As our knowledge of the functional and pharmacological architecture of the nervous system increases, we are getting better at treating cognitive and affective disorders. Along with the ability to modify cognitive and affective systems in disease, we are also learning how to modify these systems in health. “Cosmetic neurology,” the practice of intervening to improve cognition and affect in healthy individuals, raises several ethical concerns. However, its advent seems inevitable. In this paper I examine this claim of inevitability by reviewing (...) the evolution of another medical practice, cosmetic surgery. Cosmetic surgery also enhances healthy people and, despite many critics, it is practiced widely. Can we expect the same of cosmetic neurology? The claim of inevitability poses a challenge for both physicians and bioethicists. How will physicians reconsider their professional role? Will bioethicists influence the shape of cosmetic neurology? But first, how did cosmetic surgery become common? (shrink)

A new view of the functional role of the left anterior cortex in language use is proposed. The experimental record indicates that most human linguistic abilities are not localized in this region. In particular, most of syntax (long thought to be there) is not located in Broca's area and its vicinity (operculum, insula, and subjacent white matter). This cerebral region, implicated in Broca's aphasia, does have a role in syntactic processing, but a highly specific one: It is the neural home (...) to receptive mechanisms involved in the computation of the relation between transformationally moved phrasal constituents and their extraction sites (in line with the Trace-Deletion Hypothesis). It is also involved in the construction of higher parts of the syntactic tree in speech production. By contrast, basic combinatorial capacities necessary for language processing – for example, structure-building operations, lexical insertion – are not supported by the neural tissue of this cerebral region, nor is lexical or combinatorial semantics. The dense body of empirical evidence supporting this restrictive view comes mainly from several angles on lesion studies of syntax in agrammatic Broca's aphasia. Five empirical arguments are presented: experiments in sentence comprehension, cross-linguistic considerations (where aphasia findings from several language types are pooled and scrutinized comparatively), grammaticality and plausibility judgments, real-time processing of complex sentences, and rehabilitation. Also discussed are recent results from functional neuroimaging and from structured observations on speech production of Broca's aphasics. Syntactic abilities are nonetheless distinct from other cognitive skills and are represented entirely and exclusively in the left cerebral hemisphere. Although more widespread in the left hemisphere than previously thought, they are clearly distinct from other human combinatorial and intellectual abilities. The neurological record (based on functional imaging, split-brain and right-hemisphere-damaged patients, as well as patients suffering from a breakdown of mathematical skills) indicates that language is a distinct, modularly organized neurological entity. Combinatorial aspects of the language faculty reside in the human left cerebral hemisphere, but only the transformational component (or algorithms that implement it in use) is located in and around Broca's area. Key Words: agrammatism; aphasia; Broca's area; cerebral localization; dyscalculia; functional neuroanatomy; grammatical transformation; modularity; neuroimaging; syntax; trace deletion. (shrink)

One of the primordial functions of the brain is the acquisition of knowledge. The apparatus that it has evolved to do so is flexible enough to allow it to acquire knowledge about unambiguous conditions on the one hand, and about situations that are capable of two or more interpretations, each one of which has equal validity with the others. However, in the latter instance, we can only be conscious of one interpretation at any given moment. The study of ambiguity thus (...) gives us some insights into how activity at different stations of the brain can result in a micro-consciousness for an attribute, and also tell us something about interactions between different cerebral areas that result in several potential micro-conscious correlates, though only one predominates at any given time. Finally, the study of ambiguity also gives us insights into the neurological machinery that artists have tapped to create the ambiguity that is commonly a hallmark of great works of art. (shrink)

In an editorial to a recent issue of Neurology, Richard Dees expresses the same criticism in an even more rigorous epistemic tone: Veikko Launis, Ph.D., is Professor of Medical Ethics and Adjunct Professor of Ethics and Social Philosophy at the University of Turku, Finland.FootnotesThis article is part of the Neuroethics of Brainreading research project, directed by myself and funded by the Academy of Finland. I am grateful to Olli Koistinen, Pekka Louhiala, Helena Siipi, and an anonymous referee for helpful comments, (...) criticism, and suggestions. (shrink)

Over the past decades, mood enhancement effects of various drugs and neuromodulation technologies have been proclaimed. If one day highly effective methods for significantly altering and elevating one’s mood are available, it is conceivable that the demand for them will be considerable. One urgent concern will then be what role physicians should play in providing such services. The concern can be extended from literature on controversial demands for aesthetic surgery. According to Margaret Little, physicians should be aware that certain aesthetic (...) enhancement requests reflect immoral social norms and ideals. By granting such requests, she argues, doctors render themselves complicit to a collective ‘evil’. In this paper, we wish to question the extent to which physicians, psychiatrists and/or neurosurgeons should play a role as ‘moral gatekeepers’ in dealing with suspect demands and norms underlying potential desires to alter one’s mood or character. We investigate and discuss the nature and limits of physician responsibilities in reference to various hypothetical and intuitively problematic mood enhancement requests. (shrink)

This paper examines neuroethics as a discipline in which ongoing formation and development in both ethics and medicine are shedding new light on the care of patients diagnosed as being in a vegetative state. From the perspective of the Catholic moral tradition, the author proposes that ethics and recent developments in functional neuroimaging form a complementary relationship that gives rise to an ethical imperative: because we can care for patients in a vegetative state, we should do so. This imperative for (...) care finds a particular expression in the ethical debate in light of the 2004 statement of Pope John Paul II that assisted nutrition and hydration for patients in a vegetative state should be considered, in principle, ordinary care. What do neurology and developments in scientific research teach us about patients in a vegetative state? Neuroethics is providing a unique opportunity for both medicine and ethics to discover more completely not only who we are as human beings but also how we should act. National Catholic Bioethics Quarterly 12.3 (Autumn 2012): 477–488. (shrink)

The Brain and the Meaning of Life Paul Thagard Princeton: Princeton University Press, 2010 274 pages, ISBN: 9780691142722 (hbk): $29.95 This paper criticizes central arguments in Paul Thagard's The Brain and the Meaning of Life, concluding, contrary to Thagard, that there is very little that we can learn from brain research about the meaning of life. The paper offers a critical review of Thagard's argument against nihilism and his argument that it is love, work, and play, rather than other activities, (...) that make life meaningful. Moreover, the paper argues that the rich neurological information Thagard presents throughout the book does not contribute at all to his arguments and, more generally, that neurological research is irrelevant also to almost all other aspects of meaning of life research. (shrink)

This chapter provides a brief overview of the history of behavioral neurology, dividing it roughly into six eras. In the ancient and classical eras, emphasis is placed on two transitions: firstly, from descriptions of head trauma and attempted neurosurgical treatments to the exploratory dissections during the Hellenistic period and the replacement of cardiocentrism; and secondly, to the more systematic investigations of Galenus and the rise of pneumatic ventricular theory. In the medieval through post-Renaissance eras, the scholastic consolidation of knowledge and (...) the role of compendia are emphasized, along with the use of new methods from within a mechanistic framework. With the discovery of electrical conductance and the rise of experimentalism, we frame the modern era as period of intense debate over localization, decomposition, and other mechanistic principles, and marked by rapid discovery about the brain. The chapter ends with a discussion of the contemporary era, focusing on the establishment of behavioral neurology research on aphasia, apraxia, and neuropsychiatric conditions. (shrink)

This information-packed volume, without doubt a landmark event in the developing neuroscientific study of consciousness, deserves the attention of anyone interested in this subject. It is a sequel and companion to an earlier collection, The Boundaries of Consciousness: Neurobiology and Neuropathology, also edited by Steven Laureys (2005), which contains the proceedings of a 2004 conference sponsored by the Association for the Scientific Study of Consciousness (ASSC). Published initially as a special issue of Progress in Brain Research (volume 150), Boundaries has (...) been reissued in paperback and appears on the ASSC website as one of its official titles. Both volumes include many prominent figures in contemporary neuroscience, and the two volumes together constitute about as clear, comprehensive, and authoritative a picture as one can find anywhere of the current state of mainstream neuroscientific thinking about consciousness and the brain. Like classical physics of the late 19th century, it is a picture of great power and beauty; nevertheless, just as discordant phenomena such as black-body radiation and the photoelectric effect presaged the rise of quantum mechanics, this book, precisely because of its clarity, reveals signs of trouble ahead. (shrink)

Trends in thought about consciousness, the mind, and the brain at the turn of the century were surprisingly similar to major trends in thinking about these topics today. For instance, some psychiatrists as well as physiologists considered all actions of the human mind, as well as all behaviours, entirely the product of the electrochemical actions of nerve cells, while others emphasized the importance of consciousness, free will, and even the soul. The action of nerve cells, and thus the brain itself, (...) was understood largely in terms of electrical activity, energy, and resistances, all leading to views of mental health and pathology based on energy and the loss of energy. Modern metaphors for understanding the brain, and along with them mental health and illness, emphasize information processing and neurochemistry. Such differences are reflected in the differences between typical treatments at the turn of the century and today. (shrink)

In an age of modern technology and an increasing movement towards a 24-h working culture, life for many is becoming more stressful and demanding. To help juggle these work commitments and an active social life, nootropic medication, (the so-called ‘smart pills’) have become a growing part of some people’s lives. Users claim that these drugs allow them to reach their maximal potential by becoming more efficient, smarter and requiring less sleep. The use of these medications and the role of health (...) professionals in their distribution raises many ethical questions. (shrink)

It is the impression of neurologists who deal with cancer patients that the incidence of neurologic complications of cancer is increasing (Posner 1995). ...

In this paper Nietzsche's physiology of pain is critically related to recent theories of neurology of pain. Nietzsche offers no encompassing notion of a neurology of pain like the well-known theories of, for instance, Melzack and Wall do. But, as will be shown, Nietzsche's notion of physiology offers a productive connection with contemporary neurology, particularly with Wall's newest notion of the neurology of pain. Thus I shall not discuss Nietzsche's view on science in general, but the possible application of his (...) philosophy to a particular science. (shrink)

While the self-representation of our bodies is a key element in our belief that we are autonomous individuals with a “first-person perspective,” the term body image covers and has covered a variety of meanings. In neurology, this term currently designates the verbal representation of the body parts. Psychoanalysis considers body image as intertwining the imaginary and symbolic aspects of identity, and insists on its dependence on the Other’s regard; this link to regard appears in the term specular image. This paper (...) first presents a history of the modern psychiatrical, psychological and neurological conceptions of own-body representation. Next, it considers applications of the Lacanian notion of specular image in neurological disorders of body image. (shrink)

The mind cannot be an object. An object can be conceived only as that which may possibly become an object to something else. Now what can the mind become an object to? Not to me for I am it and not to something else. Not to something else without again being denuded of consciousness.And how could we descend into the depths of our nervous system to ascertain what is the nature of the psychical correlative of the physiological bottom? If we (...) could, we could only describe that correlative psychical in terms of object-consciousness, which would be a pseudo description of it.John Hughlings-Jackson.If Charles Scott Sherrington (1857-1952) was the most philosophically aware neurophysiologist of the late 19th to early 20th .. (shrink)

It is often claimed, following Joseph Levine, that there is an ‘explanatory gap’ between ordinary physical facts and the way we perceive things, so that it is impossible to explain, among other things, why colours actually look the way they do. C.L. Hardin, by contrast, argues that there are sufficient asymmetries between colours to traverse this gap. This paper argues that the terms we use to characterize colours, such as ‘warm’ and ‘cool’, are not well understood, and that we need (...) to understand the neurological basis for such associations if we are even to understand what is fully meant by saying, for example, that red is a warm colour. This paper also speculates on how Hardin’s strategy can be generalized. A PowerPoint presentation that depicts inverted colour qualia is attached as an appendix. (shrink)

Advances in cognitive neuroscience make cosmetic neurology in some form inevitable and will give rise to extremely difficult ethical issuesConsider the following hypothetical case study. A well heeled executive walks into my cognitive neurology clinic because he is concerned that he is becoming forgetful. It turns out that he is going through a difficult divorce and my clinical impression is that his memory problems stem from the stress he is experiencing. I place him on a selective seratonin reuptake inhibitor, sertraline, (...) and in a few weeks he feels better. Around this time his 13 year old daughter has difficulty at school and is diagnosed by the school psychologist as having attention deficit disorder. I place her on adderall, a stimulant combination drug, which seems to help with her behaviour in school. My patient then comes to me because he is experiencing the “tip of the tongue” phenomena more frequently. He is concerned that his word finding difficulty interferes with his ability to function in high level meetings. I suggest we try a cholinesterase inhibitor to see if this helps. I am careful to explain that the Food and Drug Administration does not approve such a use for this medication. He wants to try it and is pleased with the results.A few months later, this patient visits me with his 16 year old son, a talented middle distance runner. His father thinks if he were just a bit better, among the elite high school runners in the state, he would be far more competitive as an applicant for selective colleges. We discuss various options. Because of a recent report that sildenafil, which is used conventionally for male impotence, may improve oxygen carrying capacity, I prescribe this medication. The son does not object.Encouraged by these pharmacologic successes, my patient …. (shrink)

Confidentiality of health information is increasingly relevant in the era of electronic medical records. We discuss the case of a hospitalized patient who requested a neurology consultation for an episode he described as an “LSD-like” flashback. The patient expressed concern that the episode was a residual effect of past drug use, but subsequently requested that his drug use not be documented. Involved in a custody battle, he feared that if his records were released to the court he could lose custody (...) of his children. Ethical concerns arose with regards to the physician’s competing obligations with a duty to record information accurately and honestly, respect patient autonomy, and maintain patient confidentiality. We discuss the decision of the team to document the patient’s drug use by arguing that the obligation to maintain confidentiality did not supersede the primary role of the medical record as a complete and accurate account, which cannot be altered at a patient’s behest. (shrink)

Neurocognitive enhancement, or cosmetic neurology, offers the prospect of improving the learning, memory and attention skills of healthy individuals well beyond the normal human range. Much has been written about the ethics of such enhancement, but policy-makers in the USA, the UK and Europe have been reluctant to legislate in this rapidly developing field. However, the possibility of discrimination by employers and insurers against individuals who choose not to engage in such enhancement is a serious threat worthy of legislative intervention. (...) While lawmakers should not prevent individuals from freely pursuing neurocognitive enhancement, they should act to ensure that such enhancement is not coerced. This paper offers one model for such legislation, based upon a proposed US law, the Genetic Information Nondiscrimination Act of 2008, to address precisely this particular pitfall of the impending neuroscience revolution. (shrink)

In this paper, I consider V. S. Ramachandran's in-principle agnosticism concerning whether neurological studies of religious experience can be taken as support for the claim that God really does communicate with people during religious experiences. Contra Ramachandran, I argue that it is by no means obvious that agnosticism is the proper scientific attitude to adopt in relation to this claim. I go on to show how the questions of whether it is (1) a scientifically testable claim and (2) a plausible (...) hypothesis, serve to open up some important philosophical issues concerning interpretive backgrounds that are presupposed in the assessment of scientific hypotheses. More specifically, I argue that naturalism or scientific objectivism in its various forms is not simply a neutral or default methodological backdrop for empirical inquiry but involves acceptance of a specific ontology, which functions as an implicit and unargued constitutive commitment. Hence, these neurological studies can be employed as a lever with which to disclose something of the ways in which different frameworks of interpretation, both theistic and atheistic, serve differently to structure and give meaning to empirical findings. (shrink)

Neurological syndromes in which consciousness seems to malfunction, such as temporal lobe epilepsy, visual scotomas, Charles Bonnet syndrome, and synesthesia offer valuable clues about the normal functions of consciousness and ‘qualia’. An investigation into these syndromes reveals, we argue, that qualia are different from other brain states in that they possess three functional characteristics, which we state in the form of ‘three laws of qualia’. First, they are irrevocable: I cannot simply decide to start seeing the sunset as green, or (...) feel pain as if it were an itch; second, qualia do not always produce the same behaviour: given a set of qualia, we can choose from a potentially infinite set of possible behaviours to execute; and third, qualia endure in short-term memory, as opposed to non-conscious brain states involved in the on-line guidance of behaviour in real time. We suggest that qualia have evolved these and other attributes because of their role in facilitating non-automatic, decision-based action. We also suggest that the apparent epistemic barrier to knowing what qualia another person is experiencing can be overcome by using a ‘bridge’ of neurons; and we offer a hypothesis about the relation between qualia and one's sense of self. (shrink)

The possibility of AI consciousness depends much on the correct answer to the mind–body problem: how our materialistic brain generates subjective consciousness? If a materialistic answer is valid, machine consciousness must be possible, at least in principle, though the actual instantiation of consciousness may still take a very long time. If a non-materialistic one (either mentalist or dualist) is valid, machine consciousness is much less likely, perhaps impossible, as some mental element may also be required. Some recent advances in neurology (...) (despite the separation of the two hemispheres, our brain as a whole is still able to produce only one conscious agent; the negation of the absence of a free will, previously thought to be established by the Libet experiments) and many results of parapsychology (on medium communications, memories of past lives, near-death experiences) suggestive of survival after our biological death, strongly support the non-materialistic position and hence the much lower likelihood of AI consciousness. Instead of being concern about AI turning conscious and machine ethics, and trying to instantiate AI consciousness soon, we should perhaps focus more on making AI less costly and more useful to society. (shrink)

The problem of the relation between mind and brain has been among the most persistent in modern Western thought, one that even recent advances in neuroscience haven't been able to put to rest. Historian Larry McGrath's Making Spirit Matter is about how a particularly productive and influential generation of late nineteenth- and early twentieth-century French thinkers attempted to answer this puzzle by showing the mutual dependence of spirit and matter. The veritable revolution taking place across disciplines, from philosophy to psychology, (...) located our spiritual powers in the brain and offered a radical reformulation of the meaning of science, spirit, and the self. Pulling out connections between thinkers such as Bergson, Blondel, and Fouille̹e, among others, McGrath plots the intellectual movements that brought back to life themes of agency, time, and experience by putting into action the very sciences that seemed to undermine metaphysics and theology. In so doing, Making Spirit Matter lays bare the long legacy of this moment in the history of ideas and how it might renew our understanding of the relationship between mind and brain. (shrink)

This commentary makes a case for a connection between the hierarchically organized skills emphasized in Greenfield's (1991t) target article and rhythmic skills utilized in music. It also links hierarchical organization with automated processing. Implicit is the notion that lower levels of a hierarchy become automatic, as they go under control of higher levels of organization.

Jean-Pierre Changeux's Neuronal Man attempts to define mental activity, that is thought, with respect to the neurophysiology of the brain.*Since antiquity, the historical account of these problems has undergone the examination of classical notions: what is a mental image, a concept, a representation? Changeux, who accepts these traditional points of departure, as well as the notion of signification, aims to clarify the physical, neurophysiological counterparts of these notions, in order to arrive at less simplistic terms: image de memoire “memory image,” (...) later - objet mental “mental object,” and still later - objet de mémoire “memory object.” Behind these terms lies transition to neurophysiology, with the notion of engram, and finally with the notion of trace, a notion which is precise but very general, since the substantive reality of these traces, their anatomy and physiology in the brain has yet to be determined. (shrink)

How Technologies of Imaging are Shaping Clinical Research and Practice in Neurology Content Type Journal Article Category Past & Present Pages 315-328 DOI 10.1007/s12376-010-0037-1 Authors Nicolas Kopp, Hôpital de l’HotelDieu Lyon University Hospitals, EspaceEthique Inter-régional 69288 Lyon, Cedex 02 France Journal Medicine Studies Online ISSN 1876-4541 Print ISSN 1876-4533 Journal Volume Volume 1 Journal Issue Volume 1, Number 4.