scholarly journals The neuroethics of agency: the problem of attributing mental states to people with disorders of consciousness

2021 ◽  
Vol 20 (1) ◽  
pp. 235-250
Author(s):  
Marco Azevedo ◽  
Bianca Andrade

How can we be certain that another creature is a conscious being? One path is to rely on introspective reports we can grasp in communication or observation of their behavior. Another path is to infer mentality and consciousness by means of markers tied to their intentional behavior, that is, agency. In this paper we will argue that even if agency is a marker of consciousness in several normal instances (paradigmatically, for mature and healthy human beings), it is not a good marker in several pathological instances, such as the blindsight case, the vegetative state, the akinetic mutism and the locked-in syndrome. If we are right, this can be of great utility in neuroethics; for those kinds of disorders of consciousness are not, after all, instances of complete absence of consciousness.

Author(s):  
T.J. Kasperbauer

This chapter applies the psychological account from chapter 3 on how we rank human beings above other animals, to the particular case of using mental states to assign animals moral status. Experiments on the psychology of mental state attribution are discussed, focusing on their implications for human moral psychology. The chapter argues that attributions of phenomenal states, like emotions, drive our assignments of moral status. It also describes how this is significantly impacted by the process of dehumanization. Psychological research on anthropocentrism and using animals as food and as companions is discussed in order to illuminate the relationship between dehumanization and mental state attribution.


2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Giacomo Figà Talamanca

Abstract Joint action among human beings is characterized by using elaborate cognitive feats, such as representing the mental states of others about a certain state of affairs. It is still debated how these capacities evolved in the hominid lineage. I suggest that the consolidation of a shared practice over time can foster the predictability of other’s behavior. This might facilitate the evolutionary passage from inferring what others might know by simply seeing them and what they are viewing towards a mutual awareness of each other’s beliefs. I will examine the case for cooperative hunting in one chimpanzee community and argue that it is evidence that they have the potential to achieve common ground, suggesting that the consolidation of a practice might have supported the evolution of higher social cognition in the hominid lineage.


2000 ◽  
Vol 8 (1) ◽  
pp. 1-7 ◽  
Author(s):  
Jess F. Kraus ◽  
Corinne Peek-Asa ◽  
David McArthur

Although epidemiological studies of gender differences in outcome after brain injury are limited, studies in animals indicate higher fatality rates for females. Studies in which healthy human brain metabolism was investigated also suggest gender differences. In this paper the authors examine gender as an independent predictor of survival following brain injury. A prospective cohort of severely and moderately brain injured individuals was identified from two trauma centers over a period of 3.5 years. Patients enrolled in the cohort were followed for as long as 18 months postdischarge. The Glasgow Outcome Scale was used to measure long-term outcome. Overall, mortality was 1.28 times higher in females than males, with the greatest difference of 2.14 found in deaths postdischarge. Controlling for age, admission Glasgow Coma Score, penetrating as compared with blunt injury, and the presence of multiple trauma, females were 1.75 times more likely than males to die of their brain injury (95% confidence interval 1.09—2.82). Furthermore, females were 1.57 times more likely to experience poor outcomes (that is, severe disability or persistent vegetative state) than males. These findings suggest the need to examine similar effects in different cohorts and to identify the patho-physiological basis for the differences observed in this epidemiological study.


Author(s):  
Eric Racine ◽  
Catherine Rodrigue ◽  
James L. Bernat ◽  
Richard Riopelle ◽  
Sam D. Shemie

AbstractThe care of chronically unconscious patients raises vexing medical, ethical, and social questions concerning diagnosis, prognosis, communication with family members, and decision making, including the withdrawal of life support. We provide updates on major controversies surrounding disorders of consciousness. Issues such as withdrawal of artificial nutrition and hydration – which had been considered “settled” by many in the medical, legal and ethical communities – have resurfaced under the pressure of social groups and religious authorities. Some assumptions about the level of awareness and the prognosis of vegetative state and minimal conscious patients are questioned by advances in clinical care because of insights produced by neuroscience research techniques, particularly functional neuroimaging. Both the clinical and neuroscience dimensions of disorders of consciousness raise complex issues such as resource allocation and high levels of diagnostic inaccuracies (at least, for the vegetative state). We conclude by highlighting areas needing further research and collaboration.


2020 ◽  
Vol 26 (1) ◽  
pp. 171-191
Author(s):  
Marcus Knaup ◽  
Hanna Hubenko ◽  
Galyna Iarmolovych

The article is devoted to the bioethical reconstruction of the theoretical heritage of Hans Jonas (1903-1993) – a famous German and later American philosopher. Jonas showed that the study of ethics, namely the ethics of the living, should become an integral part of the formation of modern human, his complete education. He was one of the most fascinating thinkers of the twentieth century. He has presented groundbreaking works which are still the subject of serious discussion especially in the areas of ethics and philosophy of nature. In these publications he presents an in-depth philosophical reflection on the relationship between human beings and nature, as well as on the manner in which we approach our association with technology. Particularly in the light of possibilities presented by modern technology, Jonas was primarily interested in a new approach to the philosophy of nature as the basis, the foundation for an ethics of global responsibility. The article re-actualizes the thoughts and arguments of Jonas, which are especially relevant now, at the beginning of the XXI century. These include: the technique change the nature itself, not just human's attitude to nature; the technical sciences change a human being, the mathematization of nature leads to a change not only in human evaluation, but also in human value; critique of epiphenomenalism for underestimating mental states and identifying the non-reducibility of living creatures to its parts; the search for the potential of subjectivity in the realm of living creatures as a whole; reliance on the principle of responsibility as a way to ensure a future humanity as guaranteed, albeit limited in its capabilities. Educating a person on the basis of the principle of responsibility opens the possibility to take into account the interests of future generations and all living creatures, understanding that every person always was, is and will be a part of realm of these creatures. The philosophy of nature as such whole realm creates the preconditions and foundations for the ethics of responsibility as a postconventional universalist ethics. A new way of thinking in nature is the basis of ethics in the technological age: in addition to philosophy and science, the voices of religion, politics, education and the public sphere must also be heard to find answers to current life questions.


Neurology ◽  
2018 ◽  
Vol 91 (10) ◽  
pp. 450-460 ◽  
Author(s):  
Joseph T. Giacino ◽  
Douglas I. Katz ◽  
Nicholas D. Schiff ◽  
John Whyte ◽  
Eric J. Ashman ◽  
...  

ObjectiveTo update the 1995 American Academy of Neurology (AAN) practice parameter on persistent vegetative state and the 2002 case definition on minimally conscious state (MCS) and provide care recommendations for patients with prolonged disorders of consciousness (DoC).MethodsRecommendations were based on systematic review evidence, related evidence, care principles, and inferences using a modified Delphi consensus process according to the AAN 2011 process manual, as amended.RecommendationsClinicians should identify and treat confounding conditions, optimize arousal, and perform serial standardized assessments to improve diagnostic accuracy in adults and children with prolonged DoC (Level B). Clinicians should counsel families that for adults, MCS (vs vegetative state [VS]/unresponsive wakefulness syndrome [UWS]) and traumatic (vs nontraumatic) etiology are associated with more favorable outcomes (Level B). When prognosis is poor, long-term care must be discussed (Level A), acknowledging that prognosis is not universally poor (Level B). Structural MRI, SPECT, and the Coma Recovery Scale–Revised can assist prognostication in adults (Level B); no tests are shown to improve prognostic accuracy in children. Pain always should be assessed and treated (Level B) and evidence supporting treatment approaches discussed (Level B). Clinicians should prescribe amantadine (100–200 mg bid) for adults with traumatic VS/UWS or MCS (4–16 weeks post injury) to hasten functional recovery and reduce disability early in recovery (Level B). Family counseling concerning children should acknowledge that natural history of recovery, prognosis, and treatment are not established (Level B). Recent evidence indicates that the term chronic VS/UWS should replace permanent VS, with duration specified (Level B). Additional recommendations are included.


Author(s):  
Nikolas Rose ◽  
Joelle M. Abi-Rached

This chapter explores the neurobiological self. It argues that the emerging neuroscientific understandings of selfhood are unlikely to efface modern human beings' understanding of themselves as persons equipped with a deep interior world of mental states that have a causal relation to their action. Rather, they are likely to add a neurobiological dimension to human beings' self-understanding and their practices of self-management. In this sense, the “somatic individuality” which was once the province of the psy- sciences, is spreading to the neuro- sciences. Yet psy is not being displaced by neuro: neurobiological conceptions of the self are being construed alongside psychological ones.


Author(s):  
Robert C. Stalnaker

A mental state is luminous if and only if being in a state of that kind always puts one in a position to know that one is in the state. This chapter is a critique of Timothy Williamson’s margin-of-error argument that no nontrivial states are luminous in this sense. While I agree with Williamson’s rejection of a Cartesian internalist conception of the mind, I argue that an externalist conception (one based on information theory) can be reconciled with the luminosity of intentional mental states such as knowledge. My argument, which uses an artificial and simplified model of knowledge, is not a direct rebuttal to his argument, as applied to a more realistic notion of the knowledge of human beings, but I argue that it shows that a luminosity assumption is compatible with externalism about knowledge, and it suggest an intuitively plausible strategy for resisting his argument.


Author(s):  
Marilyn Nissim-Sabat

Some readers of Wright’s work have criticized him for failing to portray healthy human connection or solidarity. In her chapter, Marilyn Nissim-Sabbat maintains that Wright was deeply aware that people could only live as human beings through meaningful relations with one another. Wright understood both that the human need for solidarity runs deep and that the ability to forge it can be damaged. Without such solidarity, alienation from oneself and others will crush “Bigger” and Bigger-like characters on the South Side of Chicago and globally. Wright therefore championed the healing made possible by qualitatively enlarging our lived-experience of and with one another. Essential to articulating and acting on this need is a critical theory of transcendence that is implicit in Wright’s work. Such a theory emerges in this essay through a critique of Simone de Beauvoir’s views on identity politics and cross-group identity in The Second Sex as contrasted with parallel discussions by Wright in Native Son.


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