In lieu of an abstract, here is a brief excerpt of the content:Convention for Protection of Human Rights and Dignity of the Human Being with Regard to the Application of Biology and Biomedicine: Convention on Human Rights and BiomedicineCouncil of EuropePreambleThe Member States of the Council of Europe, the other States and the European Community signatories hereto,Bearing in mind the Universal Declaration of Human Rights proclaimed by the General Assembly of the United Nations on 10 December 1948;Bearing in mind the (...) Convention for the Protection of Human Rights and Fundamental Freedoms of 4 November 1950;Bearing in mind the European Social Charter of 18 October 1961;Bearing in mind the International Covenant on Civil and Political Rights and the International Covenant on Economic, Social and Cultural Rights of 16 December 1966;Bearing in mind the Convention for the Protection of Individuals with Regard to Automatic Processing of Personal Data of 28 January 1981;Bearing also in mind the Convention on the Rights of the Child of 20 November 1989;Considering that the aim of the Council of Europe is the achievement of a greater unity between its members and that one of the methods by which that aim is to be pursued is the maintenance and further realisation of human rights and fundamental freedoms;Conscious of the accelerating developments in biology and medicine;Convinced of the need to respect the human being both as an individual and as a member of the human species and recognising the importance of ensuring the dignity of the human being; [End Page 277]Conscious that the misuse of biology and medicine may lead to acts endangering human dignity;Affirming that progress in biology and medicine should be used for the benefit of present and future generations;Stressing the need for international co-operation so that all humanity may enjoy the benefits of biology and medicine;Recognising the importance of promoting a public debate on the questions posed by the application of biology and medicine and the responses to be given thereto;Wishing to remind all members of society of their rights and responsibilities;Taking account of the work of the Parliamentary Assembly in this field, including Recommendation 1160 (1991) on the preparation of a Convention on bioethics;Resolving to take such measures as are necessary to safeguard human dignity and the fundamental rights and freedoms of the individual with regard to the application of biology and medicine;Have agreed as follows:Chapter IGeneral provisionsArticle 1. (Purpose and object)Parties to this Convention shall protect the dignity and identity of all human beings and guarantee everyone, without discrimination, respect for their integrity and other rights and fundamental freedoms with regard to the application of biology and medicine.Each Party shall take in its internal law the necessary measures to give effect to the provisions of this Convention.Article 2. (Primacy of the human being)The interests and welfare of the human being shall prevail over the sole interest of society or science.Article 3. (Equitable access to health care)Parties, taking into account health needs and available resources, shall take appropriate measures with a view to providing, within their jurisdiction, equitable access to health care of appropriate quality. [End Page 278]Article 4. (Professional standards)Any intervention in the health field, including research, must be carried out in accordance with relevant professional obligations and standards.Chapter IIConsentArticle 5. (General rule)An intervention in the health field may only be carried out after the person concerned has given free and informed consent to it.This person shall beforehand be given appropriate information as to the purpose and nature of the intervention as well as on its consequences and risks.The person concerned may freely withdraw consent at any time.Article 6. (Protection of persons not able to consent)1. Subject to Articles 17 and 20 below, an intervention may only be carried out on a person who does not have the capacity to consent, for his or her direct benefit.2. Where, according to law, a minor does not have the capacity to consent to an intervention, the intervention may only be carried out with the authorisation of his or her representative or an authority or a person or... (shrink)

Disorders of Consciousness (DoCs) raise difficult and complex questions about the value of life for persons with impaired consciousness, the rights of persons unable to make medical decisions, and our social, medical, and ethical obligations to patients whose personhood has frequently been challenged and neglected. Recent neuroscientific discoveries have led to enhanced understanding of the heterogeneity of these disorders, and focused renewed attention on the medical and ethical problem of misdiagnosis. -/- This book examines the entanglement of epistemic (...) and ethical uncertainty in DoCs and other medical contexts, and how they interact to create both epistemic and ethical risks. Philosopher and bioethicist L. Syd M Johnson pulls together multiple threads in this work: the ontological mysteries of consciousness, medical uncertainty about unconsciousness, ableist bias, withdrawal of treatment in neurointensive care, and the rarely questioned view that consciousness is essential to personhood and moral status. Johnson challenges longstanding bioethical dogmas about DoC patients, and argues for an ethics of uncertainty for contexts where there is a need for decisive action in the presence of unavoidable uncertainty. The ethics of uncertainty refocuses ethical inquiry concerning persons with DoCs, placing less emphasis on their contested personhood, and more on inductive risk and uncertainty, on respect for autonomy, and especially on epistemic justice. With applications to various decisional contexts where uncertainty and ethical risk interact, this ethical approach enables surrogate decision makers facing fraught and risky choices to fulfill their obligations as moral and epistemic agents. (shrink)

Pain, suffering and positive emotions in patients in vegetative state/unresponsive wakefulness syndrome (VS/uws) and minimally conscious states (MCS) pose clinical and ethical challenges. Clinically, we evaluate behavioural responses after painful stimulation and also emotionally-contingent behaviours (e.g., smiling). Using stimuli with emotional valence, neuroimaging and electrophysiology technologies can detect subclinical remnants of preserved capacities for pain which might influence decisions about treatment limitation. To date, no data exist as to how healthcare providers think about end-of-life options (e.g., withdrawal of artificial nutrition (...) and hydration) in the presence or absence of pain in non-communicative patients. Here, we aimed to better clarify this issue by re-analyzing previously published data on pain perception (Prog Brain Res 2009 177, 329–38) and end-of-life decisions (J Neurol 2010 258, 1058–65) in patients with disorders of consciousness. In a sample of 2259 European healthcare professionals we found that, for VS/uws more respondents agreed with treatment withdrawal when they considered that VS/uws patients did not feel pain (77%) as compared to those who thought VS/uws did feel pain (59%). This interaction was influenced by religiosity and professional background. For MCS, end-of-life attitudes were not influenced by opinions on pain perception. Within a contemporary ethical context we discuss (1) the evolving scientific understandings of pain perception and their relationship to existing clinical and ethical guidelines; (2) the discrepancies of attitudes within (and between) healthcare providers and their consequences for treatment approaches, and (3) the implicit but complex relationship between pain perception and attitudes toward life-sustaining treatments. (shrink)

Human brain organoids (HBOs) are novel entities that may exhibit unique forms of cognitive potential. What moral status, if any, do they have? Several authors propose that consciousness may hold the answer to this question. Others identify various _kinds of_ consciousness as crucially important for moral consideration, while leaving open the challenge of determining whether HBOs have them. This paper aims to make progress on these questions in two ways. First, it proposes a framework for thinking about the (...) moral status of entities other than paradigmatic persons. This framework identifies four qualities that ground moral status: evaluative stance, self-directedness, agency, and other-directedness. Second, we speculate on ways in which these qualities are relevant to dimensions of conscious experience that have been, or could be, identified in nonhuman animals. We further explore how these approaches could be adapted for use in HBOs, and argue that such studies, or something similar to them, will have to be performed if we wish to have empirical indications that HBOs have consciousness of a morally significant kind. We end by proposing that in our current scientific and epistemic situation, it is too soon to attribute any moral status to HBOs, but that this might change in the future. (shrink)

The author focuses on the positive social consequences: humanity, justice. rights, responsibility and tolerance. He examines each of these principles and shows. that the ethics of social consequences can be accepted as an alternative way of considering contemporary moral problems as well as of looking for their optimal solutions.

Theories related to cognitive sciences, Human-in-the-loop Cyber-physical systems, data analysis for decision-making, and computational ethics make clear the need to create transdisciplinary learning, research, and application strategies to bring coherence to the paradigm of a truly human-oriented technology. Autonomous objects assume more responsibilities for individual and collective phenomena, they have gradually filtered into routines and require the incorporation of ethical practice into the professions related to the development, modeling, and design of algorithms. To make this possible, it is pertinent (...) and urgent to bring them closer to the problems and approaches of the humanities. Increasingly transdisciplinary research must be part of the construction of systems that provide developers and scientists with the necessary bases to understand the ethical debate and therefore their commitment to society. This article considers two theories as articulating axes: Blumenberg’s, coming from the field of philosophy, for whom the process of technification and especially the implementation of mathematical models in their algorithmic form leads to an emptying of meaning and therefore makes programmers who implement their functions to be alien to the concerns that gave them origin; Daston’s, belonging to the field of the history of science and according to which the division of labor in the processes of technification of the calculation implies a kind of subordination in which those who implement the inventions of a small group of privileged mathematicians ignore the procedures that put them into operation. Given these two theories, the black box models prevalent in AI development, and the urgency of establishing explanatory frameworks for the development of computational ethics, this article exposes the need to give a voice to the cultural history of consciousness for promoting the discussions around the implementation of mathematical algorithms. The paper takes as a reference the different points of view that have emerged around the study of technological ethics, its applicability, management, and design. It criticizes the current state of studies from a humanistic perspective and explains how the historical perspective allows promoting the training of software engineers, developers and creators so that they assume intuitions and moral values in the development of their work. Specifically, it aims to expose how cultural history, applied to the study of consciousness and its phenomena, makes those involved in this technological revolution aware of the effect that they, through their algorithms, have on society in general and on human beings in particular. (shrink)

The application of neuroimaging technology to the study of the injured brain has transformed how neuroscientists understand disorders of consciousness, such as the vegetative and minimally conscious states, and deepened our understanding of mechanisms of recovery. This scientific progress, and its potential clinical translation, provides an opportunity for ethical reflection. It was against this scientific backdrop that we convened a conference of leading investigators in neuroimaging, disorders of consciousness and neuroethics. Our goal was to develop an ethical frame (...) to move these investigative techniques into mature clinical tools. This paper presents the recommendations and analysis of a Working Meeting on Ethics, Neuroimaging and Limited States of Consciousness held at Stanford University during June 2007. It represents an interdisciplinary approach to the challenges posed by the emerging use of neuroimaging technologies to describe and characterize disorders of consciousness. (shrink)

The possibility of consciousness in human brain organoids is sometimes viewed as determinative in terms of the moral status such entities possess, and, in turn, in terms of the research protections such entities are due. This commonsense view aligns with a prominent stance in neurology and neuroscience that consciousness admits of degrees. My paper outlines these views and provides an argument for why this picture of correlating degrees of consciousness with moral status and research protections is mistaken. (...) I then provide an alternative account of the correlation between moral status and consciousness, and consider the epistemic ramifications for research protections of this account. (shrink)

Pain, suffering and positive emotions in patients in vegetative state/unresponsive wakefulness syndrome (VS/UWS) and minimally conscious states (MCS) pose clinical and ethical challenges. Clinically, we evaluate behavioural responses after painful stimulation and also emotionally-contingent behaviours (e.g., smiling). Using stimuli with emotional valence, neuroimaging and electrophysiology technologies can detect subclinical remnants of preserved capacities for pain which might influence decisions about treatment limitation. To date, no data exist as to how healthcare providers think about end-of-life options (e.g., withdrawal of artificial nutrition (...) and hydration) in the presence or absence of pain in non-communicative patients. Here, we aimed to better clarify this issue by re-analyzing previously published data on pain perception (Prog Brain Res 2009 177, 329–38) and end-of-life decisions (J Neurol 2010 258, 1058–65) in patients with disorders of consciousness. In a sample of 2259 European healthcare professionals we found that, for VS/UWS more respondents agreed with treatment withdrawal when they considered that VS/UWS patients did not feel pain (77%) as compared to those who thought VS/UWS did feel pain (59%). This interaction was influenced by religiosity and professional background. For MCS, end-of-life attitudes were not influenced by opinions on pain perception. Within a contemporary ethical context we discuss (1) the evolving scientific understandings of pain perception and their relationship to existing clinical and ethical guidelines; (2) the discrepancies of attitudes within (and between) healthcare providers and their consequences for treatment approaches, and (3) the implicit but complex relationship between pain perception and attitudes toward life-sustaining treatments. (shrink)

BackgroundAssessing consciousness in other subjects, particularly in non-verbal and behaviourally disabled subjects (e.g., patients with disorders of consciousness), is notoriously challenging but increasingly urgent. The high rate of misdiagnosis among disorders of consciousness raises the need for new perspectives in order to inspire new technical and clinical approaches. Main bodyWe take as a starting point a recently introduced list of operational indicators of consciousness that facilitates its recognition in challenging cases like non-human animals and Artificial Intelligence (...) to explore their relevance to disorders of consciousness and their potential ethical impact on the diagnosis and healthcare of relevant patients. Indicators of consciousness mean particular capacities that can be deduced from observing the behaviour or cognitive performance of the subject in question (or from neural correlates of such performance) and that do not define a hard threshold in deciding about the presence of consciousness, but can be used to infer a graded measure based on the consistency amongst the different indicators. The indicators of consciousness under consideration offer a potential useful strategy for identifying and assessing residual consciousness in patients with disorders of consciousness, setting the theoretical stage for an operationalization and quantification of relevant brain activity.ConclusionsOur heuristic analysis supports the conclusion that the application of the identified indicators of consciousness to its disorders will likely inspire new strategies for assessing three very urgent issues: the misdiagnosis of disorders of consciousness; the need for a gold standard in detecting consciousness and diagnosing its disorders; and the need for a refined taxonomy of disorders of consciousness. (shrink)

Human cerebral organoids are three-dimensional biological cultures grown in the laboratory to mimic as closely as possible the cellular composition, structure, and function of the corresponding organ, the brain. For now, cerebral organoids lack blood vessels and other characteristics of the human brain, but are also capable of having coordinated electrical activity. They have been usefully employed for the study of several diseases and the development of the nervous system in unprecedented ways. Research on human cerebral organoids is proceeding at (...) a very fast pace and their complexity is bound to improve. This raises the question of whether cerebral organoids will also be able to develop the unique feature of the human brain, consciousness. If this is the case, some ethical issues would arise. In this article, we discuss the necessary neural correlates and constraints for the emergence of consciousness according to some of the most debated neuroscientific theories. Based on this, we consider what the moral status of a potentially conscious brain organoid might be, in light of ethical and ontological arguments. We conclude by proposing a precautionary principle and some leads for further investigation. In particular, we consider the outcomes of some very recent experiments as entities of a potential new kind. (shrink)

The application of neuroimaging technology to the study of the injured brain has transformed how neuroscientists understand disorders of consciousness, such as the vegetative and minimally conscious states, and deepened our understanding of mechanisms of recovery. This scientific progress, and its potential clinical translation, provides an opportunity for ethical reflection. It was against this scientific backdrop that we convened a conference of leading investigators in neuroimaging, disorders of consciousness and neuroethics. Our goal was to develop an ethical frame (...) to move these investigative techniques into mature clinical tools. This paper presents the recommendations and analysis of a Working Meeting on Ethics, Neuroimaging and Limited States of Consciousness held at Stanford University during June 2007. It represents an interdisciplinary approach to the challenges posed by the emerging use of neuroimaging technologies to describe and characterize disorders of consciousness. (shrink)

In what ways should we include future humanoid robots, and other kinds of artificial agents, in our moral universe? We consider the Organic view, which maintains that artificial humanoid agents, based on current computational technologies, could not count as full-blooded moral agents, nor as appropriate targets of intrinsic moral concern. On this view, artificial humanoids lack certain key properties of biological organisms, which preclude them from having full moral status. Computationally controlled systems, however advanced in their cognitive or informational capacities, (...) are, it is proposed, unlikely to possess sentience and hence will fail to be able to exercise the kind of empathic rationality that is a prerequisite for being a moral agent. The organic view also argues that sentience and teleology require biologically based forms of self-organization and autonomous self-maintenance. The organic view may not be correct, but at least it needs to be taken seriously in the future development of the field of Machine Ethics. (shrink)

This paper addresses what we consider to be the most pressing challenge for the emerging science of consciousness: the measurement problem of consciousness. That is, by what methods can we determine the presence of and properties of consciousness? Most methods are currently developed through evaluation of the presence of consciousness in humans and here we argue that there are particular problems in application of these methods to nonhuman cases—what we call the indicator validity problem and the (...) extrapolation problem. The first is a problem with the application of indicators developed using the differences between conscious and unconscious processing in humans to the identification of other conscious vs. nonconscious organisms or systems. The second is a problem in extrapolating any indicators developed in humans or other organisms to artificial systems. However, while pressing ethical concerns add urgency to the attribution of consciousness and its attendant moral status to nonhuman animals and intelligent machines, we cannot wait for certainty and we advocate the use of a precautionary principle to avoid causing unintentional harm. We also intend that the considerations and limitations discussed in this paper can be used to further analyze and refine the methods of consciousness science with the hope that one day we may be able to solve the measurement problem of consciousness. (shrink)

Autism is one of the most compelling, controversial, and heartbreaking cognitive disorders. It presents unique philosophical challenges as well, raising intriguing questions in philosophy of mind, cognitive science, and philosophy of language that need to be explored if the autistic population is to be responsibly served. Starting from the "theory of mind" thesis that a fundamental deficit in autism is the inability to recognize that other persons have minds, Deborah R. Barnbaum considers its implications for the nature of consciousness, (...) our understanding of the consciousness of others, meaning theories in philosophy of language, and the modality of mind. This discussion lays the groundwork for consideration of the value of an autistic life, as well as the moral theories available to persons with autism. The book also explores questions about genetic decision making, research into the nature of autism, and the controversial quest for a cure. This is a timely and wide-ranging book on a disorder that commends itself to serious ethical examination. (shrink)

:Recent neuroimaging research on disorders of consciousness provides direct evidence of covert consciousness otherwise not detected clinically in a subset of severely brain-injured patients. These findings have motivated strategic development of binary communication paradigms, from which researchers interpret voluntary modulations in brain activity to glean information about patients’ residual cognitive functions and emotions. The discovery of such responsiveness raises ethical and legal issues concerning the exercise of autonomy and capacity for decisionmaking on matters such as healthcare, involvement in (...) research, and end of life. These advances have generated demands for access to the technology against a complex background of continued scientific advancement, questions about just allocation of healthcare resources, and unresolved legal issues. Interviews with professionals whose work is relevant to patients with disorders of consciousness reveal priorities concerning further basic research, legal and policy issues, and clinical considerations. (shrink)

This special issue of AJOB Neuroscience explores a number of ethical questions emerging from some of the most recent results of research on consciousness, including its moral interpretation, its te...

The intriguing issue of pain and suffering in patients with disorders of consciousness (DOCs), particularly in Unresponsive Wakefulness Syndrome/Vegetative State (UWS/VS) and Minimally Conscious State (MCS), is assessed from a theoretical point of view, through an overview of recent neuroscientific literature, in order to sketch an ethical analysis. In conclusion, from a legal and ethical point of view, formal guidelines and a situationist ethics are proposed in order to best manage the critical scientific uncertainty about pain and suffering (...) in DOCs and ensure the best possible care for the patient. (shrink)

People from Native American/First Nation spiritual traditions and from Christian religious backgrounds express sometimes contradictory, sometimes complementary perspectives on humans' role in an interrelated and interdependent "web of life." The extinction of salmon species in the Columbia-Snake river system of Canada and the United States, and the loss of salmon from the Haida Gwaii fisheries off the western coast of Canada, provide bioregional stimuli for reflection on whether nonhuman species have intrinsic value or solely instrumental value, and the extent to (...) which species preservation should have equitable status with, or take precedence over, human wants and apparent human needs. If societal needs and species conservation, and the common good of all creatures, are to be integrated for the good of the commons then a relational consciousness must replace "dominion" and "stewardship" attitudes toward creation. (shrink)

Recent results from neuroimaging appear to indicate that some patients in a vegetative state have partially intact awareness. These results may demonstrate misdiagnosis and suggest the need not only for alternative forms of treatment, but also for the reconsideration of end-of-life decisions in cases of disorders of consciousness. This article addresses the second consequence. First, I will discuss which aspects of consciousness may be involved in neuroimaging findings. I will then consider various factors relevant to ethical end-of-life decision-making, (...) and analyse whether and to what extent the above consequence applies to these factors. It will be shown that knowledge of the existence of partial awareness in patients with disorders of consciousness only influences end-of-life decision-making if certain background assumptions are made. (shrink)

A comprehensive study of the ethics of killing in cases in which the metaphysical or moral status of the individual killed is uncertain or controversial. Among those beings whose status is questionable or marginal in this way are human embryos and fetuses, newborn infants, animals, anencephalic infants, human beings with severe congenital and cognitive impairments, and human beings who have become severely demented or irreversibly comatose. In an effort to understand the moral status of these beings, this book develops (...) and defends distinctive accounts of the nature of personal identity, the evaluation of death, and the wrongness of killing. The central metaphysical claim of the book is that we are neither nonmaterial souls nor human organisms but are instead embodied minds. In ethical theory, one of the central claims is that the morality of killing is not unitary; rather, the principles that determine the morality of killing in marginal cases are different from those that govern the killing of persons who are self‐conscious and rational. Another important theme is that killing in marginal cases should be evaluated in terms of the impact it would have on the victim at the time rather than on the value of the victim's life as a whole. What primarily matters is how killing would affect that which would be rational for the victim to care about at the time of death. By appealing to various foundational claims about identity, death, and the morality of killing, this book yields novel conclusions about such issues as abortion, prenatal injury, infanticide, the killing of animals, the significance of brain death, the termination of life support in cases of persistent vegetative state, the use of anencephalic infants as sources of organs for transplantation, euthanasia, assisted suicide, and advance directives in cases of dementia. In particular, the book defends the moral permissibility of abortion, infanticide, and euthanasia in certain cases and argues that brain death is not the appropriate criterion of death either for a person or a human organism. (shrink)

There is ongoing ethical and legal debate about withdrawing life sup- port for patients with disorders of consciousness (DOCs). Frequently fu- eling the debate are implicit assumptions about the value of life in a state of impaired consciousness, and persistent uncertainty about the quality of life (QoL) of these persons. Yet there are no validated methods for assessing QoL in this population, and a significant obstacle to doing so is their inability to communicate. Recent neuroscientific discoveries might circumvent (...) that problem and help shed light on QoL in DOCs. There is an ethical imperative to prioritize QoL research in this patient population, to provide evidence to inform treatment, research, and end of life decisions. A minimalist and pragmatic model of QoL is proposed, targeting positive and negative affect as domains for which there is po- tential to reach across the communication gap, and restore to these voiceless persons some measure of control. (shrink)

Induced by intake of the psychedelic substances LSD, psilocybin, DMT and mescaline, psychedelic experiences have been extensively described by subjects as entailing a most unusual increase in the scope and quality of their consciousness. Accordingly, psychedelic experiences have been widely characterised as an “expansion of consciousness.” This article poses the following question, as yet unaddressed in contemporary philosophy and the tradition of phenomenology: to what exactly does “expansion of consciousness” refer as a general characterisation of psychedelic experiences, (...) and what role might attention play therein? On the basis of Aron Gurwitsch’s phenomenology of attention, the following thesis is presented: (a) “expansion of consciousness” refers to a particular restructuration of consciousness in psychedelic experiences. (b) This occurs by means of certain extreme transformations in direction, scope, mode and degree of attention. In order to explicate this thesis, the characteristic features of psychedelic experiences that pertain to expansion of consciousness and attention are first systematically identified from a survey of subject reports. Second, it is demonstrated that the few previous attempts to understand expansion of consciousness in terms of attention as a filter/reducing-valve, spotlight or zoom-lens each fail to explain how consciousness is structured in psychedelic experiences. Third, it is argued that psychedelic expansion of consciousness is a general restructuration of consciousness by means of extreme attentional transformations. In conclusion, brief consideration is given to the question of whether psychedelic expansion of consciousness can have epistemic and ethical value for life. (shrink)

Over forty years have passed since the death of Jean-Paul Sartre, still, his oeuvre stands out as a paramount achievement in existential-phenomenological thought. Among the numerous ideas and challenges he offered to contemporary continental philosophy, the problem of authenticity deserves a special place, for it connects many of existentialism’s key concerns. The ever reforming conceptualization of authenticity had spread from the mid-1930s (La transcendance de l’égo) till Sartre’s posthumously published Cahiers pour une morale that appeared in the early 1980s, and (...) it had a profound impact not only on ethical and literary theories, but also on psychiatry and psychotherapy. The present essay’s undertaking is to closely follow the trajectory of this celebrated concept, to contextualize its development in accordance with Sartre’s shifting philosophical as well as ethical projects over the years, and to point out some of the affinities this concept might have with East Asian thought, and with Buddhism in particular. (shrink)

The promise of virtual reality is that it may eventually lead us to a "third state of consciousness" transcending the objective reality of our embodied beings and opening up to us a world of expanded realization. However, the recurring themes of our hero myths, both religious and secular, remind us of the importance of remaining grounded in the real world of embodied people and phenomenal perception. Advances in neuroscience even suggest that unconscious processing of perceptual stimuli may guide our (...) behaviors. Thus, the journey from the phenomenal to the noumenal is a round-trip ticket. We take with us the strength of our moral convictions to serve us on our journey and bring back the spiritual expansion that always comes of travel. (shrink)

Recent work within such disparate research areas as the epistemology of perception, theories of well-being, animal and medical ethics, the philosophy of consciousness, and theories of understanding in philosophy of science and epistemology has featured disconnected discussions of what is arguably a single underlying question: What is the value of consciousness? The purpose of this paper is to review some of this work and place it within a unified theoretical framework that makes contributions (and contributors) from these (...) disparate areas more visible to one another. (shrink)

The present paper is devoted to a detailed presentation of a new Military Ethics doctrine of fighting terror. It is proposed as an extension of the classical Just War Theory, which has been meant to apply to ordinary international conflicts. Since the conditions of a fight against terror are essentially different from the conditions that are assumed to hold in the classical war (military) paradigm or in the law enforcement (police) paradigm, a third model is needed. The paper proposes (...) such a model in the form of principles that should govern the activity of a democratic state when faced with terror. Eleven principle are proposed. Two are on the level of the state, including the Principle of Self-Defense Duty. Six are related to military preventive acts against activities of terror, including new formulations of a Principle of Military Necessity, a Principle of Distinction, and a Principle of Military Proportionality. Principles of Low Probabilities, Time Span Considerations and Professional Understanding are also included. Finally, three principles that are related to consciousness-directed activities against terror are added: a Principle of Permanent Notice, a Principle of Compensation, and a Principle of Operational Deterrence. The exposition of the principles is accompanied by arguments about their moral justification. The doctrine has been developed on the background of the IDF fight against acts and activities of terror performed by Palestinian individuals and organizations. (shrink)

In English law there is a strong presumption that life should be maintained. This article contends that this presumption means that it is always unlawful to withdraw life-sustaining treatment from patients in permanent vegetative state and minimally conscious state, and that the reasons for this being the correct legal analysis mean also that such withdrawal will always be ethically unacceptable. There are two reasons for this conclusion. First, the medical uncertainties inherent in the definition and diagnosis of PVS/MCS are such (...) that, as a matter of medical fact, it can never be established, with the degree of certainty necessary to rebut the presumption, that it is not in the patient’s best interest to remain alive. And second, that even if permanent unconsciousness can be unequivocally demonstrated, the presumption is not rebutted. This is because there is plainly more to human existence than consciousness. It can never be said that the identity of the patient whose best interests are at stake evaporates when that person ceases to be conscious. Nor can it be said that the best interests of an unconscious person do not mandate continued biological existence. We simply cannot know. That uncertainty is legally conclusive, and should be ethically conclusive. (shrink)

Savulescu J. Is current practice around late termination of pregnancy eugenic and discriminatory? Maternal interests and abortion. J Med Ethics 2001;27:165–71. Lachlan de Crespigny contributed in a major way to the conceptualisation, design, administration of surveys, ….

Current management of people with prolonged disorders of consciousness is failing patients, families and society. The causes include a general lack of concern, knowledge and expertise; a legal and professional framework which impedes timely and appropriate decision-making and/or enactment of the decision; and the exclusive focus on the patient, with no legitimate means to consider the broader consequences of healthcare decisions. This article argues that a clinical pathway based on the principles of the English Mental Capacity Act 2005 and (...) using time-limited treatment trials could greatly improve patient management and reduce stress on families. There needs to be early and continuing use of formal best interests meetings, starting between 7 and 21 days after onset of unconsciousness. The treatment options need to evolve as the clinical state and prognosis becomes more certain. A formal discussion of treatment withdrawal should occur when the upper bound of predicted recovery falls below a level the patient would have considered acceptable, and it should always be discussed when the condition is considered permanent. Any decision to stop treatment should be contingent on a formal second opinion from an independent expert who should review the clinical situation and expected prognosis, but not the best interests decision. The article also asks how, if at all, the adverse effects on the family and the resource implications of long-term care of people left in a prolonged state of unconsciousness should be incorporated in the process. (shrink)

The scientific study of consciousness or subjective experiencing is a rapidly expanding research program engaging philosophers of mind, psychologists, cognitive scientists, neurobiologists, evolutionary biologists and biosemioticians. Here we outline an evolutionary approach that we have developed over the last two decades, focusing on the evolutionary transition from non-conscious to minimally conscious, subjectively experiencing organisms. We propose that the evolution of subjective experiencing was driven by the evolution of learning and we identify an open-ended, representational, generative and recursive form of (...) associative learning, which we call Unlimited Associative Learning (UAL), as an evolutionary transition marker of minimal consciousness. This evolutionary marker provides evidence that the evolutionary transition to consciousness has gone to completion and allows reverse-engineering from this learning capacity to the system that enables it – making possible the construction of a toy model of UAL. The model allows us to identify some of the key processes and structures that constitute minimal consciousness, points its taxonomic distribution and the ecological context in which it first emerged, highlights its function and suggests a framework for exploring developmental and evolutionary modifications of consciousness. We point to ways of experimentally testing the relationship between UAL and consciousness in human and in non-human animals and discuss the theoretical and ethical implications of our approach. The framework we offer allows the exploration of the evolutionary changes in agency, value systems, selective processes and goals that were involved in the transition to subjective experiencing from a perspective that resonates with the approaches of bio-semioticians. (shrink)

In The Matter of Consciousness (TMOC), I defend Frank Jackson’s (1982, 1986, 1995) knowledge argument, which poses a significant challenge to physicalism. I also argue that the knowledge argument leads to Russellian monism.

Starting from the separation between rational and irrational motivation, Husserl elaborates a formal ethics which justifies the universal validity of its principles on the logical feature of proposition. On the other hand, since the irrationality of motivation represents the associative stream of consciousness constituting the passive background of rational life of subject, the formal aspect of Husserlian ethics seems to be well rooted in the materiality and con-creteness of existen...

What should advocates of phenomenal intentionality say about unconscious intentional states? I approach this question by focusing on a recent debate between Tim Crane and David Pitt, about the nature of belief. Crane argues that beliefs are never conscious. Pitt, concerned that the phenomenal intentionality thesis coupled with a commitment to beliefs as essentially unconscious embroils Crane in positing unconscious phenomenology, counter-argues that beliefs are essentially conscious. I examine and rebut Crane’s arguments for the essential unconsciousness of beliefs, some of (...) which are widely endorsed. On the way I sketch a model of how belief states could participate in the stream of consciousness. I then consider Pitt’s position, arguing in reply, along Freudian lines, that we should posit not just dispositional but occurrent unconscious beliefs. This result, I argue, indeed requires advocates of phenomenal intentionality to posit unconscious qualia to fix these unconscious occurrent thoughts, and I defend the coherence of the notion of unconscious qualia against some common attacks. Ultimately, I claim, the combination of taking seriously the occurrent unconscious, and a commitment to phenomenal intentionality, should lead us to expand William James’s conception of the stream of consciousness to encompass, additionally, a stream of unconscious mental life—or, perhaps better, to posit a single partly conscious partly unconscious qualia-stream of mental goings-on. (shrink)

My basic contention in this essay is that the proper characterization of Confucian ethics is not role-based ethics, rule-based ethics, or virtue ethics, but an ethics of the self or a self-based ethics. In essence, Confucian ethics is about how to realize a self in line with inner sagehood and outer kinghood ; it is about how to realize a self as fully self-conscious being-for-itself of definite character, substance, and personality. Confucian ethics (...) does not start with the assumption that there is a given self that should be made virtuous, rule-abiding, or dutiful, but starts from the assumption that a self needs to be created, developed, and realized in the ethical life while the potentiality of building a self is given. (shrink)

BackgroundDespite consensus about the importance of implementing shared decision-making (SDM) in clinical practice, this ideal is inconsistently enacted today. Evidence shows that SDM practices differ in the degree of involvement of patients or family members, or in the amount of medical information disclosed to patients in order to “share” meaningfully in treatment decisions. Little is known on which representations and moral justifications physicians hold when realizing SDM. This study explored physicians’ experiences of SDM in the management of paediatric patients with (...) prolonged disorders of consciousness (PDOC). Specifically, we focused on physicians’ SDM approaches, representations, and ethical justifications for engaging in SDM.MethodsWe used a qualitative approach to explore the SDM experiences of 13 ICU physicians, paediatricians, and neurologists based in Switzerland who have been or were involved in the care of paediatric patients living with PDOC. A semi-structured interview format was used and interviews were audio-recorded and transcribed. Data were analysed through thematic analysis.ResultsWe found that participants followed three main decision-making approaches: the “brakes” approach, characterized by maximized family’s decisional freedom, though conditional to physician’s judgment regarding the medical appropriateness of a treatment; the “orchestra director” approach, characterized by a multi-step decision-making process led by the main physician aimed at eliciting the voices of the care team members and of the family; and the “sunbeams” approach, characterized by a process oriented to reach consensus with family members through dialogue, where the virtues of the physician are key to guide the process. We also found that participants differed in the moral justifications sustaining each approach, citing the duty to respect parental autonomy, to invest in an ethics of care, and to employ physicians’ virtues to guide the decision-making process.ConclusionOur results show that physicians come to perform SDM in different ways, with several representations, and distinct ethical justifications. SDM training among health care providers should clarify the ductility of SDM and the several ethical motivations underpinning it, rather than insisting on the principle of respect for patient’s autonomy as its only moral foundation. (shrink)

Dheensa S, Fenwick A, Lucassen A.‘Is this knowledge mine ….

This short communication explores the idea of “stream of consciousness” and considers some of the ways in which scientific writing relies – even or perhaps especially insofar as it does not signal this fact – on the resources of literary language and literary thinking. Particular attention is given to notions of literal and figurative or metaphorical language, including “hydrological” and “ontic” metaphor. A crucial figure is simile (the “like”), discussed here in relation to the Thomas Nagel’s “What is it (...) Like to Be a Bat?”, Todd Feinberg and Jon Mallatt’s Consciousness Demystified, and Anil Seth’s Being You: A New Science of Consciousness. Neuroethics cannot restrict itself to the domain of technology and the human. The deconstruction of anthropocentrism, already underway in literary modernism, calls for responsibility in relation to non-human as well as human life-forms. Virginia Woolf’s Mrs Dalloway provides rich and multifarious resources for exploring these issues. Woolf’s novel is considered as a kind of literary water music, in which sense and feeling is not limited to the human, and distinctions between consciousness and the environment are susceptible to dissolution. Woolf’s work is concerned with a conception of stream of consciousness as telepathic fluidity, as “merging minds” but without restitution of the individual or collective. (shrink)

"Displaying a masterful grasp of the texts, the author shows how otherness forces itself upon the existentialist Sartre, gradually constraining him to modify his understanding of consciousness as omnipotent. The issue is Sartre’s discovery of the social and its conceptual assimilation into his individualistic, consciousness-oriented philosophy." —Thomas R. Flynn "This very successful and accessible scholarly book... is simultaneously a succinct and clear overview of Sartre’s philosophical works.... and a fresh consideration of Sartre’s body of work." —Choice "Busch’s admirably (...) clear and compact discussion is essential reading for Sartre scholars, since it powerfully addresses many issues dividing them... " —Ethics "... a useful overview of the evolution of Sartre’s thought... " —Review of Politics "... a thought provoking reassessment of Sartre's philosophical career." —Man and World "... succinct, richly documented survey... " —International Studies in Philosophy. (shrink)

Abstract:This paper, presented as the 2019 Cambridge Quarterly Neuroethics NetworkCharcot Lecture, traces the nosology of disorders of consciousness in light of 2018 practice guidelines promulgated by the American Academy of Neurology, the American College of Rehabilitation Medicine and the National Institute on Disability, Independent Living and Rehabilitation Research. By exploring the ancient origins of Jennett and Plum’s persistent vegetative state and subsequent refinements in the classification of disorders of consciousness—epitomized by the minimally conscious state, cognitive motor dissociation, and (...) the recently described chronic vegetative state—the author argues that there is a counter-narrative to the one linking these conditions to the right to die. Instead, there is a more nuanced schema distinguishing futility from utility, informed by technical advances now able to identify covert consciousness contemplated by Jennett and Plum. Their prescience foreshadows recent developments in the disorders of consciousness literature yielding a layered legacy with implications for society’s normative and legal obligations to these patients. (shrink)

This volume is a critical investigation into the contemporary phenomenon of the dissensus of the globe and the planet, and the new terrains of consciousness that need to be negotiated towards a possibility for transformation. It examines the possibilities of alternate, sustainable modes of being and existing in a world which requires a unified, ethical, biopolitical worldview. The book explores themes like philosophical posthumanism and planetary concerns; disruption of cultural and intellectual inequality; bodily movement through nomadic subjectivity; dystopic spatialities (...) of game(re)play; globalization, and speculative imaginaries of the body; and theory of multiplicity. It also discusses impact of COVID on human beings, role of the neoliberal media, the question of rights of robots and cyborgs in sci-fi movies, and representation of refugees in literature. This book will be of interest to scholars and researchers of English literature, political philosophy, cultural studies, literary cultures, post-colonial studies, critical theory, and social anthropology. (shrink)

Sanctions such as those applied by the United Nations against Yugoslavia, or rather the actions of implementing and maintaining them, at the very least implicitly purport to have moral justification. While the rhetoric used to justify sanctions is clearly moralistic, even sanctions themselves, as worded, often include phrases indicating moral implication. On May 30, 1992, United Nation Security Council Resolution 757 imposed a universal, binding blockage on all trade and all scientific, cultural and sports exchanges with Serbia and Montenegro. In (...) addition to expressing the usual "concern' and "dismay" regarding various events, the language of this Resolution also includes, on three occasions, unmistakably moral language "deploring" failures in meeting the demands of earlier resolutions.' There is no question that sanctions have political, economic, military and trategic consequences for the sanctioned state, perhaps exactly as desired by the sanctioning party. However, the question raised in this essay is whether in addition to these consequences, sanctions also produce morally reprehensible consequences that undermine their often-cited moral justification. If so, international economic sanctions are an immoral means of achieving primarily political goals. Six morally significant consequences are: 1) The unethical, elevated susceptibility of the sanctioned to olitical (and other forms of) manipulation, 2) the inherent and unjust paternalism in the process of sanctioning, 3) the abandonment of strict moral criteria on virtually all levels of evaluation, primarily inside the sanctioned country, but also in sanctioning states best exhibited in the attitudes toward the sanctioned, 4) the general decline in moral consciousness, 5) the subsequent rise of many forms of violence within the sanctioned state in connection with the increase in lawlessness, and a general decline of expectations in all areas of life, and 6) the continual, arbitrary redefining of conditions for a final lifting of sanctions. In light of this moral phenomenology we shall argue that sanctions, lacking in moral justification, are simply a means for achieving the mentioned immoral goals. Furthermore, the argument will be that sanctions are a form of siege and, as such, an act of war, requiring the sort of justification that would be needed to justify a war. (shrink)