|Pentagon, Big Pharma: Drug Troops to Numb Them to Horrors of War|
By Penny Coleman
January 10, 2008
In June, the Department of Defense Task Force on Mental Health acknowledged
"daunting and growing" psychological problems among our troops: Nearly 40
percent of soldiers, a third of Marines and half of National Guard members are
presenting with serious mental health issues. They also reported "fundamental
weaknesses" in the U.S. military's approach to psychological health. That report
was followed in August by the Army Suicide Event Report (ASER), which reported
that 2006 saw the highest rate of military suicides in 26 years. And last month,
CBS News reported that, based on its own extensive research, over 6,250 American
veterans took their own lives in 2005 alone -- that works out to a little more
than 17 suicides every day.
That's all pretty bleak, but there is reason for optimism in the long-overdue
attention being paid to the emotional and psychic cost of these new wars. The
shrill hypocrisy of an administration that has decked itself in yellow ribbons
and mandatory lapel pins while ignoring a human crisis of monumental proportion
is finally being exposed.
On Dec. 12, Rep. Bob Filner, D-Calif., chairman of the House Veterans Affairs
Committee, called a hearing on "Stopping Suicides: Mental Health Challenges
Within the Department of Veterans Affairs." At that hearing suggestions were
raised and conversations begun that hopefully will bear fruit.
But I find myself extremely anxious in the face of some of these new
suggestions, specifically what is being called the Psychological Kevlar Act of
2007 and use of the drug propranalol to treat the symptoms of posttraumatic
stress injuries. Though both, at least in theory, sound entirely reasonable,
even desirable, in the wrong hands, under the wrong leadership, they could make
the sci-fi fantasies of Blade Runner seem prescient.
The Psychological Kevlar Act "directs the secretary of defense to develop and
implement a plan to incorporate preventive and early-intervention measures,
practices or procedures that reduce the likelihood that personnel in combat will
develop post-traumatic stress disorder (PTSD) or other stress-related
psychopathologies, including substance use conditions. (Kevlar, a DuPont fiber,
is an essential component of U.S. military helmets and bullet-proof vests
advertised to be "five times stronger than steel.") The stated purpose of this
legislation is to make American soldiers less vulnerable to the combat stressors
that so often result in psychic injuries.
On the face of it, the bill sounds logical and even compassionate. After all,
our soldiers are supplied with physical armor -- at least in theory. So why not
mental? My guess is that the representatives who have signed on to this bill are
genuinely concerned about the welfare of troops and their families. Patrick
Kennedy, D-R.I., is the bill's sponsor, and I have no reason to question his
genuine commitment to mental health issues, both within and outside of the
military. Still, I find myself chilled at the prospects. To explain my
discomfort, I need to go briefly into the history of military training.
Since World War II, our military has sought and found any number of ways to
override the values and belief systems recruits have absorbed from their
families, schools, communities and religions. Using the principles of operant
conditioning, the military has found ways to reprogram their human software,
overriding those characteristics that are inconvenient in a military context,
most particularly the inherent resistance human beings have to killing others of
their own species. "Modern combat training conditions soldiers to act
reflexively to stimuli," says Lt. Col. Peter Kilner, a professor of philosophy
and ethics at West Point, "and this maximizes soldiers' lethality, but it does
so by bypassing their moral autonomy. Soldiers are conditioned to act without
considering the moral repercussions of their actions; they are enabled to kill
without making the conscious decision to do so. If they are unable to justify to
themselves the fact that they killed another human being, they will likely --
and understandably -- suffer enormous guilt. This guilt manifests itself as
post-traumatic stress disorder (PTSD), and it has damaged the lives of thousands
of men who performed their duty in combat."
By military standards, operant conditioning has been highly effective. It's
enabled American soldiers to kill more often and more efficiently, and that
ability continues to exact a terrible toll on those we have designated as the
"enemy." But the toll on the troops themselves is also tragic. Even when troops
struggle honorably with the difference between a protected person and a
permissible target (and I believe that the vast majority do so struggle, though
the distinction is one I find both ethically and humanely problematic) in war
"shit happens." When soldiers are witness to overwhelming horror, or because of
a reflexive accident, an illegitimate order, or because multiple deployments
have thoroughly distorted their perceptions, or simply because they are in the
wrong place at the wrong time -- those are the moments that will continue to
haunt them, the memories they will not be able to forgive or forget, and the
stuff of posttraumatic stress injuries.
And it's not just the inherent conscientious objector our military finds
inconvenient: current U.S. military training also includes a component to
desensitize male soldiers to the sounds of women being raped, so the enemy
cannot use the cries of their fellow soldiers to leverage information. I think
it not unreasonable to connect such desensitization techniques to the rates of
domestic violence in the military, which are, according to the DoD, five times
those in the civilian population. Is anyone really surprised that men who have
been specifically trained to ignore the pain and fear of women have a difficult
time coming home to their wives and families? And clearly they do. There were
2,374 reported cases of sexual assault in the military in 2005, a 40 percent
increase over 2004. But that figure represents only reported cases, and, as Air
Force Brig. Gen. K.C. McClain, commander of DoD's Joint Task Force for Sexual
Assault Prevention and Response pointed out, "Studies indicate that only 5
percent of sexual assaults are reported."
I have thought a lot about the implications of "psychological Kevlar" -- what
kind of "preventive and early-intervention measures, practices or procedures"
might be developed that would "reduce the likelihood that personnel in combat
will develop post-traumatic stress disorder." How would a soldier with a shield
against moral response "five times stronger than steel" behave?
I cannot convince myself that what is really being promoted isn't a form of moral lobotomy.
I cannot imagine what aspects of selfhood will have to be excised or paralyzed
so soldiers will no longer be troubled by what they, not to mention we, would
otherwise consider morally repugnant. A soldier who has lost an arm can be
welcomed home because he or she still shares fundamental societal values. But
the soldier who sees her friend emulsified by a bomb, or who is ordered to run
over children in the road rather than slow down the convoy, or who realizes too
late that the woman was carrying a baby, not a bomb -- if that soldier's ability
to feel terror and horror has been amputated, if he or she can no longer be
appalled or haunted, something far more precious has been lost. I am afraid that
the training or conditioning or drug that will be developed to protect soldiers
from such injuries will leave an indifference to violence that will make them
unrecognizable to themselves and to those who love them. They will be alienated
and isolated, and finally unable to come home.
Posttraumatic stress injuries can devastate the lives of soldiers and their
families. The suicides that are so often the result of such injuries make it
clear that they can be every bit as lethal as bullets or bombs, and to date no
cure has been found. Treatment and disability payments, both for injured troops
and their families, are a huge budgetary concern that becomes ever more daunting
as these wars drag on. The Psychological Kevlar Act perhaps holds out the
promise of a prophylactic remedy, but it should come as no surprise that Big
Pharma has been looking for a chemical intervention.
What they have come up with has already been dubbed "the mourning after pill."
Propranalol, if taken immediately following a traumatic event, can subdue a
victim's stress response and so soften his or her perception of the memory. That
does not mean the memory has been erased, but proponents claim that the drug can
render it emotionally toothless.
If your daughter were raped, the argument goes, wouldn't you want to spare her a
traumatic memory that might well ruin her life? As the mother of a 23-year old
daughter, I can certainly understand the appeal of that argument. And a drug
that could prevent the terrible effects of traumatic injuries in soldiers? If I
were the parent of a soldier suffering from such a life-altering injury, I can
imagine being similarly persuaded.
Not surprisingly, the Army is already on board. Propranolol is a well-tolerated
medication that has been used for years for other purposes.
And it is inexpensive.
But is it moral to weaken memories of horrendous acts a person has committed?
Some would say that there is no difference between offering injured soldiers
penicillin to prevent an infection and giving a drug that prevents them from
suffering from a posttraumatic stress injury for the rest of their lives.
Others, like Leon Kass, former chairman of the President's Council on Bioethics,
object to propranolol's use on the grounds that it medicates away one's
conscience. "It's the morning-after pill for just about anything that produces
regret, remorse, pain or guilt," he says. Barry Romo, a national coordinator for
Vietnam Veterans Against the War, is even more blunt. "That's the devil pill,"
he says. "That's the monster pill, the anti-morality pill. That's the pill that
can make men and women do anything and think they can get away with it. Even if
it doesn't work, what's scary is that a young soldier could believe it will."
It doesn't take a neuroscientist to see the problem with both of these
solutions. Though both hold the promise of relief from the effects of an injury
that causes unspeakable pain, they do so at what appears to be great cost.
Whatever research projects might be funded by the Psychological Kevlar Act and
whatever use is made of propranolol, they will almost certainly involve a
diminished range of feelings and memory, without which soldiers and veterans
will be different. But in what ways?
I wish I could trust the leadership of our country to prioritize the lives and
well-being of our citizens. I don't. The last six years have clearly shown the
extent to which this administration is willing to go to use soldiers for its own
ends, discarding them when they are damaged. Will efforts be made to fix what
has been broken? Return what has been taken? Bring them home? Will citizens be
enlightened about what we are condoning in our ignorance, dispassion or
indifference? Or will these two solutions simply bring us closer to realizing
the bullet-proof mind, devoid of the inconvenient vulnerability of decent human
beings to atrocity and horror? And finally, these are all questions about the
morality of proposals that are trying to prevent injuries without changing the
social circumstances that bring them about, which sidestep the most fundamental
moral dilemma: that of sending people to war in the first place.