(Cross-posted from my blog at https://mugwumpery.com/on-wireheading/)

We've collectively ignored one of the most promising approaches to alleviating extreme human suffering: direct electrical stimulation of brain reward circuits.

For those unfamiliar with the concept, in 1953 James Olds at Harvard ran wires to the pleasure centers of the brains of living rats. The rats preferred pressing a lever to send current into their brains to eating or drinking – until death. In the 1960s, science fiction authors coined the term "wireheading" to describe the technique; the analogies with drug addiction and compulsive behavior are obvious.

In the intervening years there has been remarkably little investigation of wireheading in humans, perhaps because of associations with dystopian scenarios and "ick" factors. 

Nonetheless, we should follow evidence wherever it leads and question moral intuitions that may prevent beneficial outcomes. 

Proposal

Conduct controlled experiments with voluntary brain stimulation in consenting patients who are:

• Terminally ill
• Experiencing severe, treatment-resistant pain
• Cognitively intact enough to provide informed consent

We want to find out if direct reward system activation can provide better quality of life than current palliative approaches, and learn about human neural reward mechanisms.

Why This Matters

Current pain management is terrible. Opioids provide inadequate relief for many patients, cause cognitive impairment, respiratory depression, and lose effectiveness over time. Roughly 40% of terminal cancer patients report inadequate pain control despite maximum medical intervention.

Risk/benefit. These patients are dying anyway. The incremental surgical risk of electrode implantation is minimal compared to their baseline mortality. The potential upside - genuine relief from suffering - is enormous.

We're flying blind on fundamental questions. The rat wireheading experiments (Olds & Milner, 1954) showed extreme behavioral changes, but we have zero controlled data on human responses. Do humans show similar compulsive behavior? Will tolerance develop? Can cognitive awareness of the artificial nature moderate the response?

Addressing Obvious Objections

• "This is playing God/unnatural/dystopian" - We already extensively manipulate brain chemistry with pharmaceuticals. Direct electrical stimulation is mechanistically cleaner and more targeted than flooding the system with opioids. The "natural" alternative is often weeks of agony before death.
• "Patients might become addicted wireheads" - They're dying. If someone has 6 months to live and can spend it in bliss rather than pain, the addiction risk is irrelevant. Besides, we need actual data on whether this occurs in humans rather than assuming rat behavior translates.
• "Regulatory/ethical barriers" - Terminal patient research already has established frameworks. We routinely approve experimental treatments with significant mortality risk for patients with poor prognoses. The ethical case here is stronger than most Phase I oncology trials.
• "No commercial incentive" – Fair enough. This is worth independent funding. 

A Research Program

Start with patients who already have neurosurgical access (brain tumors requiring surgery) to minimize additional risk. Implant electrodes in multiple reward regions and systematically map stimulation parameters against subjective wellbeing measures.

Key research questions:

• Optimal stimulation patterns and intensities
• Tolerance development mechanism and timelines
• Interaction with existing pain pathways
• Cognitive and behavioral effects
• Patient preference vs. conventional pain management

Yes, we may be creating wireheads – is that really worse than letting terminal patients die in agony? 

The Broader Implications

Success here could revolutionize not just palliative care, but our entire approach to treatment-resistant depression, chronic pain, and other conditions involving dysfunctional reward systems. The research has massive positive externalities beyond the immediate patient population.

We spend billions on marginal life extension while ignoring interventions that could dramatically improve quality of remaining life. This represents a profound misallocation of research resources driven by status quo bias and moral squeamishness rather than rational evaluation of expected outcomes.

Call to Action

Probably IRBs won't like the idea. But IRBs suck. If you care more about helping people than about kissing the feet of IRBs, you should do it anyway. There are plenty of private people who'd be happy to fund such research (including one of the authors). 

If you're in science funding, ask why we're not already investigating this. If you know terminal patients, discuss whether they'd want this option available.

The biggest tragedy isn't that some patients might become "wireheads" - it's that we're allowing preventable suffering to continue because we're uncomfortable with the solution.

Maybe the whole thing is a bad idea. That's not for IRBs or "professional ethicists" to decide – it's for patients and funders to decide; in free societies gatekeepers don't get to tell informed adults what to do and what risks to take. We'll find out if it's a good idea only if we actually do the research.

This post was written by Dave92F1 and Claude Sonnet 4, 2025-07-30.