducible
complexity: that certain biological systems are too complex
to have evolved from more simple systems.
The blog posts from both the ID and the Darwinist per-
spective, despite all of their bickering, essentially come to the
same conclusion: the reversal of the glucocorticoid receptor
to its ancestral state would be an extremely low-probability
event. The ID perspective is trying to limit the scope of natural
selection, while the evolutionary biologist perspective is trying
to understand its mechanisms. In fact, the current findings of
the Bridgham study align with the idea that epistasis (where
one mutation masks another mutation), along with lack of
genetic variation limits evolutionary trajectory. Pleiotropy and
mutation expand evolutionary trajectory and the possibility
for re-evolution [2]. Further, even though the protein may
not be able to easily regain its ancestral function through
References
1. Bridgham JT, Ortlund EA, Thornton JW. An epistatic ratchet constrains
the direction of glucocorticoid receptor evolution. Nature. [Article]. 2009
Sep;461(7263):515-U78.
2. Teotonio H, Rose MR. Perspective: Reverse evolution. Evolution. 2001;55(4):653-60.
3. Yedid G, Ofria CA, Lenski RE. Historical and contingent factors affect re-evolution
of a complex feature lost during mass extinction in communities of digital organisms.
Journal of Evolutionary Biology. 2008;21(5):1335-57.
4. Collin R, Miglietta MP. Reversing opinions on Dollo’s Law. Trends in Ecology &
Evolution. 2008;23(11):602-9.
5. Casci T. EVOLUTION No turning back. Nature Reviews Genetics.
2009;10(11):742A-A.
6. Dean AM, Thornton JW. Mechanistic approaches to the study of evolution: the
functional synthesis. Nature Reviews Genetics. 2007;8(9):675-88.
7. Thornton JW. Resurrecting ancient genes: experimental analysis of extinct
22 THE TRIPLE HELIX Fall 2010
BROWN.indb 22
Perhaps with the yearlong
celebration of both Darwin’s
birthday and his publication of
On the Origin of Species, those
who believe in ID were looking
for an opening to limit the scope of
evolution. Or perhaps, it is because
research in evolution can be wrought
with political overtones?
re-evolution, that does not mean that the protein will not
evolve via another pathway. One of the beneficial parts of this
study is that it demonstrates just how many steps are needed
in evolution and how complicated it can be. The study also
shows how this complex process can occur through a series
of plausible steps, which reinforces and does not degrade
evolutionary theory.
Both the intelligent design and evolutionary biology camps
form important implications from this study. For those who
promote ID, the study provides evidence that evolution and
natural selection alone cannot form or explain the complex-
ity of living organisms. For those who promote evolution,
the study provides evidence that evolutionary trajectory is
dependent upon historical contingency rather than uniquely
upon selective pressures [5].
Laura Pischel is an undergraduate at Brown University.
Reproduced from [11]
molecules. Nature Reviews Genetics. 2004;5(5):366-75.
8. E-mail correspondence with Daniel W Weinreich, Assistant Professor of Biology in
Ecology & Evolutionary Biology at Brown University
9. Behe M. Nature Publishes Paper on the Edge of Evolution. The Discovery Institute.
[homepage on the internet]. 2009 Sep 30th; [cited 2009 Oct 31st.] Available from :
http://www.evolutionnews.org/2009/09/nature_publishes_paper_on_the.html
10. Zimmer C. The Loom [homepage on the Internet]. 2009 Oct 16th; [cited 2009 Oct
31st]. Available from: http://blogs.discovermagazine.com/loom/
11. http://en.wikipedia.org/wiki/File:Human_evolution_scheme.svg
12. http://www.nga.gov/feature/artnation/cameron/images/cameron/cameron_
darwin_300x387.jpg
13. http://www.niehs.nih.gov/research/atniehs/labs/lst/molecular/images/molecular.
jpg
14. http://www.nsf.gov/news/mmg/media/images/mammal_h1.jpg
© 2010, The Triple Helix, Inc. All rights reserved.
5/25/2010 1:33:22 PM
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From Bacon to Human Babies:

Ethical Conflict in Pigs as Surrogate Mothers
Daniel Brewer

T
he Flu isn’t the only thing swine could be giving us;
they could also provide human babies. Few people have
considered the possibilities of using pigs as surrogate
mothers for human babies, but according to Krishna Dronamraju
the idea was proposed as early as 1932 by J.B.S. Haldane [1].
It was further suggested as an alternative to abortion in 1984
by Peter Singer and Deanne Wells [2]. As absurd as it may
sound, the possibilities are real. According to Stellan Wellin,
not only is it practical, but a therapeutic imperative exists
for the development of the technology [3]. Pigs have already
been used to save human lives with transplanted pig organs
ranging from heart valves to brain cells [4]. Extensive research
has also been performed to create a transgenic pig that would
more closely resemble human genetic makeup and allow for
advanced success in organ transplantation. Although suggested
decades ago the technology is still ahead of its time. Time, in
this sense, refers not only to the feasibility of the technology
to be implemented, but also for the ethical makeup of society
to be in a position to accept it. Human baby transplantation is
still premature in its ethical acceptance but with information
and exposure it may be a real possibility in the 21st century.
New technology, especially when it pertains to human
life, unequivocally brings with it new moral dilemmas. Soci-
Reproduced from [10]
ety’s acceptance of possible technology often influences how
quickly, and even if, a technology will ever be explored. Radical
new technologies are often first rejected, then accepted, then
embraced. Because of unease and ethical questions regarding
pigs as surrogate mothers, the idea has been strictly moni-
tored and restricted in its development. The unease is nothing
new either. Persecutions and killings have arisen over ethical
controversies. According to John Fletcher in 1642 in one of the
New Haven colonies, fear of human animal relationships had
grown to the point that a one eyed man with a large nose was
executed when a one eyed pig with a large snout was born
[5]. Modern genetic understanding proves the deformed pig’s
birth was a result of coincidence and one would like to believe
that society has progressed since then. However, given that
less than a year ago an abortion doctor was gunned down
and killed while in church, there are still those who seek to
take the life of those who they feel have broken their code of
ethics [6]. Singer and Wells’ suggested that babies destined
for abortion could be saved by transplanting them to surro-
gate pigs to be gestated to term and adopted. This may help
solve the abortion issue, but will humans born to surrogate
pigs be persecuted and potentially executed because of their
involuntarily performed alleged crimes against ethics?
In order

to answer these
questions some
information as to
the acceptance of
the technology is
pertinent. Because
of the obscurity
surrounding the
technology aris-
ing from the ethi-
cal controversy
surrounding
pigs as surrogate
mothers very little
research has ex-
plored the ethical
opinion of, or its
possible accep-
tance in society.
In relation to this
lack of explorato-
ry information I
formulated re-
search to look at
both the current

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BROWN.indb 23 5/25/2010 1:33:22 PM

 ASU

acceptance of this possible technology

and how information can influence ethi-
cal decisions. The subject of animals as
surrogate mothers was chosen because
it is an issue that most people have not
considered, and it intertwines pertinent
issues relating to the rights of humans,
animals, and fetuses.
In order to explore the acceptance of
using pigs as surrogate mothers for repro-
ductive ectogenesis (the gestation of a fetus
outside the mother), and to investigate
the influence of information on ethical
acceptance, two separate surveys were
generated. Each survey contained three
identical yes or no questions regarding
aspects of the technology. The questions
were formulated to touch on some of the
main arguments surrounding reproductive
ectogenesis. Figure 1

imperative need for such a technology

and background information such as that
1 in 8 babies are born premature [7] and
that over a million die worldwide each
year [8]. It also described how pig kid-
neys and brain cells have already been
successfully transplanted to humans
to save human lives [4] and how this
technology could save lives of fetuses.
Over one hundred individuals of varying
demographic backgrounds were given
one of the two surveys to complete.
The percentage of people who said
they would accept the technology in each
question are shown in figures 1-3.
Despite the controversies associated
with the subject support for reproductive
Figure 2

Figure 3

Question 1: If possible, would you sup-

port a technology that could allow implanting
of prematurely born human babies into surrogate
animal mothers until grown to term?
Question 2: Would you support develop-
ment of a machine that could keep prematurely
born babies alive by essentially performing the
same functions as a mother’s body even if less
effective than an animal surrogate mother?
Question 3: Would you support using a
machine or an animal surrogate mother to be
used in place of abortion for mothers who did
not want to carry a baby to term so that the baby
could then be adopted?
The varying factor between the two surveys
was that second survey contained a brief intro-
duction outlining pertinent Information to the

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BROWN.indb 24 5/25/2010 1:33:22 PM

 ASU

ectogenisis was higher than predicted with 41% accepting it shows that they wouldn’t have accepted the technology until
even without any background on the subject. Results for the the correlation was drawn that showed a compromise to an
survey with the introduction showed a 29% increase in the already existing moral issue. If they could take the survey
number of people who would accept the technology of using again they might change their answer to one or both of the
animals as surrogate mothers. This portrays the value that first two questions.
information can have on ethical debates. Males also showed, Another interesting trend is that medical professionals
on average, to be significantly more likely than females to ac- were more likely to support the technology than the other
cept the idea of animals as surrogate mothers. Possible reasons categories without the introduction but significantly less likely
for this trend could be because when given the introduction.
women view this technology as The sample size was smaller
threatening their maternal roles for medical professionals and
of providing life support to the
New technology, especially more extensive research could
developing fetus and intimate when it pertains to human help to discover the validity and
connection with the fetus. cause of this trend.
Results for the second ques-
life, unequivocally brings As time tests the accep-
tion show the general acceptance with it new mnoral tance of human ectogenesis
of machines in medical technology further research in this area
and in both surveys people were
dilemmas. Society’s could include looking at how
far more likely to accept a machine acceptance of possible trends change, especially if hu-
as a solution than an animal. This man ectogenesis progresses and
could have risen from concerns for
technology often influences receives more recognition in the
the animal, but some respondents how quickly, and even next couple years. The race for
stated that they felt it threatened medical breakthroughs is a 95
the inner sense of human superi-
if, a technology will ever billion dollar endeavor in the
ority in the perceived hierarchy be explored. Radical new United Stated alone and ethical
of life. We as humans often like acceptance of those technologies
to envision ourselves at a level
technologies are often first is often crucial to their success in
higher than the animals around rejected, then accepted, the market place [9]. The power
us and the idea of being able to of information, as shown by the
exchange parts with them some-
then embraced. increase of acceptance in the sec-
how makes us feel less human. ond survey, explains why the
Also machines have been used in medical advertising field has
medicine for decades where as animals use is a more recent grown exponentially the last couple decades.
possibility. Increased use and success with human-animal The answer to how the technology and the human prod-
transplantation will likely correlate to increased approval. ucts of it will be accepted will never be fully known until
However, like other emerging technologies the acceptance the technology comes to fruition. However, as shown by the
may not completely come until a generation has grown up surveys, the subject remains controversial, but the knowledge
with the new technology. that can provide momentum to the project is already start-
Question three shows how forming correlations to al- ing to form and replace inhibition to new ideas. If human
ready existing ethical questions can influence decisions on new ectogenesis is put into practice it will still be years before the
technologies. Most people have some opinion on the abortion first human baby will be thanking a pig for carrying it in the
issue and it is widely debated in the news. However, few have womb. However, the winds of change are blowing towards
probably thought about animals as surrogate mothers and a technology that would have been not only scientifically
how this might be a possible solution to the abortion issue. impossible, but ethically impossible in any other century.
Interestingly enough, multiple survey participants answered
no to questions one and two but yes to question three. This Daniel Brewer is an undergraduate at Arizona State University.

References:
1. Dronamraju, Krishna. Haldane’s Daedalus revisited. Oxford University Press; 1995
2. Singer P, Wells D. The Reproductive Revolution: New Ways of Making Babies.
Oxford University Press; 1984
3. Welin S. Reproductive Ectogenesis. Science and Engineering Ethics 2004 10: 615-
626
4. Frontline. Organ Farm: Four Patients and Their Clinical Trials Available from: URL
http://www.pbs.org
5. Fletcher, J. Moral Problems and Ethical Issues in Prospective Human Gene
Therapy. Virginia Law Review 1983 69:3 515-546
6. CNN. Doctor Who Performed Abortions Shot to Death 7/2/09 Available from URL
http://www.cnn.com
7. Mitchell, Deborah. High Number Of Premature Births Cause for concern Emax
Health. 10/5/2009 available from: URL http://www.emaxhealth.com
8. Medical News Today. Number Of Premature Births In The U.S. ‘Discouraging’
Opinion Piece Says 3/28/2008 Available from: URL http://www.medicalnewstoday.
com
9. MSNBC Health. 95 Billion A Year Spent on Medical Research. 9/20/06 Available
from: URL http://www.msnbc.msn.com
10. http://www.ncbi.nlm.nih.gov/projects/genome/guide/img/k7974-18_pig_usda_2.
jpg

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 ASU
Romantic Roots: Shelley’s Deep Ecology
Elizabeth Koebele
S
cenes of introspective poets wandering through vast natural
landscapes in search of meaning in an ultimately holy Nature
characterize the Romantic period in England, a reaction against
eighteenth century Enlightenment ideas. However, the life of one of
the most prevalent Romantic poets, Percy Bysshe Shelley, paints a very
different picture. While he, too, shared a deep commitment to nature,
philosopherAlfred North Whitehead claims, “What the hills were to the
youth of Wordsworth, a chemical laboratory was to Shelley” [1]. Shel-
ley’s youth was filled with scientific exploration, making him infamous
for things such as burning holes in his Oxford dorm room with his
chemistry experiments [2]. His enthusiasm for investigating scientific
phenomena grew throughout his life, eventually providing the basis
for his much of his writing. Many of Shelley’s ideas, which intertwine
ecological appreciation with literary expression, are now resurfacing
in modern environmental movements. Advocates of sustainability,
and particularly those who endorse an ideology called deep ecology,
share ideas that Shelley promoted, which include recognizing the social
and psychological implications of environmental consciousness and
asserting the inherent value of nature. Identifying the power of these
cornerstone “green” concepts in literature is not only reviving interest
in Romantic ideals, but is also rediscovering the mutually beneficial
relationship between the sciences and the humanities.
One of Shelley’s early lyrics entitled “Mont Blanc: Lines Written
in the Vale of Chamouni” provides some of the most fundamental
iterations of his ideas. “Mont Blanc” relates Shelley’s encounter of the
highest mountain in Europe in July of 1816 in the form of a mental
journey. Shelley visually surveys the mountain, beginning with the
“Ravine of the Arve” running under his feet as he stands on a bridge.
He then ascends through the “piles around [Mont Blanc], ice and rock,”
whose only inhabitants are “the eagle [who] brings some hunter’s
bone / And the wolf [who] tracks her there.” Ultimately, he reaches
the summit: “Mont Blanc yet gleams on high:—the power is there
/ The still and solemn power of many sights, / And many sounds,
and much of life and death” [3]. Only at this zenith can Shelley truly
articulate the terrifyingly beautiful cycle of life and death that is so
fundamental to natural processes, an idea that functions as the basis of
his conception of the relationship between human and environment.
While Shelley makes myriad allusions to scientific concepts,
some are particularly essential to understand his integration of en-
vironmental consciousness and literature, and how important this
type of thinking is to our modern day behavior. Primarily, Shelley
remains intimate with the natural phenomena surrounding him. He
categorizes the setting in an almost phylogenetic fashion, creating the
illusion of a journey not only physically “up” the mountain, but also
one of evolutionary growth. He opens the poem by pondering how the
“everlasting universe of things...rolls its rapid waves, / Now dark—now
glittering—now reflecting gloom” [3]. Here, Shelley metaphorically
engages the concept of light in his poem as a guide and simultane-
ously alludes to contemporary speculations on the composition of
light. Carl Grabo, a Shelley scholar, claims, “Shelley was either familiar
with Newton’s Opticks or later works derived therefrom,” [2] which
explore the idea that light is composed of particles rather than of waves;
yet, this issue became critical during Shelley’s lifetime when the work
26 THE TRIPLE HELIX Spring 2010
BROWN.indb 26
of scientist Thomas Young, who discovered important gaps in New-
ton’s theory, “erupted forth into the pages of periodic literature” [4].
Although Shelley is not known to have any firsthand experience in
this area of physics, his application of such information in the poem
provides a look into Shelley’s methods: his knowledge of light serves
as a guide through his poem, suggesting the importance of scientific
principles a guiding factor in experiences of nature. Shelley exhibits a
mystified consciousness of the things that make up the earth on even
the smallest scale, which leads him on a quest to uncover their beauty
and importance in the larger scheme of nature.
As a consequence of emphasizing this link between small and
large, Shelley changes scale quite rapidly. As he continues his climb,
he traces how the Arve cuts into the base of Mont Blanc, explaining
how the water rushes down “From the ice gulphs that gird its secret
throne / Bursting through these dark mountains like the flame / Of
lightning through the tempest” [3]. This passage provides insight into
one of Shelley’s many “geology conscious” moments, where he pays
particular attention to the physical features and underlying patterns
in natural formations, portraying the astonishing aesthetic qualities
of the landscape.
Shelley’s geological scope likely included works such as James
Hutton’s 1788 Theory of the Earth, which argues that the earth changes
uniformly through processes that have always occurred and continue
to occur today. Jonathan Smith, a literature and science scholar, sug-
gests that this knowledge heavily influenced Shelley’s perspective
on his quest, making it inherently “a geological one, but [one] about
catastrophic rather than uniformitarian forces” [5]. Similar to when
Shelley reaches the summit of Mont Blanc, he recognizes the persistently
morphing nature of the earth—a progressive geological stance for his
time, yet one that is integral to most sustainability philosophies today.
Shelley’s background causes him to consider, and poeticize, factors
such as the violent geological formation of Mont Blanc. He questions,
Is this the scene
Where the old earthquake-daemon taught her young
Ruin? Were these his toys? or did a sea
Of fire envelope once this silent snow? [3].
Shelley grapples with the origins of Mont Blanc by provoking a
mythological scene that alludes to both seismic and volcanic forces. He
first mentions the power of an “earthquake god”—perhaps the Roman
god Vulcan of fire and volcanoes—as a possible source. However,
Shelley secondarily questions if the cause is a more secular “sea of
fire,” connecting his allusions with more straightforward geological
thought. Once again, Shelley employs his unique schema of scientific
knowledge to move seamlessly from the massless, in his discussion
about light in the first section of the poem, to the massive geological
forces of earth.
Yet, why does Shelley include such scientifically oriented obser-
vations in his poetry? These insights into his ideas on light dynamics
and geology are, after all, just a few of the references in this poem that
display a distinct awareness of contemporary science and it’s place in
his environment. Shelley’s consciousness about these matters seems
far more pervasive: the “science” of the mountain ultimately becomes
the driving factor in “Mont Blanc.” This phenomenon is exactly what
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5/25/2010 1:33:23 PM
 ASU
makes poetry like Shelley’s particularly integral to the science and and essentially makes it an independent character in his poem, he
culture behind the sustainability movement, where art can serve as a is articulating early ideas of deep ecology. Shelley’s question about
catalyst to the process of creating methods to better preserve the earth. nature’s vacancy promotes an ethical and ecological consciousness
In order to illuminate this con- by accepting nature as a partner
nection, we must begin with one of in human discourse, and works to
the most well-known definitions Shelley’s question about nature’s recognize the depth and importance
of sustainability. The “Brundtland to its seeming vacancy rather than
definition” defines “sustainability” vacancy promotes an ethical relegating it as something “lesser.”
as “‘meeting the needs of the pres- and ecological consciousness by Ultimately, Shelley recognizes the
ent without compromising the ability mountain’s agency, and therefore,
of future generations to meet their accepting nature as a partner in embraces a recognition, as well as
own needs’” [6]. Although this defi- human discourse...” a complete re-thinking, of the voice
nition seems focused on the future of Nature.
of human development, it contains We can now see how Shelley’s
an important facet: making a long-term effort to preserve the earth. knowledge of contemporary scientific issues leads him to a unique
Shelley’s poetry addresses this idea and makes even more explicit understanding and appreciation for nature. Shelley’s science gives him
connections to the sustainability movement by asserting the inherent the ability—and perhaps the encouragement—to take a closer look at
value of nature. Best evidenced in the final lines of the poem, Shelley his environment, to wonder how things work for nature’s sake and
questions, “And what were thou, and earth, and stars, and sea / If to not simply for what they mean to humans. Yet, the eloquent way in
the human mind’s imaginings / Silence and solitude were vacancy?” which Shelley weaves these ideas into his poetry goes beyond simply
[3]. Basically, Shelley wonders what may occur if humans continue creating art. It has the power to inspire and impassion those scientists
to perceive anything silent—such as a mountain—as purely vacant, and advocates who possess the knowledge to create more sustainable
unimportant, or unworthy of care. Scholar Christopher Hitt makes ways of living. Jonathan Bate, in a particularly stunning passage from
the claim that what Shelley suggests “is that [recognizing this] ‘va- The Song of the Earth, summarizes the deep connections between
cancy’ is the key to rediscovering ‘wonder’ or to behaving ethically,” artistic appreciation and recognizing the inherent importance of nature:
[7] providing important insight into Shelley’s views about the planet When we contract ourselves to respond sympatheti-
and its preservation. cally to an artwork, we are following the same logic
When compared to other Romantic poets such as Wordsworth, as when we let ourselves go and inhale a breath of
who was often accused of creating an anthropocentric, “egotistical fresh air in the park or the country. Even as it is a cry
sublime,” Shelley discovers agency in nature by assessing its qualities against the commodification and instrumentalization
according to contemporary science and assuming that it inherently that characterize modernity, contemplation of the
possesses a unique semiotic system capable of genuine communication. beauty of art and nature is a strong and necessary
This type of thinking represents one of the core concepts of deep ecol- deed [10].
ogy, a term that has recently become familiar with the popularization While the rift between the humanities and the sciences has drasti-
of sustainability. Often used in opposition to terms such as “reform cally widened since the Romantic Era, we can see direct ties back to
environmentalism,” deep ecology refers to “the process of ground- thinkers such as Shelley, who seamlessly integrated these two disciplines
ing ourselves through fuller experience of our connection to earth.” to create unique, informed ideas about the world. Shaped by both his
Arne Naess, the Norwegian philosopher who first coined this term in distinct scientific background and his Romantic sensibilities, Shelley
1972, promoted principles such as the intrinsic worth of human and questions the real dangers that could arise from continuing to enlarge
non-human life, the value of diversity, and the need for political and this disciplinary divide, such as perceiving our natural surroundings
ideological change devoted to the salvation of the biosphere [8]. In as vacant, potentially leading to the collapse of our ecosystem. Shelley’s
other words, deep ecologists support a “biocentric stance [that] may be science obviously influenced his own poetry, and in turn can work to
understood as focusing evolutionary theory and the science of ecology inspire those with the power to transform human treatment of the planet,
onto the idiom of humanism to expose and overcome the unwarranted whether they are scientists, those with a passion for the environment,
claim that humans are unique subjects and speakers” [9]. While this or even those without one yet. Thus, by examining examples such as
philosophy often works hand-in-hand with environmentalism and Shelley’s of the ways in which science and the humanities mutually
sustainability, it ultimately reaches beyond those ideologies—which inform and influence each other’s agendas, we can earnestly further
often focus on sustaining the environment for human purposes by our own quest toward discovering the inherent value in our natural
reversing harmful actions—to promote the idea that the environment world and devising the best methods to protect it.
is inherently worth protecting.
Thus, when Shelley refuses to force a linguistic system on nature Elizabeth Koebele is an undergraduate at Arizona State University.

References Madison: The University of Wisconsin Press; 1994.

1. Whitehead, AN. Science and the modern world. New York: MacMillan; 1926.
2. Grabo, C. A Newton among poets: Shelley’s use of science in Prometheus Unbound. Chapel Hill:
The University of North Carolina Press; 1930.
3. Shelley, PB. Mont Blanc: lines written in the vale of the Chamouni. In: Greenblatt S, editor. The
Norton anthology of English literature, 8th ed. (D). New York: W. W. Norton and Company; 2006. p.
762-766.
4. Lussier, M. Wave dynamics as primary ecology in Shelly’s Prometheus Unbound. Romanticism on
the Net 1999;16.
5. Smith, J. Fact and feeling: Baconian science and the nineteenth-century literary imagination.
6. United States Environmental Protection Agency. Sustainability: Basic Information [Online]. 2009
Aug 24 [cited 2009 Oct 18]. Available from: URL:http://www.epa.gov/sustainability/basicinfo.htm.
7. Hitt, C. Shelley’s unwriting of Mont Blanc. Texas Studies in Literature and Language 2005;47(2):139-
166.
8. Devall, B. Simple in means, rich in ends: practicing deep ecology. Layton, Utah: Gibbs Smith
Publishing; 1988.
9. Manes, C. Nature and silence. In: Glotfelty C, Fromm H, editors. The ecocriticism reader: landmarks
in literary ecology. Athens: The University of Georgia Press; 1996.
10. Bate, J. The song of the earth. Boston: Harvard University Press; 2002.

© 2010, The Triple Helix, Inc. All rights reserved. THE TRIPLE HELIX Spring 2010 27

BROWN.indb 27 5/25/2010 1:33:23 PM

 BERKELEY
E coli: The Cure for Cancer?
Kenneth Gao
F
or years, researchers have been investigating the use of
bacteria as programmed vehicles to deliver drugs. Few
successes have been reported with these experiments
due to the difficulty in finding a bacterium strong enough to
kill pathogens without harming patients [1]. Dr. J. Christopher
Anderson, an assistant professor of bioengineering at the Uni-
versity of California, Berkeley, is leading a project with high
potential—to remodel Escherichia coli (E. coli) to fight cancerous
tumors. E. coli, a species of bacteria sometimes associated with
food poisoning, are being designed by researchers at Anderson
Lab to travel through the bloodstream, identify and invade can-
cer cells, and destroy
them [3]. Utilizing
engineered bacteria
in the manner Dr.
Anderson is proposing
to combat this deadly
disorder could be a
revolutionary step in
the field of therapeutic
bacteria [2]. Current
cancer treatments in-
cluding chemotherapy
and radiotherapy, are
inefficient and cause
an array of side effects,
giving Dr. Anderson’s
experiment much at-
tention in the medical
community [3].
At Anderson Lab, researchers are attempting to develop a
drug that uses E. coli as vehicles, to deliver a cytotoxic chemi-
cal that kills tumor sites. The drug would be injected into a
patient’s bloodstream where it would to carry out three main
tasks: avoid the immune system, find and invade the tumor
site, and release the cytotoxin to kill the cancer cells [3]. The
goal of the researchers is to engineer genetic devices, each
comprised of multiple genes, that contain the instructions for
the bacteria to carry out the assignment. Each genetic device
specifies the what, when, where, and how of each step that
the E. coli must execute to ultimately kill tumor sites.
The first step the E. coli would take once injected into
the bloodstream of a cancer patient is to evade the various
levels of the human immune system [3]. Usually considered
a beneficial evolution of the human body, the immune system
would be the enemy of this cancer-killing drug as the system’s
duty is to eliminate foreign substances that enter the body.
To the immune system, the E. coli would be no different than
any other foreign germ that enters the body. With that said,
the E. coli are being engineered such that the immune sys-
tem does not recognize the drug as a foreign substance. The
28 THE TRIPLE HELIX Spring 2010
BROWN.indb 28
immune system usually recognizes pathogens by features
on their outer membrane; thus, to prevent the bacteria from
being engulfed once inside the bloodstream, the E. coli are
commanded to grow an alternate carbohydrate surface layer
instead of chains that would induce an immunity response [4].
Without worry that the injected E. coli will cause a dangerous
response from the immune system, they are free to carry out
the rest of their tasks.
With the disguise to sneak past the immune system, the
E. coli would then travel to the tumor site through the blood-
stream. These facultative anaerobes are able to sense hypoxic
regions, or regions of
the body that are de-
prived of oxygen. This
is perfect for a vector,
or vehicle, that travels
to cancerous sites as
cancer cells usually
consume high doses
of oxygen to grow
at their exponential
rates, leaving a highly
hypoxic region [5].
Tumor cells in sight,
the E. coli would bind
to surface proteins
called β1-integrins
on the cancer cells,
causing the cells to
uptake the bacteria
by phagocytosis, a process by which the bacteria outside the
cell is engulfed by the cell membrane and brought inside the
cell [5][6]. The E. coli now inside the cancer cells’ vacuoles,
or organelles that act as compartments within the cell, would
have completed their second set of instructions and would
be ready to begin their third and final task.
Once inside the tumor cell, the bacteria would deliver
a cytotoxin to the cytoplasm of the tumor cell [2]. The E. coli
would undergo lysis, or cell suicide, and burst inside the vacu-
ole, releasing the cytotoxin and a protein that degrades the
membrane of the vacuole, allowing the cytotoxin to spread
through the cytoplasm and kill the cancer cell.
Dr. Anderson has also been researching alternative meth-
ods to deliver the toxin. The second option would be to first
instruct the E. coli to escape from the vacuole and then to
secrete the cytotoxin into the cytoplasm. The advantage of
this method is that each bacterium’s potency is optimized
within each tumor cell. The third and last set of instructions
is similar to the second in that the E. coli would escape from
the vacuole and secrete the cytotoxin, with the added instruc-
tions for the bacteria to continuously release the toxin while
© 2010, The Triple Helix, Inc. All rights reserved.
5/25/2010 1:33:23 PM

spreading from cell to cell, maximizing the number of tumor
cells that would receive the drug [7]. Each set of instructions,
with its distinct advantages and disadvantages, is suited for
different types of tumors. In the end, all three sets result in the
destruction of cancer cells, the ultimate goal of the bacteria.
This project is still early in the development phase; how-
ever, advancements are being made. Dr. Anderson states, “the
drug can deliver protein payloads to cancer cells.” With further
experimentation, researchers at Anderson Lab hope to be able
to regress a tumor in a live mouse [3].
The success of this project could mean an alter-
native form of cancer treatment to the present-day
chemotherapy and radiotherapy [2]. The tumor-
killing bacteria could prove to be safer, more ef-
ficient, and less expensive due to its biospecificity,
or ability to localize and target a specific site [8].
Dr. Anderson notes that “there are very few drugs
out there that work on the basis of recognizing
the cancer cell surface; most cancer drugs work as
inhibitors of some process vital to the cancer cell”
[3]. Moreover, unlike other cancer treatments that
rely on the movement of blood to travel throughout
the body, E. coli are able to be engineered to grow
flagella, tail-like structures that provide movement,
allowing them to travel to tumor sites [6]. The ability of the
bacteria to release the drug only once they are inside the tumor
cell, as well as their self-destruction after they perform their
task, prevents damage to other healthy cells, a feat that most
other treatments cannot accomplish [7][8]. The multitudes of
side effects that are commonly associated with cancer treat-
ments today are usually attributed to damage to healthy cells
in the body, thus this drug may be able to boast fewer side
effects [8]. Additionally, the use of bacteria as a vector to de-
liver a cytotoxic chemical allows higher carrying capability
than conventional methods. These characteristics make this
developing drug a promising treatment that boasts specificity
and efficiency over current cancer treatments.
Like most synthetic biology experiments, researchers must
take an additional precaution with this experiment. The risk
of a mutation occurring within the DNA of the E. coli could
compromise the safety aspect of this drug [8]. Dr. Anderson
discusses potential instabilities: “For example, if a growth
control device were inserted into a cell that actively killed
the cell after growing for six generations, this would be the
type of device that might go awry. You have to consider what
happens when you mutate the things you add into the cell. In
this case, one loss-of-function point mutation would destroy
the safety mechanism” [3]. While mutation only has a one per
References
1. Singer E. Tumor-Killing Bacteria. Technology Review. [Online]. June 2 2006
Available from: http://www.technologyreview.com/biomedicine/16949/ [Accessed
18th October 2009].
2. Foertsch B. Cancer Cure?. Issues in Science and Technology. Weblog. [Online].
Available from: http://blog.lib.umn.edu/arrig002/1152w_fall_07/frontiers_of_
technology/ [Accessed 20th October 2009].
3. Anderson JC. Interviewed by: Gao K. 5th November 2009.
4. The Chassis. Bactoblood. [Online]. Available from: http://parts.mit.edu/igem07/
index.php/BerkiGEM2007Present4 [Accessed 24th November 2009].
5. Jain, RK. Can Engineered Bacteria Help Control Cancer?. Proceedings of the
National Academy of Sciences of the United States of America. 2001;98(26): 14748-
© 2010, The Triple Helix, Inc. All rights reserved.
BROWN.indb 29
BERKELEY
million chance of occurring per DNA base pair, scientists take
the risk into serious consideration. Devices are being upgraded
to include multiple safeguards that cause the bacteria to lyse
if certain objectives are not met. The improvement of these
safeguards could promote the use of therapeutic bacterial
drugs in the future [8].
With the increasing potential of the use of therapeutic
bacteria, Dr. Anderson worries that his drug could pose a
societal problem—it is difficult for people to cope with the idea
of injecting live bacteria into their bloodstream as a cure for a
deadly disease [3]. With hope for the future of this
project, Dr. Anderson believes that this obstacle is
something that people will be able to overcome in
time. “One reason we pick cancer above all others is
because it is a disease for which people are willing
to try something that they aren’t willing to try for
any other disease,” [3]. Other therapeutic bacteria
are already on the market in the form of dietary
supplements, otherwise known as probiotics [3].
Many dairy products, breads, meats, and other
ordinary food items eaten daily are supplemented
with probiotics for an assortment of health benefits;
however, it is rare to see people avoiding the yogurt
aisle because live bacteria are added. This may be
due to the common belief that there are already germs in food
anyway, so people are accustomed to ingesting bacteria, unlike
a cancer-killing drug, which would need to be injected [3].
Dr. Anderson’s project pioneers unchartered territory
in the use of therapeutic bacteria. Although it may require
some adaptations in terms of societal attitudes, the space for
potential design is tremendous. Only limited by the lack of
methodology, which can be developed in time, this cutting-
edge technology has a key advantage of infinite modification.
“Nothing is off limits in terms of what we can change about
these organisms” says Dr. Anderson [3]. The use of bacteria
as a delivery method for drugs allows for a complex mecha-
nism of action. Drugs would no longer be limited to a single
function, as bacteria can have multiple queues of behaviors
engineered into their genetic code [3]. Dr. Anderson’s project
would not only result in one usage of these bacteria, but could
also provide the tools for further development. It is one of the
first of its kind, a great advancement in therapeutic bacteria
and a potential to be a new cure for cancer.
Kenneth is a first-year at UC Berkeley. He is majoring in Bioengineering
and is interested in applying to Haas School of Business for a
simultaneous Business Administration degree. Email: kennethgao@
berkeley.edu.
14750.
6. Anderson JC, Clarke EJ, Arkin AP, Voigt CA. Environmentally Controlled Invasion
of Cancer Cells by Engineered Bacteria. Journal of Molecular Biology. 2006;355(4):
619-627.
7. Huh J. Payload Delivery to Tumor Cells Using Engineered E. coli: Different Modes
of Delivery by Mixing and Matching Synthetic Devices. Qualifying Exam Proposal.
University of California, Berkeley; 2009. [Requested via email from jinism83@gmail.
com].
8. Yousefi P, Wang L, Woo D, Ravela A, Graeter S. Tumor-Killing Bacteria: Hopes and
Concerns for the Present and Future of Synthetic Biology. Ars-synthetica. [Online].
2007. Available from http://www.ars-synthetica.net/archive/items/show/263.
THE TRIPLE HELIX Spring 2010 29
5/25/2010 1:33:24 PM
 CMU
The Neuroscience of Meditation:
Perspectives, Conversations, and Controversy
Cynthia Peng
T
he Dalai Lama arrived in Washington D.C. in the fall of
2005 – a sole saffron robe amongst business suits and
white lab coats – amidst controversy. As the spiritual
leader of the Tibetan people, His Holiness traveled from his
residence in Dharmasala, India, to D.C. to give a lecture on
the “Neuroscience of Meditation” at the Society for Neurosci-
ence’s annual meeting. However, even before stepping foot
in the U.S. capital, a flurry of protest centered on a religious
leader’s symbolic role in speaking at a scientific conference.
Hundreds of signatures had already been collected in an
online petition entitled “Against the Dalai Lama’s Lecture at
Society for Neuroscience (SfN) 2005.” Sentiments ranged from
concerns that the talk was going to be
a philosophical lecture and not a scien-
tific one, to vehement disagreements
that “there is no logical reasoning that
justifies including a religious talk at
SfN.” [1] At the same time, proponents
of the lecture drafted a counter-petition
on the basis of building a public un-
derstanding of neuroscience and the
fact that “such philosophical beliefs
do not necessarily conflict with the
empirically based constructions of
science.” [2]
His Holiness’ controversial lecture
was only a hint at the convergence
between Eastern and Western thought,
of using Western empirical methods to
evaluate Eastern centuries-old tradi-
tions, of collaboration between scientific
minds and contemplative experts. What
was it about this topic that stirred the
blood of some scientists but at the same
time offered interest and insight for
others? How did meditation become
prominent in the scientific realm?
Meditation is a practice that
embodies the psychological concept
of the mind, whereby a person seeks
to clear their mind into blankness and set themselves into a
relaxed but attentive state. Meditation has been likened to
the “pacification of turbulent waters” or a “glossy mirror of
immense dimension.” [3] For some, meditation is a way of
relaxation; for others, a method to practice absolute awareness;
and for a select group, a way to access the inner self in order
to achieve enlightenment.
Western scientists have taken up interest in this pre-
30 THE TRIPLE HELIX Spring 2010
BROWN.indb 30
dominantly Eastern practice for a number of reasons, one of
which is its implications for mental health. Neuroscientists
have examined which areas of the brain are most affected
by practicing meditation. A 2004 study found that there are
overlapping activation regions for expert meditators with over
10,000 hours of practice and novice meditators in attention-
related brain regions. [4] Despite these similarities, expert
meditators showed greater activation than novice meditators
in multiple attention-related and other frontoparietal regions.
In contrast, novice meditators had greater activation in regions
shown to negatively correlate with performance in a sustained
attention task. Clearly, the practice of meditation affects the
attention pathway and strength of
activation. This study promoted the
idea that one crucial aspect of mental
well-being – attention – improves with
concentration meditation.
Furthermore, another study
with HIV-1 infected adults showed
that mindfulness-based meditation
has an effect on improved health. [5]
Mindfulness meditation is based on
the foundation of seeking to be mind-
ful of one’s surroundings in a non-
judgmental manner; of being aware of
one’s senses and letting thoughts come
and go without criticism. HIV patients
who went through a multi-week mind-
fulness meditation training program
showed decreased levels of CD4+ T
lymphocytes as compared to controls.
Since CD4+ T lymphocytes are biologi-
cal markers of HIV progression, their
reduction points to the promising role
of meditation, or the mindset elicited
by meditation, for health implications.
Additionally, the Mind and Life
Institute [6] was born out of a desire
to incorporate Eastern traditions into
Reproduced from [9] Western science in a mutually beneficial
manner. The institute, whose purpose is to “promote the creation
of a contemplative, compassionate, and rigorous experimental
and experiential science of the mind which could guide and
inform medicine, neuroscience, psychology, education and
human development,” was founded by R. Adam Engle, a
North American businessman, and the late Dr. Francisco J.
Varela in order to facilitate dialogue between Western scien-
tists and the Dalai Lama. This dialogue includes promotion
© 2010, The Triple Helix, Inc. All rights reserved.
5/25/2010 1:33:24 PM
 CMU

of the experimental science of contemplative practices, such brain to change and alter its state due to experience, which
as meditation, as well as public conferences and educational is arising to be a “central issue in neuroscience.” [8] The of-
programs. ficial press release promoted the talk to be the first in a series
It is of the history of these collaborations that the Society titled “Dialogues between Neuroscience and Society,” with
for Neuroscience president at the time, Carol Barnes, justified speakers chosen by the SfN president after consultation with
the invitation, stating that the Dalai Lama’s long interest in the SfN Council. [7]
science and ongoing dialogue with leading neuroscientists The major component of the criticisms came from the
for more than fifteen years is the reason he was invited to belief that the Dalai Lama had a hidden political agenda.
speak at the meeting. Barnes added in an official statement, Some believed that choosing the exiled Tibetan leader would
“It has been agreed that the talk will not be about religion or promote strong Buddhist religious overtones and reign in sup-
politics.” [7] port for freedom for the autonomous region of Tibet, whose
However, some have argued that it is the mere notion movements toward independence have been crushed by the
of inviting a religious speaker to speak that violates the in- Chinese government. The petition argued that giving legiti-
tegrity and mission of a scientific macy to the talk created a slippery
conference. “There will be a strong slope of mixing science, politics, and
symbolic effect,” said Lu-Yang Wang, religion. [8]
associate professor in the department “Scientists should be open-
of physiology at the University of minded and open to all inputs”
Toronto. “His presence and talk at countered Howard Fields of the
the SfN meeting per se suggest an University of California at San
endorsement by SfN of a promi- Francisco. [7] On the one hand,
nent religious leader.” [7] While previous research on the impact of
some dissidents have likened the meditation on health should insti-
inappropriateness of inviting the gate further collaboration between
Dalai Lama to inviting the Pope, scientists and contemplatives to work
some were more concerned about across cultural and political borders
the political motivations; Tibet is in order to improve health for society
currently a territory of the People’s as a whole. On the other hand, the
Republic of China, and there are Society’s bylaws do state that “the
vocal groups lobbying for its in- purposes of the Society are scientific,
dependence. Though the official educational, literary, charitable, and
stance of the United States is not NO OTHER.” [1]
in support of Tibetan independence, The future of contemplative-
many worry that the Dalai Lama’s based neuroscience research will
invitation from a prominent, well- be interesting to watch develop as
known Western organization will Eastern practices become more in-
provide an outlet to generate sym- grained in Western society. While
pathy and support. “It will blur the some applaud its cross-cultural
distinctions between science, religion Reproduced from [10] multidisciplinary approach, oth-

and politics, generate bad press, and cause divisions among
SfN members,” Wang concluded. [7]
Divisions indeed! Min Zhuo of the University of Toronto
stated that The Dalai Lama “does not deserve to be invited”
because “an honored guest needs to have a major contribu-
tion in [an] area we all believe in.” [8] However, subjectivity
stems from how “areas of interest” is to be interpreted. The
talk, proponents claim, comes out of a growing interest in
neuroplasticity, otherwise known as the ability of the adult
ers will continue to point out its empirical flaws and express
healthy skepticism, which strikes a good balance in science.
As for the passionate arguments on behalf of and against the
talk, though, there was a neutral middle group of people who
picked up tickets because they were “curious.” [7] Curiosity
may have killed the cat, but it serves well in science to be open
but skeptical, analytical but curious.
Cynthia Peng is an undergraduate student at CMU.

References:
1. Against the Dalai Lama’s Lecture at SfN 2005, http://www.petitiononline.com/
sfn2005/
2. In Support of the Dalai Lama’s Lecture at SfN 2005, http://www.petitiononline.
com/sfn2005a/petition.html
3. Austin, James. Zen and the Brain: Toward an Understanding of Meditation and
Consciousness. 1st ed. New York, New York; 1998.
4. Brefczynski-Lewis, J.A., Lutz, A., Schaefer, H.S., Levinson, D.B., Davidson,
R.J. (2007) Neural Correlates of Attentional Expertise in Long-Term Meditation
Practitioners. Proceedings of the National Academy of Sciences. 104(27), 11483-11488.
5. Creswell, J.D., Meyers, H.F., Cole, S.W., and Irwin, M.R. (2008). Mindfulness
Meditation training effects on CD4+ T lymphocytes in HIV-1 infected adults: A small
randomized controlled trial. Brain, Behavior, and Immunity. In press.
6. Mind and Life Institute. http://www.mindandlife.org/
7. Members Express Opinions About Dalai Lama ‘Dialogues’ Talk at Neuroscience
2005 in DC. Neuroscience Quarterly. http://www.sfn.org/index.aspx?pagename=neur
oscienceQuarterly_05summer_dalailama&print=on
8. Dalai Drama at SfN. Published 12 September 2005. http://www.the-scientist.com/
article/display/15702/
9. http://www.cdc.gov/Features/Meditation/Meditation_a200px.jpg
10. http://sigs.nih.gov/cnc/PublishingImages/CNC.jpg

© 2010, The Triple Helix, Inc. All rights reserved. THE TRIPLE HELIX Spring 2010 31

BROWN.indb 31 5/25/2010 1:33:24 PM

 UCHICAGO
A New Age of Water Politics
Dan Plechaty
T
he annals of recorded history are replete with examples
of the deification of rain. Whether through offerings at
the Egyptian temple for the goddess Tefnut, or seasonal
rituals among the Cherokee in Native America, rain was con-
ceived of as a primal and unpredictable force, necessary for
sustaining life but also able to bring death. Although rain
remains as unpredictable as ever, instead of supplicating the
gods as in the past, we have endeavored to store rainfall and
improve our agricultural methods. Our technology is certainly
much improved, but with rapid population growth and in-
creasing demand for industrial and agricultural products,
water access issues are more important than ever. No longer
a religious issue, politics has taken over the role of deciding
who gets how much water and at what cost. Although regional
solutions differ when it comes to specific water uses, common
to all is the need to focus on policies that will ensure long-
term water availability through investments in infrastructure
and appropriate pricing strategies. Governments will need to
remove subsidies and begin taxing water, which will require
the mediation of long-standing disputes over the ownership
of this resource.
Personal water usage, such as for drinking and clean-
ing, is highly visible but not very important in terms of total
volume. In developed countries such as the United States,
personal water use accounts for less than 1% of total water
expenditures [1]. Instead, the main uses are agricultural and
industrial, specifically for the production of thermoelectric
energy. Thus it makes more sense to focus on maintaining
water access levels for these industries. It would seem odd
to worry about water running out, given its ubiquity, but it
is not necessarily available in the location or form that we
desire. The vast majority of water on earth is salt water, and
desalination is currently cost-prohibitive on agricultural and
industrial scales [2]. Furthermore, freshwater is not always
located where we need it, such as near large urban centers or
fields and factories. Transporting water is costly, and as we
will see the unsustainable use of aquifers and groundwater
will pose major developmental challenges in the decades to
come. We will focus on regional industrial and agricultural
practices and water access, with the caveat that they are con-
nected to and affected by global markets.
The Ogallala Aquifer in the central United States, for
example, has experienced steady declines in water levels,
reaching over 10% in most areas following post-war economic
development in the 1950s [3]. Spanning the High Plains from
South Dakota down to Texas, this aquifer provides drink-
ing water for 82% of the area’s population, as well as 30% of
national irrigation [3]. Large cities are a major drain on water
supplies, and arid regions support agriculture only through
large-scale irrigation. Water subsidies also encourage farm-
ers to grow crops that are not suitable for these regions, and
32 THE TRIPLE HELIX Spring 2010
BROWN.indb 32
reduces the incentive to invest in more efficient drip irrigation
systems. While patchwork water policies have not helped the
matter, subsidies and state-by-state legislation are not the only
problems [4]. Even when free market practices prevail, water
prices would only reflect the cost of extraction, storage and
transportation. This means that we are using water without
taking into account whether or not there will be any left in
the years to come; in the parlance of economics, it is a market
failure. One way to fix this is to enforce a tax to internalize
these social costs, known as a Pigouvian tax after the English
economist Arthur Pigou [5]. The same effect could also be
achieving by limiting the quantity extracted, such as through
a cap and trade system. While this would raise prices for
farmers (and food prices for consumers), it would also set our
agriculture on a more sustainable path and prevent large-scale
water shortages in the future. However, higher water prices
are regressive as the poor will spend a greater proportion of
their income on food and water, justifying increased govern-
ment assistance in this realm.
Half the world away in India, water access problems are
even more omnipresent in national politics. Compared to the
United States, India has a much greater population density,
an economy more dependent on agriculture (21% of GDP),
and employs relatively more people in it as its technology
is less capital-intensive [6]. The upshot of this is that many
more people are dependent on farming for their livelihood,
and farming is much more dependent on rainfall. This is par-
ticularly dangerous in India, where monsoons provide more
than half of the water in less than 15 days [7]. Collecting and
storing this water for the rest of the year is an infrastructural
challenge that the government could undertake to fix. Aquifer
depletion is again a problem, as are local subsidies, but they
are more understandable given the level of poverty amongst
the farmers.
Sustainable use of their aquifers will be necessary soon,
though, as the Indian subcontinent begins to feel the effects of
global warming. The general effect will be an increase in the
intensity of the hydrological cycle [8]. This means that total
rainfall will likely remain the same (though specific regions
could see more or less rain), and monsoons will account for even
more of the rainfall, perhaps inducing flash floods that would
be damaging to crops. Extensive investment in infrastructure
and water efficiency technologies, combined with a gradual
fadeout of subsidies (and eventually taxes) on aquifer water,
will be necessary in years to come. Otherwise, there will not
be enough water during the majority of the growing seasons,
while there will be dangerous amounts of it at other times.
As for the United States, total rainfall is expected to de-
crease significantly, using the midrange predictions of a survey
of climate models [9]. This will be combined with decreasing
aquifers and river levels that are already well below historical
© 2010, The Triple Helix, Inc. All rights reserved.
5/25/2010 1:33:24 PM
 UCHICAGO

averages [3]. One can first expect more clashes between states ing claims in a peaceful manner, but we must first recognize
over water use. It is unclear whether the western United States the formidable challenges in international relations that this
will even be able to continue its current level of population presents. Failing to do so may result in a century where wars
growth; the mid-West, however, could see a boom as its wetter for oil are supplanted by wars over water.
climate and the freshwater of the Great Lakes become more Population growth means that it is even more imperative
valuable [9]. Regardless, the net effect is that Americans can to use land and water in the most efficient ways possible, as
expect to pay much they are inputs into
more for both food almost every eco-
and water. This will nomic process. One
likely lead to political part of the solution
support for offsetting is making sure that
these price increases these decisions are
in some way; either not distorted by local
through price sup- water use rules that
ports, or some way do not price water
to further hide prices adequately, either
and market forces. through subsidies
Decreasing the or not adjusting for
overall costs paid by more sustainable use
consumers, however [4]. Higher prices will
will only worsen our hopefully induce
long-term water is- people to invest in
sues. If no action is more efficient wa-
taken until aquifers ter technologies or
are depleted and even explore ideas
the effects of global for desalination.
warming are begin- This framework can
ning to be felt, it be further extended
could be debilitating by more clearly de-
for both agriculture fining property rights
and industry. to common water re-
The actual sources. The second
implementation of part of the solution is
such policies, how- government regula-
ever, may not be so tion: there is a respon-
simple. Many wa- Expected decadally averaged changes in the global distribution of precipitation per degree of sibility to let market
ter resources touch warming (percentage of change in precipitation per degree of warming, relative to 1900–1950 as experiences decide
the baseline period) in the dry season at each grid point, based upon a suite of 22 AOGCMs for a
multiple political midrange future scenario (A1B, see ref. 5). Reproduced from [9]. what technologies
jurisdictions, mean- are best for farmers,
ing that there is often no clearly defined set of property rights. and governments can invest in water infrastructure which
This has already led to conflicts among the Great Lakes states will have spillover benefits, such as flood prevention. Water
over access to Lake Michigan. How do we determine how much politics is not one-size fits all, however, and special care must
water Indiana citizens should get vis-à-vis Illinois, and if the be paid to regional climates, economies, water sources, and
water is a common resource, who exactly are we going to tax populations. By laying the groundwork and discussing seri-
for its use? The problem becomes more pronounced when the ously the perils of water shortage, we can move to conserve
political entities are antagonistic, such as the dispute between our water use today and secure this most precious of resources
Israel and Syria over the Golan Heights and its large water for the long term.
reserves. It should be a goal of the international community
to try and enforce a legal framework to address these compet- Dan Plechaty is an undergraduate at the University of Chicago.
References: 5. Pigou, Arthur. Wealth and Welfare. New York: Macmillan Company, 1912.
1. Hutson, Susan B. Estimated Use of Water in the United States in 2000. Mar. 2004. 6. “India: Priorities for Agriculture and Rural Development.” The World Bank.
U.S. Geological Survey. 1 Dec. 2008 <http://pubs.usgs.gov/circ/2004/circ1268/pdf/ http://go.worldbank.org/8EFXZBL3Y0
circular1268.pdf>. 7. “India’s Water Crisis: When the Rain Falls.” 10 Sept. 2009. The Economist.
2. “Thirsty? How ‘bout a cool, refreshing cup of seawater?” 7 Nov. 2008. U.S. http://www.economist.com/displaystory.cfm?story_id=14401149
Geological Survey. 1 Dec. 2008 <http://ga.water.usgs.gov/edu/drinkseawater.html>. 8. Chattopadhyay, N, and M. Hulme. Evaporation and potential evapotranspiration
3. “Area-weighted water-level change.” High Plains Aquifer Water-Level Monitoring in India under conditions of recent and future climate change. Agricultural and
Study. 9 July 2007. U.S. Geological Survey. 1 Dec. 2008 <http://ne.water.usgs.gov/ogw/ Forest Meteorology 87 (1997) 55-73.
hpwlms/tablewlpre.html>. 9. Solomon, S. et al. Irreversible climate change due to carbon dioxide emissions.
4. Howe, Charles. Water Pricing: An Overview. Summer 1993. Universities Council Proceedings of the National Academy of Sciences in the United States of America,
on Water Resources, Issue 92. http://www.ucowr.siu.edu/updates/92/V92_A1.pdf vol. 106 no. 6. 10 Feb. 2009.

© 2010, The Triple Helix, Inc. All rights reserved. THE TRIPLE HELIX Spring 2010 33

BROWN.indb 33 5/25/2010 1:33:24 PM

 UCHICAGO

Fighting Disease:
Are Global Funds Misallocated?
Chana Messinger

O
f the many global issues the world faces, one of the to fighting infectious disease, child mortality and promoting
most prominent is allocation of the world’s resources maternal health. AIDS/HIV, alone, constitutes a 64% slice of
to fight disease. Three of the eight Millennium De- the budget, which amounts to over 2.5 million dollars [7]. The
velopment Goals agreed to by 192 nations and over twenty- President’s Emergency Plan for AIDS Relief, created in 2003,
three international organizations relate to combating disease gave $15 billion to fight AIDS, and this amount was increased
and promoting health. These goals, set forth in 2001, are the to $48 billion when it was renewed earlier this year. To fight
markers by which the United Nations evaluates progress on malaria, which kills one person every 15 seconds, $1.2 billion
important global issues. Unfortunately, policy decisions are not was given in 2005 by USAID, to be spent over a period of five
always entirely based on the scientific and statistical evidence years[8]. An argument might be made for research, given that
available. In fact, there are severe misallocations in the way AIDS has no known cure, whereas the others do. However,
that limited funds have been used to fight disease. Current only 12% of the US budget for AIDS is allocated specifically
policies on AIDS, malaria, diarrhea and other diseases are to research, undercutting this line of reasoning[9]. Money
almost entirely at odds with the way that the money could allocated to combat diarrhea-related illness and pneumonia
save the most lives, focusing money and attention on the first, was not even listed on the USAID site. Those diseases, which
an expensive and as yet unsolved problem, and underfunding are leading causes of death in the developing world, are part
and marginalizing the others, which are curable and less costly. of a larger initiative to promote maternal and child health and
In deciding how much funding to funnel towards a suppress infectious diseases.
particular disease, one important factor should be fatality. Not only, however, is money not donated in proportion
Malaria kills over 1 million people every year [1], AIDS kills 2 to how deadly a disease is, but also, the costs of prevention
million[2], and diarrhea causes the death of up to 6 million[3]. and treatment are not being addressed. Treatment of some
The numbers are even starker when specifically children are diseases is, overall, more cost-effective than treatment of other
considered, as they should be, given that the fourth millen- diseases, and so would save more lives per dollar donated.
nium development goal relates to child mortality. In Nigeria Even if AIDS were responsible for as many deaths as it might
and Ethiopia, 237,000 people died appear to be from the amount of
from AIDS [4]. Over twice that money the US apportions against
number of children under five [B]ased solely on the relative it, the fact remains that AIDS is
died of pneumonia and diarrhea a much more expensive disease
[5]. Researchers at the Johns Hop- preponderance and fatality to treat than are the others. Yet,
kins Bloomberg School of Public of the diseases at hand, that all the aforementioned diseases
Health and the WHO estimate that – AIDS, diarrhea, pneumonia,
10.6 million children die before diseases such as malaria and malaria – are preventable: AIDS
their fifth birthday worldwide. diarrhea should receive at with safe sex practices and drugs
Diarrhea accounts for 17% of these for mothers, diarrhea with clean
deaths and malaria for 8%. In fact, least as much fiscal attention water, pneumonia with vaccines
diarrhea has been described as the as AIDS. This is not the case. and malaria with drugs and the
leading cause of death for chil- use of bed nets. Diarrhea requires
dren. In contrast, AIDS caused a one-time investment into clean
the deaths of only 2.5% of these children[8]. It makes sense water and hygienic sewage for any given community, which
then, that based solely on the relative preponderance and might be expensive, but could easily recoup its own cost as
fatality of the diseases at hand, that diseases such as malaria these simple but effective measures reduced the prevalence of
and diarrhea should receive at least as much fiscal attention the disease. Vaccines, such as the one for pneumonia, must be
as AIDS. This is not the case. distributed on a case-by-case basis, but once it is eliminated
The actions of the United States, the most powerful and from an area, it often never returns, as is clear from the ex-
wealthy participant in this global summit, are quite telling. In ample of the United States. Bed nets are extremely inexpensive,
2008, United States aid, mostly in the form of direct bilateral and hugely reduce the rate of malaria if used correctly. But
donations to combat AIDS and HIV, constituted half of the stopping the spread of HIV and AIDS requires continued
world’s funds allocated to this particular problem[6]. Of the education, voluntary implementation of safe sexual practices
United States Agency for International Development’s (USAID) and an intensive drug regimen.
total Health budget of $4.15 billion, 24%, combined, is allocated The treatments themselves put the disconnect between

34 THE TRIPLE HELIX Spring 2010 © 2010, The Triple Helix, Inc. All rights reserved.

BROWN.indb 34 5/25/2010 1:33:25 PM

 UCHICAGO

disease fatality and funding for treatment into sharper perspec- would necessarily include a focus on AIDS, as this disease kills
tive. Oral Rehydration Salts, the most widely accepted treat- 270,000 children each year. However, the artificial division
ment for acute diarrhea, created by emphasiz-
cost 8 cents per person. ing them separately
Pneumonia antibiotics quickly gives rise to al-
generally cost $1 a day, lotment of funding that
and only have to be tak- equates one disease,
en for a few weeks[10]. AIDS, with the rest of
Malarial drugs are more the illnesses that affect
expensive, about $4 a children. AIDS is still
day, but a new program extremely important,
has been implemented and needs funding, but
that combines pressure these other diseases
on drug companies and are being unfairly dis-
subsidies to make them missed. The problem is
cost approximately 5 that, as separate causes,
cents[11]. By compari- any money donated to
son, an HIV cocktail in combat AIDS is not
the United States costs given to alleviate any
thousands of dollars a other disease and vice
month. UNAIDS esti- versa.
mates that to treat and Secondly, societal
care for all Africans perspectives on the
infected with HIV/ issues, which often
AIDS in a given year Reproduced from [28] inform political deci-
would cost $1.5 billion sion-making, seem to
[12]. Implementing prevention programs and antiretroviral be playing a large part. AIDS is at the forefront of the national
therapy would cost billions more. From a strictly utilitarian and global consciousness. Google Trends, for example, a fairly
perspective, money allocated to fight malaria, pneumonia, accurate measure of internet-user sentiment, puts searches
diarrhea and other preventable, curable diseases would help for “AIDS” and “HIV” at 4 to 10 times more frequent than
and save more people than money given to fight AIDS. As “malaria”, “pneumonia” or “diarrhea [16].” Similarly, the
Nigerian President Olesegun Obasanjo noted, “It should be New York Times has published almost 6,000 articles dealing
recognized that given the nexus of malaria and HIV/AIDS, it with AIDS in the last 27 years, with articles on the subject of
makes no practical sense to spend diarrhea numbering just 48 [17].
so much on one while leaving the The reasons are varied. Tropical
other underfunded.”[13]. diseases have been a part of the
There are four main reasons Money allocated to combat human condition for hundreds
why AIDS is overly emphasized. diarrhea-related illness and of years, whereas the first known
The first is that it is treated as sepa- cases of AIDS were discovered in
rate from other diseases. The 2004 pneumonia was not even 1981. Another aspect of popular
annual World Health report from listed on the USAID site. pressure is the fact that AIDS is
the World Health Organization still a problem in the US, whereas
(WHO) addressed AIDS and the Those diseases, which are the other diseases mentioned are
need for a comprehensive strategy leading causes of death in the not, and furthermore, while the
to stop and reverse the spread tropical diseases mostly affect
of this pandemic. It asked for developing world, are part of children, AIDS is widespread
expanded treatment, more com- a larger initiative to promote across the age spectrum, and
munity involvement and further in fact mostly affects people of
integration of different sources of maternal and child health prime working and child-bearing
knowledge[14]. In order to achieve and suppress infectious age [18].
such a goal, the WHO called on Thirdly, lobbyists fighting
the international community to diseases. for more funding for AIDS ap-
respond quickly, with money and pear to have been hugely success-
aid, so as to effectively fight the ful. As Philip Lee, University of
disease. The very next year, the annual health report focused on California at San Francisco professor of social medicine says on
child mortality, noting that almost 11 million children under the the subject, “The system is a political process.”[19]. There is not
age of five die each year [15]. An emphasis on child mortality one AIDS lobby, but rather multiple organizations that have

© 2010, The Triple Helix, Inc. All rights reserved. THE TRIPLE HELIX Spring 2010 35

BROWN.indb 35 5/25/2010 1:33:25 PM

 UCHICAGO
formed powerful coalitions, such as National Organizations
Responding to AIDS, which has over 170 member organiza-
tions[20]. They even have specific lobby days in Congress,
which are May 24 through June 3 [21]. Just last year, in Mas-
sachusetts, over 500 people lobbied their state Congress for
the yearly AIDS Lobby Day on behalf of Project AIDS Budget
Legislative Effort (ABLE) [22]. The AIDS Action Council claims
to have successfully helped in the reauthorization of the CARE
Act and attained agreement in House of Representatives for
removing a ban on funding of syringe exchange programs
in Washington, DC. Their mission involves “advocacy on a
national level” and they profess to have assisted in implement-
ing important public health policies in the United States [23].
A centralized source of information on South African NGOs
called NGO pulse runs a class called the Advanced HIV and
AIDS Lobbying and Advocacy Course [24]. This is but one
example, but it is indicative of a broader trend. There is no
malaria lobby, pneumonia lobby or diarrhea lobby; such lob-
bies simply do not exist.
All such causes are in desperate need of funds, and chari-
table policies of any kind should be encouraged as much as
possible. At the same time, there is also the matter of responsible
giving. Good intentions are not enough. Political decisions,
even if made in the name of doing good for people around the
world, generally ought to be done on the basis of good evidence.
When money is given with as much thought to the status of
the cause as the help that is needed, there is a substitution
of opinion for fact. Ezekiel Emanuel, a bioethicist, calls the
ignored issues “mundane but deadly diseases,” emphasizing
not only the danger of these illnesses but also the effect that
social approval has on the attention and support they receive
[25]. Philanthropists are free to distribute their monies as they
References
1. NIAID Malaria Research Program.” National Institute of Allergy and Infectious
Disease. October 30, 2009. http://www3.niaid.nih.gov/topics/Malaria/
2. “Global HIV/AIDS estimates.” AVERT. January, 2008. http://www.avert.org/
worldstats.htm
3. “Deaths from Diarrhea.” Wrong Diagnosis. January, 2005. http://www.
wrongdiagnosis.com/d/diarrhea/deaths.htm
4. “Global HIV/AIDS estimates.” AVERT. January, 2008. http://www.avert.org/
worldstats.htm
5. Dugger, Cecilia. “As Donors Focus on AIDS, Child Illnesses Languish.” New
York Times. October 29, 2009. http://www.nytimes.com/2009/10/30/world/30child.
html?_r=2&scp=1&sq=AIDS childhood mortality&st=cse
6. “Report on funding for AIDS by G8 countries and other major donors.”
Kaiser Family Foundation & UNAIDS. July, 13, 2009. http://www.unaids.org/en/
KnowledgeCentre/Resources/FeatureStories/archive/2009/20090708_kaiser_G8.asp
7. “Funding.” USAID. November 20, 2009. http://www.usaid.gov/our_work/global_
health/pop/funding/index.html
8. “AIDS funding from national governments,.” AVERT. November 19, 2009. http://
www.avert.org/aids-funding.htm
9. U.S. Federal Funding for HIV/AIDS: The FY 2007
Budget Request. February, 2006. http://74.125.95.132/
search?q=cache:Phsd8QOPH18J:www.kff.org/hivaids/upload/7029-03.
pdf+AIDS+funding+us+research&cd=1&hl=en&ct=clnk&gl=us&client=firefox-a
10. “Pneumonia Treatments and Drugs.” Mayo Clinic. May 9, 2009. http://www.
mayoclinic.com/health/pneumonia/DS00135/DSECTION=treatments-and-drugs
11. McNeil, Donald. “Plan Tries to Lower Malaria Drug Cost.” New York Times.
April 17, 2009. http://www.nytimes.com/2009/04/17/health/18malaria.html
12. Hernandez, Julia. “The High Cost of AIDS Drugs in Africa.” July 23, 2001. http://
www.law.uh.edu/healthlaw/perspectives/HIVAIDS/010723.html
13. “Africa-malaria-funding: One billion dollars a year needed on malaria: summit.”
Agence France-Press. April 25, 2000. http://www.aegis.com/NEWS/AFP/2000/
AF000477.html
36 THE TRIPLE HELIX Spring 2010
BROWN.indb 36
wish, but the federal government of the United States must be
held to a higher standard. Obasanjo’s message, given in the
year 2000 at a world summit on malaria is still relevant. As
he said, “Africans have consistently put it to the world that
malaria is the number one health problem. When recognition
of the HIV/AIDS virus came to the fore, Africans continued
with their message that malaria was still killing more people.
But we went unheeded.”[26].
It seems to be a fact that popular opinion is a major
factor in the way money is allocated to combat disease, one
that is perhaps stronger than how the money can be used to
save the most lives. The future of change in this area is the
molding of public opinion to make underfunded diseases as
well known as those such as AIDS. People who feel that these
other, ignored, diseases need more attention and funding are
likely to create organizations dedicated solely to one of these
problems. This focus demonstrates the importance of each
particular illness. Then, coalitions can form and eventually
give rise to lobbies, which can affect political decisions. More
importantly, the rise of organizations in relation to one disease,
for example, malaria, should work to raise awareness and
disseminate important information. In this way, it will become
part of the national consciousness and relevant evidence, such
as that found in this article, will become common knowledge
among both the public and politicians. These strategies have
been used successfully by those concerned, rightfully, about
AIDS, and they can be appropriated for use to fight other
diseases. When all of the causes are equally well-known, then
the relative importance and opportunity costs will be brought
into question and funds may be allocated more fairly.
Chana Messinger is an undergraduate at University of Chicago.
14. “Annual World Health Organization Report: 2004.” World Health Organization.”
January, 2005. http://www.who.int/whr/2004/en/
15. “Annual World Health Organization Report: 2005.” World Health Organization.”
January, 2006. http://www.who.int/whr/2005/en/
16. “Google Trends.” Google Trends. November 20, 2009. http://www.google.com/tre
nds?q=AIDS%2C+HIV%2C+malaria%2C+pneumonia%2C+diarrhea
17. “Diseases, Conditions, and Health Topics.” New York Times. January 24, 2010.
http://topics.nytimes.com/topics/news/health/diseasesconditionsandhealthtopics/
aids/index.html?s=oldest&
18. “AIDS & HIV Statistics for the USA by Race and Age.” AVERT. January 24, 2010.
http://www.avert.org/usa-race-age.htm
19. Thompson, Dick. “The AIDS Political Machine.” Time Magazine. January 22,
1990. http://www.time.com/time/magazine/article/0,9171,969229-2,00.html
20. “National Organizations Responding to AIDS.” NORA.
http://www.aidsaction.org/legislation/nora.htm
21. “National AIDS Lobby Days.” AIDS.org. http://www.aids.org/atn/a-126-03.html
22. Jacobs, Ethan. “As funding cuts take toll, AIDS lobby day brings huge crowd to
State House.” AIDS Education Global Information System. February 5, 2009. http://
www.aegis.com/news/bayw/2009/BY090201.html
23. “About AIDS Action.” AIDS Action. http://www.aidsaction.org/about-aids-action-
mainmenu-187
24. “RECABIP: Advanced HIV and AIDS Lobbying and Advocacy Course.” NGO
Pulse. December 3, 2008. http://www.ngopulse.org/event/recabip-advanced-hiv-and-
aids-lobbying-and-advocacy-course
25. “Google Trends.” Google Trends. November 20, 2009. http://www.google.com/tre
nds?q=AIDS%2C+HIV%2C+malaria%2C+pneumonia%2C+diarrhea
26. Dugger, Cecilia. “As Donors Focus on AIDS, Child Illnesses Languish.” New York
Times. October 29, 2009.
27. “Africa-malaria-funding: One billion dollars a year needed on malaria: summit.”
Agence France-Press. April 25, 2000. http://www.aegis.com/NEWS/AFP/2000/
AF000477.html
28. http://www.michigan.gov/images/mosquito_65147_7.jpg
© 2010, The Triple Helix, Inc. All rights reserved.
5/25/2010 1:33:28 PM
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