Patient outcome after serious brain injury is highly variable. Following a period of coma, some patients recover while others progress into a vegetative state (unresponsive wakefulness syndrome) or minimally conscious state. In both cases, assessment is difficult and misdiagnosis may be as high as 43%. Recent advances in neuroimaging suggest a solution. Both functional magnetic resonance imaging and electroencephalography have been used to detect residual cognitive function in vegetative and minimally conscious patients. Neuroimaging may improve diagnosis and prognostication. These techniques (...) are beginning to be applied to comatose patients soon after injury. Evidence of preserved cognitive function may predict recovery, and this information would help families and health providers. Complex ethical issues arise due to the vulnerability of patients and families, difficulties interpreting negative results, restriction of communication to “yes” or “no” answers, and cost. We seek to investigate ethical issues in the use of neuroimaging in behaviorally nonresponsive patients who have suffered serious brain injury. The objectives of this research are to: (1) create an approach to capacity assessment using neuroimaging; (2) develop an ethics of welfare framework to guide considerations of quality of life; (3) explore the impact of neuroimaging on families; and, (4) analyze the ethics of the use of neuroimaging in comatose patients. (shrink)

: This paper responds to the sense of "crisis" or "trouble" that dominates contemporary feminist debate about the categories of sex and gender. It argues that this perception of crisis has emerged from a fundamental confusion of theoretical and political issues concerning the implications of the sex/gender debate for political representation and agency. It explores the sense in which this confusion is manifest in a debate between Seyla Benhabib and Judith Butler.

Higher education has been changing radically in recent years, with increasing numbers of students, and complaints about declining standards. This volume brings together leading intellectuals from the US and UK to examine the issues involved.

This paper responds to the sense of “crisis” or “trouble” that dominates contemporary feminist debate about the categories of sex and gender. It argues that this perception of crisis has emerged from a fundamental confusion of theoretical and political issues concerning the implications of the sex/gender debate for political representation and agency. It explores the sense in which this confusion is manifest in a debate between Seyla Benhabib and Judith Butler.

BackgroundSevere brain injury is a leading cause of death and disability. Diagnosis and prognostication are difficult, and errors occur often. Novel neuroimaging methods can improve diagnostic and prognostic accuracy, especially in patients with prolonged disorders of consciousness (PDoC). Yet it is currently unknown how family caregivers understand this information, raising ethical concerns that disclosure of neuroimaging results could result in therapeutic misconception or false hope.MethodsTo examine these ethical concerns, we conducted semi-structured interviews with caregivers of patients with PDoC who were (...) enrolled in a concurrent neuroimaging research program designed to detect covert consciousness following severe brain injury. Caregivers held surrogate decision-making status for a patient. Interviews were conducted at two time points for each caregiver. The first interview occurred before the disclosure of neuroimaging results. The second occurred after disclosure. Descriptive analysis was applied to the data of four interview topics: (1) expectations for neuroimaging; (2) reactions to evidence of preserved cognition; (3) reactions to null results; and (4) understanding of the results and study.ResultsTwelve caregivers participated in the study; two caregivers shared surrogate decision-making status for one patient with PDoC. Twenty-one interviews were completed; one caregiver declined to participate in the post-disclosure interview. Three patients with PDoC associated with the study displayed evidence of covert consciousness. Overall, caregivers understood the neuroimaging research and results. Caregivers who received results of covert consciousness were generally pleased. However, there was some variation in expectations and reactions to these data and null results.ConclusionThis study, for the first time, reveals caregiver expectations for and reactions to neuroimaging evidence of covert consciousness in patients with PDoC. Caregivers understood the neuroimaging research and results, casting doubt on speculative ethical concerns regarding therapeutic misconception and false hope. However, disclosure of neuroimaging result could be improved. Pre-disclosure consultations might assist professionals in shaping caregiver expectations. Standardization of disclosure might also improve comprehension of the results. (shrink)

This article focuses on Manuel Castells's claim that the information age announces major changes in stratification and, accordingly, in social and political mobilization. His assertion that informational labour displaces generic labour in informational capitalism is examined in terms of its conceptual and historical accuracy, and questions are raised about the notion of meritocracy embedded in his depiction of informational labour. The idea that the network society is characterized by `a faceless collective capitalist' is also called into question by evidence of (...) the persistence of a propertied class. Finally, Castells's analysis of the emergence and significance of identitybased mobilizations is examined. (shrink)

Examines the nature of life from physical life and nutrition, to behavior and sentient life, to conscious life and mind, to values and spirituality.