To conclude that there is enough or not enough evidence demonstrating that deep brain stimulation causes unintended postoperative personality changes is an epistemic problem that should be answered on the basis of established, replicable, and valid data. If prospective DBS recipients delay or refuse to be implanted because they are afraid of suffering from personality changes following DBS, and their fears are based on unsubstantiated claims made in the neuroethics literature, then researchers making these claims bear great responsibility for prospective (...) recipients' medical decisions and subsequent well-being. Our article “Deflating the ‘DBS causes personality’ bubble” reported an increase in theoretical neuroethics publications suggesting putative DBS-induced changes to personality, identity, agency, autonomy, authenticity and/or self and a critical lack of supporting primary empirical studies. This special issue of Neuroethics brings together responses to our initial publication, with our own counter-responses organized according to common themes. We provide a brief summary for each commentary and its main criticisms as well as a discussion of the way in which these responses can: 1) help clarify the meaning of PIAAAS, suggesting supplementary frameworks for understanding the impact of DBS on PIAAAS; 2) provide further empirical evidence of PIAAAS by presenting results from the researchers’ own work; and/or 3) offer a critique of our research approach and/or findings. Unintended postoperative putative changes to PIAAAS remain a critical ethical concern. It is beyond dispute that we need to develop reliable empirical and conceptual instruments able to measure complex cognitive, affective, and behavioural changes in order to investigate whether they are attributable to DBS alone. (shrink)

The idea that deep brain stimulation (DBS) induces changes to personality, identity, agency, authenticity, autonomy and self (PIAAAS) is so deeply entrenched within neuroethics discourses that it has become an unchallenged narrative. In this article, we critically assess evidence about putative effects of DBS on PIAAAS. We conducted a literature review of more than 1535 articles to investigate the prevalence of scientific evidence regarding these potential DBS-induced changes. While we observed an increase in the number of publications in theoretical neuroethics (...) that mention putative DBS-induced changes to patients’ postoperative PIAAAS, we found a critical lack of primary empirical studies corroborating these claims. Our findings strongly suggest that the theoretical neuroethics debate on putative effects of DBS relies on very limited empirical evidence and is, instead, reliant on unsubstantiated speculative assumptions probablyin lieuof robust evidence. As such, this may reflect the likelihood of a speculative neuroethics bubble that may need to be deflated. Nevertheless, despite the low number of first-hand primary studies and large number of marginal and single case reports, potential postoperative DBS changes experienced by patients remain a critical ethical concern. We recommend further empirical research in order to enhance theoretical neuroethics work in the area. In particular, we call for the development of better instruments capable of capturing potential postoperative variations of PIAAAS. (shrink)

The phenomenological effects of deep brain stimulation (DBS) on the self of the patient remains poorly understood and under described in the literature, despite growing evidence that a significant number of patients experience postoperative neuropsychiatric changes. To address this lack of phenomenological evidence, we conducted in-depth, semistructured interviews with 17 patients with Parkinson's disease who had undergone DBS. Exploring the subjective character specific to patients' experience of being implanted gives empirical and conceptual understanding of the potential phenomenon of DBS-induced self-estrangement. (...) Our study concluded that (1) the more patients preoperatively felt alienated by their illness, the more they experienced postoperative self-estrangement, and (2) the notion of self-estrangement seems to exist in association with certain common qualitative characters, namely, loss of control, which reflects a deteriorative estrangement, and distorted perception of capacities, which reveals a restorative estrangement. These findings indicate that subjective self-reports help us to understand some aspects of the potential phenomenon of DBS-induced self-estrangement. (shrink)

Optogenetics is being optimistically presented in contemporary media for its unprecedented capacity to control cell behavior through the application of light to genetically modified target cells. As such, optogenetics holds obvious potential for application in a new generation of invasive medical devices by which to potentially provide treatment for neurological and psychiatric conditions such as Parkinson's disease, addiction, schizophrenia, autism and depression. Design of a first-in-human optogenetics experimental trial has already begun for the treatment of blindness. Optogenetics trials involve a (...) combination of highly invasive genetic and electronic interventions that results in irreversible and permanent modifications of an individual's nervous system. Given its novelty, its uncertain benefit to patients, and its unique risk profile of irreversible physiological alteration, optogenetics requires a reassessment of the ethical challenges for protecting human participants in clinical trials, particularly at formative stages of clinical evaluation. This study explores the evolving ethical issues surrounding optogenetics’ potential harm to participants within trial design, especially focusing on whether Phase 1 trials should incorporate efficacy as well as safety endpoints in ways that are fair and respectful to research trial participants. (shrink)

Bioethics, Volume 36, Issue 1, Page 25-41, January 2022.

The article Deflating the "DBS causes personality changes" bubble, written by Frederic Gilbert, J. N. M. Viaña and C. Ineichen, was originally published electronically on the publisher’s internet portal on 19 June 2018 without open access.

Postmortem research on the brains of American tackle football players has revealed the presence of chronic traumatic encephalopathy (CTE), a degenerative brain disease caused by repeated head trauma. Repeated concussion is a risk factor for CTE, raising ethical concerns about the long-term effects of concussion on athletes at risk for football-related concussion. Of equal concern is that youth athletes are at increased risk for lasting neurocognitive and developmental deficits that can result in behavioral disturbances and diminished academic performance. In this (...) article, we consider evidence of the effects of concussion in youth athletes, and discuss ethical duties to youth athletes and how these duties might be satisfied, given the intrinsic risks of football. Finally, we evaluate potential strategies for reducing concussions in junior football, and recommend the optimal strategy for reducing brain injury to an acceptable level while still making available the benefits of football participation for youth athletes. (shrink)

There has been a surge in mass media reports extolling the potential for using three-dimensional printing of biomaterials to treat a wide range of clinical conditions. Given that mass media is recognized as one of the most important sources of health and medical information for the general public, especially prospective patients, we report and discuss the ethical consequences of coverage of 3D bioprinting in the media. First, we illustrate how positive mass media narratives of a similar biofabricated technology, namely the (...) Macchiarini scaffold tracheas, which was involved in lethal experimental human trials, influenced potential patient perceptions. Second, we report and analyze the positively biased and enthusiastic portrayal of 3D bioprinting in mass media. Third, we examine the lack of regulation and absence of discussion about risks associated with bioprinting technology. Fourth, we explore how media misunderstanding is dangerously misleading the narrative about the technology. (shrink)

In her article, Pascale Hess raises the issue of whether her proposed model may be extrapolated and applied to clinical research fields other than stem cell-based interventions in the brain (SCBI-B) (Hess 2012). Broadly summarized, Hess’s model suggests prioritizing efficacy over safety in phase 1 trials involving irreversible interventions in the brain, when clinical criteria meet the appropriate population suffering from “degenerative brain diseases” (Hess 2012). Although there is a need to reconsider the traditional phase 1 model, especially with respect (...) to first-in-human clinical trials involving novel technologies, the question arises as to whether it is appropriate to advocate for a new model that prioritizes efficacy over safety across all phase 1 clinical research trials involving irreversible interventions in the brain. -/- . (shrink)

Geron recently announced that it had begun enrolling patients in the world's first-in-human clinical trial involving cells derived from human embryonic stem cells (hESCs). This trial raises important questions regarding the future of hESC-based therapies, especially in spinal cord injury (SCI) patients. We address some safety and efficacy concerns with this research, as well as the ethics of fair subject selection. We consider other populations that might be better for this research: chronic complete SCI patients for a safety trial, subacute (...) incomplete SCI patients for an efficacy trial, and perhaps primary progressive multiple sclerosis (MS) patients for a combined safety and efficacy trial. (shrink)

'Peut-être que putain tu as juste un peu besoin de te calmer/calm the fuck down. Je m'appelle Jenny et j'offre des services de coaching stoïcien avec juste un tantinet de grossièreté/dash of profanity/et des résultats', lance sur son site promotionnel avec sa photo souriante en noir-et-blanc une jeune 'coach' à lunettes. 'En tant que coach, annonce un autre du même âge qui pose avec un livre à la main doctus cum libro, j'apporte l'expertise d'un praticien stoïcien professionnel ainsi que la (...) connaissance de la façon dont le cerveau apprend de nouvelles informations. Avec huit ans de pratique stoïcienne quotidienne, je suis le témoignage vivant de son succès. C'est ma passion d'armer les gens avec les techniques mentales pour vivre une vie pleine et calme/full and calm life!' Le néo-stoïcisme est en vogue auprès de la jeunesse, élixir d'endurance pour époque tourmentée. Ce nouveau courant est-il fidèle au geste cynique initial qui inspira jadis Zénon, Cléanthe, et Chrysippe? Fournit-il des réponses adaptées à la dictature écologique qui vient, au culte de la guerre, aux fantasmes du transhumanisme? Il donne en tout cas ici l'occasion d'un retour sur 2300 ans d'histoire d'une philosophie de la liberté humaine, en des temps où celle-ci est de plus en plus déniée"--Page 4 of cover. (shrink)

Etudes de morale / par F. Rauh,...; recueillies et publiees par H. Daudin, M. David, G. Davy... [et al.]Date de l'edition originale: 1911Collection: Bibliotheque de philosophie contemporaineCe livre est la reproduction fidele d'une oeuvre publiee avant 1920 et fait partie d'une collection de livres reimprimes a la demande editee par Hachette Livre, dans le cadre d'un partenariat avec la Bibliotheque nationale de France, offrant l'opportunite d'acceder a des ouvrages anciens et souvent rares issus des fonds patrimoniaux de la BnF.Les oeuvres (...) faisant partie de cette collection ont ete numerisees par la BnF et sont presentes sur Gallica, sa bibliotheque numerique.En entreprenant de redonner vie a ces ouvrages au travers d'une collection de livres reimprimes a la demande, nous leur donnons la possibilite de rencontrer un public elargi et participons a la transmission de connaissances et de savoirs parfois difficilement accessibles.Nous avons cherche a concilier la reproduction fidele d'un livre ancien a partir de sa version numerisee avec le souci d'un confort de lecture optimal. Nous esperons que les ouvrages de cette nouvelle collection vous apporteront entiere satisfaction.Pour plus d'informations, rendez-vous sur www.hachettebnf.frhttp: //gallica.bnf.fr/ark: /12148/bpt6k5622683z. (shrink)

À la fois observateur des mœurs de ses contemporains, journaliste, attentif aux goûts vestimentaires, et spécialiste des images, John Grand Carteret, écrivait que l’on n’a pas pu jusqu’à présent trouver les vertus fin-de-siècle mais uniquement les « crimes fin-de-siècle », soulignant de la sorte qu’il existe des modes dans la manière de s’emparer de la vie d’autrui ou de provoquer d’irréparables blessures et lésions corporelles. Le vitriolage en fait partie. Le mot apparaît vers 1873. Il dési...

"The extensive attention devoted to abortion has led Christians for too long to overlook much of the exploding bioethics agenda. Moreover, to focus only on 'issues' is to fail to address the profound changes taking place in the very nature of the medical profession. This book signals the commitment of the Center for Bioethics and Human Dignity to help expand the church's bioethical vision and to foster a more substantial Christian contribution to the public debate."--BOOK JACKET.Title Summary field provided by (...) Blackwell North America, Inc. All Rights Reserved. (shrink)

Transmissible cancers are elusive and understudied parasitic life forms caused by malignant clonal cells (nine lineages are known so far). They emerge by completing sequential steps that include breaking cell cooperation, evade anti‐cancer defences and shedding cells to infect new hosts. Transmissible cancers impair host fitness, and their importance as selective force is likely largely underestimated. It is, therefore, crucial to determine how common they might be in the wild. Here, we draw a parallel between the steps required for a (...) transmissible cancer to emerge and the steps required for an intelligent civilisation to emerge in the Milky Way using a modified Drake equation. Using numerical analyses, we estimate the potential number of extant marine and bivalve species in which transmissible cancers might exist. Our results suggest that transmissible cancers are more common than expected, and that new lineages can be found by screening a large number of species. (shrink)

Using this case, Lavazza and Reichlin (2018) explored the ethical dilemmas associated with decision making in people with Alzheimer’s disease (AD), specifically when their new preferences conflict...

Dans cet article nous étudions trois notes de M. Fréchet sur les opérations linéaires et leur rôle dans l’émergence de l’analyse fonctionnelle au début du XXème siècle. Dans un premier temps nous mettons en évidence les processus de sélection, d’extraction et de réinterprétation mis en oeuvre par Fréchet à partir de matériaux publiés antérieurement. A partir de cette analyse nous nous attachons à montrer comment la progression vers une vision plus générale met en jeu des éléments structurels fondamentaux dans la (...) constitution d’un champ nouveau des mathématiques. Notre étude permet finalement de préciser le concept de structure dans son rôle central dans l’émergence de l’analyse fonctionnelle. (shrink)

Background: The bioethics literature contains speculation but little data about sociodemographic differences between patients for whom ethics committees (EC) are consulted for conflict about life-sustaining treatment (LST) and the broader hospital population that these committees serve. To provide an empirical context for this discussion, we examined differences in five sociodemographic factors between patients for whom an EC was consulted for conflict over LST and the general inpatient population, hypothesizing that nonwhite patients were most likely to be disproportionately represented. Methods: This (...) was a retrospective cohort study comparing self-reported race/ethnicity, household income, insurance status, primary language, and religious affiliation between patients involved in EC consultations for conflict over LST and the general adult inpatient population at a large academic hospital from January 1, 2007, through December 31, 2013. Results: There were 169 EC consultations involving conflict over LST and 243,197 adult inpatient admissions over the study period. On bivariate analysis, patients for whom the EC was consulted for conflict over LST were more likely to be nonwhite, low-income, and to speak a primary language other than English. They were not more likely to be underinsured or to report a religious affiliation. On multivariate analysis, patients for whom the EC was consulted for conflict over LST were more likely to be nonwhite (odds ratio [OR], 2.5; 95% confidence interval [CI], 1.7–3.7; p <.001). They were also more likely to be low income (OR, 1.8; 95% CI, 1.1–3.0; p =.02). They were not more likely to speak a primary language other than English (OR, 1.4; 95% CI, 0.9–2.1; p =.17). None of the assessed variables were associated with conflict over LST requiring additional meetings beyond the first EC consultation. Conclusions: Nonwhite and low-income status patients are disproportionately represented in EC committee consultation for conflict over LST compared to the general inpatient population. (shrink)

Ce livre propose de relire la philosophie de Walter Benjamin à partir de sa cosmologie. Le cosmos de Benjamin n'est pas un univers ordonné, composé de corps célestes identifiables, mais l'occasion d'une expérience fulgurante: dans l'univers post-copernicien de Benjamin, l'intériorité du désir et l'extériorité des étoiles, le politique et le théologique, le présent et le distant passé se rencontrent sans fusionner. Situant Benjamin dans la tradition philosophique (G. W. Leibniz, K. Marx, F. Hegel) tout en s'appuyant sur des pensées contemporaines (...) (J. Butler, S. Hartmann, M. Löwy), ce livre crée une 'correspondance' entre Benjamin et notre actualité. Dans un monde soumis aux replis nationalistes, aux virus destructeurs d'altérité et à l'intrusion technologique, le lointain semble s'évanouir. En prise avec l'histoire la plus récente, celle du New Space et de la Sixième Extinction, de Black Lives Matter et des Communes éphémères, ce livre soutient qu'aucune transformation politique radicale, aucune émancipation, aucun communisme n'est possible, et souhaitable, sans relation avec un lointain telle l'Étoile du Nord que les esclaves en fuite suivaient dans le ciel nocturne pour les guider vers la liberté."--Page 4 of cover. (shrink)

Concussion and Mild Traumatic Brain Injury affect millions of people worldwide. mTBI has been called the “signature injury” of the recent conflicts in Iraq and Afghanistan, affecting thousands of active duty service men and women, and veterans. Sport-related concussion represents a significant public health problem, with elite and professional athletes, and millions of youth and amateur athletes worldwide suffering concussions annually. These brain injuries have received scant attention from neuroethicists, and the focus of this special issue is on defining the (...) ethical considerations and developing and elucidating the neuroethical contributions to the discussion about concussion and mTBI. (shrink)

The dominant position of science in our culture has ended. In our postmodern world, belief that science will provide the answer to our problems and that progress is inevitable has been shaken, if not toppled. Optimism has been replaced by realism, creating a milieu for the development of intelligent Christian belief. Participating in the Trinity Institute's conference on ÒThe Church in a Postmodern Age, these six prominent scholars explore the breakdown of the basic tenets of the Enlightenment, the sorry state (...) of biblical literacy in our culture, Christian faith in a pluralistic world, the relevance of the Bible today, and the role of the church in our age. Contributors include Robert N. Bellah, Diogenes Allen, George A. Lindbeck, James B. Miller, Sandra M. Schneiders, and Rowan D. Williams. (shrink)