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)

Moral Case Deliberations are reflective dialogues with a group of participants on their own moral dilemmas. Although MCD is successful as clinical ethics support, it also has limitations. 1. Lessons learned from individual MCDs are not shared in order to be used in other contexts 2. Moral learning stays limited to the participants of the MCD; 3. MCD requires quite some organisational effort, 4. MCD deals with one individual concrete case. It does not address other, similar cases. These limitations warrant (...) research into complementary ways of providing CES to healthcare professionals. Our research objective was therefore to develop a low threshold CES tool based on a series of MCDs on autonomy in long-term care. We used a qualitative research design in which we analyzed the process and content of a series of MCDs, combined with reflections on the theoretical background of MCD. In total 28 MCDs were analyzed by means of a thematic content analysis. In various rounds of development, the results of the analysis were combined with theoretical reflections on CES. Consequently, the tool was evaluated in three focus groups and adjusted. The CES tool, called ‘moral compass’, guides the users through a series of six subsequent questions in order to methodically reflect on their concrete moral dilemma, in the form of a booklet of 23 pages. It combines a methodical element that encourages and structures a reflection process with a substantive element, including norms, values, options, strategies, and insights regarding dealing with client autonomy. By using data from a series of MCDs, combined with theoretical reflections on MCD, ethics support and moral learning, we developed a thematic, low-threshold CES tool that supports healthcare professionals in daily practice in dealing with moral questions regarding client autonomy. It integrates examples and insights from earlier MCDs on the same topic. The moral compass is not a replacement of, but can be used complementary to MCD. The feasibility and impact of the moral compass need to be investigated in an evaluative follow-up study. The methodology presented in this paper may be used to develop moral compasses on different topics in various healthcare organizations. (shrink)

We have arrived at an inflection point, a moment in history when the sentience, conscious- ness, intelligence, agency, and even the moral agency of many nonhuman animals can no longer be questioned without ignoring centuries of accumulated scientific knowledge. Nowhere is this more true than in our understanding of nonhuman primates (NHPs). A neu- roethics committed to probing the ethical implications of brain research must be able to respond to and anticipate the challenges ahead as brain projects globally prepare to (...) increase the use of NHPs in research. This requires adopting a less anthropocentric focus that includes nonhuman animals within its scope. But the Neuroethics Roadmap represents a missed opportunity to critically examine the future direction of research with NHPs in an ethically-responsive neuroscience. (shrink)

_The Routledge Handbook of Neuroethics_ offers the reader an informed view of how the brain sciences are being used to approach, understand, and reinvigorate traditional philosophical questions, as well as how those questions, with the grounding influence of neuroscience, are being revisited beyond clinical and research domains. It also examines how contemporary neuroscience research might ultimately impact our understanding of relationships, flourishing, and human nature. The _Handbook_ features easy-to-follow chapters that appear here for the first time in print and—written by (...) 61 key scholars and fresh voices—represent the wide range of viewpoints in neuroethics. The volume spotlights new technologies and historical articulations of key problems, issues, and concepts, and includes cross-referencing between chapters to highlight the complex interactions of concepts and ideas within neuroethics. These features enhance the _Handbook_’s utility by providing readers with a contextual map for different approaches to issues, and a guide to further avenues of interest. (shrink)

The Emerging Issues Task Force (Kellmeyer et al. 2019) identifies several important trends and concerns that neuroethics will encounter and grapple with in the com- ing decades. Among these are ethical issues related to the creation of new nonhuman entities, such as artificial intelligence systems, and human origin entities like brain organoids. The task force briefly mentions animal minds and animal rights, to which neuroethics to date has paid scant attention (Buller et al. 2014). As neuroscientific knowledge and knowledge from (...) other fields, including, to name a few, comparative psychology, primatology, ethology, biology, genetics, and medical sociology, accu- mulate, ethical concerns about the use of nonhuman ani- mals in research, agriculture, entertainment, and elsewhere will grow more visible and more urgent. Turning neuroethical attention toward nonhuman ani- mals also promises to illuminate issues related to specific human populations that are within the purview of a more expansive, forward-looking neuroethics. (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)

The phenomenon whereby severely disabled persons self-report a higher than expected level of subjective well-being is called the “disability paradox.” One explanation for the paradox among brain injury survivors is “response shift,” an adjustment of one’s values, expectations, and perspective in the aftermath of a life-altering, disabling injury. The high level of subjective well-being appears paradoxical when viewed from the perspective of the non-disabled, who presume that those with severe disabilities experience a quality of life so poor that it might (...) make their lives not worth living. This presumption has profound consequences, for it may inform end-of-life choices made in advance directives, or influence decisions made by surrogates on behalf of persons who are unable to direct their own medical treatment. -/- Peterson et al propose a cautious, well-considered plan to use fMRI-based brain-computer interfaces to assess the decision making capacity of covertly aware, behaviorally non-responsive individuals who retain high levels of preserved cognition. Their plan, if it succeeds, could eventually restore autonomy and empower some severely disabled persons, allowing them to participate in clinical decision making. Peterson et al discuss possible in-principle objections to their proposal, among them the “argument from psychological health,” and the “changing sets of values” objection. These objections both presume that deviations from a pre-injury norm could indicate diminished decision making capacity. This presumption threatens the autonomy of the patient who is capable of making decisions, but whose post-injury decisions appear to diverge from pre-injury preferences or values. In light of the potential for response shift, and the disability paradox, it should not be inferred that changes in values or preferences are unreflective of the true current preferences of a brain-injured person, nor are they conclusive evidence of diminished capacity. Presuming diminished capacity on the basis of unexpected or unconventional preferences has, in the past, been used to disempower patients whose autonomy and capacity would not have been doubted had they made choices that accorded with the expectations or values of others. We must be cautious, and vigilant, to prevent similarly diminishing the autonomy of covertly aware, behaviorally non-responsive individuals on the basis of empirically and ethically questionable inferences about their decision making capacity. (shrink)

A Papyrus commentary on Alcman published in 19571 brings us news of a poem in which Alcman “physiologized”. The lemmata and commentary together witness to a semi-philosophical cosmogony unlike any other hitherto known from Greece. The evidence is meagre, but it seems worth while to see what can be made of it; for it is perhaps possible to go a little farther than has so far been done.

City archives, mined by Aristotle for his Didaskaliai, preserved a reasonably complete record of dramatic productions in the fifth century. But how far back did these archives go? The so-called Fasti, an inscription set up c. 346 and listing dithyrambic, comic and tragic victors year by year, must have been based on the same archives, but went back, it is thought, only as far as 502/1. Its heading πρ]τον κμοι ἦσαν τ[ι διονσ]ωι τραγωιδο δ[, however supplemented, implies an intention of (...) going back to the beginning of things, in other words to the beginning of the archival record. This raises serious doubt as to whether that record went back to the alleged date of Thespis' première, or indeed to those given for Choerilus' and Phrynichus'. (shrink)

Résumé : Le PPBS a été conçu comme un instrument destiné à ceux qui décident de l'allocation des ressources publiques : il doit leur permettre de prendre de meilleures décisions. S'il est très difficile de repérer et de juger les choix que le développement du système a inspirés aux Etats-Unis, il n'en est pas mains certain que ses résultats tangibles sant maigres car la masse des anciens programmes, principale source potentielle de moyens nouveaux, n'a guère été remise en question.La valeur (...) intrinsèque du PPBS ne peut être mise en cause. Ce qui doit l'être, c'est la lenteur de son développement, qui demeure peu avancé. Cette lenteur s'explique, car le système ne peut produire des fruits dans une terre stérile qu'on n'a pas préparée.La brutalité et les maladresses de l'opération déclenchée en 1965 dans le gouvernement fédéral américain ne pouvaient que renforcer la résistance au changement et retarder, sinon compromettre, le succès final. Les perspectives demeurent heureusement favorables, puisque la nouvelle administration ne semble pas décidée à faire machine arrière et que les Etats et Villes ont démarré sous de bien meilleurs auspices.La principale conclusion qu'imposent les expériences américaines est que toute juridiction intéressée par le PPBS doit impérativement développer, de la façon la plus générale, la volonté d'instaurer le système et s'assurer les moyens de le faire. C'est dire qu'il est peu sage d'engager la bataille sur tous les fronts à la fois : il faut tenter des percées. Mais c'est dire aussi combi en l'information et la formation sant essentielles. A cet égard, l'installation généralisée de certains éléments du système, à savoir la structure de programmes et le budget-programme, loin de présenter des inconvénients, peut constituer un excellent exercice en dehors de son utilité directe pour le preneur de décision. La bataille en cause est surtout celle de la conviction: l'outil est prêt, il est bon, encore faut-il que l' ouvrier accepte de s'en servir.Samenvatting:Planning-programming-budgeting werd ontworpen als een instrument voor diegenen die beslissen over de toewijzing van de overheidsmiddelen.Dit instrument moet de beslissers in staat stellen betere beslissingen te treffen. Het is niet makkelijk deze beslissingen op te sporen en te beoordelen welke in de Verenigde Staten getroffen werden onder invloed van de ontwikkeling van deze systeembenadering. Toch is het met vrij grote zekerheid te stellen dat de tastbare resultaten gering zijn omdat de veelheid aan oude programma's die tenslotte toch de voornaamste potentiële bronnen zijn van nieuwe middelen, nooit werden aangevochten.De intrinsieke waarde van PPBS kan daarom evenwel niet worden genegeerd. Wat wel dient aangeklaagd is de traagheid van zijn aanslepende ontwikkeling. Deze traagheid is te verklaren door het feit dat het systeem slechts vruchten kan afwerpen zo het ingeplant wordt in degelijk voorbereid terrein.De brutaliteit en de onhandigheden bij de operatie die in 1965 werd ingezet in het amerikaans federaal overheidsbestel konden niets anders dan de weerstand tegen de verandering versterken en afbreuk doen aan het uiteindelijk slagen van het systeem. Gelukkiglijk blijven de vooruitzichten gunstig want de nieuwe beleidsvoerders sinds de presidentsverkiezingen, blijken ermee te willen doorgaan en de staten en lokale overheden zijn ermee van wal gestoken onder veel betere omstandigheden. Het doorslaggevend besluit uit de amerikaanse ervaringen terzake is wel dat elke instantie welke belangstelling heeft voor PPBS, nodig moet op zo breed mogelijk vlak de wil doen groeien om het systeem te ontwikkelen en er ook de nodige middelen toe ter beschikking stellen. Dit betekent tevens dat het weinig aan te bevelen is de strijd op alle fronten terzelvertijd aan te binden maar wel geleidelijk doorbraken te verwezenlijken. Dit brengt dan evenwel ook met zich dat informatie en vorming essentieel zijn bij deze strategie. In dit verband moet dan ook gezegd worden dat reeds het invoeren van sommige deelementen van het systeem, zoals de programmastructuur en het programmabudget, voor de beslisser nuttig kan zijn voor zijn persoonlijk inzicht en vorming.De te voeren actie dient nog slechts te worden toegespitst op het overtuigen van de verantwoordelijken. Het instrument is immers gebruiksklaar en degelijk, er is alleen nog het wachten op de wil van de gebruiker dit instrument ter hand te nemen. (shrink)

An alternative notion of an existential quantifier on four-valued Łukasiewicz algebras is introduced. The class of four-valued Łukasiewicz algebras endowed with this existential quantifier determines a variety which is denoted by \. It is shown that the alternative existential quantifier is interdefinable with the standard existential quantifier on a four-valued Łukasiewicz algebra. Some connections between the new existential quantifier and the existential quantifiers defined on bounded distributive lattices and Boolean algebras are given. Finally, a completeness theorem for the monadic four-valued (...) Łukasiewicz predicate calculus corresponding to the dual of the alternative existential quantifier is proven. (shrink)

An earlier version of this paper was presented at the 2011 IEEE International Symposium on Technology and Society at Saint Xavier University in Chicago, Illinois. This paper describes a proposed mobile platform, Transafe, that captures and analyses public perceptions of safety to deliver 'crowdsourced' collective intelligence about places in the City of Melbourne, Australia, and their affective states at various times of the day. Public perceptions of crime on public transport in Melbourne are often mismatched with actual crime statistics and (...) such perceptions thus can act as social barriers to visitors and locals traversing within and through the city. Using interactive mobile applications and social media, the visualization of this crowdsourced safety perception information will increase the commuter's awareness of various situations in the City of Melbourne. In addition, through social behavioral analysis and ethnographic research, the collective public intelligence will also help inform the stakeholders of the city for future policy-making and policing strategies for safety perception management. At the centre of the proposed platform is the design and development of a mobile phone application that can contribute to people feeling safer by supporting users to report crimes and misdemeanors that they witness, and provide information about transportation and emergency services around where the users are located. The proposed application can also act as a crime deterrent with one feature that enables user tracking by up to three nominated friends if the user opts to activate tracking when feeling unsafe while roaming the city. (shrink)

In CQ 20 , 277–87, 1 argued for dating Corinna to the third century B.C. In my Greek Metre , p. 141, I continued to assume this date, observing that not everyone accepted it but that I knew of no attempt to answer my arguments. I must confess to having overlooked at least one such attempt, by A. Allen in CJ 68 , 26–8; and now M. Davies has mounted another in SIFC 81 , 186–94, largely repeating Allen's points but (...) with some new touches. Allen upholds the traditional fifth-century date. Davies has yet to come to a decision, but meanwhile he is eager to discredit what he regards as an unsatisfactory case for a Hellenistic dating. (shrink)

They used to believe that mankind began in 4004 B.C. and the Greeks in 776. We now know that these last five thousand years during which man has left written record of himself are but a minute fraction of the time he has spent developing his culture. We now understand that the evolution of human society, its laws and customs, its economics, its religious practices, its games, its languages, is a very slow process, to be measured in millennia. In the (...) case of Greek religious usage it is now appreciated that it has its roots not in Mycenaean but in Palaeolithic times. As for Greek poetry, comparative studies have shown that it goes back by a continuous tradition to Indo-European poetry. (shrink)

Walter Freeman's theory of nonlinear neurodynamics has had a major impact on brain dynamics in modern cognitive neuroscience. Steven Bressler's theory of neurocognitive networks follows from Freeman's work, and his empirical evidence for the coordination of cortical areas by phase-coupled beta rhythms in large-scale cognitive brain networks supports Freeman's ideas on nonlinear brain dynamics. Bressler's work, taking Freeman's concepts into the realm of cognitive neurodynamics, also supports Scott Kelso's theory of metastability in coordination dynamics. The aims of the present paper (...) are threefold: 1) to explore relevant concepts in Freeman's theoretical framework, 2) unify it and provide empirical support for it, and 3) explore its import for the study of consciousness. We take as our point of departure Bressler and Kelso's 2016 publication on cortical coordination dynamics and the Freeman-Kelso dialogue noted in the literature on this topic. In our view, Freeman's conceptual framework has great explanatory power. Its grounding in a dynamical systems approach to the study of brain function, and its incorporation of embodiment, make it relevant to the study of consciousness. Thus, with Freeman, we argue that the scientific understanding of consciousness must move beyond notions of computationalism and mental representations, to employ concepts of nonlinear brain dynamics and embodiment. (shrink)

It is generally accepted that the Homeric Hymn to Apollo was not conceived as a single poem but is a combination of two: a Delian hymn, D, performed at Delos and concerned with the god's birth there, and a Pythian hymn, P, concerned with his arrival and establishment at Delphi. What above all compels us to make a dichotomy is not the change of scene in itself, but the way D ends. The poet returns from the past to the present, (...) and takes leave of his audience; farewell, he says, and remember me ever after. He is quite clearly finishing. Whereupon there is an abrupt and unsatisfactory transition to P. (shrink)

Histories of literature tend to treat Stesichorus as just one of the lyric poets, like Alcman or Anacreon. But the vast scale of his compositions puts him in a category of his own. It has always been known that his Oresteia was divided into more than one book; P. Oxy, 2360 gave us fragments of a narrative about Telemachus of a nearly Homeric amplitude; and from P. Oxy. 2617 it was learned that the Geryoneis contained at least 1,300 verses, the (...) total being perhaps closer to two thousand. Even allowing for the shorter lines, this was as long as many an epic poem. Indeed, these were epic poems, in subject and style as well as in length: epics to be sung instead of recited. What was behind them ? Who was this Stesichorus, and how did he come to be, in Quintilian's phrase, ‘sustaining on the lyre the weight of epic song’ ? The biographical problem must be tackled first. The question of Stesichorus’ historical setting and date is confused by legendary elements as well as by contradiction in the sources. On the whole scholars remain spellbound by the specious precision of the Suda's dates , although it has long been realized that they are founded on nothing but the assumption that Stesichorus was younger than Alcman and older than Simonides. There have been excellent discussions by Wilamowitz and Maas, but they seem to have had little influence. (shrink)