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ʻYour brain isnʼt just what youʼre given. Itʼs what you turn it into. It changes, the stuff of it changes with what you do.ʼ Mother, Scene Seven - The Cracked Land. 2017


Learning Objectives!..................................................................................4 Learning Opportunities!.............................................................................5 The Trailer!...................................................................................................6 Stunted Trees and Broken Bridges in Your School!................................7 Sensitive Issues!........................................................................................8 Any Questions?!.........................................................................................8 Preparing Your Students!..........................................................................8 Short Of Time?!...........................................................................................8 Write a Review competition!......................................................................9 Characters!................................................................................................15 Synopsis!..................................................................................................16 Preparatory Activity 1: What does it mean?!.........................................17 Preparatory Activity 2: What do we feel?!..............................................18 Preparatory Activity 3: What do we think?!...........................................19 Preparatory Activity 4: Iʼd like to ask…!.................................................20 Bioethics!..................................................................................................21 Neurotechnology!.....................................................................................21 Novel Neurotechnologies!.......................................................................22 Brainwaves Tumblr Blog!.........................................................................24 Deep Brain Stimulation Surgery Game!.................................................24 Brain scans should not be used in court... for now!.............................26 Brain scan could prevent Abu Hamza's extradition!.............................27 Guilty, but not responsible?!...................................................................28 This is your brain on neural implants!...................................................30 Glossary!...................................................................................................33


Development of Stunted Trees and Broken Bridges !...........................36 Find Out More About Our Work!..............................................................38 Links !.........................................................................................................38 Contact Us!...............................................................................................38 Credit!........................................................................................................39


STUNTED TREES AND BROKEN BRIDGES

INTRODUCTION

Introduction

‘Wouldn’t it be wonderful if they could show you a map of your brain that told you the secret – the secret of where things went wrong? An X on the spot. Maybe you could dig down and get it, get out the badness. Or at least, with a map of the brain You might find a way out.’ Miles, Scene Five - Diminished Responsibility. 2017.

Stunted Trees and Broken Bridges is Y Touring Theatre Companyʼs Theatre of Debate production developed in partnership with the Nuffield Council on Bioethics, the British Neuroscience Association and the Association of Medical Research Charities. The starting point for this project was the Nuffield Council on Bioethicsʼ consultation on ʻNovel Neurotechnologies: intervening in the brainʼ which explores the ethical issues raised by technologies and devices that intervene in the brain. This pack outlines the learning objectives and opportunities that the project offers and provides you with background information to support any follow up work you may choose to do. It also offers you a menu of four cross-curricular activities which you may choose to use prior to our visit to your school.

Learning Objectives As a consequence of participation in the Stunted Trees and Broken Bridges Theatre of Debate production we hope that most of the audience will:

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Report increased awareness about how new developments in science could have an impact on their lives in the future. Contribute to a debate which examines the ethical issues raised through advances in neurotechnologies. Have valued the opportunity to participate in a Theatre of Debate production. Be able to demonstrate acquired knowledge in at least one of the more detailed learning opportunities (see next section). We recognise that some individuals in the audience will gain a wider range of benefits, including; a more reflective approach to developments in scientific research, improved knowledge and understanding of the full range of learning points and articulation of associated feelings. In addition we hope that some of the audience will Report that the Theatre of Debate production has impacted upon their feelings about the role of research and its implications for human health. Be able to demonstrate acquired knowledge in more than one of the learning opportunites. Demonstrate ability to evaluate the live performance commenting on aspects such as scenic elements, characterisation and plot.

Learning Opportunities Stunted Trees and Broken Bridges will, through the performance, debate and online resources, present opportunities for participants to learn about one or more of the following themes: The UK criminal justice system is based on the concept of ʻchoiceʼ to commit crime. Our criminal justice system asserts that after a certain age most people are responsible for their actions, and have some sort of choice when deciding to break the law. The law is compassionate to those who are unable to exercise choice, by reason of age, learning impairment or other form of ʻdiminished responsibilityʼ at the time the criminal act is committed. The structure of our brain affects our decision-making (e.g. damage, ageing and development). However, scientific research is raising questions as to whether there is such a thing as a ʻnormalʼ brain. For example, the teenage brain goes through a massive growth spurt, which affects behaviour, judgement and empathy. This fact has been used with some success as defence in criminal cases in USA. The brain is organised around structures controlling simple tasks, emotional responses and intelligent thought. There are different hierarchical levels within the brain.  The more complex, prefrontal cortex is the “intelligent” part of the brain, PAGE 5 OF 39

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INTRODUCTION

whereas the mid-brain is involved in more ʻanimal-likeʼ emotions such as fear and anger.  The prefrontal cortex is responsible for inhibiting and therefore controlling some of the more basic animal behaviours. If the prefrontal cortex does not develop properly or is damaged, this can lead to anti-social behaviour. We can see which part of the brain is working at any moment using scanning techniques. Some types of brain scanning shows blood flow to specific brain regions. Greater flow of blood to a region suggests heightened activity, so blood flow measurement is an indicator of (proxy for) the extent of brain activity. The brain itself develops under the influences of our inherited genes and our experience. Though our genes largely determine the basic structure of the human brain, the ways in which we think about the world, the development of attitudes and our behaviours also rely on our development, experiences and learning. Our personalities and behaviours are thought to arise from a combination of nature and nurture. Supportive family and friends and a secure environment in childhood have been shown to offer some protection against antisocial behaviour in people whose brain chemistry or genes may make them vulnerable in this way. Brain scans cannot tell us whether someone is a criminal or has a psychopathic personality. The brain is quite adaptable, so damage or abnormal development in one region may be compensated for by another. Furthermore, the information provided by a scan is likely to give only part of the picture of what occurs within this highly complex organ.  This places limits on what brain scans can tell us about personality and behaviour.

The Trailer

Watch the trailer for the production - http://theatreofdebatebrainwaves.tumblr.com/

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INTRODUCTION

Stunted Trees and Broken Bridges in Your School The Performance - The play is set in the not too distant future, the story begins in the year 2017. Before the performance, the Y Touring facilitator will introduce the audience to the use of the electronic voting system and the subject matter. The play will be performed in traverse, which means  that the audience will be seated on either side of the performance space, facing each other.

Model of the set for Stunted Trees and Broken Bridges The Debate - After the performance there will be a facilitated debate in which the actors return in character and answer questions. Electronic voting is used before the performance and then throughout the following debate. Online Resources - Online resources will be made available to you through the Y Touring Resource Cloud. The resources will include interactive activities which you can use as the basis for follow-up lessons and a series of short film clips of sequences from the play that you can use to stimulate further exploration of the issues raised and to refresh the studentsʼ memory of the topic if appropriate.

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Sensitive Issues Stunted Trees and Broken Bridges explores challenging issues that affect us all, from what makes us who we are to using interventions to enhance us or cure illness, and asks us to consider how technological advances may affect our future. 850,000 children and young people in the UK have a mental health problem - and thatʼs just the ones who have been diagnosed. But what do we – and they - do with that diagnosis? And what would happen if we could offer a cure by implanting something in the brain? The play opens discussions on a range of topics that may raise questions for young people, and looks specifically at young people who are searching for diagnosis to explain why they are as they are.   Several organisations/websites can help inform your discussion and act as back-up. A good starting point for further information about young peopleʼs mental health is Young Minds http://www.youngminds.org.uk/

Any Questions? If you have any questions after reading through this information, please donʼt hesitate to contact us either by phone, on 020 75203090, or by email, to a.geddes@ytouring.org.uk

Preparing Your Students Evaluations of previous Theatre of Debate projects have emphasised the importance of preparing students to ensure that they gain the maximum benefit from the project. That said, we know that some teachers prefer not to prepare their students for the event, believing that our productions have greater impact if the students have no preparation other than being told that they are going to see a live performance. Either way we hope that you will find the information in this pack helpful. We offer below some generic preparatory lessons and a glossary that you may choose to use with your students before we visit your school. In addition, regardless of whether or not you choose to use the preparatory lessons, we have provided some background information which we hope you will find useful. This information includes: An overview of novel neurotechnologies by the Nuffield Council on Bioethics. Four recent articles that examine some of the issues explored in the play and debate. A link to a computer game that you and your students can play to explore Deep Brain Stimulation.

Short Of Time? If you are short of time, we suggest that you prioritise the ʻWhat Does it Mean?ʼ and the ʻWhat Do We Think?ʼ activities, as they offer the most direct way to prepare your students for the play. In order to prepare yourself we suggest you familiarise yourself with the plot outline, the background information and the glossary. PAGE 8 OF 39

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WRITE A REVIEW

Write a Review competition For the last four Theatre of Debate productions, we have offered our audiences the opportunity of entering a write a review competition, announcing this at the end of live performances and inviting students to send us their reviews via email. For the last production, the entries were judged by Susan Elkin, a journalist and reviewer for The Stage and a number of national newspapers including The Independent, and the winner was awarded an iPad. The reviews are very useful to us and to our funders, as they offer insights into the effectiveness of our productions, both as pieces of theatre and as ways of engaging our target audience in learning about advances in scientific research.  For this tour, we are trying a different approach and would really appreciate your support. We have included two “worksheets” below, to be used before and after our visit. The first covers what to look for while watching a live performance, the second is a guide to writing a review of a live theatre performance. We will be offering two iPads as prizes, one to the winning student and one to the school that submits the most reviews. All reviews should be sent to info@ytouring.org.uk

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Worksheet 1- What to look for while watching a live performance

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The Set Type of set? Naturalistic? Stylised? Colourful? Atmospheric? Simple? Complex?

Prompts Did it add to (or detract from) the atmosphere? How? (Give examples.) Was the set in any way surprising? In what way? Were the actors always in/on the 'stage areas'?

Costumes  Period? Colour? Fabric and details?

Prompts Did the colours/styles add to the effect of the set? In what way?

Sound Was there music? Other sounds?

Prompts How was sound used? Did it heighten atmosphere or impact? How? When? Give a couple of examples.

Characters Who were the characters? Who were the more/less important characters?

Prompts Were the characters believable? Which of them was strong/weak? Comment on accents, voices, body language.

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WRITE A REVIEW

The script What was the theme of the play? What issues does the play confront? 

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Prompts Most memorable moments? Describe them. What questions do you think the production/play was asking the audience?

Moments of impact?

Did the production seem to try to send the audience a message or make a certain point?

Dialogue Naturalistic or stylised? Formal or informal?

Prompts There are many different registers - varieties of language - an actor can use in English - which were used in this production? Was the vocabulary understandable? Give examples of dialogue that stood out for you.

Pacing and timing Fast or slow-moving sequences.

Prompts Were there times when the action was slowed down or speeded up? Why do you think this was? What was the effect?  Describe the sequence first.

Casting Was it well cast or poorly cast?

Prompts Any double casting? How did the actors play their two parts?

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WRITE A REVIEW

Worksheet 2 - Writing a review Section1 – The Production You need to include information about the particular production that you saw Make sure you mention the full title of the play and the name of the playwright  the date, time and location of the place you saw this production name of the theatre company the name of the director  names of the main characters – and the actors too if youʼre going to talk about later in your review names of any other people who played an important part in the show – the designer, musicians, etc. If you don't know or can't remember any of this information check out the Theatre of Debate website were you will be able to find out. Section 2 – The Productionʼs Plot or Narrative Give a brief outline of the story and the main characters Do make sure that it is brief – up to 750 words. Did you find the story convincing? Which bits of the story worked best? Did any moments stir your emotions – made you laugh or feel sad or scared? How did you feel about the characters? What was the theme of the play, what questions do you think the production was asking the audience? What issues does the play confront. Did the production seem to try to send the audience a message or make a certain point? What was it? Did it hold the audienceʼs interest? At all times? How?  If not, why not? How was this production different from other productions you have seen? What did you think about the Debate?

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Section 3 – The Technical Stuff (Set, the music, the costumes etc…) Describe the setting or main features of scenery. Did the set add something extra to the play? Some sets are very elaborate whereas others seem little more than a bare stage. How appropriate was this particular set to the production you saw and to the space it was being performed in?  Did anything about the set particularly catch your eye? Discuss the interaction of the design and the performers. Some sets can free up actors on stage and give them areas to play on or with. Some sets may limit the performances of actors instead. This is especially important if a set has doors, levels, rakes or items of scenery that are flown in from above. Mention any obvious soundtrack, special effects or music. How was sound used in the production? Did a soundtrack add to or create setting, mood or atmosphere? Was there any music? Did the production choices add to your understanding or enjoyment? If so, when and how? Include other important aspects of design: What did you think about the costumes or props? Did they help actors in their performance? Did they help to express the characters or themes of the production? Did any actor excel in using them to show you what kind of person they are? Did the costumes suit the characters? Section 4 – The Acting and Performances Comment on important characters How did you rate the actors? Describe voice and movement choices How did the actors use their bodies to show the characters they played and how they felt? Describe character interaction Did any actors use particular movements to express feelings or status to other actors? What things did the actors do that particularly impressed you? Give examples of good and bad things about voice, gesture and movement throughout the play.

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WRITE A REVIEW

Section 5 – Conclusion On balance was it a successful production? Did it work for you – did it make you laugh, cry, think? Did you enjoy it?  Did it keep your interest and involve you with the characters?   Do you think differently as a result of seeing this play and participating in the debate, from the way you thought before? What questions would you like to ask the playwright? Did it leave you with other questions and if so what were they? Where they about the characters, the storyline or about neuroscience and the brain? What questions would you like to ask a neuroscientist as a result of seeing this play? Who do you think should see this play?

Hints and Tips "The first rule is that there are no rules – you're writing a review to express your thoughts and feelings about a theatre show, not taking an exam. There are as many ways to write a review as there are personal responses to any production. There is no right or wrong. Allow yourself to develop your own distinctive voice, and be honest about what you really think about a production: convey your enthusiasm for it or explain why you disliked it" Lyn Gardner Theatre Critic The Guardian When writing your review of  the performance, be honest. Just because your friend loved the show doesn't mean that you have to. If you didn't like it, say so. But please remember that although you may express any opinion about the production you have seen they must be justified – good or bad. e.g. “I thought the scene with the monkey was boring” is no help to your review, whereas… “The scene with the monkey was quite boring because it went on too long and didnʼt seem to fit with the rest of the story” …is much better and will get you points from the judges whether or not they agree with your personal opinion. Always give examples to support the point you are making, use details from the performance; acting, set, sound, lighting, audience response etc.

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THE PLAY

The Play

Characters ‘This is the dream. It’s night. I’m in a weird country. There’s more stars than I’ve ever seen. There’s no towers there’s no roads There’s no city. It’s like… Africa. A moon over the plains. And heat.’ Emerson, Scene One - My Country. 2017.

Emerson: young and misunderstood, finds his aggressive nature has got him into serious trouble. He undergoes a brain scan to see if he can plead diminished responsibility. Hayley: his girlfriend, brave, compassionate and in love with Emerson. She stands by him through the trial and begins to take an interest in neurotechnology. Miles: weedy and cunning, befriends Hayley and Emerson for motives that at first seem unclear. He has a strong interest in science and the brain. Jeannette: a forensic investigator, meets Emerson after he has committed a crime. She is part of the defence team that can plead diminished responsibility, but what consequences will this have for Emerson?

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THE PLAY


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THE PLAY

Synopsis Beginning in the year 2017, the story revolves around a young man, Emerson, who experiences volatile episodes after the death of his mother. He is expelled from school after a violent outburst and then seriously assaults a rival when provoked. Despite Emerson始s increasingly erratic behaviour and hostility, his girlfriend, Hayley, and sympathetic friend, Miles, continue to offer their support, encouraging him to seek help. Facing trial and becoming increasingly concerned about his inability to control his behaviour, Emerson reluctantly agrees to undergo a brain scan. This scan will determine if he has a brain abnormality and can therefore plead diminished responsibility in court. The outcome of the scan will govern his future, but how reliable is this new technology, and what are the consequences of using it in this way?

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THE PLAY


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PREPARATORY LESSONS

Preparatory Lessons

Emerson I can’t get too excited, now. Whenever I… Whenever I start to overheat I get… I get pulses in my brain Hayley That’s… Emerson It’s for the best. Emerson and Hayley Scene Eleven – the Buzz. 2018

Preparatory Activity 1: What does it mean? Objective

To ensure that your students are familiar with the key terms and phrases used in the play. Process

Explain that you are going to say a word or phrase and that when you call out their name, you want each of your students to say the first word that comes into their head. Explain that if they canʼt think of a word or if their mind goes blank, they can say ʻPassʼ. PAGE 17 OF 39

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After each round, clarify the actual meaning of the word or phrase if appropriate and discuss, as a class, some of the associations that have been shared. You may wish to scan the included glossary and substitute alternative words or phrases that you may feel are more relevant to your students. Words and Phrases

Forensic Investigator

Deep Brain Stimulation

Brain Disorder

Lobotomy

Anti Social Personality Disorder Identity

Diminished Personality

Neuroforensics

Brain Scanner

Transcranial Magnetic Stimulation

Neurotransmitters

Intervention

Preparatory Activity 2: What do we feel? Objective

To explore the emotions that students might attach to some of the key words and phrases associated with Stunted Trees and Broken Bridges. Process Explain that you are going to say a word or phrase and that when you call out their name, you want each of your students to say the emotion that they associate with that word. Explain that if they can始t think of a word or if their mind goes blank, they can say 驶Pass始. Discuss, as a class, some of the associations that have been shared. You may wish to scan the included glossary and substitute alternative words or phrases that you may feel are more relevant. Words and Phrases

Brain Disorder

Identity

Intervention

Lobotomy

Diminished Responsibility

Neurotechnology

Neuroethics

Psychiatric Institution

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Preparatory Activity 3: What do we think? Objective To explore what your students know, think and feel about issues posed by advances in neurotechnology and the questions raised in Stunted Trees and Broken Bridges, before seeing the play and participating in the debate. You may also wish to repeat this activity as a follow-up.

Resources A large empty classroom or drama studio. Process Ask your students to stand in the centre of the space. Explain that there is an imaginary line running down the centre of the space, one end of the line represents ʻAgreeʼ and the opposite end of the line represents ʻDisagreeʼ. The middle of the line is ʻDonʼt Knowʼ. Explain that you are going to read out a series of statements. If they agree with the statement they should go and stand at the end of the line that is ʻAgreeʼ. If they disagree they should go and stand at the end of the line that is ʻDisagreeʼ. If they are not sure or donʼt know what they think they should stay in the middle. After they have taken up their positions, ask your students to explain why they have chosen their position. After hearing from several students, give them all the opportunity of changing their position. Repeat the process for each statement. Statements Anything you can do to your brain that makes you happier is OK. Brain implants to enhance performance and abilities would be a good thing. Science is as much the downfall as the saviour of society. Medical technologies are the best way of improving human health and well-being . I would have brain surgery or a device implanted into my brain if it could cure me of an illness. I would be happy to undergo a brain scan, if it could tell me what type of person I am. I would welcome having a chip implanted in my brain to enhance my performance. I think brain scans should be used in court to determine guilt or innocence. PAGE 19 OF 39

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Preparatory Activity 4: I’d like to ask… Objective To prepare students with questions that they may wish to ask in the debate following Stunted Trees and Broken Bridges. Resources Pen and paper.

Process In pairs, ask the students to come up with two questions. Both are for people who have strong opinions on neurotechnology: Question 1. Is for a scientist who is using neurotechnology to help people with a neurological disease such as Parkinsonʼs or epilepsy. Question 2. Is for someone who has been wrongly diagnosed by a brain scanner as having a brain disorder. Ask the students to make a note of the questions and then share them with the class. They could also take the questions with them into the play and ask them in the debate.

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INFORMATION

Information

Bioethics Bioethics is the study of the ethical and moral implications of new biological discoveries and biomedical advances. Bioethicists are concerned with the ethical questions that arise in the relationships between life sciences, biotechnology, medicine, politics, law and philosophy.

Neurotechnology

Hayley What’s a scanner going to tell us that we don’t already know? Jeannette I’m going to… look inside his head. And ask him some questions. And see what lights up in his brain. Jeanette and Hayley, Scene 6 - Antisocial. 2017.

Neurotechnology is an emerging science comprising the development and application of advanced technology for the study of the brain and treatment of its disorders.

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Novel Neurotechnologies

Miles The thoughts I have aren’t normal. (Miles picks up his drill.) Do you know what they did in the stone age when they believed someone was possessed with evil spirits? They used to drill into your head to release them. Emerson Evil spirits? Miles Perhaps the evil spirits were just disorders… Emerson I don’t have evil spirits! Emerson/Miles. Scene Five – Diminished Responsibility. 2017.

Humans have intervened directly in the brain for a long time. Archaeological evidence shows that people in the late Stone Age in Europe, pre-Incan civilizations, the Ancient Egyptians, the Romans and Byzantines all performed brain surgery for medical, spiritual and magical purposes. During the last century, brain intervention experienced a steep rise and fall: electroconvulsive therapy (ECT), ʻsplit-brainʼ surgery and lobotomy were each first heralded as wonder cures for depression, epilepsy, schizophrenia and many other illnesses in the first half of the 20th century. But each was to some extent discredited as they came to be seen as treatments that were often inappropriate and sometimes harmful, leading to the view that their uncritical and widespread use arose from the hubris of a medical profession bound by too few rules. Far more targeted applications of these treatments, and other treatments that intervene directly into the human brain, are only slowly being re-introduced to medical practice, with very strict risk/benefit assessments and strong consent and oversight procedures in place. Intervening in the brain has always raised hope and fear in equal measure: hope of curing crippling neurological conditions or improving human capabilities beyond normal limits against fear of harmful manipulation with unforeseen consequences or the wilful destruction of what it means to be human. Currently, technologies are emerging that intervene in the brain which seem to promise significant benefits to people with neurological conditions. Such neurotechnologies could also potentially be used in nonPAGE 22 OF 39

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medical settings. For example, Brain Computer Interfaces (BCIs) which connect the brain to a computer system could help people who have a locked-in syndrome to communicate or even interact with the outside world by using thoughts to direct a bed, wheelchair or speech computer. BCIs can be used in non-medical ways, for computer gaming, where games are ʻthought-controlledʼ - and there is growing interest in using BCIs in the military, to enable military personnel who have lost limbs to control their prosthetic devices directly from their brain, or to improve soldiersʼ capabilities or employ though-controlled, remote weaponry.  Neurostimulation such as Deep-Brain Stimulation (DBS), where electrodes are implanted into the brain, has been used to treat illnesses such Parkinsonʼs and severe depression. Transcranial Direct Current Stimulation (tDCS), where areas of the brain are stimulated directly with low electrical current, is being used to treat some psychiatric disorders, to aid rehabilitation and in some cases in the hope of enhancing cognitive performance. Non-Invasivetranscranial Magnetic Stimulation (TMS), where the brain is stimulated from outside using a magnetic field, is used to treat patients with depression and is also being researched to improve cognitive skills, both in patients and healthy subjects. Finally, Neural Stem Cells, inserted into the brain, are being investigated for treating people with stroke and dementia. While the clinical benefits of some of these treatments are thought to be significant for particular groups of patients, they nevertheless raise questions not only about safety, but about possible effects on personality and personhood; about responsibility; about enhancing human capabilities; and about how we secure beneficial uses, whilst avoiding the dangers. Most of this is still being researched, but it is important that we address the ethical considerations at this early stage. In contrast to established interventional neurotechnologies - such as electroconvulsion or brain prostheses - that have been discussed for several decades, 'novel neurotechnologies' are in the early stages of transition from the laboratory to use in medical treatment or in other, non-medical settings. Through the performance, debate and online resources Stunted Trees and Broken Bridges explores how the use of neurotechnology and novel neurotechnologies impact on our lives now, and might in the future. The project is also a starting point for exploring the bioethics related to this area of scientific research. This article is taken from the Nuffield Council on Bioethics website http://www.nuffieldbioethics.org/

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Brainwaves Tumblr Blog

During the development of this project, we created a Ideas Dump on Tumblr as a way of collecting together relevant articles, short films and audio clips – itʼs a great resource if you are looking for ideas or up to date stories on novel neurotechnologies. Have a look and please do feel free to add material yourselves. http://theatreofdebatebrainwaves.tumblr.com/

Deep Brain Stimulation Surgery Game

The link below takes you to to a Deep Brain Stimulation Surgery game, appropriate for use with secondary school students. It includes simulation of surgery to drill into the patientʼs skull, insert a stimulation probe and test impairment levels post-op. The activity includes photos of real surgery. http://www.edheads.org/activities/brain_stimulation/index.shtml PAGE 24 OF 39

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USEFUL ARTICLES

Useful Articles

Hayley He doesn’t trust himself. It’s like someone else has to tell him if he’s doing it right, what foot to go/ next. We looked at the study that implicated his brain with anti-social personality disorder.We found that most of the control group in the study were university students. Who’s to say their brains were normal? Just think of all the normal brains in the world that don’t make it under a scanner. Warrior princes and street children and monks and fireeaters and Why does it seem so important, to say someone’s brain is normal, and another’s not? To pack people in boxes, neatly away from view Hayley Scene Thirteen – Neurojustice. 2025.

The following four newspaper/web articles influenced our thinking as we created the project and, we hope, highlight a number of issues that underpin the learning opportunities presented by the play, debate and resources.

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Brain scans should not be used in court... for now The New Scientist - Jessica Hamzelou, contributor Should an offender's sentence be decided on the basis of a brain scan? A group of neuroscientists have put together a report for the Royal Society to assess this issue and other ways that progress in brain science might impact the law. Neuroscience is already making waves in court: an Italian woman convicted of murder recently had her sentence reduced on the grounds that her behaviour could be explained by abnormalities in her brain and genes. The authors on the Royal Society panel, led by Nicholas Mackintosh of the University of Cambridge, also flag up research that suggests the brains of psychopaths are fundamentally different. This raises the question: should individuals with the brain anatomy of a psychopath have their sentence reduced on the ground of diminished responsibility, or should brain scan evidence be used to keep dangerous individuals locked away? Perhaps one day we may also be able to find neurological clues that help predict whether a criminal is likely to reoffend. The report only goes so far as to suggest that such information may be useful in conjunction with other evidence. Another key issue is that of the age of criminal responsibility. In England, the age at which a child can be tried as an adult is ten - this is too low, say the report's authors. Recent research into brain development suggests that crucial brain regions - such as the prefrontal cortex, which is important in decision making and impulse control - don't actually finish maturing until the age of around 20. Neuroscientists claim to be able to identify certain patterns of brain activity that are associated with lying, a finding that has raised the possibility of brain scan-based lie detection. But many remain skeptical that such an approach can ever be useful in the legal setting. Lie detection research is often based on students telling untruths that are unlikely to have any impact on their lives - a situation that's difficult to compare to a criminal who might be lying for his life, not to mention that of a cunningly deceptive psychopath. Moreover, as the report points out, if such lie detection were possible, it wouldn't detect when a person was telling a falsehood they believed was true, or whether a person had learned how to trick the system. "In one experiment, the success rate for distinguishing truth from lies dropped from 100 per cent to 33 per cent when participants used countermeasures," say the authors. They conclude that "for the foreseeable future reliable fMRI lie detection is not a realistic prospect." In the same vein, attempts to measure the amount of pain that a person is in - perhaps to catch people who cheat on health insurance payouts - could also be foiled by individuals who learn how to simulate the brain activity associated with the experience of pain, the authors say. PAGE 26 OF 39

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And then there's that old chestnut: "my brain made me do it". In some cases it seems the argument can be made. For one man, paedophilic tendencies appeared and disappeared with a tumour in his orbitofrontal cortex - a region linked to judgement and social behaviour. Most cases aren't so clear cut. The report concludes by recommending that neuroscientists and lawyers from around the globe meet to discuss the latest in each discipline once every three years. In the meantime, the authors recommend that the legal system consult with groups such as the British Neuroscience Association to assess how lawyers currently access scientific expertise. The authors also reckon it would be useful for law degrees to include some background in neuroscience, and for neuroscientists in training to consider the societal applications of their science. This article was originally published in the New Scientist, 13 December 2011.

Brain scan could prevent Abu Hamza's extradition Brain scan could prevent could prevent Abu Hamza's extradition, the high court reserved judgement on a plea by radical cleric Abu Hamza who is fighting extradition to the US to have further medical tests  His QC said a brain scan could establish that he is unfit to plead and should not be extradited to face trial on terrorism charges. Alun Jones QC told two judges in London that Hamzaʼs health is “deteriorating” and he is suffering from long-term depression, inability to concentrate and short-term memory loss. Sir John Thomas, President of the Queenʼs Bench Division, said the court would give its ruling at a later date. Hamza is one of five terror suspects who have launched last-ditch legal challenges after the European Court of Human Rights refused to stop their US extradition. Lawyers for the 54-year-old former imam at Finsbury Park mosque in north London are asking Sir John and Mr Justice Ouseley to continue an injunction preventing extradition, pending tests recommended by two doctors. Mr Jones said the application was not “a device” to avoid removal. Hamza is suffering from long-standing clinical depression as a result of being held for more than eight years in “harsh, utterly unacceptable conditions” in the high-security unit at Belmarsh prison in south-east London. Mr Jones said a scan could establish whether he is suffering from some organic, degenerative condition affecting his ability to concentrate on legal proceedings, and thus his fitness to plead. This article was originally published in the Scotsman 12th October 2012. Note: Abu Hamza has since been extradited. PAGE 27 OF 39

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Guilty, but not responsible? Monsters are born, not made: the latest round in the debate about criminal responsibility questions the very existence of intuitive morality Rosalind English for the UK Human Rights Blog, part of the Guardian Legal Network The US neuroscientist Sam Harris claims in a new book that free will is such a misleading illusion that we need to rethink our criminal justice system on the basis of discoveries coming from the neurological wards and MRI scans of the human brain in action. The physiologist Benjamin Libet famously demonstrated in the 1980s that activity in the brain's motor regions can be detected some 300 milliseconds before a person feels that he has decided to move. Subjects were hooked up to an EEG machine and were asked to move their left or right hand at a time of their choosing. They watched a specially designed clock to notice what time it was when they were finally committed to moving their left or right hand. Libet measured the electrical potentials of their brains and discovered that nearly half a second before they were aware of what they were going to do, he was aware of their intentions. Libet's findings have been borne out more recently in direct recordings of the cortex from neurological patients. With contemporary brain scanning technology, other scientists in 2008 were able to predict with 60% accuracy whether subjects would press a button with their left or right hand up to 10 seconds before the subject became aware of having made that choice (long before the preparatory motor activity detected by Libet). Clearly, findings of this kind are difficult to reconcile with the sense that one is the conscious source of one's actions. The discovery that humans possess a determined will has profound implications for moral responsibility. Indeed, Harris is even critical of the idea that free will is "intuitive": he says careful introspection can cast doubt on free will. In an earlier book on morality, Harris argues Thoughts simply arise in the brain. What else could they do? The truth about us is even stranger than we may suppose: The illusion of free will is itself an illusion (The Moral Landscape) But a belief in free will forms the foundation and underpinning of our enduring commitment to retributive justice. The US supreme court has called free will a "universal and persistent" foundation for our entire system of law. Implications for the criminal justice system Any scientific developments that threatened our notion of free will would seem to put the ethics of punishing people for their bad behaviour in question. In Free Will Harris debates these ideas and asks whether or not, given what brain science is telling us, criminal justice, in focusing on retribution, rests on an entirely false basis. An example he gives is a murderer who kills because of a brain tumour. This person is a victim, not a criminal. The tumour is the cause of his crimes. People imagine that the normal brain is a different story. But in fact the study of any criminal brain, says Harris, is the equivalent of finding a tumour PAGE 28 OF 39

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in it – the wrong genes being transcribed, the brain being dictated by events over which he has no control. Human choice, says Harris, is as important as fanciers of free will believe. But the next choice you make will come out of the darkness of prior causes that you, the conscious witness of your experience, did not bring into being. Clearly we need to lock up dangerous people. But there is no sense to the idea that they somehow deserve it. Retributive justice is like requiring us to hate, as well as shoot, a wild animal who escapes from the zoo. His short book opens with an account of an horrific crime that mesmerised America with its cruelty - the home invasion in Connecticut by two men in 2007. Two career criminals first brutally bludgeoned the father (the only survivor), then raped and murdered the mother, and finally killed the two young daughters when they set the house on fire. As one reviewer says, Harris gives voice to most everyone's worry when he writes that, without (contra-causal) free will, monsters like these men are "nothing more than poorly calibrated clockwork," and therefore they aren't really responsible for their actions. They're just damaged goods. Speaking on an WNYC interview, Harris explains that the brain precedes a motor plan before our consciousness of our planning of it, even while we think we're still free to decide which way to go. You can't really take credit for your unconscious predelict. This reaches back into everything we think and do and decide. There is no place in which we can say, the buck stops here. The buck just never stops. Your wants themselves emerge out of a wilderness of causes which you yourself cannot inspect. The only tools at your disposal are those which you inherit from your past. There are certain things about morality and about the legal system which do shift when you take on board that there is no free will. The evolutionary biologist Stephen Pinker reminds us that our sense of justice tells us that where someone commits a crime, the perpetrator's culpability depends not just on the harm done but on their mental state, what any first year law student knows is the mens rea, the subjective state of intentionality prerequisite to establishing criminal liability. In his recent study of the decline of violence in human history, he gives the following example: Suppose a woman kills her husband by putting rat poison in his tea. Our decision as to whether to send her to the electric chair very much depends on whether the container she spooned it out of was mislabeled DOMINO SUGAR or correctly labelled D-CON: KILLS RATS – that is, whether she knew she was poisoning him and wanted him dead, or it was all a tragic accident. A brute emotional reflex to the actusreus, the bad act ("She killed her husband! Shame!") could trigger an urge for retribution regardless of her intention. (The Better Angels of our Nature: Ch8, Inner Demons, p 547) This type of retributive impulse of course we all condemn as unpardonable in civilised society. But if we follow Harris's argument to its logical conclusion, the correct label should no more condemn the murderer to retribution than the misleading one, for the proclivity to PAGE 29 OF 39

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do harm is at large, and is in no wise governed by rational choices immediately preceding the actus reus. He is not making a case for exculpation on the basis of identifiable brain lesions or particular genetic mutations, which the psychologist Harold Schechter showed were notably absent from all the notorious subjects of his authoritative compendium The Serial Killer Files. Are we really rational actors? Where does this leave human rights? Harris' prescription for rethinking criminal justice may lead to a compassionate outcome: the criminal cannot help himself, restrain him but don't hate him; but let us remind ourselves of the first provision of the Universal Declaration of Human Rights, endorsed in 1948 by forty-eight countries: All human beings are born free and equal in dignity and rights. They are endowed with reason and conscience and should act towards one another in a spirit of brotherhood. But if we cannot even be sure that our conscious minds can dictate the movement of our own limbs, how can we direct the whole macro-organism to behave in a civilised manner to the rest of the world, because some international agreement tells us to? By breaching the boundaries between scientific facts and human values, Sam Harris argues convincingly that most people are simply mistaken about the relationship between morality and the rest of human knowledge. Instead of bowing to secular but quasi-biblical commandments such as the UN Declaration, the Covenant on Civil and Political Rights and so on, we would do better to think about morality in terms of human and animal wellbeing, viewing the experiences of conscious creatures as peaks and valleys in what Harris calls a "moral landscape." As the abstract of his exploration of morality proposes, there will be a time when science will no longer limit itself to merely describing what people do in the name of "morality"; in principle, science should be able to tell us what we ought to do to live the best lives possible. This article was originally published in the Guardian Tuesday 29 May 2012.

This is your brain on neural implants Are you still you if devices improve your memory, attention span, and other cognitive skills? By Ray Kurzweil|Posted Friday, Nov. 16, 2012, at 8:32 AM ET You are in the future with technologies more advanced than todayʼs. While you are sleeping, some group scans your brain and picks up every salient detail. Perhaps they do this with blood-cell–sized scanning machines traveling in the capillaries of your brain or with some other suitable noninvasive technology, but they have all of the information about your brain at a particular point in time. They also pick up and record any bodily details that might reflect on your state of mind, such as the endocrine system. They instantiate this “mind file” in a nonbiological body that looks and moves like you and has the requisite subtlety and suppleness to pass for you. In the morning you are informed about this transfer and you watch your mind clone, whom weʼll call You 2. You 2 is talking about his PAGE 30 OF 39

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or her life as if s/he were you, and relating how s/he discovered that very morning that s/he had been given a much more durable new version 2.0 body. “Hey, I kind of like this new body!” s/he exclaims. If you were to, uh, disappear, no one would notice. You 2 would go around claiming to be you. All of your friends and loved ones would be content with the situation and perhaps pleased that you now have a more durable body and mind. Maybe your more philosophically minded friends would express concerns, but for the most part, everybody would be happy, including you, or at least the person who is convincingly claiming to be you. So we donʼt need your old body and brain anymore, right? OK if we dispose with it? Youʼre probably not going to go along with this. Your sense of identity is still with you, not with You 2. Our conclusion? You 2 is conscious but is a different person than you—You 2 has a different identity. S/he is extremely similar, much more so than a mere genetic clone, because s/he also shares all of your neocortical patterns and connections. Or I should say s/he shared those patterns at the moment s/he was created. At that point, the two of you started to go your own ways, neocortically speaking. You are still around. You are not having the same experiences as You 2. Bottom line: You 2 is not you. Now consider another thought experiment—one that is, I believe, more realistic in terms of what the future will bring. You undergo a procedure to replace a very small part of your brain with a nonbiological unit. This is not so far-fetched, as it is done routinely for people with neurological and sensory impairments, such as the neural implant for Parkinsonʼs disease and cochlear implants for the deaf. As promised, the procedure works just fine— certain of your capabilities have improved. (You have a better memory, perhaps.) So are you still you? There is no good argument that youʼre suddenly a different person. Encouraged by these results, you now decide to have another procedure, this time involving a different region of the brain. The result is the same: You experience some improvement in capability, but youʼre still you. You keep opting for additional procedures, your confidence in the process only increasing, until eventually youʼve changed every part of your brain. Each time the procedure was carefully done to preserve all of your neocortical patterns and connections so that that you have not lost any of your personality, skills, or memories. There was never a you and a You 2; there was only you. Our conclusion: You still exist. Thereʼs no dilemma here. Everything is fine. Except for this: You, after the gradual replacement process, are entirely equivalent to You 2 in the prior thought experiment (which I will call the scan-and-instantiate scenario). You, after the gradual replacement scenario, have all of the neocortical patterns and connections that you had originally, only in a nonbiological substrate, which is also true of You 2 in the scan-and-instantiate scenario. You, after the gradual replacement scenario, have some additional capabilities and greater durability than you did before the process, but this is likewise true of You 2 in the scan-and-instantiate process..

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We naturally undergo a gradual replacement process. Most of our cells in our body are continually being replaced. (You just replaced 100 million of them in the course of reading the last sentence.) Cells in the inner lining of the small intestine turn over in about a week. The life span of white blood cells range from a few days to a few months, depending on the type. Neurons persist, but their organelles and their constituent molecules turn over within a month.  So you are completely replaced in a matter of months. Are you the same person you were a few months ago? Certainly there are some differences. Perhaps you learned a few things. But you assume that your identity persists, that you are not continually destroyed and recreated. Fundamentally, we are not the stuff that makes up our bodies and brains. These particles essentially flow through us in the same way that water molecules flow through a river. We are a pattern that changes slowly but has stability and continuity, even though the stuff comprising the pattern changes quickly. The gradual introduction of nonbiological systems into our bodies and brains will be just another example of the continual turnover of parts that comprise us. It will not alter the continuity of our identity any more than the natural replacement of our biological cells do. We have already largely outsourced our historical, intellectual, social, and personal memories to our devices and the cloud. The devices we interact with to access these memories will become smaller and smaller, making their way into our bodies. It will be a useful place to put them—we wonʼt lose them that way. And in the coming years, we will continue on the path of the gradual replacement and augmentation scenario until ultimately most of our thinking will be in the cloud.  From How To Create a Mind. © Ray Kurzweil, 2012.

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GLOSSARY

Glossary Anti-Social Personality Disorder - is described by the American Psychiatric Association's Diagnostic and Statistical Manual, fourth edition, as personality disorder characterised by "...a pervasive pattern of disregard for, and violation of, the rights of others that begins in childhood or early adolescence and continues into adulthood." Autism – is a disorder of neural development characterised by impaired social interaction and communication, and by restricted and repetitive behaviour. The diagnostic criteria require that symptoms become apparent before a child is three years old. Autism affects information processing in the brain by altering how nerve cells and their synapses connect and organise; how this occurs is not well understood. Brain Disorder – Any disorder or disease related to the brain. Brain imaging/neuroimaging - includes the use of various techniques to either directly or indirectly image the structure, function/pharmacology of the brain. It is a relatively new discipline within medicine and neuroscience/psychology. Doctors who specialise in the performance and interpretation of neuroimaging in the clinical setting are called neuroradiologists. Brain scanners – are machines that “picture” activity within the brain or parts of it. In the play, the forensic investigator uses functional magnetic resonance imaging or functional MRI (fMRI). This procedure measures brain activity by detecting associated changes in blood flow. Cochlear implants - are surgically implanted electronic devices that provide a sense of sound to a person who is profoundly deaf or severely hard of hearing. Cochlear implants are also referred to as bionic ears. Cognitive function – is an intellectual process by which one becomes aware of, perceives, or comprehends ideas. It involves all aspects of perception, thinking, reasoning and remembering. Deep brain stimulation (DBS) - is a surgical treatment involving the implantation of a medical device sometimes called a brain pacemaker, which sends electrical impulses to specific parts of the brain. DBS in select brain regions has provided remarkable therapeutic benefits for otherwise treatment-resistant movement and affective disorders such as chronic pain, Parkinson's disease and tremor. Depression – can be described as severe despondency and dejection, accompanied by feelings of hopelessness and inadequacy.  A condition of mental disturbance, typically with lack of energy and difficulty in maintaining concentration or interest in life. Interventions – a term used in the play to refer to scientific inventions (techniques or therapies) used to help Emerson.

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GLOSSARY

Diminished responsibility – or diminished capacity is a potential defence by which defendants argue that although they broke the law, they should not be held fully criminally liable for doing so, as their mental functions were "diminished" or impaired. Dyslexia – is a common type of learning difficulty that mainly affects the skills involved in the reading and spelling of words. A person with dyslexia has difficulty "decoding" words despite appropriate learning opportunities, and this difficulty will be significantly greater than for other areas of their learning. Electrodes - are conductors that pass electrical current between metallic and non-metallic parts of a circuit, and are used in various ways to study and influence the brain. Forensic science - often shortened to forensics, is the application of a broad spectrum of sciences to answer questions of interest to a legal system. This may be in relation to a crime or a civil action. A forensic investigator is someone who uses forensic science to investigate crime. Free running/parkour  – is a relatively new sport that was developed out of military obstacle course training. Practitioners aim to move from one place to another, negotiating the obstacles in between. The discipline uses no equipment and is non-competitive. Lobotomy – is a form of brain surgery in which the connections to and from the prefrontal cortex - at the front of the brain – are cut. The procedure has been controversial since it was first used in 1935, yet was a mainstream procedure for more than two decades to treat psychiatric (and occasionally other) conditions, despite general recognition of frequent and serious side-effects. Neuroforensics  – is the application of neurophsychological  principles and practices to matters relating to legal decision-making. In the play, the forensic investigator uses brain scans to determine Emersonʼs role in the crime he is being questioned about. Neurones – are brain cells that process and transmit information by electrical and chemical signalling. Neurotransmitters – are the chemicals which allow signals to be sent between neurones across gaps called synapses. They are also released at the “neuromuscular junction” where neurones stimulate muscle fibres and so initiate movement. Oxytocin – is a powerful hormone which also acts as a neurotransmitter in the brain. It seems to play a major role in our reaction to friends and loved ones: its levels go up when we hug or kiss, during sex, birth, breast feeding, and the list goes on. It has been described as the thing that makes us human. Pre-frontal cortex - is the part of the frontal lobes of the brain, lying in front of the motor and premotor areas. This brain region has been implicated in planning complex behaviour, as well as personality, decision-making and moderating social behaviour. The basic activity of this brain region is considered to be orchestration of thoughts and actions in accordance with internal goals.

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Psychiatrist – is a doctor who specialises in the diagnosis and treatment of mental disorders. Psychiatric institutions – are also known as mental hospitals, and specialise in the treatment of serious mental disorders. Patients are often admitted on a voluntary basis, but where an individual poses a risk to themselves or others, they may be “sectioned” – which refers to their compulsory admission under a section of the mental health act. Smack – is a slang name for heroin, a highly addictive illegal drug that can be injected or smoked. Transcranial  magnetic stimulation (TMS) - is a non-surgical method that uses magnetism to stimulate areas of the brain without causing pain and while the patient is conscious. Scientists hope to use TMS to investigate illnesses such as schizophrenia, and also to see how the brain rewires after damage such as stroke. Doctors now use TMS to diagnose diseases that affect the communication between brain and body, such as multiple sclerosis. It also seems to be effective in treating some forms of depression.

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PRODUCTION DEVELOPMENT

Development of Stunted Trees and Broken Bridges

‘When I’m running. Things fall into place. I don’t think when I run. My feet just drop… And push off in perfect balance. I understand  When I’m running I never doubt myself. I never doubt my step. Never doubt my legs Or my head.’ Emerson, Scene Two – The Scanner. 2017.

Stunted Trees and Broken Bridges has been developed in partnership with the Nuffield Council on Bioethics, the British Neuroscience Association and the Association of Medical Research Charities as a teacher resource designed to support the achievement of attainment targets outlined in Key Stage 4 in Science, English, Drama, ICT, PSHE and RS. The creative team has been supported throughout the development of this production by an advisory group comprised of: Professor  Jonathan Cole:  Honorary Senior Lecturer in Clinical Neurosciences, University of Southampton Professor Jenny Kitzinger: Professor of Communications Research, Cardiff School of Journalism, Media and Cultural Studies, Cardiff University Dr Sophie Petit-Zeman: Scientific Advisor to Y Touring Theatre Company Dr Liz Philpots:  Head of Research, Association of Medical Research Charities Professor Steven Rose: Emeritus Professor of Neurobiology, Department of Life, Health and Chemical Sciences, Open University and Emeritus Professor of Genetics and Society, Gresham College, London Professor Sophie Scott: Wellcome Senior Research Fellow in Basic Biomedical Science and Professor of Cognitive Neuroscience, Institute of Cognitive Neuroscience, University College London Elaine Snell: Chief Operating Officer, British Neuroscience Association

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PRODUCTION DEVELOPMENT

Sarah Walker-Robson: Acting Communications Manager, Nuffield Council on Bioethics$ Professor Vincent Walsh: Professor of Human Brain Research, Institute of Cognitive Neuroscience, University College London Professor Kevin Warwick: Professor of Cybernetics, University of Reading

Students from The Angmering School in Littlehampton, East Sussex  and Maria Fidelis Upper School in Camden have also contributed to the development of the project. Stunted Trees and Broken Bridges is supported by the Wellcome Trust and Central YMCA.

Writer                              

$

Director                         Assistant Director/Facilitator

$

Ben Musgrave Nigel Townsend

$

Dominique Poulter

Designer                        

$

Jamie Todd

Composer

$

Alex Parsons

Movement

$

Robin Guiver

Y Touring Executive Director           

  $

Nigel Townsend

General Manager              

$

Sarah Cook

Participation  Producer    

$

Steven Byrne

Digital Producer

$

Neal Parsons

Tour Producer & Office Manager               $

David Jackson

General Assistant                

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$

Adele Geddes

PRODUCTION DEVELOPMENT


STUNTED TREES AND BROKEN BRIDGES

MORE ABOUT OUR WORK

Find Out More About Our Work ʻWorks like Y Touringʼs ʻThe Giftʼ, which raise key ethical questions without giving glib answers, are important in preparing us for the future.ʼ Robin McKie, The Observer Between 1995 and 2012 Y Touring Theatre Company commissioned and produced UKwide tours of 12 plays exploring scientific advances in partnership with the Wellcome Trust and other organisations including: the Mental Health Foundation, Nuffield Council on Bioethics, British Heart Foundation, John Innes Centre, European Dana Alliance for the Brain, Association of Medical Research Charities, Department of Trade and Industry, Medical Research Council, Department of Health, University of Ulster, Royal Albert Hall, National Institute for Health Research, Royal Academy of Engineering and Department for Children, Schools and Families.

Links If you would like to find out more about our work please visit one of the following websites: www.theatreofdebate.com Here you will not only find more information about our work, but also short films and audio recordings along with educational resources relating to a number of our Theatre of Debate productions. www.theatreofdebate.com/ytouring21/ Our 21st anniversary site includes a series of essays about our work and a series of video interviews by leading scientists, opinion formers, young people, teachers and artists. These include Professor Lewis Wolpert; our patron, Baroness Joan Bakewell; and many others http://ytouring.myresourcecloud.net/ This is our new resource website that offers online resources, as well as downloadable lessons for the classroom.

Contact Us Tel: $ 020 7520 3090 Email: info@ytouring.org.uk Web: www.theatreofdebate.com

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CREDIT

Credit Y Touring would like to thank Dr Sophie Petit-Zeman, Scientific Advisor to Y Touring for her contribution to these teacher support notes

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CREDIT


Stunted Trees and Broken Bridges Teachers Support pack