Explanation does not exist in a metaphysical vacuum. Conceptions of the structure of a phenomenon play an important role in guiding attempts to explain it, and erroneous conceptions of a phenomenon may direct investigation in misleading directions. I believe that there is a case to be made for thinking that much work on the neural underpinnings of consciousness—what is often called the neural correlates of consciousness—is driven by an erroneous conception of the structure of consciousness. The aim of this paper (...) is lay bare some connections between the explanation of consciousness and the structure of consciousness, and to argue for a conception of the structure of consciousness that is more adequate than that which currently drives much research into the neural correlates of consciousness. (shrink)

Realism about consciousness conjoins a claim that consciousness exists with a claim that the existence is independent in some interesting sense. Consciousness realism so conceived may thus be opposed by a variety of anti-realisms, distinguished from each other by denying the first, the second, or both of the realist’s defining claims. I argue that Dennett’s view of consciousness is best read as an anti-realism that affirms the existence of consciousness while denying an important independence claim.

The concept of futility is sometimes regarded as a cloak for medical paternalism in that it rolls together medical and value judgments. Often, despite attempts to disambiguate the concept, that is true and it can be applied in such a way as to marginalize the real interests of a patient. I suggest we replace it with a conceptual toolkit that includes physiological futility, substantial benefit (SB), and the risk of unacceptable badness (RUB) in that these concepts allow us to articulate (...) what is at stake in ethical judgments where outcomes are crucial in determining what should be done. (shrink)

Are conscious states conscious in virtue of representing themselves? Content Type Journal Article Pages 1-8 DOI 10.1007/s11098-011-9762-x Authors Berit Brogaard, Department of Philosophy, University of Missouri, St. Louis, 599 Lucas Hall, One University Blvd., St. Louis, MO 63121-4400, USA Journal Philosophical Studies Online ISSN 1573-0883 Print ISSN 0031-8116.

Conscious states as objects of awareness: on Uriah Kriegel, Subjective consciousness: a self - representational theory Content Type Journal Article Pages 1-9 DOI 10.1007/s11098-011-9763-9 Authors Brie Gertler, Corcoran Department of Philosophy, University of Virginia, Charlottesville, VA 22904, USA Journal Philosophical Studies Online ISSN 1573-0883 Print ISSN 0031-8116.

In a recent issue of Neuroethics, I considered whether the notion of human dignity could help us in solving the moral problems the advent of the diagnostic category of minimally conscious state (MCS) has brought forth. I argued that there is no adequate account of what justifies bestowing all MCS patients with the special worth referred to as human dignity. Therefore, I concluded, unless that difficulty can be solved we should resort to other values than human dignity in (...) addressing the moral problems MCS poses. In his new book Christopher Kaczor criticizes the argument I put forward. Below, I respond to Kaczor’s criticism. I maintain that the considerations he presents do not undermine my argument nor succeed in providing adequate justification for the view that all MCS patients possess the worth referred to as human dignity. (shrink)

Recent progress in neurosciences has improved our understanding of chronic disorders of consciousness. One example of this advancement is the emergence of the new diagnostic category of minimally conscious state (MCS). The central characteristic of MCS is impaired consciousness. Though the phenomenon now referred to as MCS pre-existed its inclusion in diagnostic classifications, the current medical ethical concepts mainly apply to patients with normal consciousness and to non-conscious patients. Accordingly, how we morally should stand with persons in (...) minimally conscious state remains unclear. In this paper, I examine whether the notion of human dignity could provide us with guidance with the moral difficulties MCS gives rise to. More precisely, I focus on the question of whether we are justified in holding that persons in minimally conscious state possess human dignity. (shrink)

I draw attention to an ambiguity of the expression ‘phenomenal consciousness’ that is an avoidable yet persistent source of conceptual confusion among consciousness scientists. The ambiguity is between what I call phenomenality and what I call conscious states, where the former denotes an abstract property and the latter denotes a phenomenon or class of its instances. Since sentences featuring these two terms have different semantic properties, it is possible to equivocate over the term ‘consciousness’. It is also possible to (...) fail to distinguish between statements that are true about conscious states in virtue of their phenomenality, and statements that are true in virtue of other properties of conscious states. I review empirically informed arguments by scientists Bernard Balleine and Anthony Dickinson, Stevan Harnad, and Jeffrey Alan Gray, arguing that each of them makes errors based on the ambiguity. I conclude with some tentative suggestions for avoiding further confusion about the ambiguity. (shrink)

Abstract In a recent issue of Neuroethics , I considered whether the notion of human dignity could help us in solving the moral problems the advent of the diagnostic category of minimally conscious state (MCS) has brought forth. I argued that there is no adequate account of what justifies bestowing all MCS patients with the special worth referred to as human dignity. Therefore, I concluded, unless that difficulty can be solved we should resort to other values than human (...) dignity in addressing the moral problems MCS poses. In his new book Christopher Kaczor criticizes the argument I put forward. Below, I respond to Kaczor’s criticism. I maintain that the considerations he presents do not undermine my argument nor succeed in providing adequate justification for the view that all MCS patients possess the worth referred to as human dignity. Content Type Journal Article Category Original Paper Pages 1-11 DOI 10.1007/s12152-011-9147-z Authors Jukka Varelius, Department of Behavioural Sciences and Philosophy, University of Turku, Turku, 20014 Finland Journal Neuroethics Online ISSN 1874-5504 Print ISSN 1874-5490. (shrink)

One of the final obstacles to understanding consciousness in physical terms concerns the question of whether conscious states can exist in posterior regions of the brain without active connections to the brain's prefrontal lobes. If they can, difficult issues concerning our knowledge of our conscious states can be resolved. This paper contains a list of types of conscious states that may meet this criterion, including states of coma, states in which subjects are absorbed in a perceptual task, (...) states in brains with damaged prefrontal lobes, states of meditation and conscious states of some infants and animals. Recent evidence also suggests that conscious states of some people with autism may meet this criterion. (shrink)

Intuitively it has seemed to many that our concepts conscious state and conscious creature are sharp rather than vague, that they can have no borderline cases. On the other hand, many who take conscious states to be identical to, or realized by, complex physical states are committed to the vagueness of those concepts. In the paper I argue that conscious state and conscious creature are sharp by presenting four necessary conditions for conceiving borderline (...) cases in general, and showing that some of those conditions cannot be met with conscious state. I conclude that conscious state is sharp, and the conclusion is then extended to conscious creature. The paper ends with a brief discussion of some implications. (shrink)

Striking experimental results by Benjamin Libet and colleagues have had an impor- tant impact on much recent discussion of consciousness. Some investigators have sought to replicate or extend Libet’s results (Haggard, 1999; Haggard & Eimer, 1999; Haggard, Newman, & Magno, 1999; Trevena & Miller, 2002), while others have focused on how to interpret those findings (e.g., Gomes, 1998, 1999, 2002; Pockett, 2002), which many have seen as conflicting with our commonsense picture of mental functioning.

Neurostimulation to restore cognitive and physical functions is an innovative and promising technique for treating patients with severe brain injury that has resulted in a minimally conscious state (MCS). The technique may involve electrical stimulation of the central thalamus, which has extensive projections to the cerebral cortex. Yet it is unclear whether an improvement in neurological functions would result in a net benefit for these patients. Quality-of-life measurements would be necessary to determine whether any benefit of neurostimulation outweighed (...) any harm in their response to different degrees of cognitive and physical disability. These measures could also indicate whether the technique could be ethically justified and whether surrogates could give proxy consent to its use on brain-injured patients. (shrink)

Patients in a Minimally Conscious State (MCS) constitute a subgroup of awareness impaired patients who show minimal signs of awareness as opposed to patients in a Vegetative State who do not exhibit any such signs. While the empirical literature is rich in studies investigating either overt or covert signs of awareness in such patients the question of self-awareness has only scarcely been addressed. Even in the occasion where self-awareness is concerned, it is only higher-order or reflective self-awareness (...) that is the target of such investigations. In the first part of this paper, I briefly review the relevant clinical neuroscience literature to demonstrate that the conception of self-awareness at play in such studies is indeed that of reflective self-awareness. In the second part, I present the philosophical notion of pre-reflective (or minimal) self-awareness. This is shown to primarily refer to the implicit awareness of our embodied subjectivity which essentially permeates all our experiences. As discussed, this minimal self-awareness is not specifically addressed when clinically or experimentally assessing patients in MCS. My suggestion is that neuroimaging studies targeting minimal self-awareness as in First-Person Perspective-taking paradigms could be used with MCS patients to shed light on the question of whether those individuals are minimally self-aware even in the case where they lack self-reflective abilities. Empirical evidence of this kind could have important theoretical implications for the discussion about the notion of self-awareness but also potential medical and social/legal implications for awareness impaired patients’ management. (shrink)

Sleep researchers in different disciplines disagree about how fully dreaming can be explained in terms of brain physiology. Debate has focused on whether REM sleep dreaming is qualitatively different from nonREM (NREM) sleep and waking. A review of psychophysiological studies shows clear quantitative differences between REM and NREM mentation and between REM and waking mentation. Recent neuroimaging and neurophysiological studies also differentiate REM, NREM, and waking in features with phenomenological implications. Both evidence and theory suggest that there are isomorphisms between (...) the phenomenology and the physiology of dreams. We present a three-dimensional model with specific examples from normally and abnormally changing conscious states. Key Words: consciousness; dreaming; neuroimaging; neuromodulation; NREM; phenomenology; qualia; REM; sleep. (shrink)

This chapter explains how mindmelding — the direct experience by one person of another's conscious states — is in fact possible. The temporal lobes causally interact with the prefrontal lobes by way of fiber bundles that run underneath the cortical surface. This provides the perfect first experiment in mindmelding: to ‘branch’ those fiber bundles and run the other end into the brain of another person. Evidence is provided that these bundles have close connections to consciousness, in that whatever affects (...) them has immediate effects on consciousness. Then, before responding to several objections, the chapter considers another issue brought up by these experiments — the question of the relation between mindmelding and mindreading. Is mindmelding similar to mindreading? Does the existence of a mindreading system help us achieve mindmelding? (shrink)

Sleep researchers in different disciplines disagree about how fully dreaming can be explained in terms of brain physiology. Debate has focused on whether REM sleep dreaming is qualitatively different from nonREM (NREM) sleep and waking. A review of psychophysiological studies shows clear quantitative differences between REM and NREM mentation and between REM and waking mentation. Recent neuroimaging and neurophysiological studies also differentiate REM, NREM, and waking in features with phenomenological implications. Both evidence and theory suggest that there are isomorphisms between (...) the phenomenology and the physiology of dreams. We present a three-dimensional model with specific examples from normally and abnormally changing conscious states. Key Words: consciousness; dreaming; neuroimaging; neuromodulation; NREM; phenomenology; qualia; REM; sleep. (shrink)

Patients in a minimally conscious state (MCS) fall into a different diagnostic category than patients in the more familiar vegetative states (VS). Not only are MCS patients conscious in some sense, they have a higher chance for recovery than VS patients. Because of these differences, we ostensibly have reason to provide MCS patients with care that goes beyond what we provide to patients with some VS patients. But how to justify this differential treatment? I argue we can’t (...) justify it solely by looking to MCS patients’ actual levels of consciousness. We must look also to the ways in which these patients are potentially conscious. Specifically, I argue that certain sensible and well-regarded policy recommendations cannot be justified by looking solely to patients’ actual levels of consciousness, but that they can be justified by looking to patients’ potential for consciousness. Insofar then as we have prima facie reason to follow the recommendations, we also have prima facie reason to view the potential for consciousness as morally salient. If that is true, however, several important implications follow: first, if the potential for consciousness is morally salient, this translates into actual and pressing obligations to patients with disorders of consciousness generally. Second, if the potential for consciousness is morally salient, this has implications that go beyond our obligations to patients with disorders of consciousness. Indeed, if the potential for consciousness is morally salient, this adds an important layer of complexity to the normative landscape, a layer we may not have sufficiently noticed before. (shrink)

The phenomenon of hypnosis provides a rich paradigm for those seeking to understand the processes that underlie consciousness. Understanding hypnosis tells us about a basic human capacity for altered experiences that is often overlooked in contemporary western societies. Throughout the 200 year history of psychology, hypnosis has been a major topic of investigation by some of the leading experimenters and theorists of each generation. Today hypnosis is emerging again as a lively area of research within cognitive (systems level) neuroscience informing (...) basic questions about the structure and biological basis of conscious states. This book describes the latest advances in understanding hypnosis and similar trance states by researchers within the neuroscience of consciousness. It contains many new and exciting contributions from up and coming researchers and provides a lively debate on methodological and theoretical issues central to the development of emerging research paradigms in the neuroscience of conscious states. The book introduces and describes many of the recent new tools that have become available to researchers in this field. Academics, researchers, and clinicians wanting to develop their knowledge of the latest findings, theories and methods in the scientific study of hypnosis and related states of consciousness will find this an up to date guide to this rapidly advancing field. (shrink)

Argues that the brain and the mind are one--that the thoughts, feelings, dreams, and memories that constitute our consciousness are in fact an amalgam of electrical impulses and chemical interactions.

The right to die has for decades been recognised for persons in a vegetative state, but there remains controversy about ending life-sustaining medical treatment for persons in the minimally conscious state. The controversy is rooted in assumptions about the moral significance of consciousness, and the value of life for patients who are conscious and not terminally ill. This paper evaluates these assumptions in light of evidence that generates concerns about quality of life in the MCS. It (...) is argued that surrogates should be permitted to make decisions to withdraw life-sustaining medical treatment from patients in the MCS. (shrink)

The phenomenon of hypnosis provides a rich paradigm for those seeking to understand the processes that underlie consciousness. Understanding hypnosis tells us about a basic human capacity for altered experiences that is often overlooked in contemporary western societies. Throughout the 200 year history of psychology, hypnosis has been a major topic of investigation by some of the leading experimenters and theorists of each generation. Today hypnosis is emerging again as a lively area of research within cognitive neuroscience informing basic questions (...) about the structure and biological basis of conscious states. This book describes the latest advances in understanding hypnosis and similar trance states by researchers within the neuroscience of consciousness. It contains many new and exciting contributions from up and coming researchers and provides a lively debate on methodological and theoretical issues central to the development of emerging research paradigms in the neuroscience of conscious states. The book introduces and describes many of the recent new tools that have become available to researchers in this field. Academics, researchers, and clinicians wanting to develop their knowledge of the latest findings, theories and methods in the scientific study of hypnosis and related states of consciousness will find this an up to date guide to this rapidly advancing field. (shrink)

For a wide range of concepts, a thinker’s understanding of what it is for a thing to fall under the concept plausibly involves knowledge of an identity. It involves knowledge that the thing has to have the same property as is exemplified in instantiation of the concept in some distinguished, basic instance. This paper addresses the question: can we apply this general model of the role of identity in understanding to the case of subjective, conscious states? In particular, can (...) we explain our understanding of what it is for someone else to be in a particular conscious state in terms of our knowledge of the relation of identity which that state bears to some of our own states?[1] This is a large issue, with many ramifications both within and beyond the philosophy of mind; so let me give a map for the route I aim to take. We first need to consider the features of explanations of concepts in terms of identity in domains outside the mental. There are substantial constraints on legitimate explanation of concepts in terms of identity. There are also reasons that it is harder to meet these constraints in the case of concepts of conscious states than it is in other cases. I will go on to suggest a way in which we can overcome the special difficulties of the conscious case, and to try to elaborate the nature both of our understanding of first person applications of concepts of conscious states, and of our grasp of an identity relation applied to these states. A positive account of understanding in this area, as in any other, has to dovetail with a credible epistemology of conscious states in oneself and in others. I will offer something under that head, and say how the resulting position steers a middle way distinct from each of the two classic rival positions on conscious states of the later Wittgenstein on the one hand, and of Frege on the other. (shrink)

What is it for a thinker to possess the concept of perceptual experience? What is it to be able to think of seeings, hearings and touchings, and to be able to think of experiences that are subjectively like seeings, hearings and touchings?

This short comment on the Court of Protection decision in W v M draws attention to the primacy the judge gave to the preservation of life and discusses the relative lack of weight accorded to M's previously expressed views.

Consciousness is known to be limited in processing capacity and often described in terms of a unique processing stream across a single dimension: time. In this paper, we discuss a purely temporal pattern code, functionally decoupled from spatial signals, for conscious state generation in the brain. Arguments in favour of such a code include Dehaene et al.'s long-distance reverberation postulate, Ramachandran's remapping hypothesis, evidence for a temporal coherence index and coincidence detectors, and Grossberg's Adaptive Resonance Theory. A time-bin (...) resonance model is developed, where temporal signatures of conscious states are generated on the basis of signal reverberation across large distances in highly plastic neural circuits. The temporal signatures are delivered by neural activity patterns which, beyond a certain statistical threshold, activate, maintain, and terminate a conscious brain state like a bar code would activate, maintain, or inactivate the electronic locks of a safe. Such temporal resonance would reflect a higher level of neural processing, independent from sensorial or perceptual brain mechanisms. (shrink)

Objective: The value of spontaneous EEG oscillations in distinguishing patients in vegetative and minimally conscious states was studied. Methods: We quantified dynamic repertoire of EEG oscillations in resting condition with closed eyes in patients in vegetative and minimally conscious states (VS and MCS). The exact composition of EEG oscillations was assessed by the probability-classification analysis of short-term EEG spectral patterns. Results: The probability of delta, theta and slow-alpha oscillations occurrence was smaller for patients in MCS than for VS. (...) Additionally, only patients in MCS demonstrated fast-alpha oscillation occurrence. Depending on the type and composition of EEG oscillations, the probability of their occurrence was either aetiology dependent or independent. The probability of EEG oscillations occurrence differentiated brain injuries with different aetiologies. Conclusions: Spontaneous EEG oscillations have a potential value in distinguishing patients in VS and MCS. Significance: This work may have implications for clinical care, rehabilitative programs and medical–legal decisions in patients with impaired consciousness states following coma due to acute brain injuries. (shrink)

In this article, I consider whether the advance directive of a person in minimally conscious state ought to be adhered to when its prescriptions conflict with her current wishes. I argue that an advance directive can have moral significance after its issuer has succumbed to minimally conscious state. I also defend the view that the patient can still have a significant degree of autonomy. Consequently, I conclude that her advance directive ought not to be applied. Then (...) I briefly assess whether considerations pertaining to respecting the patient's autonomy could still require obedience to the desire expressed in her advance directive and arrive at a negative answer. (shrink)

What altered states of consciousness—the dissolution of feelings of time and self—can tell us about the mystery of consciousness. During extraordinary moments of consciousness—shock, meditative states and sudden mystical revelations, out-of-body experiences, or drug intoxication—our senses of time and self are altered; we may even feel time and self dissolving. These experiences have long been ignored by mainstream science, or considered crazy fantasies. Recent research, however, has located the neural underpinnings of these altered states of mind. In this book, neuropsychologist (...) Marc Wittmann shows how experiences that disturb or widen our everyday understanding of the self can help solve the mystery of consciousness. Wittmann explains that the relationship between consciousness of time and consciousness of self is close; in extreme circumstances, the experiences of space and self intensify and weaken together. He considers the emergence of the self in waking life and dreams; how our sense of time is distorted by extreme situations ranging from terror to mystical enlightenment; the experience of the moment; and the loss of time and self in such disorders as depression, schizophrenia, and epilepsy. Dostoyevsky reported godly bliss during epileptic seizures; neurologists are now investigating the phenomenon of the epileptic aura. Wittmann describes new studies of psychedelics that show how the brain builds consciousness of self and time, and discusses pilot programs that use hallucinogens to treat severe depression, anxiety, and addiction. If we want to understand our consciousness, our subjectivity, Wittmann argues, we must not be afraid to break new ground. Studying altered states of consciousness leads us directly to the heart of the matter: time and self, the foundations of consciousness. (shrink)