Northoff provides a compelling argument supporting a kind of “double dissociation” of Parkinson's disease and catatonia. We discuss a related form of akinetic mutism linked to mesodiencephalic injuries and suggest an alternative to the proposed “horizontal” versus “vertical” modulation distinction. Rather than a “directional” difference in patterned neuronal activity, we propose that both disorders reflect hypersynchrony within typically interdependent but segregated networks facilitated by a common thalamic gating mechanism.

In this article we will draw on experiences from our own research on deep brain stimulation of the central thalamus in the minimally conscious state. We describe ethical challenges faced in clinical research involving medical devices and offer several cautionary notes about its funding and the interplay of market forces and scientific inquiry and suggest some reforms.

This is the second paper in a two-part series describing subject and family perspectives from the CENTURY-S (CENtral Thalamic Deep Brain Stimulation for the Treatment of Traumatic Brain InjURY-Safety) first-in-human invasive neurological device trial to achieve cognitive restoration in moderate to severe traumatic brain injury (msTBI). To participate, subjects were independently assessed to formally establish decision-making capacity to provide voluntary informed consent. Here, we report on post-operative interviews conducted after a successful trial of thalamic stimulation. All five msTBI subjects met (...) a pre-selected primary endpoint of at least a 10% improvement in completion time on Trail-Making-Test Part B, a marker of executive function. We describe narrative responses of subjects and family members, refracted against that success. Interviews following surgery and the stimulation trial revealed the challenge of adaptation to improvements in cognitive function and emotional regulation as well as altered (and restored) relationships and family dynamics. These improvements exposed barriers to social reintegration made relevant by recoveries once thought inconceivable. The study’s success sparked concerns about post-trial access to implanted devices, financing of device maintenance, battery replacement, and on-going care. Most subjects and families identified the need for supportive counseling to adapt to the new trajectory of their lives. (shrink)

This is the first article in a two-part series describing subject and family perspectives from the central thalamic deep brain stimulation for the treatment of traumatic brain injury using the Medtronic PC + S first-in-human invasive neurological device trial to achieve cognitive restoration in moderate to severe traumatic brain injury, with subjects who were deemed capable of providing voluntary informed consent. In this article, we report on interviews conducted prior to surgery wherein we asked participants about their experiences recovering from (...) brain injury and their perspectives on study enrollment and participation. We asked how risks and benefits were weighed, what their expectations and fears were, and how decisions were reached about trial participation. We found that informed consent and enrollment decisions are fraught. Subjects and families were often split, with subjects more focused on putative benefits and families concerned about incremental risk. Both subjects and families viewed brain injury as disruptive to personal identity and relationships. As decisions were made about study enrollment, families struggled with recognizing the re-emergent agency of subjects and ceding decision-making authority to subjects who had previously been dependent upon them for protection and guidance. Subjects and family members reported a hope for the relief of cognitive disabilities, improved quality of life, normalization of interpersonal interactions, and a return to work or school as reasons for study participation, along with altruism and a desire to advance science. Despite these aspirations, both subjects and families appreciated the risks of the intervention and did not suffer from a therapeutic misconception. A second essay to be published in the next issue of Cambridge Quarterly of Healthcare Ethics—Clinical Neuroethics will describe interviews conducted after surgery, the effects of cognitive restoration for subjects, families, and challenges presented to the social structures they will call upon to support them through recovery. This subsequent article will be available online prior to its formal publication in October 2023. (shrink)

DBS Think Tank IX was held on August 25–27, 2021 in Orlando FL with US based participants largely in person and overseas participants joining by video conferencing technology. The DBS Think Tank was founded in 2012 and provides an open platform where clinicians, engineers and researchers can freely discuss current and emerging deep brain stimulation technologies as well as the logistical and ethical issues facing the field. The consensus among the DBS Think Tank IX speakers was that DBS expanded in (...) its scope and has been applied to multiple brain disorders in an effort to modulate neural circuitry. After collectively sharing our experiences, it was estimated that globally more than 230,000 DBS devices have been implanted for neurological and neuropsychiatric disorders. As such, this year’s meeting was focused on advances in the following areas: neuromodulation in Europe, Asia and Australia; cutting-edge technologies, neuroethics, interventional psychiatry, adaptive DBS, neuromodulation for pain, network neuromodulation for epilepsy and neuromodulation for traumatic brain injury. (shrink)

In “Proposed Principles for International Bioethics Conferencing: Anti-Discriminatory, Global, and Inclusive” the authors offer a framework for assessing the ethics of international bioethics confe...

This paper is an essay in counterfactual epistemology. What if experience have high-level contents, to the effect that something is a lemon or that someone is sad? I survey the consequences for epistemology of such a scenario, and conclude that many of the striking consequences could be reached even if our experiences don't have high-level contents.

Modern science began as natural philosophy, an admixture of philosophy and science. It was then killed off by Newton, as a result of his claim to have derived his law of gravitation from the phenomena by induction. But this post-Newtonian conception of science, which holds that theories are accepted on the basis of evidence, is untenable, as the long-standing insolubility of the problem of induction indicates. Persistent acceptance of unified theories only in physics, when endless equally empirically successful disunified rivals (...) are available, means that physics makes a persistent, problematic metaphysical assumption about the universe: that all disunified theories are false. This assumption, precisely because it is problematic, needs to be explicitly articulated within physics, so that it can be critically assessed and, we may hope, improved. The outcome is a new conception of science—aim-oriented empiricism—that puts science and philosophy together again, and amounts to a modern version of natural philosophy. Furthermore, aim-oriented empiricism leads to the solution to the problem of induction. Natural philosophy pursued within the methodological framework of aim-oriented empiricism is shown to meet standards of intellectual rigour that science without metaphysics cannot meet. (shrink)

This article questions whether the ‘problem’ of trans issues lies more in the binary, patriarchal structures of our society than it does in our bodies. I utilize Marcella Althaus-Reid’s ‘Hermeneutic of Mutilation’, arguing that, much as ‘to give hospitality to our own fragmentations may require sometimes acts of transformations’, we must not support the heteropatriarchal pattern and system as it attempts to normalize, police, control or punish the ‘deviant’ bodies of transgender individuals, from ‘wrong’ and ‘less than’ into ‘right’ and (...) ‘cured’. As postmodern deconstruction has informed and influenced our thinking around identity, the modern, biological approach to sex/gender has been profoundly challenged. I will make a parallel between current debates around trans issues and disability, body and liberation theology; if disability only ‘becomes’ a disability when the able-bodied majority designates it as ‘other’, are trans folk being similarly ‘othered’, as their different bodies, perspectives or identities challenge the fearful, defended mind-sets of society? Should we continue to prioritize ‘fixing’ trans bodies, in order to have them fit more neatly within that society? Or, should we challenge the patriarchal, heteronormative moulds of a culture that would rather trans individuals ‘accept’ their ‘wrongness’ and take steps to ‘correct’ that wrongness? This is not to say that trans+ individuals should not continue to make exactly the same medical/surgical choices as are currently the norm and even to choose modes of gender expression that are binary or ‘traditional’, should that be their desire and choice. Rather, this is an appeal for all of us to challenge a society that deems some bodies ‘right’ and others as ‘wrong’, and expects such painful conformity. (shrink)

I propose a revision of Cantor’s account of set size that understands comparisons of set size fundamentally in terms of surjections rather than injections. This revised account is equivalent to Cantor's account if the Axiom of Choice is true, but its consequences differ from those of Cantor’s if the Axiom of Choice is false. I argue that the revised account is an intuitive generalization of Cantor’s account, blocks paradoxes—most notably, that a set can be partitioned into a set that is (...) bigger than it—that can arise from Cantor’s account if the Axiom of Choice is false, illuminates the debate over whether the Axiom of Choice is true, is a mathematically fruitful alternative to Cantor’s account, and sheds philosophical light on one of the oldest unsolved problems in set theory. (shrink)

Centring on human perception, attunement to others, and a transcendent conception of the good, Iris Murdoch's intervention in moral philosophy remains an insightful and evocative source for ethical theory. Discerning some pervasive dualisms that hamper its coherence and development, I suggest that her work finds a generative conversation partner in the contemporary metaphysician, William Desmond. Desmond's thought offers promising avenues to overcome these dualisms by repositioning the source and nature of value and by theorising an anti-reductive, relational ontology. Staging a (...) constructive encounter between these two thinkers that preserves Murdoch's distinct prioritisation of attention and individuality within a Desmond-inspired metaphysics, I present a synthetic ethical approach that promotes the ideal of attending to an other—in the givenness of its particularity, manifold surplus, and constitutive relationality—as good in itself. (shrink)

A doctrine of intelligent design through evolution is not going to find many friends. It is destined to encounter opposition on all sides. Among scientists the backlog of evolution will have little patience for intelligent design. Among religiousists, many who form intelligent design have their doubts about evolution. In the general public s mind there is a diametrical opposition between evolution and intelligent design: one excludes the other. This book will argue that this view of the matter is not correct, (...) and that in actuality one can regard evolution itself as a pathway to intelligent design. We would do well to go beyond The Origin of Species and taking as our guide such works as W. Wentworth Thomson s On Growth and Form acknowledging that evolutionary adaptation can result in solutions of a sort that intelligence could readily ratify. Accordingly, what the present book seeks is a naturalization of Intelligent Design that sees such design as itself the result of natural and evolutionary processes.". (shrink)

Here I show that the one-variable fragment of several first-order relevant logics corresponds to certain S5ish extensions of the underlying propositional relevant logic. In particular, given a fairly standard translation between modal and one-variable languages and a permuting propositional relevant logic L, a formula $$\mathcal {A}$$ A of the one-variable fragment is a theorem of LQ (QL) iff its translation is a theorem of L5 (L.5). The proof is model-theoretic. In one direction, semantics based on the Mares-Goldblatt [15] semantics for (...) quantified L are transformed into ternary (plus two binary) relational semantics for S5-like extensions of L (for a general presentation, see Seki [26, 27]). In the other direction, a valuation is given for the full first-order relevant logic based on L into a model for a suitable S5 extension of L. I also discuss this work’s relation to finding a complete axiomatization of the constant domain, non-general frame ternary relational semantics for which RQ is incomplete [11]. (shrink)

There is an extensive literature on time travel in both philosophy and physics. Part of the great interest of the topic stems from the fact that reasons have been given both for thinking that time travel is physically possible—and for thinking that it is logically impossible! This entry deals primarily with philosophical issues; issues related to the physics of time travel are covered in the separate entries on time travel and modern physics and time machines. We begin with the definitional (...) question: what is time travel? We then turn to the major objection to the possibility of backwards time travel: the Grandfather paradox. Next, issues concerning causation are discussed—and then, issues in the metaphysics of time and change. We end with a discussion of the question why, if backwards time travel will ever occur, we have not been visited by time travellers from the future. (shrink)

Pragmatic processes crucially rely on background or contextual information supplied by the hearer, which may significantly affect the outcome of the comprehension process. Construed as a branch of cognitive psychology, pragmatics is the study of the cognitive systems apart from the I‐language and the parser which enable speaker and hearer (or communicator and audience) to co‐ordinate on the intended interpretation, and this is how we propose to treat it here. This chapter considers some of Noam Chomsky's suggestions about how the (...) cognitive systems underlying human abilities might be investigated. It discusses his reasons and consider how far this skepticism may be due to his particular conception of pragmatics. The chapter outlines an approach to pragmatics that seems to be compatible with his general methodology and is based on an alternative conception of pragmatics that we sketch out. (shrink)

A world of legal conflicts -- The limits of sovereigntist territoriality -- From universalism to cosmopolitanism -- Towards a cosmopolitan pluralist jurisprudence -- Procedural mechanisms, institutional designs, and discursive practices for managing pluralism -- The changing terrain of jurisdiction -- A cosmopolitan pluralist approach to choice of law -- Recognition of judgments and the legal negotiation of difference.

The aim of the Schematism chapter of the Critique of Pure Reason is to solve the problem posed by the “inhomogeneity” of intuitions and categories: the sensible properties of objects represented in intuition are of a different kind than the properties represented by categories. Kant's solution is to introduce what he calls “transcendental schemata,” which mediate the subsumption of objects under categories. I reconstruct Kant's solution in terms of two substantive premises, which I call Subsumption Sufficiency (i.e., that subsuming an (...) object under a transcendental schema is sufficient to subsume it under the corresponding category) and Real Possibility (i.e., that it is really possible to subsume objects under each of the transcendental schemata). These two principles, together with a trivial modal one (the Subsumption-Possibility Link), entail that it is possible to subsume objects under categories; in other words, the argument of the Schematism is valid. The main work of the paper consists in reconstructing Kant's arguments for, and explanations of, these premises. I argue that they hinge on Kant's claim that transcendental schemata are “time-determinations,” which I interpret to mean: rules for reflexively representing the temporal relations among our own representational states. On the basis of this reading, I reconstruct Kant's argument for Subsumption Sufficiency, category by category. I also explain why Real Possibility follows almost immediately. Granting Kant the argument up to this point in the Critique, the argument of the Schematism is sound. (shrink)

The ‘interpretive turn’ in twentieth-century hermeneutics rests on the general ontological claim that human reality is the reality of self-interpreting animals. But under the circumstances of advanced modernity, there are aspects of human life, or spheres of human thought and action, that appear to contradict this general thesis, in that they do not present themselves as the doings of self-interpreting animals at all. Of these, the predominant one is the sphere of work or 'productive' action. In face of historical circumstances (...) in which work presents itself as bereft of the meanings that concern self-interpreting animals, hermeneutic philosophy faces a choice: Does it exempt work from the realm of self-interpretive activity, making it an exception to the general ontological thesis; or does it seek to retrieve the hermeneutic provenance of productive action? With a focus on the writings of Gadamer and Ricoeur, the chapter shows that philosophical hermeneutics has vacillated on this issue and it suggests that retrieval of the self-interpretive dimension of productive action is a central task for hermeneutics today. (shrink)

Commentators have shown a steady interest in the role of feeling in Kant’s moral and practical philosophy over the last few decades. Much attention has been given to the notion of ‘moral feeling’ in general, as well as to what Kant calls the ‘feeling of respect’ for the moral law. My focus in this essay is on the role of feeling in practical judgment. My claim in what follows is that the act of judging in the practical domain—i.e., determining what (...) one ought to do, or what action one ought to perform, in a specific case—crucially involves feeling. Put more simply: I argue that practical judgment has an essentially affective dimension. The upshot of the account I will give is that it provides us with a richer and more complex account of moral feeling than has previously been appreciated in the literature. While it is recognized that feeling plays a certain role in moral motivation, what I hope to demonstrate here is that feeling is involved much earlier in the exercise of moral agency. Far from entering only at the point at which we are trying to muster the strength of will to carry out what we know we ought to do, feeling is present the moment we begin to deliberate about what it is that we ought to do. (shrink)

What is the meaning of life? Does anything really matter? In the past few decades these questions, perennially associated with philosophy in the popular consciousness, have rightly retaken their place as central topics in the academy. In this major contribution, Nicholas Waghorn provides a sustained and rigorous elucidation of what it would take for lives to have significance. Bracketing issues about ways our lives could have more or less meaning, the focus is rather on the idea of ultimate meaning, (...) the issue of whether a life can attain meaning that cannot be called into question. Waghorn sheds light on this most fundamental of existential problems through a detailed yet comprehensive examination of the notion of nothing, embracing classic and cutting-edge literature from both the analytic and Continental traditions. Central figures such as Heidegger, Carnap, Wittgenstein, Nozick and Nagel are drawn upon to anchor the discussion in some of the most influential discussion of recent philosophical history. In the process of relating our ideas concerning nothing to the problem of life's meaning, Waghorn's book touches upon a number of fundamental themes, including reflexivity and its relation to our conceptual limits, whether religion has any role to play in the question of life's meaning, and the nature and constraints of philosophical methodology. A number of major philosophical traditions are addressed, including phenomenology, poststructuralism, and classical and paraconsistent logics. In addition to providing the most thorough current discussion of ultimate meaning, it will serve to introduce readers to philosophical debates concerning the notion of nothing, and the appendix engaging religion will be of value to both philosophers and theologians. (shrink)

According to Fumerton in his "How Does Perception Justify Belief?", it is misleading or wrong to say that perception is a source of justification for beliefs about the external world. Moreover, reliability does not have an essential role to play here either. I agree, and I explain why in section 1, using novel considerations about evil demon scenarios in which we are radically deceived. According to Fumerton, when it comes to how sensations or experiences supply justification, they do not do (...) so on their own, and instead only do so only in conjunction with support for background beliefs about how the sensations or experiences are best explained. Here I disagree. In section 2, I first clarify the question of whether sensations or experiences provide justification on their own. I then respond to Fumerton’s arguments that use considerations about concept-possession and about how to close possible gaps between experience and truth. In section 3, I develop my main concern about his positive view, where that concern also brings out some of the merits of the view that experiences do justify beliefs about the external world on their own. (shrink)

This chapter discusses ontological commitment to properties, understood as ontological correlates of predicates. We examine the issue in four metaontological settings, beginning with an influential Quinean paradigm on which ontology concerns what there is. We argue that this naturally but not inevitably avoids ontological commitment to properties. Our remaining three settings correspond to the most prominent departures from the Quinean paradigm. Firstly, we enrich the Quinean paradigm with a primitive, non-quantificational notion of existence. Ontology then concerns what exists. We argue (...) that this strengthens the Quinean case against ontological commitment to properties while also newly distinguishing between stronger and weaker forms of nominalism. Secondly, we enrich the Quinean paradigm with the ideology of fundamentality. Ontology then centrally concerns what’s fundamental. We argue that this leaves ontological commitment to properties wide open although Bradleyan regress threatens. Thirdly, we enrich the Quinean paradigm with primitive higher-order quantifiers. Ontology then expands to concern what there higher-order is and what there first-order is. We argue that this naturally but not inevitably incurs ontological commitment to properties. (shrink)

Participation in religious liturgies and rituals is a pervasive and complex human activity. This book discusses the nature of liturgical activity and the various dimensions of such activity. Nicholas Wolterstorff focuses on understanding what liturgical agents actually do and shows religious practice as a rich area for philosophical reflection.

Over the years Nicholas Rescher has published various essays on religious issues from a philosophical point of view. The chapters of the present volume collect these together, joining to them four further pieces which appear here for the first time (Chapters 3, 7, and 8). While these studies certainly do not constitute a system of religious philosophy, they do combine to give a vivid picture of a well-defined point of view on the subject-the viewpoint of a Roman Catholic philosopher (...) who, in the longstanding manner of this tradition, seeks to harmonize the commitments of faith with the fruits of inquiry proceeding under the auspices of reason. (shrink)

Navigating the ambiguity of invasiveness: is it warranted? Authors De Marco and colleagues have presented a new model on the concept of invasiveness, redefining both its technical definition and practical implementation. 1 While the authors raise valid critiques regarding the discrepancy in definitions, I cannot help but wonder about the purpose of redefining terms for which little confusion, if any, exists? This commentary seeks to scrutinise the rationale supporting the new model in the absence of significant clinical confusion and to (...) explore the implications for clinical practice. What are we trying to solve? Initially, one may notice there is no mention of clinical relevancy, confusion among patients or whether the discrepancy in terms is causing miscommunication. It seems reasonable that some clinical confusion may exist, but so too does a similar imbalance of terms when speaking technically across the specialties; take depression and its definition... (shrink)

If our experiences are cognitively penetrable, they can be influenced by our antecedent expectations, beliefs, or other cognitive states. Theorists such as Churchland, Fodor, Macpherson, and Siegel have debated whether and how our cognitive states might influence our perceptual experiences, as well as how any such influences might affect the ability of our experiences to justify our beliefs about the external world. This article surveys views about the nature of cognitive penetration, the epistemological consequences of denying cognitive penetration, and the (...) epistemological consequences of affirming cognitive penetration. (shrink)