Nithya Nuvvala

12/21/21
G/T Intern/Mentor

Annotated Source List

Bourke, J. (2021, March 17). Propranolol and the Politics of Forgetting Rape. Shame BBK.
https://shame.bbk.ac.uk/blogpropranolol-and-the-politics-of-forgetting-rape/

The source details the ethical, legal and social implications of adminstering propranolol
to victims of sexual violence, of whom 65% develop Post-traumatic stress disorder (PTSD).
Propranolol has little efficacy in making an individual forget the occurrence of a traumatic event,
but it removes the personal emotional turbulence -- fear, anxiety, depression -- that the event
carries, making the experience seem detached and not their own. The beta-blocker also arouses
the amygdala, which is linked to emotional regulation; thus, propranolol makes a person appear
more composed and not emotionally-affected. Apathy in a courtroom and a reduced consistency
of events does not demonstrate severe sexual trauma to a judge/jury, increasing the difficulty of
conviction. The drawback of propranolol is not only a struggle with pursuing criminal justice,
but also a personal effect for someone who does not take the drug in the courtroom. Humans are
naturally expected to seek remedies when experiencing harm, such as taking medication for a
severe wound. In the future, a judge may view not taking propranolol as “a failure to mitigate
their own injuries” or a lack of severe emotional distress.
The source was beneficial to the reader’s understanding of how a judge/jury perceives
victims of PTSD. The author discusses both the implications for how the drug affects
understanding of eye-witness testimony and how a courtroom would react when propranolol is a
standard medication and a patient refuses to take it. Using this information, the reader can search
for court cases in which a victim has taken propranolol and whether that impacted the conviction.

Dombeck, M. (n.d.). Treating PTSD with Beta-Blockers. MentalHelp.Net.

https://www.mentalhelp.net/blogs/treating-ptsd-with-beta-blockers/

Clinical psychologist, Mark Dombeck, illustrates his desire to improve treatments for
Post-traumatic Stress disorder. Several of his patients face severe anxiety, have nightmares, and
feel the effects of trauma for 20-40 years after an incident. A common method of psychotherapy,
exposure and eye movement and desensitivity reprocessing therapy (EMDR), allows patients to
gradually inure themselves to trauma by revisiting the experience and re-storing that memory
with a more detached outlook. Other methods include medications to control fear emotions, but
Dombeck argues that none of the treatments used cure PTSD. Dombeck references two
psychologists who have tested propranolol, a drug originally used to treat heart diseases: Dr.
Roger Pitman at Harvard and Alain Bruget at Montreal. Brunet highlights the effects of
propranolol; a patient with social anxiety who took the drug before a speech was able to deliver
with confidence and focus. Dr. Pitman displayed that when a patient is given propranolol and
asked to speak on their trauma, they lower PTSD symptoms and reduce the chance of developing
intense emotional pain. The author notes how monumental such a drug is for PTSD and hopes
that patients will suffer less using a new treatment.
 The source is highly effective because the author discusses the previous uses of
propranolol, considers the reasoning behind how propranolol may block storage of emotional
memory, and includes testimony from reputable figures in psychology on an unfamiliar topic.
The diction is also clear and conversational, making the source easily comprehensible. Using this
source, the reader can look for more viewpoints against propranolol to develop an unbiased
paper.

Eugene, A. R., & Nicholson, W. T. (2015). The Brain and Propranolol Pharmacokinetics in the
Elderly. Brain : broad research in artificial intelligence and neuroscience, 6(1-4), 5–14.

The paper tests a theory: propranolol, a non-selective beta-blocker, can reduce

stimulation in the amygdala and suspend creation of emotional memories. The goal of the study
is to design a pharmacokinetic simulation to determine what dosage of propranolol is most
effective and safe for young and older patients. Though a multitude of studies have shown that
propranolol can target migraines, hemangioma, tremor, angina, and can block noradrenergic
receptors in middle-aged and younger individuals, there is more concern with the elderly because
the brain composition chances are a person ages. The hypothesis is that to target emotional
memories at the same saliency as other patients, elderly patients will require a higher plasma
drug level at half the concentration. In the patient data, there was a control group with 9
participants at age 27 and an experimental group with 9 participants at age 77; order absorption
and linear elimination were methods used by the researchers with a Sandwich simulator to
envision results, a similar simulator used to develop the Pfizer vaccine. Ultimately, the results
showed that a 40mg dose was most effective, and the researchers called for more clinical trials to
test propranolol on elders with skull fractures.
The source was highly beneficial because the study was described in straightforward
terms, and the paper includes quantitative data, diagrams, charts, graphs and references. The
research also aligns with the reader’s thesis statement that propranolol is an effective treatment
for Post-traumatic stress disorder, with a specific focus on elder patients. The in-text citations
also helped to find more human clinical trials with propranolol.

Giustino, T., Fitzgerald, P., & Maren, S. (2016, April). Revisiting propranolol and PTSD:
Memory erasure or extinction enhancement? ScienceDirect.
https://www.sciencedirect.com/science/article/abs/pii/S1074742716000216?via%3Dihub

With about 8% of the American population developing PTSD in their lifetime,

propranolol has high prospects as an emerging treatment for the disorder. The source discusses
the effectiveness of propranolol as it relates to the pathophysiology of PTSD; when an individual
takes propranolol coupled with therapy, stress-related neurotransmitter norephrine (NE) (a
prominent biomarker of PTSD) has a significant drop in production, lowering fear association
and memory reconsolidation. The author argues that current pharmaceutical treatments for PTSD
-- serotonin inhibitors, sertraline and paroxetine -- simply do not have a high efficacy compared
to propranolol. In memory reactivation trials on both rodents and humans, chronic propranolol
was shown to mostly block NE production, while acute propranolol dampened physiological fear
levels. Moreover, even when extra stimulation was given through the B-adrenoceptor after a
brief memory reactivation, propranolol reduced long-term fear. The source acknowledges that
the likelihood of complete memory erasure is not high and would be volatile, but still embraces
the scientific potential of propranolol.
The source is very useful to the reader because it discusses specific studies/experiments
on propranolol and articulates the findings. It also contains over 100 references to scientific
journal publications, which the reader can easily access to find more information within each
header.

Hui, K., & Fisher, C. E. (2017). The ethics of molecular memory modification. Journal of
Medical Ethics, 41(7), 515-520. https://www.jstor.org/stable/44014137

The source evaluates ethical perspectives on memory alteration and addresses memory
errors (forgetting, persistence, distortion), personal identity, and the social obligation to
remember. Recent studies highlight that propranolol has the ability to dampen recollection of
emotionally-arousing experiences, but also worsen long-term conceptual understanding and
cognitive memory decline. The idea that memories are intrinsically linked to identity arises the
question of whether removing lived events and emotions harms human empathy and awareness.
The author voices a social justice perspective that the distribution of propranolol may only be
accessible to the rich, which is an issue of wealth inequality. He also emphasizes that humanity’s
values -- agency, truth and validity -- are affected by propranolol, calling for a harness on
memory-editing power; when an individual is involved in an experience that applies to the
greater good or is essential to eyewitness testimony in a courtroom, then the source argues that
memory manipulation is not an option. Ultimately, using a drug like propranolol bridges the gap
between justice and autonomy.
The source is highly effective in investigating the neuroethics of propranolol because it
delineates the decision-making process of taking propranolol and who is involved in its use. With
multiple section headers and a diagram showing the consolidation of memory, the reader can
easily navigate the journal and use the references page to find further information.

Kolber, A. (n.d.). Therapeutic Forgetting: The Legal and Ethical Implications of Memory
Dampening. Brooklyn Works, 59, 1562-1598.
https://brooklynworks.brooklaw.edu/cgi/viewcontent.cgi?article=1572&context=faculty

The journal publication delineates memory dampening drugs, and the factors involving
its use from a legal and ethical standpoint. A specific drug, propranolol, can dull the emotional
memory associated with a traumatic incident and it is very cost-effective, making the drug of
interest to the pharmacological industry. Research shows that emotional memories, both positive
and negative, linger much longer and are more detailed in comparison to non-emotional
experiences, so such a medication is a prospective treatment for victims of post-traumatic stress
disorder (PTSD). However, the author notes his reasons to be cautious of seeking remedies in
memory-dulling ailments. Propranolol is most effective 6 hours after a traumatic event, so an
individual may be heavily influenced by the pain and trauma of an event to make a conscious
decision on whether to take it. Additionally, the source emphasizes that memories hold a vital
role in the trial process, and for the preservation of history; thus, the drug does not simply alter
the personal identity of an individual, but also has societal implications.
The source is useful to the reader because it provides insight into the informational
importance of a memory and certain legal problems, like informed consent. The article, with 69
pages, covers the concerns regarding both an individual and their surrounding community; the
author discusses from a psychological viewpoint that altering memories can make one’s moral
standing or compassion degraded, and continues into how ethically, we are required to preserve
our identities because it affects our interpersonal interactions.

Levin, D., & Caplan, A. (2011, January). Ethics of Erasing Memory. Public Broascasting
Service. https://www.pbs.org/wgbh/nova/body/caplan-memory-au.html

Art Caplan, director of Bioethics at the University of Pennsylvania, discusses the

possibility of a “drug” that has the potential of erasing specific memories that are unwanted. In
the CBS podcast, he argues that on one hand, there is an extensive list of memories that might be
tormenting individuals, but on the other hand, memories are vital to self-identity and makes us
better people. In some cases, a memory might not be helpful to you but may be crucial for
someone else; Then, it is hard to determine whether you have control over removing a memory
that is in some way affecting society. Dr. Caplan suggests that we are our memories; this is why
Alzheimer’s disease is one of the most difficult forms of neurodegeneration to deal with, since
the person begins to lose themselves and all of their memories slowly. Another topic that arises
in the podcast is whether using a drug to remove memory is effective when other people may
remind you of the trauma. The response is that drugs like propranolol detach emotion from a
memory, so even if you speak, think or hear of your trauma, it feels external, as if it happened to
a friend or movie character. Caplan worries about the ability to form a conscience if a drug can
desensitize people to pain.
The question and answer format of the podcast allowed the listener to easily track key
points and chronology. Using the perspective of Dr. Caplan, the reader can search for more
sources on expert opinion.

OpenStax College, & Laney, C. (n.d.). Eyewitness Testimony and Memory Construction. Lumen
Learning.
https://courses.lumenlearning.com/wmopen-psychology/chapter/reading-eyewitness-testi
mony-and-memory-construction/

The author notes the irregularity of memory and how it affects the legislative process.
One of the most important factors in the court’s conviction is eyewitness testimony and accounts.
In fact, a diagram shows that eyewitness misidentification leads to 75 percent of wrongful
convictions, while forensic science, false confessions and information only account for 25
percent. In 1984, a 22-year old woman named Jennifer Thompson was a victim of rape. When
shown 5-6 suspects, she misidentified the criminal, partly due to cues and suggestions by the
examiners. The man who was wrongfully arrested was sentenced to life in prison and fifty more
years, until DNA evidence proved his innocence. The source highlights that when old memories
are revisited and temporarily placed in our short-term memory, we modify them slightly and
unintentionally. This implies that if a victim is providing unfactual information during a
proceeding, it is often not on purpose, and if they were hooked to a lie detector, their account
would pass as the truth. The author suggests that once false information is introduced to a person,
it is very unlikely to differentiate truth from fiction in the courtroom.
The reader has read sources relating propranolol and memory, so this article’s topics of
memory reconstruction and unreliable testimony provided new insight on memory failure in the
courtroom due to humor error. The structure is very simplistic and forces the reader to truly
comprehend because the source contains learning objectives, headers, diagrams with labels, links
to learn more, a “dig deeper” section, multiple choice questions and a glossary.

Phillips, D. (n.d.). Preventing Bad Memories: Is It Ethical? AMA Journal of Ethics.

https://doi.org/10.1001/virtualmentor.2008.10.11.jdsc1-0811

The journal publication examines the potential of propranolol in blocking memory

retention of trauma, and details three reasons to be concerned about its use: truthfulness, moral
reaction and obligation. Heavy, emotional memories trigger a larger emission of
neurotransmitters -- epinephrine and norephrine -- which allow for greater memory consolidation
each time a traumatic event is revisited. A drug like propranolol blocks reconsolidation, but an
ethical issue is that it may change an individual’s recollection of what they assume to be true
from an event; for example, a war veteran may incorrectly believe that they were fighting for a
different country, creating a false understanding in a major part of their lives. The author further
emphasizes that such a drug will change one’s moral standing and dull emotive responses in the
future, ultimately dampening self-growth. The source notes that ethical issues should continue to
be debated in hopes of finding the most ethically permissible method to integrate propranolol
into the pharmacological industry.
The source was very useful because it delineates various factors involving personal
identity that may not be morally acceptable to alter through propranolol. The author also
employs anecdotal evidence, and compares the results of a study from two opposing viewpoints,
eliminating bias towards the issue. The reader can use the article to search for more scientific
opinions and studies regarding the use of propranolol and its effectiveness for PTSD victims.

Propranolol -Brand names: Angilol, Bedranol, Beta-prograne, Half Beta-prograne. (n.d.).

Retrieved November 26, 2021, from
https://www.nhs.uk/medicines/propranolol/#:~:text=Propranolol%20treats%20the%20ph
ysical%20symptoms,chemical%20imbalances%20in%20the%20brain.

The article provides a detailed overview of the drug propranolol: what it does, how to
take it, side effects, important facts and common questions. Since propranolol is generally
prescribed as a heart medication, the author identifies the main uses to treat high blood pressure,
heart beat irregularity, angina (chest pain caused by exercise strain), and heart attacks. In effect,
propranolol works to lower heart rate and ensure there is a proper distribution of blood in the
body, so this calming effect helps to treat anxiety and physical shaking. A drawback is that there
is limitations on who can take propranolol, such as those above the age of 12, so an equity issue
comes to play when using the drug to treat mental trauma; while two people may have undergone
the same heavy, emotional experience, only one may qualify to take the drug and remove their
fear, while the other is forced to cope with the fright or intrusive thoughts associated with the
trauma. Likewise, propranolol usually cannot be taken alongside other common medications,
such as antidepressants, Parkinson’s disease, asthma, diabetes, ephedrine or noradrenaline (used
for allergies), and cold/congestion medications. Overall, the source recommends that patients
speak with a doctor to determine whether propranolol will be right for them, and what dosage is
healthy to take.
The format of the source, with headings, subheadings and bolded details, makes it very
easy for the reader to find general information about propranolol. The author includes several
hyperlinks to informative sources on related conditions, responses to common patient questions
and a forum discussion about the drug.

Reyna, V., Mills, B., Estrada, S., & Breinerd, C. J. (n.d.). False Memory in Children: Data,
Theory, and Legal Implications. Cornell Journal of Ethics.

The authors at Cornell University discuss the legal implications of false memories, which
exaggerate or tweak existing inferences to incorrectly portray a situation. They acknowledge that
though misrepresentations of facts are common, even harmless in daily life, the same does not
hold true for the court of law. Prejudices, religious superstitions and personal motives come into
play both consciously and subconsciously when a victim is testifying in the courtroom.
Researchers Reyna and Lloyd highlight that semantic gist and natural human nature calls for
spontaneous false recollection, especially in children when prompted by a biased question. The
authors also note that laboratory tests may not be generalizable to practical applications because
children respond differently in a controlled setting. In fact, older children are more prone to
misinformation, whether it is spontaneous, gist-based or the DRM paradigm (when people
wrongly recall words not presented in a semantic list). The authors suggest that to increase the
integrity of the courtroom, prosecutors should not use leading questions, recall prompts or
recognition probes (e.g. He yelled at you, correct?).
The research paper is beneficial to the reader because it narrows on an aspect of
neuroethics: memory and law. With 30 pages, a table of contents, and a list of sources, the paper
will be useful in finding more articles related to the societal impact of misinformation and how
propranolol might have similar amnestic effects. The authors also take on various viewpoints
such as theoretical, practice and societal/legal so the reader can track down specific information.
There is an appropriate balance of quotations, interpretation, experiments and reasoning.

Srinivasan, A. V. (n.d.). Propranolol: A 50-Year Historical Perspective. Official Journal of Indian

Academy of Neurology. https://doi.org/10.4103/aian.AIAN_201_18

A neurology professor overviews the 50-year history of propranolol, including its

invention by Sir James Black to treat angina pectoris and its current use to manage
cardiovascular diseases -- myocardial infarctions, hypertension and arrhythmia. While
propranolol is also commonly used in non-cardiovascular therapy for anxiety, migraine, tremors
and hypertension, it is important to note that the drug can trigger discomfort to the
gastrointestinal system and cause fatigue/insomnia. The source describes a specific double-blind
study, which discovered that propranolol improved depression and anxiety scores in the
experimental group, even having an amnestic effect on negative, emotional memories, increasing
cognitive function, and decreasing migraine activity. He stressed the feasibility to manufacture
propranolol given its low-cost composition, and that it is the singular FDA-approved drug to
manage essential tremors. The source acknowledges that despite having research on propranolol
for half a decade to ensure its safety, its full potential has not been discovered.
The source is useful toward the reader in providing context of propranolol both in
memory-dampening and its various uses in the neurological and cardiovascular fields. However,
the source’s extensive information on angina pectoris is unrelated to the neuroscience of its use.
Using this information, the reader can find further information on side effects, whether
propranolol can be localized, and if its use will automatically impact different parts of the body.

Thompson, J. (2009). Apology, historical obligations and the ethics of memory. Memory Studies,
2(2), 195-210. SAGE Journals Online.
https://journals.sagepub.com/doi/pdf/10.1177/1750698008102052

The research article discusses ethics of memory, specifically in relation to historical

injustice and collective responsibility. The author highlights the perspective that individuals
cannot theoretically remove a memory that has historical significance to their predecessors or a
targeted group by their predecessors. Even though such memories like apartheid or enslavement
are not from experience, they are components of shared heritage and serve as a reminder of
corrupted regimes and hatred. Collective memory is not a readily-accepted concept; for example,
the Australian government declared that citizens need not make amends for mistakes of past
generations. This intergenerational idea further bolsters the flawed view that past mistakes are
better forgotten, allowing pride, privilege and a lack of legislative accountability. In ahistorical
liberalism, citizens heavily take pride in the nation’s achievements and strongly identify with the
historical institutions that gave rise to the nation. On one hand, they support constitutional
patriotism and national solidarity to their allegiances, but on the other hand, they forget the
origins of systems based on racism, sexism and violence. The author clearly denounces this type
of liberalism, stating that people are obliged to remember and teach past sacrifices and
wrongdoings.
The reader’s thesis statement describes that an individual with Post-traumatic stress
disorder may consider their social obligation to remember crucial information before taking a
memory-dampening drug, propranolol. Since it is difficult to find sources both on the ethics of
collective memory and PTSD, this article provides useful general background on the importance
of memory beyond an individual. The source list also allows the reader to further understand
historical injustice to discuss that current memories also may be politically or socially
constructed.

U.S. Department of Veteran Affairs. (n.d.). PTSD Treatment Basics.

https://www.ptsd.va.gov/understand_tx/tx_basics.asp

The source examines various treatments for PTSD with the most promising research
results. The author discusses psychotherapy, in which a therapist focuses on the true meaning
behind a patient’s fear or trauma by reframing their negative emotions towards the experience.
Among these techniques, prolonged exposure (PE) forces the patient to directly face their fears
in writing and physically revisit the trauma, while eye movement desensitization and
reprocessing (EMDR) encourages the patient to think of their trauma while a sound or movement
is nearby. In the video, the trauma victims discuss how in 8-20 sessions their therapist rewired
their view of the trauma; they still remember what happened, but they were desensitized by the
intensity of emotion and did not need to take as much medication to block their recurring fears.
One woman stated that accessing a therapist was a new beginning for her and allowed them to
view their trauma from a different perspective, rather than their own. Talking with a trained
professional ensured that the patients did not blame themselves for witnessing the death of their
comrades.
The source was very useful because it delineates various treatments for those with
Post-traumatic stress disorder. The video employs anecdotal evidence, including testimonies of
over 5 veterans with PTSD on their struggles and successes with traditional treatments. The
reader can use the article to search for more scientific studies regarding the efficacy of therapy
and medications compared to that of propranolol.