“Brain death,” the determination of human death by showing the irreversible loss of all clinical functions of the brain, has become a worldwide practice. A biophilosophical account of brain death requires four sequential tasks: agreeing on the paradigm of death, a set of preconditions that frame the discussion; determining the definition of death by making explicit the consensual concept of death; determining the criterion of death that proves the definition has been fulfilled by being both necessary and sufficient for death; (...) and determining the tests of death for physicians to employ at the patient's bedside to demonstrate that the criterion of death has been fulfilled. The best definition of death is “the cessation of functioning of the organism as a whole.” The whole-brain criterion is the only criterion that is both necessary and sufficient for death. Brain death tests are used only in the unusual case in which a patient's ventilation is being supported. Brain death critics have identified weaknesses in its formulation. But despite its shortcomings, the whole-brain death formulation comprises a concept and public policy that make intuitive and practical sense and that has been well accepted by many societies. (shrink)
Lewis emphasizes the role of theta oscillations in emergent coupling among neural subsystems during emotionally relevant tasks or situations. Here I present some recent data on the relationship of rhythmic neuronal discharge in the supramammillary nucleus and the large-scale theta oscillations in the limbic system which provide support to many of his ideas regarding vertical integration in dynamic systems.
This essay examines the relationship between Eric Voegelin and Leo Strauss in order to show the central themes necessary to elucidate their philosophical positions. The essay reveals the centrality of the figure of Plato as a point of departure to understand the agreement and the disagreement concerning fundamental questions (such as the way of reading ancient texts, the importance of the historical perspective or the importance of the study of the past in order to orient the modern science) which revolves (...) around the issue of the relation between revelation and philosophy. The work concludes with an identification of the common core of both thinkers that allows us to understand their differences (homogeneity or heterogeneity of reality and the human) and, moreover, identifies both perspectives with a «foundational» (Voegelin) or «negative» (Strauss) interpretation of Plato’s thought. (shrink)
RELIGIOUS RATIONALISM OF WISZOWATY AND LEIBNIZ The purpose of this article is to show that religious rationalism presented by Polish Socinian Andrzej Wiszowaty is different from Leibniz’s religious rationalism. At the beginning of the article the author analyzed the dispute between Wiszowaty and Leibniz about Trinity. While comparing religious and philosophical concept of Wiszowaty and Leibniz the author has proved that both philosophers presented different views related to the nature of God, perception of the truths of faith, predestination and miracles. (...) Wiszowaty in a dispute about the Trinity represented Socinian ideas and believed the dogma of the Trinity is contrary to the reason and inconsistent with the Bible, while Leibniz defended the Christian dogma against the alleged contradictions. (shrink)
The distinction between the "permanent" (will not reverse) and "irreversible" (cannot reverse) cessation of functions is critical to understand the meaning of a determination of death using circulatory–respiratory tests. Physicians determining death test only for the permanent cessation of circulation and respiration because they know that irreversible cessation follows rapidly and inevitably once circulation no longer will restore itself spontaneously and will not be restored medically. Although most statutes of death stipulate irreversible cessation of circulatory and respiratory functions, the accepted (...) medical standard is their permanent cessation because permanence is a perfect surrogate indicator for irreversibility, and using it permits a more timely declaration. Therefore, patients properly declared dead in donation after circulatory death (DCD) protocols satisfy the requirements of death statutes and do not violate the dead donor rule. The acronym DCD should represent organ "donation after circulatory death" to clarify that the death standard is the permanent cessation of circulation, not heartbeat. Heart donation in DCD does not retroactively negate the donor's death determination because circulation has ceased permanently. (shrink)
Although death statutes permitting physicians to declare brain death are relatively uniform throughout the United States, academic debate persists over the equivalency of human death and brain death. Alan Shewmon showed that the formerly accepted integration rationale was conceptually incomplete by showing that brain-dead patients demonstrated a degree of integration. We provide a more complete rationale for the equivalency of human death and brain death by defending a deeper understanding of the organism as a whole and by using a novel (...) strategy with shared objectives to justify death determination criteria. Our OaaW account describes different types of OaaW, defining human death as the loss of status as a human OaaW. We defend human death as similar to nonhuman death in terms of wakefulness, but also distinct in terms of the sui generis properties, particularly conscious awareness. We thereby defend the equivalency of brain death and human death using a resulting neurocentric rationale. (shrink)
The publicity surrounding the recent McMath and Muñoz cases has rekindled public interest in brain death: the familiar term for human death determination by showing the irreversible cessation of clinical brain functions. The concept of brain death was developed decades ago to permit withdrawal of therapy in hopeless cases and to permit organ donation. It has become widely established medical practice, and laws permit it in all U.S. jurisdictions. Brain death has a biophilosophical justification as a standard for determining human (...) death but remains poorly understood by the public and by health professionals. The current controversies over brain death are largely restricted to the academy, but some practitioners express ambivalence over whether brain death is equivalent to human death. Brain death remains an accepted and sound concept, but more work is necessary to establish its biophilosophical justification and to educate health professionals and the public. (shrink)
The definition of death is one of the oldest and most enduring problems in biophilosophy and bioethics. Serious controversies over formally defining death began with the invention of the positive-pressure mechanical ventilator in the 1950s. For the first time, physicians could maintain ventilation and, hence, circulation on patients who had sustained what had been previously lethal brain damage. Prior to the development of mechanical ventilators, brain injuries severe enough to induce apnea quickly progressed to cardiac arrest from hypoxemia. Before the (...) 1950s, the loss of spontaneous breathing and heartbeat were perfect predictors of death because the functioning of the brain and of all other organs ceased rapidly and nearly simultaneously thereafter, producing a unitary death phenomenon. In the pretechnological era, physicians and philosophers did not have to consider whether a human being who had lost certain “vital functions” but had retained others was alive, because such cases were technically impossible. (shrink)
Prior research has demonstrated that antisocial behavior, substance-use disorders, and personality dimensions of aggression and impulsivity are indicators of a highly heritable underlying dimension of risk, labeled externalizing. Other work has shown that individual trait constructs within this psychopathology spectrum are associated with reduced self-monitoring, as reflected by amplitude of the error-related negativity (ERN) brain response. In this study of undergraduate subjects, reduced ERN amplitude was associated with higher scores on a self-report measure of the broad externalizing construct that links (...) these various indicators. In addition, the ERN was associated with a response-locked increase in anterior theta (4–7 Hz) oscillation; like the ERN, this theta response to errors was reduced among high-externalizing individuals. These findings suggest that neurobiologically based deficits in endogenous action monitoring may underlie generalized risk for an array of impulse-control problems. (shrink)
Notwithstanding these wise pronouncements, my project here is to characterize the biological phenomenon of death of the higher animal species, such as vertebrates. My claim is that the formulation of “whole- brain death ” provides the most congruent map for our correct understanding of the concept of death. This essay builds upon the foundation my colleagues and I have laid since 1981 to characterize the concept of death and refine when this event occurs. Although our society's well-accepted program of multiple (...) organ procurement for transplantation requires the organ donor first to be dead, the concept of brain death is not merely a social contrivance to permit us to obtain the benefits of organ procurement. Rather, the concept of whole- brain death stands independently as the most accurate biological representation of the demise of the human organism. (shrink)
The locked-in syndrome is a state of profound paralysis with preserved awareness of self and environment who typically results from a brain stem stroke. Although patients in LIS have great difficulty communicating, their consciousness, cognition, and language usually remain intact. Medical decision-making by LIS patients is compromised, not by cognitive impairment, but by severe communication impairment. Former systems of communication that permitted LIS patients to make only “yes” or “no” responses to questions was sufficient to validate their consent for simple (...) medical decisions but not for consequential medical decisions such as whether to refuse further life-sustaining therapy. Emerging technologies including computer-tracking assistance of retained partial motor function and brain-computer interfaces promise to improve the communication ability of LIS patients and, when better developed, will allow them to fully exercise their right to actively participate in consequential medical decisions about their own medical care. Although so-called “covert cognition” patients clinically diagnosed as vegetative state that are shown to be aware by functional neuroimaging maybe metaphorically considered locked-in, it is nosologically more coherent not to categorize them formally as LIS. (shrink)
This paper studies how Europe conceived America, not only as a place inhabited by monsters, but also as a monstrous space in itself, as soon as its mere appearance meant an alteration of the previous ontological order. By way of illustration we analyze how the Europeans imagined projected on America each of the different theratologic currents that dominated during the 16TH and 17TH centuries.
:Disturbing cases continue to be published of patients declared brain dead who later were found to have a few intact brain functions. We address the reasons for the mismatch between the whole-brain criterion and brain death tests, and suggest solutions. Many of the cases result from diagnostic errors in brain death determination. Others probably result from a tiny amount of residual blood flow to the brain despite intracranial circulatory arrest. Strategies to lessen the mismatch include improving brain death determination training (...) for physicians, mandating a test showing complete intracranial circulatory arrest, or revising the whole-brain criterion. (shrink)
Este trabajo estudia el concepto de “lo sublime” en la cultura barroca, con el objetivo de demostrar que, aunque no fue teorizado sistemáticamente hasta el siglo XVIII, este cobró durante el siglo XVII una centralidad y, sobre todo, un significado filosófico semejantes a los que se impondrían posteriormente y que, según veremos, está estrechamente ligado con el concepto de “nihilismo”.
This paper studies the role of literature and rethorics as a tool of philosophical practice within the classical tradition of «spiritual exercises». The aim of this study is to propose new ways of thinking the relations among philosophy and literature as formative or psicagogic disciplines, as well as for stand up for the role of philosophy and literature in our society.
One of Darwin’s purposes in writing The Origin of Species was to rebut the doctrine of separate creations. Moreover, the argument he was chiefly concerned with—which was both his target and the model of his own argument—was the familiar argument from design.
Fraud can cause severe financial losses and affect the physical and mental health of victims. This study aimed to explore the manipulative characteristics of fraudsters and their relationship with other psychological variables. Thirty-four fraudsters were selected from a medium-security prison in China, and thirty-one healthy participants were recruited online. Both groups completed an emotional face-recognition task and self-report measures assaying emotional manipulation, psychopathy, emotion recognition, and empathy. Results showed that imprisoned fraudsters had higher accuracy in identifying fear and surprise faces (...) but lower accuracy in identifying happiness than controls. Significantly lower scores on non-prosocial factors on the Managing the Emotions of Others scale were found for imprisoned fraudsters, relative to controls. Imprisoned fraudsters had low scores in the assessment of psychopathy than the control group, especially Factor 1. For empathy, imprisoned fraudsters had significantly higher scores in perspective-taking than controls. Correlation analyses revealed that psychopathic traits were positively correlated with non-prosocial factors in both groups. However, the relationships between emotional manipulation and emotional recognition and empathy were not consistent across the groups. The results suggest that fraudsters may pretend to be as prosocial as healthy controls, who had lower antisocial tendencies, normal empathy ability, and would like to manipulate others’ emotions positively during social interaction. (shrink)
The fundamental determinant of death in donation after circulatory determination of death is the cessation of brain circulation and function. We therefore propose the term donation after brain circulation determination of death [DBCDD]. In DBCDD, death is determined when the cessation of circulatory function is permanent but before it is irreversible, consistent with medical standards of death determination outside the context of organ donation. Safeguards to prevent error include that: 1] the possibility of auto-resuscitation has elapsed; 2] no brain circulation (...) may resume after the determination of death; 3] complete circulatory cessation is verified; and 4] the cessation of brain function is permanent and complete. Death should be determined by the confirmation of the cessation of systemic circulation; the use of brain death tests is invalid and unnecessary. Because this concept differs from current standards, consensus should be sought among stakeholders. The patient or surrogate should provide informed consent for organ donation by understanding the basis of the declaration of death. In cases of circulatory cessation, such as occurs in DBCDD, death can be defined as the permanent cessation of brain functions, determined by the permanent cessation of brain circulation. (shrink)
Using a classical conditioning technique, this study investigated whether nonconscious associative learning could be indexed by event-related brain activity . There were three phases. In a preconditioning baseline phase, pleasant and unpleasant facial schematics were presented in awareness . A conditioning phase followed, in which stimuli were presented outside awareness , with an unpleasant face linked to an aversive shock and a pleasant face not linked to a shock. The third, postconditioning phase, involved stimulus presentations in awareness . Evidence for (...) acquisition of a conditional response was sought by comparing suprathreshold pre- and postconditioning phases, as well as in the subthreshold conditioning phase itself. For the pre-postconditioning phase analyses, significant ERP component differences differentiating CS+ and CS− were observed for N1, P2, and especially P3. For the conditioning phase, significant differences were observed in the 100–400 ms. post-stimulus region reflecting a CS+ processing negativity. Brain activity does indeed index the acquisition of a conditional response to subthreshold stimuli. Associative learning can occur outside awareness. (shrink)
Our life in this broken world requires tools to own and express our grief in ways that are connected to our faith in God. We find that the biblical genre of lament is appropriate to the task. However, we do not come to lament without baggage, and we sometimes require additional help in the form of symbolic capital borrowed from stories and songs. In this case, The Chronicles of Narnia provide such capital. As we reflect on these stories, we can (...) see lament in a new way that helps us bring our pain to God. As we engage in the discipline of lament, we are spiritually formed into the image of Jesus. (shrink)