Life-sustaining treatment is sometimes withdrawn or withheld from critically ill newborn infants with poor prognosis. Guidelines relating to such decisions place emphasis on the best interests of the infant. However, in practice, parental views and parental interests are often taken into consideration.In this paper I draw on the example of newborn infants with severe muscle weakness (for example spinal muscular atrophy). I provide two arguments that parental interests should be given some weight in decisions about treatment, and that they should (...) be given somewhat more weight in decisions about newborns than for older children. Firstly, the interests of the infant and of parents intersect, and are hard to separate. Parents’ views about treatment may be relevant to an assessment of the infant’s interests, and they may also affect those interests. Secondly, the interests of the infant in her future are relatively reduced by her developmental immaturity. In some situations parents’ welfare interests outweigh those of the infant. However, I argue that this would not justify treatment limitation except in the setting of severe impairment. (shrink)

Estimates of the burden of disease assess the mortality and morbidity that affect a population by producing summary measures of health such as quality-adjusted life years and disability-adjusted life years. These measures typically do not include stillbirths among the negative health outcomes they count. Priority-setting decisions that rely on these measures are therefore likely to place little value on preventing the more than three million stillbirths that occur annually worldwide. In contrast, neonatal deaths, which occur in comparable numbers, have a (...) substantial impact on burden of disease estimates and are commonly seen as a pressing health concern. In this article we argue in favor of incorporating unintended fetal deaths that occur late in pregnancy into estimates of the burden of disease. Our argument is based on the similarity between late-term fetuses and newborn infants and the assumption that protecting newborns is important. We respond to four objections to counting stillbirths: that fetuses are not yet part of the population and so their deaths should not be included in measures of population health; that valuing the prevention of stillbirths will undermine women's reproductive rights; that including stillbirths implies that miscarriages should also be included; and that birth itself is in fact ethically significant. We conclude that our proposal is ethically preferable to current practice and, if adopted, is likely to lead to improved decisions about health spending. (shrink)

Talia Welsh (2006) argues that Shaun Gallagher and Andrew Meltzoff's (1996) application of neonatal imitation research is insufficient grounds for their claim that neonates are born with a primitive body image and thus an innate self-awareness. Drawing upon an understanding of the self that is founded upon a ?theory of mind,? Welsh challenges the notion that neonates have the capacity for self-awareness and charges the supposition with an essentialism which threatens to disrupt more social constructionist understandings of the self. In (...) this paper, I initially defend Gallagher and Meltzoff's (1996) application of infant imitation to understandings of neonatal self-awareness by explaining how body image schemas can be understood as non-representational embodied cognitive phenomena that challenge ?theory of mind? theory. I then further develop the claim that neonates are born self-aware with reference to my own work in fetal development. I conclude that Welsh's political concerns are unfounded by showing how the conclusion that a neonate is self-aware does not signal a return to an essentialist understanding of self-awareness, but rather introduces into philosophical and psychological discourse possible alternate understandings of an embodied sense of self that are embedded within intersubjective contexts. (shrink)

I present empirical evidence suggesting that an infant first becomes aware of herself as the focal center of a caregiver's attending. Yet that does not account for her awareness of herself as agent. To address this question, I bring in research on neonatal imitation, as well as studies demonstrating the existence of a neural system in which parts of the same brain areas are activated when observing another's action and when executing a similar one. Applying these findings, I consider gestural (...) exchanges between infant and caregiver, such as reciprocal smiles and imitative vocalizations. Lacking self-awareness at first, the infant is unaware of her own agency. By returning her unwitting gesture, the caregiver singles out for her—thanks to neural matching—the gesture's kinesthesis. Moreover, the caregiver's smile, imitative vocalization, or other gesture is the form that focusing takes. The kinesthesis of the infant's gesture, in being singled out, is experienced by the infant as what the caregiver is focusing on. It is experienced as being within the focal center. In this way, the infant becomes aware of herself as a bodily entity acting toward the caregiver. Exchanges that involve matching are at first essential, I argue, in making the infant present to herself in action. Matching will cease to be necessary, but self-awareness continues to depend fundamentally on others until the acquisition of language, when the child becomes capable of talking to herself as if she were the caregiver. (shrink)

When I see a mountain to be far away, there is non-reflective awareness of myself as that from which distance is measured. Likewise, there is self-awareness when I see a tree as offering shade or a hiding place. In such cases, how can the self I am aware of be the same as I who am aware of it? Can the perceived be its perceiver? Mobilizing infancy research, I offer the following thesis as to how one can be aware of (...) oneself, at a single stroke, as perceiver and as embodied entity. During face-to-face interaction at 2 or 3 months, the infant has a sensuous perception of the caregiver as well as a non-sensuous impression of something she is eyeing and vocalizing toward. This implicit target is the self as it first becomes present to the child. It is shown how the target of her attending is experienced by him as embodied, active, affective, and continuous. After acquiring language, however, the child becomes capable of playing the caregiver toward himself: He can speak in her manner while listening as the one addressed. Thus the relation is internalized. The outcome is the independent and secure self-awareness that typifies post-infancy life. Independence bears a price, which is assessed. (shrink)

Although philosophical approaches to the self are diverse, several of them are relevant to cognitive science. First, the notion of a 'minimal self', a self devoid of temporal extension, is clarified by distinguishing between a sense of agency and a sense of ownership for action. To the extent that these senses are subject to failure in pathologies like schizophrenia, a neuropsychological model of schizophrenia may help to clarify the nature of the minimal self and its neurological underpinnings. Second, there is (...) good evidence to suggest that although certain aspects of the minimal self are primitive and embodied, other aspects may be accessed only in reflective consciousness. Employing a modified concept of the minimal self, it may be possible to construct a robotic form of non-conscious self-reference that depends on an interaction between the robotic body and its environment. In contrast to the minimal self, the narrative self involves continuity over time and is directly relevant to discussions of memory and personal identity. There is growing consensus among philosophers and cognitive scientists about the importance of narrative and its relation to episodic memory and left-hemisphere functions. There are, however, at least two different views of how the narrative self is structured. On one model it is nothing more than an abstract point. On a more extended view, proposed here, the self is a rich amalgam of narratives that allows for the equivocations, contradictions, and self-deceptions of personal life. Even in this case, however, neurocognitive models contribute to our understanding of how narrative identity is structured. (shrink)

On the phenomenological view, a minimal form of self-consciousness is a constant structural feature of conscious experience. Experience happens for the experiencing subject in an immediate way and as part of this immediacy, it is implicitly marked as my experience. For the phenomenologists, this immediate and first-personal givenness of experiential phenomena must be accounted for in terms of a pre-reflective self-consciousness. In the most basic sense of the term, selfconsciousness is not something that comes about the moment one attentively inspects (...) or reflectively introspects one's experiences, or in the instant of self-recognition of one's image in the mirror, or in the proper use of the first-person pronoun, or in the construction of a self-narrative. Rather, these different kinds of self-consciousness are to be distinguished from the pre-reflective self-consciousness which is present whenever I am living through or undergoing an experience, i.e., whenever I am consciously perceiving the world, whenever I am thinking an occurrent thought, whenever I am feeling sad or happy, thirsty or in pain, and so forth. (shrink)

Imitation and mirroring processes are necessary but not sufficient conditions for children to develop human sociality. Human sociality entails more than the equivalence and connectedness of perceptual experiences. It corresponds to the sense of a shared world made of shared values. It originates from complex ‘open’ systems of reciprocation and negotiation, not just imitation and mirroring processes that are by definition ‘closed’ systems. From this premise, we argue that if imitation and mirror processes are important foundations for sociality, human inter-subjectivity (...) develops primarily in reciprocation, not just imitation. Imitation provides a basic sense of social connectedness and mutual acknowledgment of existing with others that are ‘like me.’ However, it does not allow for the co-construction of meanings with others. For human sociality to develop, imitation and mirroring processes need to be supplemented by an open system of reciprocation. Developmental research shows that from the second month, mirroring, imitative, and other contagious emotional responses are by-passed. Imitation gives way to first signs of reciprocation (primary intersubjectivity), joint attention to objects (secondary intersubjectivity), the emergence of values that are jointly represented and negotiated with others (tertiary intersubjectivity), and eventually the development of an ethical stance accompanying theories of mind by 4 years of age. We review this development and propose that if mirroring processes enable individuals to bridge their subjective experiences, human inter-subjectivity proper develops from reciprocal social exchanges that lead to value negotiation and mutual recognition, both cardinal trademarks of human sociality. (shrink)

Cooperation admits of degrees. When factory workers stage a slowdown, they do not cease to cooperate with management in the production of goods altogether, but they are not fully cooperative either. Full cooperation implies that participants in a joint action are committed to rendering appropriate contributions as needed toward their joint end so as to bring it about, consistently with the type of action and the generally agreed upon constraints within which they work, as efficiently as they can, where their (...) contributions are sensitive to information (where available) about how others are contributing in the sense that they adjust as needed their contributions in light of information about how others are contributing to ensure effective pursuit of their joint end, where this includes rendering aid to other participants if needed, insofar as they are able. Full cooperation entails those cooperating are engaged in a joint intentional action. Some prominent studies of joint intentional action focus exclusively on cases of full cooperation (notably that of Michael Bratman (2014)). But not all joint intentional action is fully cooperative. One example is the work slowdown. Another example is provided by competitive games like chess and football, or sports like boxing and wrestling, where participants are clearly not intending to contribute to the pursuit of all of the goals of the others engaged in the activity, even when those goals are internal to the type of activity in question, but instead intend actively to frustrate some of them. In this paper, I provide a taxonomy of forms of non-cooperative behavior within the context of behavior that is still to some degree cooperative, and I argue that the minimal conditions of joint intentional action define minimal cooperative behavior, that is, that minimally joint intentional action is per se minimally cooperative behavior. I define in precise terms what that comes to, and how it is possible in cases in which it seems that one or more participants are in one or more ways acting so as to frustrate the contributions of other participants to their joint action. (shrink)

This paper examines how three central aspects of personhood — the capacities of individuals, their normative status, and the social aspect of being recognized — are related, and how personhood depends on them. The paper defends first of all a ‘basic view’that while actual recognition is among the constitutive elements of full personhood, it is the individual capacities (and not full personhood) which ground the basic moral and normative demands concerning treatment of persons. Actual recognition depends analyti- cally on such (...) pre-existing normative requirements: it is a matter of responsiveness to them. The paper then discusses four challenges. The challenges claim that pace the basic view, the relevant capacities depend on recognition, that recognition seems to have normative rele- vance, and that the basic view cannot as such explain the equality either of persons, or of humans. Responding to these challenges amounts to refining the basic view accordingly. (shrink)

The interaction theory of social cognition contends that intersubjective interaction is characterized by both immersion and irreducibility. This motivates a question about autonomy and self-agency: If I am always caught up in processes of interaction, and interaction always goes beyond me and my ultimate control, is there any room for self-agency? I outline an answer to this question that points to the importance of communicative and narrative practices.

This paper argues that self-consciousness and moral agency depend crucially on both embodied and social aspects of human existence, and that the capacity for practical wisdom, phronesis, is central to moral personhood. The nature of practical wisdom is elucidated by drawing on rival analyses of expertise. Although ethical expertise and practical wisdom differ importantly, they are alike in that we can acquire them only in interaction with other persons and through habituation. The analysis of moral agency and practical wisdom is (...) framed by Dennett's proposal that moral personhood requires satisfaction of six conditions, including self-consciousness. (shrink)

This work represents an interdisciplinary attempt at the development of a-- scientific theory of norms and normativity. Normativity, understood in its most general interpretation as value determinations and prescriptions, has traditionally been troublesome to account by science and difficult to “place” within a scientific worldview. Such an accomplishment is attempted by the joining in conversation of two bodies of literature. The first of these is Steve Fuller’s naturalist epistemology and the second corresponds to the situated study of cognition, along with (...) the epistemologies that have resulted from their findings. These two bodies of literature constitute the most radically naturalist attempts at developing a viable frame of epistemological and/or normative reference within their respective fields. (shrink)