The Japanese Transplantation Law is unique among others in that it allows us to choose between "brain death" and "traditional death" as our death. In every country 20 to 40 % of the popularion doubts the idea of brain death. This paper reconsiders the concept, and reports the ongoing rivision process of the current law. Published in Hastings Center Report, 2001.

Since 1968, the irreversible loss of functioning of the whole brain, called brain death, is assimilated to individual’s death. The almost universal acceptance of this neurological criterion of death had decisive consequences for the contemporary medicine, such as the withdrawal of mechanical ventilation in these patients and organ retrieval for transplantation. The new criterion was successfully accepted in part because the assimilation of brain death state to death was presented by medicine --and acritically assumed by most of (...) societies-- as a scientific and objective fact. Nevertheless, many people do not think that the patients suffering brain death are actually dead. We show here that those people are not necessarily wrong. It can be argued that, in fact, the justification of the neurological criterion is not scientific but moral. We outline the thesis that the problem surrounding the vital status of brain dead patients is due to a confusion between factual and normative questions. Furthermore, we claim that the donation of organs and the withdrawal of life-support could be ethically acceptable even if the patients suffering brain death are considered as alive. As an alternative to the dead donor rule, we propose a justification for organ donation of brain-dead patients based on the (moral) concepts of harm and consent : what truly justifies the procurement of organs on those patients is not that they are dead, but that they wish to donate their organs and that, since they have irreversibly lost their brain, they cannot be harmed. (shrink)

Nils-Frederic Wagner takes issue with my argument that influential critics of “transplant” thought experiments make two cardinal mistakes. He responds that the mistakes I identify are not mistakes at all. The mistakes are rather on my part, in that I have not taken into account the conceptual genesis of personhood, that my view of thought experiments is idiosyncratic and possibly self-defeating, and in that I have ignored important empirical evidence about the relationship between brains and minds. I argue that (...) my case still stands and that transplant thought experiments can do damage to rivals of a psychological continuity theory of personal identity like Marya Schechtman’s Person Life View. (shrink)

Animalism is prima facie the most plausible view about what we are; it aligns better with science and common sense, and is metaphysically more parsimonious. Thought experiments involving the brain, however, tend to elicit intuitions contrary to animalism. In this paper, I examine two classical thought experiments from the literature, brain transplant and cerebrum transplant, and a new one, cerebrum regeneration. I argue that they are theoretically possible, but that a scientifically informed account of what would (...) actually happen shows that in none of the cases would the person be separated from the animal. Our intuitions in these cases, when adequately informed by neuroscience, do not conflict with animalism – rather, they suggest a correction of the animalist position: the persisting animal should be at least minimally sentient. Sentience animalism is a new formulation of the animalist account of personal identity that allows us to reconcile facts about our biological persistence conditions with the intuition that human persistence should involve some kind of psychological continuity. (shrink)

The dead donor rule justifies current practice in organ procurement for transplantation and states that organ donors must be dead prior to donation. The majority of organ donors are diagnosed as having suffered brain death and hence are declared dead by neurological criteria. However, a significant amount of unrest in both the philosophical and the medical literature has surfaced since this practice began forty years ago. I argue that, first, declaring death by neurological criteria is both unreliable and unjustified (...) but further, the ethical principles which themselves justify the dead donor rule are better served by abandoning that rule and instead allowing individuals who have suffered severe and irreversible brain damage to become organ donors, even though they are not yet dead and even though the removal of their organs would be the proximal cause of death. (shrink)

Conventionalists hold that the sorts of events that one survives—such as teletransportation, or a brain transplant—is at least partly determined by our attitudes. But if Conventionalism is true, whose attitudes directly determine whether one survives? Do the individual's attitudes do all the work as Private Conventionalists hold, or do the community's attitudes also factor in as Public Conventionalists hold? There has recently been a greater push towards Private Conventionalism, while explicit arguments for Public Conventionalism are difficult to come (...) by. In this paper, I attempt to rectify the situation by presenting my case for Public Conventionalism. (shrink)

Here I develop an account of our persistence that accommodates each of the following compelling intuitions: (i) that we are animals, (ii) that we existed prior to the onset of whatever psychological capacities are necessary for personhood, and we can continue to exist with the loss of those and other psychological capacities, (iii) that with suitable psychological continuity, the person goes with the brain/cerebrum in remnant person and brain/cerebrum transplant cases, and (iv) that it is possible for (...) us to survive gradual large-scale replacement of organic with inorganic parts. With the help of a couple of recent “hybrid” animalist accounts I develop an analysis of our persistence that entails (ii)–(iv) while being consistent with (i). (shrink)

In reaching his narrative view of the self in Oneself as Another, Paul Ricoeur argues that, while literature offers revealing insights into the nature of the self, the sort of fictions involving brain transplants, fission, and so on, that philosophers often take seriously do not (and cannot). My paper is a response to Ricoeur's charge, contending that the arguments Ricoeur rejects are not flawed in the way he suggests, and that his own arguments are sometimes guilty of the very (...) charges he lays at the door of his opponents. (shrink)

Derek Parfit argues that fission is prudentially better for you than ordinary death. But is having more fission products with good lives prudentially better for you than having just one? In this paper, we argue that it is. We argue that, if your brain is split and the halves are transplanted into two recipients (who both have good lives), then it is prudentially better for you if both transplants succeed than if only one of them does (other things being (...) equal). This upshot rules out, among other things, that the prudential value of standing in the relation that matters in survival to multiple people is equal to their average well-being. (shrink)

Ontologies formally represent reality in a way that limits ambiguity and facilitates automated reasoning and data fusion, but is often daunting to the non-technical user. Thus, many researchers have endeavored to hide the formal syntax and semantics of ontologies behind the constructs of Controlled Natural Languages (CNLs), which retain the formal properties of ontologies while simultaneously presenting that information in a comprehensible natural language format. In this paper, we build upon previous work in this field by evaluating prospects of implementing (...) International Technology Alliance Controlled English (ITACE) as a middleware for ontology editing. We also discuss at length a prototype of a natural language conversational interface application designed to facilitate ontology editing via the formulation of CNL constructs. (shrink)

Research by neuroscientists suggests there is a distinction in the BSTc area of the brain between males and females. In transsexual females, those considered male at birth, but who had a strong conviction that they were female, the BSTc region appears to be similar in size to the female BSTc and transsexuals considered female at birth, but who were certain they were male, had a BSTc similar to the male BSTc. This distinction leads to the conclusion that in addition (...) to the recognised markers for gender - genitalia, gonads and chromosomes - we may need to also include the BSTc, given that this current research seems to substantiate what transsexuals are saying about their gender. This paper sets out to challenge our current reliance on the standard gender indicators alone and seeks to address some issues faced by transsexuals. (shrink)

‘Transplant’ thought-experiments, in which the cerebrum is moved from one body to another, have featured in a number of recent discussions in the personal identity literature. Once taken as offering confirmation of some form of psychological continuity theory of identity, arguments from Marya Schechtman and Kathleen Wilkes have contended that this is not the case. Any such apparent support is due to a lack of detail in their description or a reliance on predictions that we are in no position (...) to make. I argue that the case against them rests on two serious misunderstandings of the operation of thought-experiments, and that even if they do not ultimately support a psychological continuity theory, they do major damage to that theory’s opponents. (shrink)

A dissociated area of medical research warrants bioethical consideration: a proposed transplantation of a donor’s entire body, except head, to a patient with a fatal degenerative disease. The seeming improbability of such an operation can only underscore the need for thorough bioethical assessment: Not assessing a case of such potential ethical import, by showing neglect instead of facing the issue, can only compound the ethical predicament, perhaps eroding public trust in ethical medicine. This article discusses the historical background of full-body (...) transplantation, documents the seriousness of its current pursuit, and builds an argument for why prima facie this type of transplant is bioethically distinct. Certainly, this examination can only be preliminary, indicating what should be a wide and vigorous discussion among practitioners and ethicists. It concludes with practical suggestions for how the medical and bioethics community may proceed with ethical assessment. (shrink)

The potential to collect brain data more directly, with higher resolution, and in greater amounts has heightened worries about mental and brain privacy. In order to manage the risks to individuals posed by these privacy challenges, some have suggested codifying new privacy rights, including a right to “mental privacy.” In this paper, we consider these arguments and conclude that while neurotechnologies do raise significant privacy concerns, such concerns are—at least for now—no different from those raised by other well-understood (...) data collection technologies, such as gene sequencing tools and online surveillance. To better understand the privacy stakes of brain data, we suggest the use of a conceptual framework from information ethics, Helen Nissenbaum’s “contextual integrity” theory. To illustrate the importance of context, we examine neurotechnologies and the information flows they produce in three familiar contexts—healthcare and medical research, criminal justice, and consumer marketing. We argue that by emphasizing what is distinct about brain privacy issues, rather than what they share with other data privacy concerns, risks weakening broader efforts to enact more robust privacy law and policy. (shrink)

Deep brain stimulation has been of considerable interest to bioethicists, in large part because of the effects that the intervention can occasionally have on central features of the recipient’s personality. These effects raise questions regarding the philosophical concept of authenticity. In this article, we expand on our earlier work on the concept of authenticity in the context of deep brain stimulation by developing a diachronic, value-based account of authenticity. Our account draws on both existentialist and essentialist approaches to (...) authenticity, and Laura Waddell Ekstrom’s coherentist approach to personal autonomy. In developing our account, we respond to Sven Nyholm and Elizabeth O’Neill’s synchronic approach to authenticity, and explain how the diachronic approach we defend can have practical utility, contrary to Alexandre Erler and Tony Hope’s criticism of autonomy-based approaches to authenticity. Having drawn a distinction between the authenticity of an individual’s traits and the authenticity of that person’s values, we consider how our conception of authenticity applies to the context of anorexia nervosa in comparison to other prominent accounts of authenticity. We conclude with some reflections on the prudential value of authenticity, and by highlighting how the language of authenticity can be invoked to justify covert forms of paternalism that run contrary to the value of individuality that seems to be at the heart of authenticity. (shrink)

In Canada, there are currently no guidelines at either the federal or provincial level regarding the provision of kidney transplantation services to foreign nationals (FN). Renal transplant centres have, in the past, agreed to put refugee claimants and other FNs on the renal transplant waiting list, in part, because these patients (refugee claimants) had health insurance through the Interim Federal Health Programme to cover the costs of medication and hospital care. However, severe cuts recently made to this programme (...) have forced clinicians to question whether they should continue with transplants for FNs, for financial and ethical reasons. This paper first examines different national policies (eg, in Canada, USA, France and the UK) to map the diversity of approaches regarding transplantation for FNs, and then works through different considerations commonly used to support or oppose the provision of organs to these patients: (1) the organ shortage; (2) the free-rider problem; (3) the risk of becoming a transplant destination; (4) the impact on organ donation rates; (5) physicians’ duties; (6) economic concerns; (7) vulnerability. Using a Canadian case as a focus, and generalising through a review of various national policies, we analyse the arguments for and against transplantation for FNs with a view to bringing clarity to what is a sensitive political and clinical management issue. Our aim is to help transplant centres, clinicians and ethicists reflect on the merits of possible options, and the rationales behind them. (shrink)

An analysis of the identity issues involved in facial allograft transplantation is provided in this paper. The identity issues involved in organ transplantation in general, under both theoretical accounts of personal identity and subjective accounts provided by organ recipients, are examined. It is argued that the identity issues involved in facial allograft transplantation are similar to those involved in organ transplantation in general, but much stronger because the face is so closely linked with personal identity. Recipients of facial allograft transplantation (...) have the potential to feel that their identity is a mix between their own and the donor’s, and the donor’s family is potentially likely to feel that their loved one ‘‘lives on’’. It is also argued that facial allograft transplantation allows the recipients to regain an identity, because they can now be seen in the social world. Moreover, they may regain expressivity, allowing for them to be seen even more by others, and to regain an identity to an even greater extent. Informing both recipients and donors about the role that identity plays in facial allograft transplantation could enhance the consent process for facial allograft transplantation and donation. (shrink)

The biophilosophic justification for the idea that “brain death” is death needs to support two claims: that what dies in human death is a human organism, not merely a psychological entity distinct from it; that total brain failure signifies the end of the human organism as a whole. Defenders of brain death typically assume without argument that the first claim is true and argue for the second by defending the “integrative unity” rationale. Yet the integrative unity rationale (...) has fallen on hard times. In this article, I give reasons for why we should think of ourselves as organisms, and why the “fundamental work” rationale put forward by the 2008 President’s Council is better than the integrative unity rationale, despite persistent objections to it. (shrink)

This paper deals with the core version of the Trolley Problem. In one case many people favor an act which will bring about the death of one person but save five other persons. In another case most people would refuse to “sacrifice” one person in order to save five other lives. Since the two cases seem similar in all relevant respects, we have to explain and justify the diverging verdicts. Since I don’t find current proposals of a solution convincing, I (...) propose an alternative one according to which —but not —violates two forms of equality. I also test the underlying egalitarian principle against other cases. I argue that it offers a good explanation and also a normative justification of our intuitive verdicts about the cases. (shrink)

The brain in its plasticity and inherent 'sociality' can be proclaimed and projected as a revolutionary organ. Far from the old reactions which opposed the authenticity of political theory and praxis to the dangerous naturalism of 'cognitive science' (with images of men in white coats, the RAND Corporation or military LSD experiments), recent decades have shown us some of the potentiality of the social brain (Vygotsky, and more recently Negri 1995 and Negri 2000, Virno 2001). Is the (...) class='Hi'>brain somehow inherently a utopian topos? If in some earlier papers I sought to defend naturalism against these reactions, here I consider a new challenge: the recently emerged disciplines of neuronormativity, which seek in their own way to overcome the nature-normativity divide. This is the task of a materialist brain theory today. 1. The setup: horns of a dilemma There is a lingering zone of what one might think of as sore cognitive muscle tissue in the area of materialism. It is an area of both contested territory and in some cases, a kind of pathos of distance of the 'Ugh! Keep that thing away from me!' sort. I have in mind the combination of materialism as an emancipatory socio-political project (which need not be construed in strictly Marx-Engels terms, if we think of Lucretius et al.) and as a cold-hearted 'spontaneous philosophy of the men in white coats', e.g. nefarious neurophilosophers. Faced with this rather massive alternative, this choice between two projects, I have stubbornly been saying since some discussions with Negri in the late 90s. (shrink)

In this paper, we engage in dialogue with Jonathan Pugh, Hannah Maslen, and Julian Savulescu about how to best interpret the potential impacts of deep brain stimulation on the self. We consider whether ordinary people’s convictions about the true self should be interpreted in essentialist or existentialist ways. Like Pugh et al., we argue that it is useful to understand the notion of the true self as having both essentialist and existentialist components. We also consider two ideas from existentialist (...) philosophy – Jean-Paul Sartre and Simone de Beauvoir’s ideas about “bad faith” and “ambiguity” – to argue that there can be value to patients in regarding themselves as having a certain amount of freedom to choose what aspects of themselves should be considered representative of their true selves. Lastly, we consider the case of an anorexia nervosa-patient who shifts between conflicting mind-sets. We argue that mind-sets in which it is easier for the patient and his or her family to share values can plausibly be considered to be more representative of the patient’s true self, if this promotes a well-functioning relationship between the patient and the family. However, we also argue that families are well-advised to give patients room to figure out what such shared values mean to them, since it can be alienating for patients if they feel that others try to impose values on them from the outside. (shrink)

Deep Brain Stimulation (DBS) is a relatively new, experimental treatment for patients suffering from treatment-refractory Obsessive Compulsive Disorder (OCD). The effects of treatment are typically assessed with psychopathological scales that measure the amount of symptoms. However, clinical experience indicates that the effects of DBS are not limited to symptoms only: patients for instance report changes in perception, feeling stronger and more confident, and doing things unreflectively. Our aim is to get a better overview of the whole variety of changes (...) that OCD patients experience during DBS treatment. For that purpose we conducted in-depth, semi-structured interviews with 18 OCD patients. In this paper, we present the results from this qualitative study.We list the changes grouped in four domains: with regard to (a) person, (b) (social) world, (c)characteristics of person-world interactions, and (d) existential stance. We subsequently provide an interpretation of these results. In particular, we suggest that many of these changes can be seen as different expressions of the same process; namely that the experience of anxiety and tension gives way to an increased basic trust and increased reliance on one’s abilities. We then discuss the clinical implications of our findings, especially with regard to properly informing patients of what they can expect from treatment, the usefulness of including CBT in treatment, and the limitations of current measures of treatment success. We end by making several concrete suggestions for further research. (shrink)

Bioethical discourse on organ donation covers a wide range of topics, from informed consent procedures and scarcity issues up to ‘transplant tourism’ and ‘organ trade’. This paper presents a ‘depth ethics’ approach, notably focussing on the tensions, conflicts and ambiguities concerning the status of the human body. These will be addressed from a psychoanalytical angle. First, I will outline Lacan’s view on embodiment as such. Subsequently, I will argue that, for organ recipients, the donor organ becomes what Lacan refers (...) to as an object a, the ‘partial object’ of desire, the elusive thing we are deprived of, apparently beyond our grasp. Within the recipient’s body an empty space emerges, a kind of ‘vacuole’, once occupied by a faltering organ. This space can only be filled by a ‘gift’ from the other, by an object a. Once implanted, however, this implant becomes an ‘extimate’ object: something both ‘external’ and ‘intimate’, both ‘embedded’ and ‘foreign’, and which is bound to remain an object of concern for quite some time, if not for life. A Lacanian analysis allows us, first of all, to address the question what organ transplantation has in common with other bodily practices involving bodily parts procured from others, such as cannibalism. But it also reveals the basic difference between the two, as well as the distance between the ‘fragmented body’ of Frankenstein’s ‘monster’—as an aggregate of replaceable parts—and the multiple organ recipients of today. (shrink)

Does a diagnosis of brain dysfunction matter for ascriptions of moral responsibility? This chapter argues that, while knowledge of brain pathology can inform judgments of moral responsibility, its evidential value is currently limited for a number of practical and theoretical reasons. These include the problem of establishing causation from correlational data, drawing inferences about individuals from group data, and the reliance of the interpretation of brain findings on well-established psychological findings. Brain disorders sometimes matter for moral (...) responsibility, however, because they change an individual’s moral psychology in a way that is beyond their control. While control over psychological changes is not an excusing factor, brain disorders can mitigate moral responsibility because they confront individuals with new psychological deficits or urges for which their previous moral education and existing external and internal moral resources have not prepared them. (shrink)

Neuroscience has studied deductive reasoning over the last 20 years under the assumption that deductive inferences are not only de jure but also de facto distinct from other forms of inference. The objective of this research is to verify if logically valid deductions leave any cerebral electrical trait that is distinct from the trait left by non-valid deductions. 23 subjects with an average age of 20.35 years were registered with MEG and placed into a two conditions paradigm (100 trials for (...) each condition) which each presented the exact same relational complexity (same variables and content) but had distinct logical complexity. Both conditions show the same electromagnetic components (P3, N4) in the early temporal window (250–525 ms) and P6 in the late temporal window (500–775 ms). The significant activity in both valid and invalid conditions is found in sensors from medial prefrontal regions, probably corresponding to the ACC or to the medial prefrontal cortex. The amplitude and intensity of valid deductions is significantly lower in both temporal windows (p = 0.0003). The reaction time was 54.37% slower in the valid condition. Validity leaves a minimal but measurable hypoactive electrical trait in brain processing. The minor electrical demand is attributable to the recursive and automatable character of valid deductions, suggesting a physical indicator of computational deductive properties. It is hypothesized that all valid deductions are recursive and hypoactive. (shrink)

Philosophers have given sustained attention to the controversial possibility of (legal) markets in transplantable human organs. Most of this discussion has focused on whether such markets would enhance or diminish autonomy, understood in either the personal sense or the Kantian moral sense. What this discussion has lacked is any consideration of the relationship between self-ownership and such markets. This paper examines the implications of the most prominent and defensible conception of self-ownership--control self-ownership (CSO)--for both market and nonmarket organ-allocation mechanisms. The (...) paper contends that CSO rules out a large set of nonmarket mechanisms, including escheatage ("presumed consent"), compensated takings of organs, and restricted gifting. It also argues that CSO, if accompanied by an economistic concern for welfare, can underwrite varying types of markets in human organs, ranging from mutual-insurance pools to inter vivos (i.e., live donor) organ sales. (shrink)

Contemporary discussions of epistemological skepticism - the view that we do not and cannot know anything about the world around us - focus very much on a certain kind of skeptical argument involving a skeptical scenario (a situation familiar from Descartes’ First Meditation). According to the argument, knowing some ordinary proposition about the world (one we usually take ourselves to know) requires knowing we are not in some such skeptical scenario SK; however, since we cannot know that we are not (...) in SK we also cannot know any ordinary proposition. One of the most prominent skeptical scenarios is the brain-in-the-vat-scenario: An evil scientist has operated on an unsuspecting subject, removed the subject’s brain and put it in a vat where it is kept functioning and is connected to some computer which feeds the brain the illusion that everything is “normal”. This paper looks at one aspect of this scenario after another – envatment, disembodiment, weird cognitive processes, lack of the right kind of epistemic standing, and systematic deception. The conclusion is that none of these aspects (in isolation or in combination) is of any relevance for a would-be skeptical argument; the brain-in-the-vat-scenario is irrelevant to and useless for skeptical purposes. Given that related scenarios (e.g., involving evil demons) share the defects of the brain-in-the-vat-scenario, the skeptic should not put any hopes on Cartesian topoi. (shrink)

The scarcity of livers available for transplants forces tough choices upon us. Lives for those not receiving a transplant are likely to be short. One large group of potential recipients needs a new liver because of alcohol consumption, while others suffer for reasons unrelated to their own behaviour. Should the former group receive lower priority when scarce livers are allocated? This discussion connects with one of the most pertinent issues in contemporary political philosophy; the role of personal responsibility in (...) distributive justice. One prominent theory of distributive justice, luck egalitarianism, assesses distributions as just if, and only if, people's relative positions reflect their exercises of responsibility. There is a principled luck egalitarian case for giving lower priority to those who are responsible for their need. Compared to the existing literature favouring such differentiation, luck egalitarianism provides a clearer rationale of fairness, acknowledges the need for individual assessments of responsibility, and requires initiatives both inside and outside of the allocation systems aimed at mitigating the influence from social circumstances. Furthermore, the concrete policies that luck egalitarians can recommend are neither too harsh on those who make imprudent choices nor excessively intrusive towards those whose exercises of responsibility are assessed. (shrink)

This article considers one seemingly compelling justification for immigration restrictions: that they help restrict the brain drain of skilled workers from poor states. For some poor states, brain drain is a severe problem, sapping their ability to provide basic services. Yet this article finds that justifying immigration restrictions on brain drain grounds is far from straightforward. For restrictions to be justified, a series of demanding conditions must be fulfilled. Brain drain does provide a successful argument for (...) some immigration restrictions, but it is an argument that fails to justify restrictions beyond a small minority of cases. (shrink)

People suffering from Obsessive-Compulsive Disorder (OCD) do things they do not want to do, and/or they think things they do not want to think. In about 10 percent of OCD patients, none of the available treatment options is effective. A small group of these patients is currently being treated with deep brain stimulation (DBS). Deep brain stimulation involves the implantation of electrodes in the brain. These electrodes give a continuous electrical pulse to the brain area in (...) which they are implanted. It turns out that patients may experience profound changes as a result of DBS treatment. It is not just the symptoms that change; patients rather seem to experience a different way of being in the world. These global effects are insufficiently captured by traditional psychiatric scales, which mainly consist of behavioural measures of the severity of the symptoms. In this article we aim to capture the changes in the patients’ phenomenology and make sense of the broad range of changes they report. For that we introduce an enactive, affordance-based model that fleshes out the dynamic interactions between person and world in four aspects. The first aspect is the patients’ experience of the world. We propose to specify the patients’ world in terms of a field of affordances, with the three dimensions of broadness of scope (‘width’ of the field), temporal horizon (‘depth’), and relevance of the perceived affordances (‘height’). The second aspect is the person-side of the interaction, that is, the patients’ self-experience, notably their moods and feelings. Thirdly, we point to the different characteristics of the way in which patients relate to the world. And lastly, the existential stance refers to the stance that patients take towards the changes they experience: the second-order evaluative relation to their interactions and themselves. With our model we intend to specify the notion of being in the world in order to do justice to the phenomenological effects of DBS treatment. (shrink)

Is it rational to believe that the mind is identical to the brain? Identity theorists say it is (or looks like it will be, once all the neuroscientific evidence is in), and they base this claim on a general epistemic route to belief in identity. I re-develop this general route and defend it against some objections. Then I discuss how rational belief in mind–brain identity, obtained via this route, can be threatened by an appropriately adjusted version of the (...) anti-physicalist knowledge argument. Responses to this threat usually appeal either to different modes of presentation or to phenomenal concepts. But neither type of response is satisfactory. I provide a novel response, which appeals to an innocuous epistemic peculiarity of phenomenal states, namely their, as I shall call it, evidential insulation. (shrink)

Under the current Mental Health Act of England and Wales, it is lawful to perform deep brain stimulation in the absence of consent and independent approval. We argue against the Care Quality Commission's preferred strategy of addressing this problematic issue, and offer recommendations for deep brain stimulation-specific provisions in a revised Mental Health Act.

Liver transplantation (LT) activities during the COVID-19 pandemic have been curtailed in many countries. The impact of various policies restricting LT on outcomes of potential LT candidates is unclear. We studied all patients on the nationwide LT waitlists in Hong Kong and Singapore between January 2016 and May 2020. We used continuous time Markov chains to model the effects of different scenarios and varying durations of disruption on LT candidates.

The “Human Brain Project” (HBP) is a large-scale European neuroscience and information communication technology (ICT) project that has been a matter of heated controversy since its inception. With its aim to simulate the entire human brain with the help of supercomputing technologies, the HBP plans to fundamentally change neuroscientific research practice, medical diagnosis, and eventually the use of computers itself. Its controversial nature and its potential impacts render the HBP a subject of crucial importance for critical studies of (...) science and society. In this paper, we provide a critical exploratory analysis of the potential mid- to long-term impacts the HBP and its ICT infrastructure could be expected to have, provided its agenda will indeed be implemented and executed to a substantive degree. We analyse how the HBP aspires to change current neuroscientific practice, what impact its novel infrastructures could have on research culture, medical practice and the use of ICT, and how, given a certain degree of successful execution of the project’s aims, potential clinical and methodological applications could even transform society beyond scientific practice. Furthermore, we sketch the possibility that research such as that projected by the HBP may eventually transform our everyday world, even beyond the scope of the HBP’s explicit agenda, and beyond the isolated ‘application’ of some novel technological device. Finally, we point towards trajectories for further philosophical, historical and sociological research on the HBP that our exploratory analysis might help to inspire. Our analysis will yield important insights regardless of the actual success of the HBP. What we drive at, for the most part, is the broader dynamics of scientific and technological development of which the HBP agenda is merely one particularly striking exemplification. (shrink)

[This download includes the table of contents and chapter 1.] -/- When we praise, blame, punish, or reward people for their actions, we are holding them responsible for what they have done. Common sense tells us that what makes human beings responsible has to do with their minds and, in particular, the relationship between their minds and their actions. Yet the empirical connection is not necessarily obvious. The “guilty mind” is a core concept of criminal law, but if a defendant (...) on trial for murder were found to have serious brain damage, which brain parts or processes would have to be damaged for him to be considered not responsible, or less responsible, for the crime? The authors argue that evidence from neuroscience and the other cognitive sciences can illuminate the nature of responsibility and agency. They go on to offer a novel and comprehensive neuroscientific theory of human responsibility. (shrink)

50 years after its introduction, brain death remains controversial among scholars. The debates focus on one question: is brain death a good criterion for determining death? This question has been answered from various perspectives: medical, metaphysical, ethical, and legal or political. Most authors either defend the criterion as it is, propose some minor or major revisions, or advocate abandoning it and finding better solutions to the problems that brain death was intended to solve when it was introduced. (...) Here I plead for a different approach that has been overlooked in the literature: the philosophy of science approach. Some scholars claim that human death is a matter of fact, a biological phenomenon whose occurrence can be determined empirically, based on science. We should take this claim seriously, whether we agree with it or not. The question is: how do we know that human death is a scientific matter of fact? Taking the philosophy of science approach means, among other things, examining how the determination of human death became an object of scientific inquiry, exploring the nature of the brain death criterion itself, and analysing the meaning of its core concepts such as “irreversibility” and “functions”. (shrink)

The search for causes of perinatal brain damage needs a solid theoretical foundation. Current theory apparently does not offer a unanimously accepted view of what constitutes a cause, and how it can be identified. We discuss nine potential theoretical misconceptions: (1) too narrow a view of what is a cause (causal production vs. facilitation), (2) extrapolating from possibility to fact (potential vs. factual causation), (3) if X, then invariably Y (determinism vs. probabilism), (4) co-occurrence in individuals vs. association in (...) populations, (5) one cause is all that is needed (single cause attribution vs. multicausal constellations), (6) drawing causal inferences from very small numbers of observations (the tendency to generalize), (7) unstated causal inferences, (8) ignoring heterogeneity, and (9) failing to consider alternative explanations for what is observed. We hope that our critical discussion will contribute to fruitful research and help reduce the burden of perinatal brain damage. (shrink)

The growing demand for uterus transplantation (UTx) invites continued philosophical evaluation of the function of UTx (and what constitutes its ‘success’), as well as the recipient eligibility for UTx. Currently, UTx caters to partnered, cisgender women of childbearing age looking to get pregnant and give birth to a biogenetically related child. The medical justification for this—the treatment of uterine infertility—explains the primacy of this practice. However, this dominant conceptualization of UTx does not necessarily capture the diverse needs for which both (...) cis‐ and transgender women might take interest in UTx that are not strictly procreative, such as bodily integrity and gender identity reasons. In this paper, I argue that non‐procreative motivations for uterus acquisition ought to be taken seriously as a matter of non‐discrimination and consistency. (shrink)

In her debate with Michael Blake, Gillian Brock sets out to justify emigration restrictions on medical workers from poor states on the basis of their free-riding on the public investment that their states have made in them in form of a publicly funded education. For this purpose, Brock aims to isolate the question of emigration restrictions from the larger question of responsibilities for remedying global inequalities. I argue that this approach is misguided because it is blind to decisive factors at (...) play in the problem of medical brain drain and consequently distorts the different responsibilities this problem generates. Brock’s strategy, if successful, would effectively lead to punishing emigrating workers from poor states for the free-riding and exploitation that is committed by affluent states – which is a counter-intuitive result. (shrink)

Davis called for “extreme caution” in the use of non-invasive brain stimulation to treat neurological disorders in children, due to gaps in scientific knowledge. We are sympathetic to his position. However, we must also address the ethical implications of applying this technology to minors. Compensatory trade-offs associated with NIBS present a challenge to its use in children, insofar as these trade-offs have the effect of limiting the child’s future options. The distinction between treatment and enhancement has some normative force (...) here. As the intervention moves away from being a treatment toward being an enhancement—and thus toward a more uncertain weighing of the benefits, risks, and costs—considerations of the child’s best interests diminish, and the need to protect the child’s autonomy looms larger. NIBS for enhancement involving trade-offs should therefore be delayed, if possible, until the child reaches a state of maturity and can make an informed, personal decision. NIBS for treatment, by contrast, is permissible insofar as it can be shown to be at least as safe and effective as currently approved treatments, which are themselves justified on a best interests standard. (shrink)

There is a strong philosophical intuition that direct study of the brain can and will constrain the development of psychological theory. When this intuition is tested against case studies on the neurophysiology and psychology of perception and memory, it turns out that psychology has led the way toward knowledge of neurophysiology. An abstract argument is developed to show that psychology can and must lead the way in neuroscientific study of mental function. The opposing intuition is based on mainly weak (...) arguments about the fundamentality or objectivity of physics or physiology in relation to psychology. -/- Philosophy of Science, Vol. 67, Supplement. Proceedings of the 1998 Biennial Meetings of the Philosophy of Science Association. Part II: Symposia Papers (Sep., 2000). (shrink)

Introduction: the objective of the investigation is to analyse the informational operating-mode of the brain and to extract conclusions on the structure of the informational system of the human body and consciousness. Analysis: the mechanisms and processes of the transmission of information in the body both by electrical and non-electrical ways are analysed in order to unify the informational concepts and to identify the specific essential requirements supporting the life. It is shown that the electrical transmission can be described (...) by typical YES/NO (all or nothing) binary units as defined by the information science, while the inter and intra cell communication, including within the synaptic junction, by mechanisms of embodiment/disembodiment of information. The virtual received or operated information can be integrated in the cells as matter-related information, with a maximum level of integration as genetically codified info. Therefore, in terms of information, the human appears as a reactive system changing information with the environment and between inner informational subsystems which are: the centre of acquisition and storing of information (acquired data), the centre of decision and command (decision), the info-emotional system (emotions), the maintenance informational system (matter absorption/desorption/distribution), the genetic transmission system (reproduction) and info-genetic generator (genetically assisted body evolution). The dedicated areas and components of the brain are correlated with such systems and their functions are specified. Result: the corresponding cognitive centres projected into consciousness are defined and described according to their specific functions. The cognitive centres, suggestively named to appropriately include their main characteristics are detected at the conscious level respectively as: memory, decisional operation (attitude), emotional state, power/energy status and health, associativity and offspring formation, inherited predispositions, skills and mentality. The near-death and religious experiences can be explained by an Info-Connection pole. Conclusion: consciousness could be fully described and understood in informational terms. (shrink)

Hilary Putnam’s BIV argument first occurred to him when ‘thinking about a theorem in modern logic, the “Skolem–Löwenheim Theorem”’ (Putnam 1981: 7). One of my aims in this paper is to explore the connection between the argument and the Theorem. But I also want to draw some further connections. In particular, I think that Putnam’s BIV argument provides us with an impressively versatile template for dealing with sceptical challenges. Indeed, this template allows us to unify some of Putnam’s most enduring (...) contributions to the realism/antirealism debate: his discussions of brains-in-vats, of Skolem’s Paradox, and of permutations. In all three cases, we have an argument which does not merely defeat the sceptic; it also shows us that we must reject some prima facie plausible philosophical picture. (shrink)

The tendency to draw mind-brain dichotomies and evaluate mental disorders dualistically arises in both laypeople and mental health professionals, leads to biased judgments, and contributes to mental health stigmatization. This paper offers a theory identifying an underlying source of these evaluations in social practice. According to this theory, dualistic evaluations are rooted in two mechanisms by which we represent and evaluate the beliefs of others in folk psychology and theory of mind: the doxastic conception of mental disorders and doxastic (...) voluntarism. Tracing these origins contributes to our understanding of mental state representation in cognitive science and philosophy of psychiatry, the concept of belief in philosophy of mind, and may help improve patient experience and treatment in light of social stigmatization and bias toward mental illness. (shrink)

It is well documented that people with moderate-to-severe traumatic brain injury (TBI) can undergo personality changes, including becoming more impulsive in terms of how they behave. Legal guidance and academic commentary support the view that impulsiveness can render someone decisionally incompetent as defined by English and Welsh law. However, impulsiveness is a trait found within the healthy population. Arguably, impulsiveness is also a trait that gives rise to behaviours that should normally be tolerated even when they cause harm to (...) the person enacting the behaviours. The purpose of this paper is to show why both of these considerations present as significant challenges to the law in England and Wales. (shrink)

EEG signals are records of nonlinear solitary waves in human brains. The waves have several types (e.g., α, β, γ, θ, δ) in response to different levels of consciousness. They are classified into two groups: Group-1 consists of complex storm-like waves (α, β, and γ); Group-2 is composed of simple quasilinear waves (θ and δ). In order to elucidate the mechanism of EEG wave formation and propagation, this paper extends the Vlasov-Maxwell equations of Plasma Brain Dynamics (PBD) to a (...) set of two-fluid, self-similar, nonlinear solitary wave equations. Numerical simulations are performed for different EEG signals. Main results include: (1) The excitation and propagation of the EEG wave packets are dependent of electric and magnetic fields, brain aqua-ions, electron and ion temperatures, masses, and their initial fluid speeds; (2) Group-1 complex waves contain three ingredients: the high-frequency ion-acoustic (IA) mode, the intermediate-frequency lower-hybrid (LH) mode, and, the low-frequency ion-cyclotron (IC) mode; (3) Group-2 simple waves fall within the IA band, featured by one or a combination of the three envelopes: sinusoidal, sawtooth, and spiky/bipolar. The study proposes an alternative model to Quantum Brain Dynamics (QBD) by suggesting that the formation and propagation of the nonlinear solitary EEG waves in the brain have the same mechanism as that of the waves in space plasmas. (shrink)

To maintain my neutral monist or multi-aspect view of human reality (or indeed to defend the Cartesian dualism assumed by Puccetti & Dykes, it is wrong to relate the mind to the brain alone. A person's mind should be related to the physical environment, including the body, in addition to the brain. Furthermore, we are unlikely to understand the detailed functioning of an individual brain without knowing the history of its interactions with the external and internal environments (...) during that person's life, or indeed any inherited neurogenomics (circuitry innately adapted to ecology. (shrink)

The connection between brain and mind is an important scientific and philosophical question that we are still far from completely understanding. A crucial point to our work is noticing that thermodynamics provides a convenient framework to model brain activity, whereas cognition can be modeled in information-theoretical terms. In fact, several models have been proposed so far from both approaches. A second critical remark is the existence of deep theoretical connections between thermodynamics and information theory. In fact, some well-known (...) authors claim that the laws of thermodynamics are nothing but principles in information theory. Unlike in physics or chemistry, a formalization of the relationship between information and energy is currently lacking in neuroscience. In this paper we propose a framework to connect physical brain and cognitive models by means of the theoretical connections between information theory and thermodynamics. Ultimately, this article aims at providing further insight on the formal relationship between cognition and neural activity. (shrink)

: The idea of enhancing our mental functions through medical means makes many people uncomfortable. People have a vague feeling that altering our brains tinkers with the core of our personalities and the core of ourselves. It changes who we are, and doing so seems wrong, even if the exact reasons for the unease are difficult to define. Many of the standard arguments against neuroenhancements—that they are unsafe, that they violate the distinction between therapy and enhancements, that they undermine equality, (...) and that they will be used coercively—fail to show why the use of any such technologies is wrong in principle. Two other objections—the arguments that such changes undermine our integrity and that they prevent us from living authentic lives—will condemn only a few of the uses that are proposed. The result is that very few uses of these drugs are morally suspect and that most uses are morally permissible. (shrink)

In recent times we have seen an explosion in the amount of attention paid to the conscious brain from scientists and philosophers alike. One message that has emerged loud and clear from scientific work is that the brain is a dynamical system whose operations unfold in time. Any theory of consciousness that is going to be physically realistic must take account of the intrinsic nature of neurons and brain activity. At the same time a long discussion on (...) consciousness among philosophers has resulted in our distinguishing several kinds of consciousness. So when we ask where the place of consciousness is in nature we may mean several different things. In this chapter I will argue that it is plausible that all of the kinds of consciousness turn out to be nothing but patterns of synchronized neural activity in various frequencies against a dynamically changing chemical background. (shrink)