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)

The intersection of AI and neurotechnology has resulted in an increasing number of medical and non-medical applications and has sparked debate over the need for new human rights, or “neurorights,”...

Deep brain stimulation (DBS) has been regarded as an efficient and safe treatment for Parkinson’s disease (PD) since being approved by the Food and Drug Administration (FDA) in 1997. It is estimated that more than 150 000 patients have been implanted, with a forecasted rapid increase in uptake with population ageing. Recent longitudinal follow-up studies have reported a significant increase in postoperative survival rates of patients with PD implanted with DBS as compared with those not implanted with DBS. Although DBS (...) tends to increase life expectancy for most patients with PD, this medical benefit does not come without attendant negative consequences. For example, emerging forms of iatrogenic harms are sometimes induced—harms which were not initially expected when clinicians proposed neurosurgery and patients or their guardians consented to the treatment. We report and discuss the clinical case of a patient who was implanted with DBS more than 20 years ago (at the time of writing) and is now experiencing unexpected stages of PD. This case illustrates how extending the life span without improving quality of life may introduce a burden of harms for patients and families. As well, this case shows why we should prepare for the expanding numbers of PD-implanted patients experiencing a gain of longevity but with severe stages of disease leading to diminution in quality of life. This newly observed effect of DBS treatment requires us to explore ethical questions related to iatrogenic harms, informed consent, end of life and caregivers’ burden. (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)

Les recherches de Natalie Depraz sur l’intersubjectivité rejoignent ici celles de Frédéric Mauriac, particulièrement dans les cas dits « d’urgence psychiatrique ». La question est ainsi de savoir comment poser et penser le rapport fulgurant de la force vitale à ce désir tout humain de vouloir en finir. En ces cas, quelles paroles faut-il oser et quel mode de relation convient-il d’instaurer? La contribution entend offrir des perspectives théoriques et pratiques, essentiellement thérapeutiques, en mettant d’abord en évidence, d’une part, (...) la situation de la phénoménologie henryenne devant la phénoménologie historique et, d’autre part, sa situation devant une praxis fondée sur la singularité de l’approche en deuxième personne. (shrink)

One important concern regarding implantable Brain Computer Interfaces is the fear that the intervention will negatively change a patient’s sense of identity or agency. In particular, there is concern that the user will be psychologically worse-off following treatment despite postoperative functional improvements. Clinical observations from similar implantable brain technologies, such as deep brain stimulation, show a small but significant proportion of patients report feelings of strangeness or difficulty adjusting to a new concept of themselves characterized by a maladaptive je ne (...) sais quoi despite clear motor improvement. Despite the growing number of cases in the DBS literature, there is currently no accepted or standardized tool in neuroethics specifically designed to capture the phenomenological postoperative experience of patients implanted with DBS or BCI devices. Given potential risks of postoperative maladaptation, it is important for the field of neuroethics to develop a qualitative instrument that can serve as a shared method for capturing postoperative variations in patient experience of identity and agency. The goal of this article is to introduce an instrument we have developed for this purpose and call for further neuroethical efforts to assess the phenomenology of implantable brain device use. (shrink)

In their article, Herrera-Ferra et al. (2023) highlight how the progress and implementation of neurotechnology, especially in conjunction with artificial intelligence, have revealed potential impli...

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

Postmortem evidence of chronic traumatic encephalopathy (CTE) in the brains of American National Football League players who suffered concussions while playing have intensified concerns about the risks of concussion in sport.1 Concussions are frequently sustained by amateur and professional players of Australia’s three most popular football codes (Australian football, rugby league, and rugby union) and, to a lesser extent, other contact sports such as soccer. This raises major concerns about possible long-term neurological damage, cognitive impairment and mental health problems in (...) players of these sports. (shrink)

For John Wyclif, the fundamental belief that Scripture is true de virtute sermonis is grounded in the fact that the meanings of the words therein are equivocal. A word can have several different meanings depending on whether it is outside or inside Scripture as well as on its location in Scripture. This principle allows each and every word in Scripture to be endowed with its own meaning — however figurative, i.e., metaphorical, allegorical etc. it may be —, tailored for the (...) very context in which it is used. Scripture cannot then fail to be true in virtue of the syntactic-semantic properties of language, which are precisely set up in accordance with the message to be delivered. All in all, Scripture as the matrix of all logics and semantics is a holistic system that may serve as master key for deciphering any possible meaning of a word. (shrink)

Current discussions about concussion in sport are based on a crucial epistemological question: whether or not we should believe that repetitive mild Traumatic Brain Injury causes Chronic Traumatic Encephalopathy. This epistemological question is essential to understanding the ethics at stake in treating these cases: indeed, certain moral obligations turn on whether or not we believe that mTBI causes CTE. After discussing the main schools of thought, namely the CTE-sceptic position and the CTE-orthodox position, this article examines the concussion debate in (...) sport and asks if its current articulation helps to answer whether or not we should call for responsive, ethical action. (shrink)

La bibliographie Platon 1990-1995 prend concretement la suite du travail bibliographique (couvrant la periode 1950-1990) deja paru dans la revue Lustrum publiee a Gottingen et qui preserve, pour l'essentiel, la presentation materielle. Pour la periode ici consideree (1990-1995), on denombre plus de 70 entreprises d'edition et de traduction, et surtout pres de 1800 travaux d'interpretation, livres ou articles eux-memes publies dans des periodiques, actes de congres, melanges ou recueils. Ces travaux, ecrits en une dizaine de langues differentes, sont ici accompagnes (...) pour la plupart d'une notice et analyses dans un index tres detaille. Le chercheur dispose ainsi d'une sorte de carte geographique lui permettant de s'orienter facilement dans cet immense territoire de litterature secondaire et d'aller rapidement d'un point a un autre en evitant les detours fastidieux et les impasses. (shrink)

Using an international sample of environmental and social firm-level ratings between 2007 and 2019, we form synthetic overlapping region-based equity portfolios to examine the impact of screening stringency on abnormal returns and specific risk. While previous literature analyzes this relationship in a bidimensional setting, inferences made in this study are additionally robust to regional levels of market efficiency. Our results suggest that (1) screening stringency displays an inverted curvilinear relationship with risk-adjusted returns and (2) the impact on specific risk is (...) strictly increasing. Thus, portfolios that employ marginal and substantial screening incur the cost of responsible investing. However, moderate screening has the benefit of increasing performance without the burden of financing the least responsible corporations. (shrink)

According to several recent studies, a big chunk of college students in North America and Europe uses so called ‘smart drugs' to enhance their cognitive capacities aiming at improving their academic performance. With these practices, there comes a certain moral unease. This unease is shared by many, yet it is difficult to pinpoint and in need of justification. Other than simply pointing to the medical risks coming along with using non-prescribed medication, the salient moral question is whether these practices are (...) troubling in and of themselves. In due consideration of empirical insights into the concrete effects of smart drugs on brain and behavior, our attempt is to articulate wherein this moral unease consists and to argue for why the authors believe cognitive enhancement to be morally objectionable. The authors will contend that the moral problem with these practices lies less in the end it seeks, than in the underlying human disposition it expresses and promotes. Some might ask, what is wrong with molding our cognitive capacities to achieve excellence, get a competitive edge, or, as the whim takes us? In all of these occasions, the usage of smart drugs serves a certain goal, a telos. The goal is, broadly speaking, this: outsmarting opponents in an arms race for limited resources and thereby yielding a competitive edge. In plain words: competition is valued higher than cooperation or solidarity. What is wrong with striving for this goal? The authors submit that the question whether people really want to live in a society that promotes the mentality ‘individual competition over societal cooperation' deserves serious consideration. In developing their answer, the authors draw on an ‘Ethics of Constraint' framework, arguing that widespread off-label use of smart drugs bears the risk of negative neural/behavioral consequences for the individual that might, in the long run, be accompanied by changing social value orientations for the worse. (shrink)

The question of whether Deep Brain Stimulation (DBS), as open-loop, closed-loop or adaptative technology, induces unwanted effects on patients’ personality is still an ongoing multidisciplinary deb...

In an ironic rejoinder to the postmodern politics of nature, I will adopt an anthropological perspective on culture, which is conspicuous by its absence in the latest wave of science studies, and reformulate the distinction between nature and culture as a reflexive distinction within culture that emerges with modernity. In order to countering the hypertextualism of the constructivists, I will next sketch out a realist theory of nature. Combining the transcendental realism of Roy Bhaskar with the transcendental phenomenology of Edmund (...) Husserl, I will then try to outline the contours of a realist phenomenology of the ontological regions of physical, animal and human nature. Resuming my anthropological considerations on culture, I will finish the article with a progressive account of how the opposition between regional ontologies and regional typologies could be overcome. (shrink)

Le présent volume reprend la plupart des interventions prononcées lors d’une journée d’étude organisée à l’Université de Strasbourg le 28 mars 2004, à l’occasion du 250e anniversaire de la publication du Neues Organon (Leipzig, 1764) de Johann Heinrich Lambert (Mulhouse, 1728-Berlin, 1777). Cette journée avait été organisée par le Centre de recherche en philosophie allemande et contemporaine (CREPHAC) de l’Université de Strasbourg. Quoi qu’il soit difficile dans le cas de cet auteur de tracer...

This work has been selected by scholars as being culturally important, and is part of the knowledge base of civilization as we know it. This work was reproduced from the original artifact, and remains as true to the original work as possible. Therefore, you will see the original copyright references, library stamps, and other notations in the work. This work is in the public domain in the United States of America, and possibly other nations. Within the United States, you may (...) freely copy and distribute this work, as no entity has a copyright on the body of the work. As a reproduction of a historical artifact, this work may contain missing or blurred pages, poor pictures, errant marks, etc. Scholars believe, and we concur, that this work is important enough to be preserved, reproduced, and made generally available to the public. We appreciate your support of the preservation process, and thank you for being an important part of keeping this knowledge alive and relevant. (shrink)

The Positive Evolution of Religion CHAPTEB I ORTHODOX CRITICISM IT may surprise not a few, but it is certainly true that on general principles, in spirit, ...

Ce livre retrace la vie et l’activité éducative de Marie Souvestre, qui crée durant la seconde moitié du XIXe siècle deux établissements d’enseignement non confessionnels destinés à accueillir des jeunes filles en internat. Avec Caroline Dussaut – dont on sait peu de choses – elle fonde le premier, baptisé « Les Ruches », à Avon (Fontainebleau). Cette institution novatrice, réservée à des élèves non françaises, est dirigée par les deux femmes de 1864 à 1883. Après sa rupture – à la (...) fois amour... (shrink)

Frédéric Le Blay René Théophile Hyacinthe Laennec entreprit la traduction des Traités des maladies aiguës et des maladies chroniques du médecin romain Caelius Aurelianus. À partir de l’édition des manuscrits établie en 2009, je propose une analyse interprétative de la démarche du clinicien. Au-delà de la curiosité érudite d’un amoureux des classiques, je cherche à montrer que l’exercice de lecture et de traduction des textes constitutifs d’une histoire de la clinique s’intègre dans la méthode de Laennec et contribue à (...) fonder son épistémologie médicale, à une époque où les pratiques sont soumises à des redéfinitions majeures. Une telle entreprise, qui fait du texte, constituant d’une littérature, une donnée d’expérience en vue du diagnostic, n’est pas sans présenter quelque analogie avec certaines orientations contemporaines. (shrink)

Depuis qu’a paru Le fromage et le vers, le cas du meunier Menocchio a donné lieu à de nombreuses exégèses. On cherche ici à le comprendre à la lumière d’un existentialisme de la connaissance, en partant du principe que son système d’idées est cohérent, et qu’il dérive de la situation qui est la sienne, dans ses dimensions indissolublement personnelles, sociales et « écologiques ». Pour appréhender le sens d’une telle expérience tout en restituant la portée d’une épistémologie élargie aux conditions (...) de toute existence, il paraît essentiel de s’appuyer sur les réflexions méthodologiques de Carlo Ginzburg aussi bien que sur des analyses d’ethnologie européenne qu’il lui est arrivé de mentionner. (shrink)

Clinical cases of frontal lobe lesions have been significantly associated with acquired aggressive behaviour. Restoring neuronal and cognitive faculties of aggressive individuals through invasive brain intervention raises ethical questions in general. However, more questions have to be addressed in cases where individuals refuse surgical treatment. The ethical desirability and permissibility of using intrusive surgical brain interventions for involuntary or voluntary treatment of acquired aggressiveness is highly questionable. This article engages with the description of acquired aggressiveness in general, and presents a (...) rare clinical case to illustrate the difficulties of treating this population. To expand the debate further, this article explores the ethics related to invasive brain surgery in three parts: a) it examines coercive involuntary invasive brain surgery for the benefit of protecting others on individuals suffering from acquired aggressiveness who lack decision-making capacities to consent; b) it addresses voluntary psychosurgery on individuals suffering from acquired aggressiveness who are competent to consent; and, c) it questions whether acquired aggressive individuals, who are legally competent, have a duty to consent to invasive brain surgery, in order to maintain their autonomy by reducing or even eliminate their aggressive drives. Ensuring the safety and efficacy of surgical brain interventions could increase the ethical permissibility of voluntary treatment, but it would not necessarily entail ethical justification for proceeding with invasive brain surgery for treatment of intractable acquired aggressive behaviour. (shrink)

In this book Frederic Schick develops his challenge to standard decision theory. He argues that talk of the beliefs and desires of an agent is not sufficient to explain choices. To account for a given choice we need to take into consideration how the agent understands the problem, how he sees in a selective way the options open to him. The author applies his new logic to a host of common human predicaments. Why do people in choice experiments act so (...) often against expectations? Why do people cooperate in situations where textbook logic predicts that they won't? What exactly is weakness of will? What are people reporting when they say their lives have no meaning for them? This book questions the foundations of technical and philosophical decision theory and will appeal to all those who work in that field, be they philosophers, economists and psychologists. (shrink)