In 2001, I experienced severe radial neuropathy, leading to permanent dysfunctions in the fingers of my left hand. In this personal account of nerve damage, medical and surgical treatment, and adaptation, I first describe the sequence of neuropathies, then turn to how through serendipity, the brace enabled other connections—nervelines—with individuals and places. The brace is a metonym of a severed nerve with its associated loss of movement and capacity; it is also both a functional orthotic and an (...) affordance. It carries me forward, activating other nervelines and networks to make things happen. I write of literal and metaphoric nerves, evolving connectivities, and fiber lines, thought lines and collaborations. I then extend the idea of nervelines and networks to global connnections; I emphasize how the organization of labor, the distribution of goods and services, and the expectations of workers shape body histories and life outcomes. (shrink)

This commentary provides experimental data in support of the critical role of capsaicin-sensitive primary afferent fibers in the initiation and maintenance of pathological pain. The demonstration of capsaicin-induced, centrally-evoked cutaneous hyperalgesia, and of neuroplastic changes elicited by the degeneration of C-fiber primary afferent terminals following peripheral nerve damage, indicates a significant contribution of capsaicin-sensitive sensory ganglion neurons in the development of pathological pain conditions. [coderre & katz].

A cut or crush injury to a peripheral nerve results in the degeneration of that portion of the axon isolated from the cell body. The rapid degeneration of this distal segment was for many years believed to be a process intrinsic to the nerve. It was believed that Schwann cells both phagocytosed degenerating axons and myelin sheaths and also provided growth factors to promote regeneration of the damaged axons. In recent years, it has become apparent that the degenerating (...) distal segment is invaded by monocytes from the blood. We will review the evidence that these recruited macrophages play a role in both degeneration and regeneration of peripheral nerve axons after injury and consider whether the slow degeneration and poor monocyte recruitment in the central nervous system may contribute to the poor regeneration there. (shrink)

The author presents an autobiographical story of serious peripheral motor nerve damage resulting from chemotoxicity induced as a side effect of Hodgkin’s Lymphoma treatment. The first-person, phenomenological account of the condition naturally leads to philosophical questions about consciousness, felt presence of oneself all over and within one’s body, and the felt constitutiveness of peripheral processes to one’s mental life. The first-person data only fit well with a philosophical approach to the mind that takes peripheral, bodily events and states (...) at their face value, and not as a body-in-the-brain, which has been popular with most neuroscientists. Thus the philosophical tradition that comes closest to the idea of the peripheral mind is Maurice Merleau-Ponty’s bodily phenomenology. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 10.1 (2003) 33-35 [Access article in PDF] In the Spirit of Giving Uptake Nancy Nyquist Potter IT IS BOTH WONDERFUL and daunting to now be in the middle of a dialogical exchange on the messy and difficult topic of self-injury and how ethically to interact with patients who self-injure. It is wonderful that authors such as Carolyn Sargent have contributed very helpful examples from the (...) discipline of anthropology that expand the ideas I have been grappling with. And it is daunting to begin to sharpen and correct my thoughts along the lines that the commentators suggest. In the spirit of giving uptake both to the praise and the criticism I have received, I first situate the "Commodity/Body/Sign" article in the context of my larger project and then focus on one problem area: my claim that giving uptake is necessary to ethical healing practices. Giving Too Much Uptake to the Dsm Rob Woolfolk is right that borderline is diagnostically imprecise. But what initially caught my interest in this personality disorder was its pejorative connotations. I will mention my favorite example, which comes from a past chairman of the psychiatry department at New York University that "borderliners are the patients you think of as PIAs—pains in the ass," (Medical World News 1983). Why are the patients who exhibit the behaviors associated with borderline personality disorder (BPD) so disliked, I wondered? Who are these patients, and what are they doing that brings upon themselves such rejection? My investigation, in other words, has been focused on behaviors and their meanings, using a philosophical lens to examine underlying assumptions. I completely agree with Woolfolk and Carolyn Sargent that much more analysis needs to be done on BPD, and I am eager to do it. It is true that I do not take up larger questions about the gendered nature of this diagnosis in general (Sargent, Woolfolk), nor do I challenge the validity of the diagnosis in this article (Woolfolk). In my view, that larger project must be held in abeyance until more philosophical probing on a number of other issues is done. Hopefully, my book-length project will benefit from continuing guidance from these authors.I focus first on self-injury for two reasons. First, it is the most common symptom for which people with BPD come to clinical attention (Gunderson 2001, 22). Second, of all the behaviors associated with BPD, self-injurious behavior is the kind that people most tend to dig in their heels about when its status as pathological is questioned. Gunderson cautions that "because the diagnosis of BPD underscores a serious, long-standing mental health problem, the diagnosis should not be offered too readily to anyone who cuts or otherwise self-mutilates" (2001, 23). I add to that caution that we ought not too readily assume that self-injury is pathological: Lynne Cox (2003) swam to the Antarctic Peninsula in water temperatures of 32° Fahrenheit and with 25 foot waves; she suffered nerve damage and numbness in her extremities. Self-injurious behavior? [End Page 33] Pathological? Cox trained for two years to accomplish this feat. In problematizing self-injury, I raise questions about some associations and assumptions we make. Calling into question the whole taxonomy requires looking at symptoms, behaviors, and criteria as a whole, and that cannot be done until systematic analysis of concepts such as self-injury, impulsivity, identity disturbance, and manipulativity are undertaken. To put things in terms of Woolfolk's reasonable criticism that he wishes I would "give less uptake to the framers of the DSM-IV," I appreciate that point. But I do think that those of us who are not ourselves clinicians must do our research carefully and proceed conservatively rather than attempting to tear a house down that may not need to be condemned. Methods and Morals Woolfolk says that the concept of uptake is "familiar and central" to therapy; Katherine Morris says it is "simple and uncontroversial"; Sargent says it is "unexceptionable"; and Christa Krüger says it may be "very difficult if not more or less doomed... (shrink)

Non-suicidal self-harm is common in youth. The behavior may have negative and sometimes dangerous consequences, such as feelings of guilt, scars, nerve damage and accidental death. Is this behavior a mental disorder? This question is attracting serious consideration. I want to say that non-suicidal self-harm in youth is never a mental disorder in its own right. Yet, I do not want to commit to saying what is a mental disorder. So I identify the characteristic features and functions of (...) non-suicidal self-harm in youth and show that these features and functions are also seen in non-disordered behaviors in youth. This, I say, shows that non-suicidal self-harm in youth is non-disordered too. I say that non-suicidal self-harm in youth is a characteristic youth behavior that when seen in youth has an understandable practical function. I offer to the general discussion about mental disorder the strategy I use. (shrink)

The Liver kinase B1 with its downstream target AMP activated protein kinase (LKB1‐AMPK), and the key nutrient sensor mammalian target of rapamycin complex 1 (mTORC1) form two signaling systems that coordinate metabolic and cellular activity with changes in the environment in order to preserve homeostasis. For example, nutritional fluctuations rapidly feed back on these signaling systems and thereby affect cell‐specific functions. Recent studies have started to reveal important roles of these strategic metabolic regulators in Schwann cells for the trophic support (...) and myelination of axons. Because aberrant intermediate metabolism along with mitochondrial dysfunction in Schwann cells is mechanistically linked to nerve abnormalities found in acquired and inherited peripheral neuropathies, manipulation of the LKB1‐AMPK, and mTORC1 signaling hubs may be a worthwhile therapeutic target to mitigate nerve damage in disease. Here, recent advances in our understanding of LKB1‐AMPK and mTORC1 functions in Schwann cells are covered, and future research areas for this key metabolic signaling network are proposed. (shrink)

"Features photographs that portray people who have varying degrees of facial paralysis, a condition that usually occurs on just one side of the face and can result from a multitude of causes, including Bell's palsy, tumors, strokes, accidents, and congenital nerve damage"--Whitcoulls website.

Grafts of embryonic neural tissue into the brains of adult patients are currently being used to treat Parkinson's disease and are under serious consideration as therapy for a variety of other degenerative and traumatic disorders. This target article evaluates the use of transplants to promote recovery from brain injury and highlights the kinds of questions and problems that must be addressed before this form of therapy is routinely applied. It has been argued that neural transplantation can promote functional recovery through (...) the replacement of damaged nerve cells, the reestablishment of specific nerve pathways lost as a result of injury, the release of specific neurotransmitters, or the production of factors that promote neuronal growth. The latter two mechanisms, which need not rely on anatomical connections to the host brain, are open to examination for nonsurgical, less intrusive therapeutic use. Certain subjective judgments used to select patients who will receive grafts and in assessment of the outcome of graft therapy make it difficult to evaluate the procedure. In addition, little long-term assessment of transplant efficacy and effect has been done in nonhuman primates. Carefully controlled human studies, with multiple testing paradigms, are also needed to establish the efficacy of transplant therapy. (shrink)

Along with political, economic, ethical, rehabilitative and military dimensions, psychopathological sequelae of war and terrorism also deserve our attention. The terrorist attack on the World Trade Centre ( W.T.C.) in 2001 and the Gulf War of 1990-91 gave rise to a number of psychiatric disturbances in the population, both adult and children, mainly in the form of Post-traumatic Stress disorder (PTSD). Nearly 75,000 people suffered psychological problems in South Manhattan alone due to that one terrorist attack on the WTC in (...) New York and the Pentagon in Washington. In Gulf War I, more that 1,00,000 US veterans reported a number of health problems on returning from war, whose claims the concerned government has denied in more than 90% cases. Extensive and comprehensive neurological damage to the brain of Gulf War I veterans has been reported by one study, as has damage to the basal ganglia in another, and Amyotrophic Lateral Sclerosis (ALS) in a third, possibly due to genetic mutations induced by exposure to biological and chemical agents, fumes from burning oil wells, landfills, mustard or other nerve gases. The recent Gulf War will no doubt give rise its own crop of PTSD and related disorders. In a cost-benefit analysis of the post Gulf War II scenario, the psychopathological effects of war and terrorism should become part of the social audit any civilized society engages in. Enlightened public opinion must become aware of the wider ramifications of war and terrorism so that appropriate action plans can be worked out. (shrink)

In a similar way to what happens when a wave of electricity impacts the animal body and provokes a convulsive stir of muscles and nerves which can burn and ultimately paralyze the affected surface, some rough emotional experiences may lead us to sudden numbness. Keeping abreast with the most sophisticated phenomenological tools to account for an extremely damaging kind of psychological experience that can ultimately defeat the purpose of a sheer descriptive approach, this chapter does provide a descriptive analysis of (...) the kind of emotional shock that risks threatening the moral integrity of an agent. I shall zoom in my analysis on the typically acknowledged moment when disturbing information from a socially shared context outside ourselves comes suddenly to the fore of our attention, thus disrupting the focus even of the the most trivial perceptive input. I argue that in the longer run the outcome of such an experience may amount to a reconfiguration of the subject’s core values, daily routines and even her life-long expectations and projects. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Kennedy Institute of Ethics Journal 14.1 (2004) 97-114 [Access article in PDF] Stem Cell Research in the U.S. after the President's Speech of August 2001 Cynthia B. Cohen On 9 August 2001, in a nationally televised speech, President Bush addressed the contentious question of whether to provide federal funds for human embryonic stem cell research (White House 2001).1 This research involves taking the primordial cells found in embryos and (...) transforming them into certain specialized cells, such as those of the heart, nerves, and muscles, with the ultimate goal of transferring these cells into patients to repair damaged cells and tissues. In his remarks, the President authorized funding for research only on stem cells already harvested from remaining embryos at in vitro fertilization (IVF) centers as of 9 August 2001, the date of the speech. In a "Fact Sheet" about embryonic stem cell research, he added the ethical requirements that (1) the donors of embryos gave informed consent to the derivation of stem cells from their embryos, (2) the embryos were created solely for reproductive purposes, and (3) no financial inducements were given to the embryo donors. The President also prohibited federally funded research on embryonic stem cells derived from embryos after 9 August 2001, as well as the creation of embryos for research purposes and the cloning of human embryos for both reproductive and research purposes. He did not seek to ban the pursuit of embryonic stem cell research with private funds. "This allows us to explore the promise and potential of stem-cell research without crossing a fundamental moral line by providing taxpayer funding that would sanction or encourage further destruction of embryos," the President stated (White House 2001).The President's speech stirred intense controversy. Many applauded the new policy because it allowed some embryonic stem cell research to proceed, thereby raising hope that treatments might be developed for those suffering from such conditions as Parkinson's disease, Alzheimer's disease, and diabetes. Others supported it on grounds that it would discourage the future destruction of embryos in stem cell research. They maintained that although it was wrong to have derived stem cells from embryos, this wrong was no longer remediable and it therefore was justifiable to allow research using such embryos to proceed. Some, however, objected to the new policy because they held that it unduly limited the [End Page 97] number of embryonic stem cells available for federally funded research. Still others opposed it on grounds that it made the federal government complicit in what they took to be the wrongful destruction of human embryos that had taken place prior to 9 August 2001. The President established the President's Council on Bioethics by executive order in November 2001 and charged it, among other tasks, with monitoring stem cell research and recommending guidelines and regulations for biomedical innovations.Questions about the moral status of human embryos have so captured public attention since the President issued his remarks that other significant ethical and policy issues raised about stem cell research inside the Beltway have remained in the shadows. A number of individuals and organizations—legislators, scientists, patient groups, the President's Council on Bioethics, ethicists, religious task forces, and social commentators—have attempted to bring these other issues to legislative and public attention. They also have revisited the more publicly prominent question of what sorts of protections we owe to human embryos. In response, Congress has attempted to address several of these newly emerging issues at hearings and in legislation. I review these efforts, consider developing issues and arguments, and conclude by exploring possible future directions for federal and private sector stem cell policy. The Availability of Embryonic Stem Cell Lines to Federally Funded Researchers President Bush, in developing his stem cell research policy, accepted a distinction between the "derivation" and the "use" of embryos enunciated by the General Counsel of the Department of Health and Human Services toward the end of the Clinton administration. This distinction was adopted to avoid contravening the Dickey-Wicker Amendment (added... (shrink)

Anamniote animals, such as fish and amphibians, are able to regenerate damaged CNS nerves following injury, but regeneration in the mammalian CNS tracts, such as the optic nerve, does not occur. However, severed adult mammalian retinal axons can regenerate into peripheral nerve segments grafted into the brain and this finding has emphasized the importance of the environment in explaining regenerative failure in the adult mammalian CNS. Following lesions, regenerating axons encounter the glial cells, oligodendrocytes and astro‐cytes, and their (...) derivatives, respectively myelin and the astrocytic scar. Experiments to investigate the influence of these components on axon growth in culture have revealed cell‐surface and extracellular matrix molecules that inhibit axon extension and growth cone motility. Structural and functional characterization of these ligands and their receptors is underway, and may solve the interesting neurobiological conundrum posed by the failure of mammalian CNS regeneration. Simultaneously, this might allow new possibilities for treatment of the severe clinical disabilities resulting from injury to the brain and spinal cord. (shrink)

Love, fear, hope, calculus, and game shows-how do all these spring from a few delicate pounds of meat? Neurophysiologist Ian Glynn lays the foundation for answering this question in his expansive An Anatomy of Thought, but stops short of committing to one particular theory. The book is a pleasant challenge, presenting the reader with the latest research and thinking about neuroscience and how it relates to various models of consciousness. Combining the aim of a textbook with the style of a (...) popularization, it provides all the lay reader needs to know to participate in the philosophical debate that is redefining our attitudes about our minds. Drawing on the rich history of neurological case studies, Glynn picks through the building blocks of our nervous system, examines our visual and linguistic systems, and probes deeply into our higher thought processes. The stories of great scientists, like Ramon y Cajal, and famous patients, like Sperry's split-brained epileptics, illuminate the scientific issues Glynn selects as essential for understanding consciousness. Some might argue that his lengthy explorations of natural selection overemphasize evolutionary explanations of psychological phenomena, but they must also agree that evolutionary psychology has distanced itself mightily from social Darwinism in recent years and merits a reappraisal. The great consciousness debate may form the core of the 21st-century Zeitgeist; get ready for it with An Anatomy of Thought. -Rob Lightner From Publishers Weekly How do we know? What do we think? How could a philosophical problem-'the mind-body problem,' say-induce a headache? What can evolutionary theory, molecular biology, the history of medicine and experimental psychology tell us about the features of human consciousness, and (once again) how do we know? Glynn, a physician and Cambridge University professor, meticulously attempts to answer these questions and more, setting forth the results of all sorts of research relevant to our brains-from 19th-century dissections to Oliver Sacks-like case studies, work with monkeys and supercomputers, and the enduring puzzles of philosophy, which he rightly saves for near the end. After explaining evolution by natural selection and 'clearing away much dross,' Glynn lays out the experiments and theories that have shown 'how nerve cells can carry information about the body, how they can interact' and how sense organs work; demonstrates the 'mixture of parallel and hierarchical organization' in our brains and 'the striking localization of function within it'; considers where neuroscience is likely to go; and admits that, among the many fields of exciting research just ahead, 'we can be least confident of progress toward a complete, scientific explanation of our sensations and thoughts and feelings.' Other recent explaining-the-brain books have sometimes advanced simplistic, or implausibly grand, claims about the nature and features of consciousness in general. Instead, Glynn offers a patient, informative, well-laid-out researcher's-eye view of what we have learned, how we figured it out and what we still don't know about neurons, senses, feelings, brains and minds. (Apr.) Copyright 2000 Reed Business Information, Inc. From Library Journal The nature of consciousness, which perennially troubles the minds of scientists and philosophers, is the subject of an ever-growing body of literature. Two of the latest entries approach the topic from different perspectives. Glynn, a professor of physiology and head of the Physiological Laboratory at Cambridge, offers a comprehensive summary of what we know about the brain-both its evolution and its mechanisms. Among the topics he covers are natural selection, molecular evolution, nerves and the nervous system, sensory perception, and the specific structures responsible for our intellect. Using the mechanisms involved in vision and speech as models, Glynn skillfully describes various neurological deficiencies that can lead to 'disordered seeing' and problems with the use of language. He carefully distinguishes what we know through experimental evidence from what we know through the observation of patients with neurological damage. He also describes some of the major theories that attempt to explain why these structures arose. While his book concentrates on the structures that make up the mind, Glynn is well aware that some physical events appear explicable only in terms of conscious mental events-a situation that conflicts with the laws of modern physics. Only briefly, however, does he consider the various approaches that have been taken to deal with the issues of mind/body and free will. In contrast, this is the primary focus of The Physics of Consciousness. After reviewing the fundamentals of classic physics, Walker (who has a Ph.D. in physics) summarizes elements of the new physics in which our knowledge of space, time, matter, and energy are all dependent on the moment of observation. Walker explores the meaning of consciousness as a characteristic of the observer. In this context both the observer and the act of measurement are critical. In essence, Walker leads his reader on a journey through his concept of a 'quantum mind,' which can both affect matter (including other minds) and can be affected by other distant matter/minds. To break up what would otherwise be an extremely dense text, Walker also relates the very touching story of the loss of his high-school sweetheart to leukemia. Indeed, it is his memory of their relationship that drives Walker to seek an understanding of ultimate reality. At times, he has a tendency to be dogmatic-as when he concludes, 'our consciousness, our mind, and the will of God are the same mind.' While An Anatomy of Thought is appropriate for most academic libraries, the Physics of Consciousness will be most accessible to readers with some knowledge of advanced physics. -Laurie Bartolini, Illinois State Lib., Springfield Copyright 2000 Reed Business Information, Inc. From Booklist The codiscoverers of natural selection-Charles Darwin and Alfred Wallace-disagreed over the possibility of finding an evolutionary explanation for the human mind. Glynn here argues Darwin's side of the debate, tracing an eons-long path of development starting from simple amino acids floating in primal seas and extending through the erect hominids in which the powers of a massive brain first manifest themselves. Patiently adducing evidence of an evolutionary origin for the underlying molecular machinery, Glynn dissects the nerve centers that make possible speech and hearing, sight, and reading. Pressing deeper, he lays bare the cortical foundations of personality. But those who deal with the mind must attend also to the arguments advanced by philosophers. And it is when he turns from dendrites to syllogisms (especially the vexing mind-body paradox) that Glynn's empirical reasoning fails him. In the end, he concedes his perplexity in trying to conceive of an evolutionary origin for human consciousness. This concession may set the shade of Alfred Wallace to chortling, but it will draw readers into an honest confrontation with a profound enigma. Bryce Christensen. (shrink)

This chapter is a science fiction story about a hunter named Eckels, who pays money to join a hunting party that will travel back to the late Jurassic Era, on a guided safari to kill a Tyrannosaurus rex. Although Eckels is initially excited about the hunt, when the monstrous Tyrannosaur approaches, he loses his nerve. Travis tells him he cannot leave, but Eckels panics, steps off the path and runs into the forest. Realizing that Eckels has fallen off the (...) path, Travis threatens to leave him in the past unless he removes the bullets from the dinosaur's body, as they cannot be left behind. He frantically pleads with Travis to take him back into the past to undo the damage, but Travis explains that the time machine cannot return to any point in time that has already been visited. Travis raises his gun, and there is “a sound of thunder”. (shrink)

Until comparatively recently, say the middle of the last century, spinal cord injury was fatal as pressure sores and other infections took their toll. Those with severe brain injuries, unable to move or even communicate, fared even worse; without movement or feeding such patients were nursed until nature took its course. Over the last few decades medical and nursing advances have enabled some of these vegetative patients to survive for considerable time, provoking, at times, ethical and legal dilemmas. Though they (...) survived, without overt behaviour or clear communication their carers were frequently unsure how much residual function remained. Now real progress is occurring in this area thanks to the application of neuro-scientific methods by some outstanding groups of workers. Subjects with severe brain injury may begin in complete, unresponsive coma but then ‘lighten’ to one of three categories. In vegetative state (VS), patients are apparently awake but without evidence of voluntary behaviour and have no apparent awareness of self or environment, whilst in minimally conscious state (MCS) patients have some behaviour beyond the reflex but are not able to communicate effectively. These conditions usually result from widespread brain damage at either or both cortical and subcortical levels due to injury or anoxia, though they can also be seen in end stage neurological conditions like Alzheimer’s. In locked in syndrome (LIS), patients ‘awake’ from coma, usually due to stroke, aware of their surroundings and their situation but unable to speak or move, beyond eye lid control and eye movement. For many, LIS will be recognised from Bauby’s extraordinary account in ‘The Diving Bell and the Butterfly,’ though, incidentally, it was presaged in Samuel Beckett’s novella ‘The Unnameable.’ LIS reflects a profound disconnection between brain and body, except for the upper cranial nerves involved in eyelid movement. The overriding question is how much awareness these patients have.. (shrink)

This volume explores how functional brain imaging techniques like positron emission tomography have influenced cognitive studies. The first chapter outlines efforts to relate human thought and cognition in terms of great books from the late 1800s through the present. Chapter 2 describes mental operations as they are measured in cognitive science studies. It develops a framework for relating mental operations to activity in nerve cells. In Chapter 3, the PET method is reviewed and studies are presented that use PET (...) to map the striate cortex and to activate extrastriate motion, color, and form areas. Chapter 4 shows how top down processes involving attention can lead to activation of these same areas in the detection of targets, visual search, and visual imagery. This chapter reveals complex networks of activations. Chapters 5 and 6 deal with the presentation of words. Chapter 5 illustrates PET studies of the anatomy of visual word processing and shows how the circuitry used for generating novel uses of words changes as the task becomes automated. Chapter 6 applies high density electrical recording to explore these activations in real time and to show how a constant anatomy can be reprogrammed by task instructions to produce and perform different cognitive tasks. Chapter 7 shows how studies of brain lesions and PET converge on common networks underlying attentional functions such as visual orienting, target detection, and maintenance of the alert state. Chapters 8 and 9 apply the network approach to examine normal development of attention in infants and pathological conditions resulting from brain damage, and psychiatric pathologies of depression, schizophrenia, and attention deficit disorder. In Chapter 10, new developments such as functional MRI are discussed in terms of future developments and integration of cognitive neuroscience. (shrink)

This is exciting medical researchers because it means that, at least in theory, the cells from an early embryo could eliminate the need for organ transplants entirely, cure leukaemia, enable people with diabetes to manufacture insulin, treat Parkinson's and Alzheimer's disease, and repair the nerve systems of quadriplegics. Though these prospects are still far from realisation, results achieved by Oliver Brustle at the University of Bonn Medical Centre have brought them a step closer. In an article published in Science (...) on July 30, Brustle reported that he was able to repair the damaged nervous systems of rats using cells taken from embryos. (shrink)

Neuroimaging studies of brain-damaged patients diagnosed as in the vegetative state suggest that the patients might be conscious. This might seem to raise no new ethical questions given that in related disputes both sides agree that evidence for consciousness gives strong reason to preserve life. We question this assumption. We clarify the widely held but obscure principle that consciousness is morally significant. It is hard to apply this principle to difficult cases given that philosophers of mind distinguish between a range (...) of notions of consciousness and that is unclear which of these is assumed by the principle. We suggest that the morally relevant notion is that of phenomenal consciousness and then use our analysis to interpret cases of brain damage. We argue that enjoyment of consciousness might actually give stronger moral reasons not to preserve a patient's life and, indeed, that these might be stronger when patients retain significant cognitive function. (shrink)

Moral judgments, whether delivered in ordinary experience or in the courtroom, depend on our ability to infer intentions. We forgive unintentional or accidental harms and condemn failed attempts to harm. Prior work demonstrates that patients with damage to the ventromedial prefrontal cortex deliver abnormal judgments in response to moral dilemmas and that these patients are especially impaired in triggering emotional responses to inferred or abstract events, as opposed to real or actual outcomes. We therefore predicted that VMPC patients would (...) deliver abnormal moral judgments of harmful intentions in the absence of harmful outcomes, as in failed attempts to harm. This prediction was confirmed in the current study: VMPC patients judged attempted harms, including attempted murder, as more morally permissible relative to controls. These results highlight the critical role of the VMPC in processing harmful intent for moral judgment. (shrink)

In the literature investigating the long history of appeals to ‘nature’, in its multiple meanings, for rules of conduct or justification of social order, little attention has been paid to a long-standing tradition in which medical and physiological arguments merged into moral and social ones. A host of medical authors, biologists, social writers and philosophers assumed that nature spoke its moral language not only in its general economy, but also within and through the body. This is why, for instance, many (...) critics of Malthus argued that physiological self-regulating mechanisms ensured a spontaneous adaptation of fertility to the circumstances. Beliefs in a beneficent economy of nature persisted when Providence was replaced by evolution. To some, they provided reasons for hope even when others worried about ‘unfit’ members of society increasing at a quicker rate than ‘fit’ ones. The nerves gradually replaced food and blood as moral mediators between society and the body. When faith in bio-social progress was shaken by degeneration theories, and fin de siècle anxiety concerned underpopulation rather than overpopulation, not an insignificant proportion of those who emphasised the bad effects of modern civilisation resorted to ideas and arguments based on a view of the body in which physiology and morality worked together. A common language and common assumptions linked the Kulturpessimisten to their optimistic eighteenth-century colleagues, in spite of their different forecasts. The present paper traces continuities and discontinuities in the operation of a persistent set of interrelated ideas and assumptions on the coalescence of the physiological and the moral across disciplines and contexts. (shrink)

I show, building on Warren Quinn's puzzle of the self-torturer, that destructive conduct with respect to the environment can flourish even in the absence of interpersonal conflicts. As Quinn's puzzle makes apparent, in cases where individually negligible effects are involved, an agent, whether it be an individual or a unified collective, can be led down a course of destruction simply as a result of following its informed and perfectly understandable but intransitive preferences. This is relevant with respect to environmental ethics, (...) since environmental damage is often the result of the accumulation of individually negligible effects. (shrink)

Mind and matter.--Moral nerve.--Herbert Spencer as a moralist.--Huxley as a moralist.--Substitutional morals: the principle of punishment.--Literary and scientific verdicts.--The genesis of modern kindliness.--Stuart Mill.--Thomas Carlyle.--The French revolution.--Epoch-making incidents and persons.--The slow change in the fundamental characteristics of peoples and individuals.--Emerson on Napoleon.--Goldwin Smith.--Material prosperity and religion.--Nerve forces as totalities.--The evolution of the direct man (direct brain).

Many morally important facts about the way we affect one another, in particular the psychological damage we can inflict, are hard to imagine .

The segregation of damaged components at cell division determines the survival and aging of cells. In cells that divide asymmetrically, such as Saccharomyces cerevisiae, aggregated proteins are retained by the mother cell. Yet, where and how aggregation occurs is not known. Recent work by Zhou and collaborators shows that the birth of protein aggregates, under specific stress conditions, requires active translation, and occurs mainly at the endoplasmic reticulum. Later, aggregates move to the mitochondrial surface through fis1‐dependent association. During replicative aging, (...) aggregate association with the mother‐cell mitochondria contributes to the asymmetric segregation of aggregates, because mitochondria in the daughter cell do not carry aggregates. With increasing age of mother cells, aggregates lose their connection to the mitochondria, and segregation is less asymmetric. Relating these findings to other mechanisms of aggregate segregation in different organisms, we postulate that fusion between aggregates and their tethering to organelles such as the vacuole, nucleus, ER, or mitochondria are common principles that establish asymmetric segregation during stress resistance and aging. (shrink)

In Philip J. Ivanhoe’s introduction to his Readings from the Lu-Wang School of Neo-Confucianism, he argues convincingly that the Ming-era Neo-Confucian philosopher Wang Yang-ming (1472–1529) was much more influenced by Buddhism (especially Zen’s Platform Sutra) than has generally been recognized. In light of this influence, and the centrality of questions of selfhood in Buddhism, in this article I will explore the theme of selfhood in Wang’s Neo-Confucianism. Put as a mantra, for Wang “self-awareness is world-awareness.” My central image for this (...) mantra is the entire cosmos anthropomorphized as a doctor engaged in constant self-diagnosis, in which effort s/he is assisted by an entire staff of the nerves/nurses—individual humans enlightened as Wangian sages. In short, I will argue that the world for Wang could be meaningfully understood as a mindful, self-healing body within which humans are the sensitive nerves, using our mindful awareness to direct attention to the affected areas when injury or disease occurs. We are, and must thus recognize that we are, the bold but sensitive nervous system of the cosmos, sharing (like neurons) our loving excitement, carrying out (like a medical nurse) the doctor’s orders for the self-care of our cosmic body/medical corps. (shrink)

Thomas Hobbes’ theory of punishment plays a constitutive role in the Leviathan’s theory of state sovereignty. Despite this, Hobbes’ justification for punishment is widely found to be discrepant, weak, inconsistent, and contradictory. Two dominant tendencies in the scholarship attempt to stabilize the Leviathan’s justification for the state’s right to punish by either identifying it with the sovereign’s right to war or by elaborating a theory of authorization within the state. In contrast, by tracing the deployments of the metaphor that Hobbes (...) utilizes to evoke the state’s right to punish in the Leviathan (i.e. that of the nerves of the Leviathan) this paper finds that these two accounts can be made to be consistent with each other — thereby destabilizing the grounds upon which the theory of punishment can be founded. (shrink)

Four models of forgiveness are identified; the health model, the philosophical model, the Christian model and the prosocial model. All define the term ‘forgiveness’ in a way which is consistent with their particular perspective. The authors offer a definition of forgiveness and propose an integrated model of forgiveness which seeks to incorporate contributions from all four areas, but is not biased towards any one model. Four levels of transgression are identified and categorized according to the degree of perceived damage. (...) Apology-automatic and apology-dependent responses are distinguished from a forgiveness response which is restricted to Levels 3 and 4. The advantages of adopting a forgiveness strategy for both the forgiver and forgiven as opposed to other responses, i.e., revenge, denial, and condoning are discussed. The authors provide a definition and model which integrates the important contributions from each of the areas discussed. (shrink)

The psychological and neurobiological processes underlying moral judgement have been the focus of many recent empirical studies1–11. Of central interest is whether emotions play a causal role in moral judgement, and, in parallel, how emotion-related areas of the brain contribute to moral judgement. Here we show that six patients with focal bilateral damage to the ventromedial prefrontal cortex (VMPC), a brain region necessary for the normal generation of emotions and, in particular, social emotions12–14, produce an abnor- mally ‘utilitarian’ pattern (...) of judgements on moral dilemmas that pit compelling considerations of aggregate welfare against highly emotionally aversive behaviours (for example, having to sacrifice one person’s life to save a number of other lives)7,8. In contrast, the VMPC patients’ judgements were normal in other classes of moral dilemmas. These findings indicate that, for a selective set of moral dilemmas, the VMPC is critical for normal judgements of right and wrong. The findings support a necessary role for emotion in the generation of those judgements. (shrink)

Edmund Pellegrino claims that medical ethics must be derived from a perception of the patient's damaged humanity, rather than from the self-imposed duties of professionals. This essay explores the meaning and examines the challenges to this patient-centered ethic. Social scientific and bioethical interpretations of medicine constitute one kind of challenge. A more pervasive challenge is the ascendancy of managed care, and especially investor-owned, for-profit managed care. A list of questions addressed to patients, physicians and organizations is offered as one means (...) of assessing this threat and moving toward morally trustworthy relationships. (shrink)

The Classical Theory of function in the nervous system postulates that the nerve impulse is the result of a sequential reversal of the membrane potential due to an increased permeability of the membrane, first to sodium ions, then to potassium ions. The new theory presents a bio-physical model which depicts the nerve impulse as an event involving the motions of electrons and waves, and their interactions with sodium and potassium atoms and ions. The velocity of the nerve (...) impulse (the most important parameter of nerve function) is determined by the product of two constants: c = the speed of light, which is a constant for all nerves; k =a constant for each nerve and is believed to be a specific property of nerve matter related in some way to the atomic process. The theory proposes that the nerve impulse in the axon is dualistic in nature (particles and waves play equally significant roles). The dualistic nature accounts for the three most fundamental characteristics of conduction of the nerve impulse: periodicity (conduction of a nerve impulse over long distances with constant velocity and form); non-summing (two nerve impulses cannot be in the same place at the same time); quantum nature of each nerve impulse — i.e., the unit message of the nerve impulse is an indivisible unit. (shrink)

This article is a review of the 2010 book Collateral Damage by Dan Walter.

Cognitive dysfunction in Alzheimer’s disease is caused by disturbances in neuronal circuits of the brain underpinned by synapse loss, neuronal dysfunction and neuronal death. Amyloid beta and tau protein cause these pathological changes and enhance neuroinflammation, which in turn modifies disease progression and severity. Vagal nerve stimulation, via activation of the locus coeruleus, results in the release of catecholamines in the hippocampus and neocortex, which can enhance synaptic plasticity and reduce inflammatory signalling. Vagal nerve stimulation has shown promise (...) to enhance cognitive ability in animal models. Research in rodents has shown that VNS can have positive effects on basal synaptic function and synaptic plasticity, tune inflammatory signalling, and limit the accumulation of amyloid plaques. Research in humans with invasive and non-invasive VNS devices has shown promise for the modulation of cognition. However, the direct stimulation of the vagus nerve afforded with the invasive procedure carries surgical risks. In contrast, non-invasive VNS has the potential to be a broadly available therapy to manage cognitive symptoms in early AD, however, the magnitude and specificity of its effects remains to be elucidated, and the non-inferiority of the effects of non-invasive VNS as compared with invasive VNS still needs to be established. Ongoing clinical trials with healthy individuals and patients with early AD will provide valuable information to clarify the potential benefits of non-invasive VNS in cognition and AD. Whether invasive or non-invasive VNS can produce a significant improvement on memory function and whether its effects can modify the progression of AD will require further investigation. (shrink)

This article addresses a still unsolved puzzle in private law regarding the proper explanation of cases in which courts make substantial awards of damages to claimants whose rights have been infringed, but who appear to have suffered no factual loss in consequence of the infringement. The paradigm examples tend to involve awards of ‘user’, license fee or ‘hypothetical bargain’ damages in cases involving interference with property rights. It suggests that existing explanations of such cases are all unsatisfactory in one or (...) another respect and posits a new and potentially more powerful explanatory thesis, drawing on Hohfeld. Such awards, it argues, compensate right-holders for the loss of legal powers associated with their primary claim-rights—in particular, the loss of powers they are accorded by the law to ‘prevent’ the infringement of certain types of primary claim right ex ante. Legal powers are thus to be regarded as assets or amenities, the loss of which is amenable to monetary compensation. (shrink)

Richard McCormick justified his move to proportionalism in part because of the perceived inadequacy of the Grisez-Finnis approach to morality to answer the following question: “What is to count for turning against a basic good, and why?” In this paper, I provide the beginnings of an account of what it means to intend damage to a good; I then show that the account is readily exportable to judgments regarding killing and lying defended by Grisez and others. I then indicate (...) that the account comports well with some of what Grisez says about sexual morality and suggest areas in which further clarification is necessary. In thus proceeding, I hope to inoculate the Grisez view from McCormick's reservations. (shrink)

This article focuses on the ethical implications of so-called ‘collateral damage’. It develops a moral typology of collateral harm to innocents, which occurs as a side effect of military or quasi-military action. Distinguishing between accidental and incidental collateral damage, it introduces four categories of such damage: negligent, oblivious, knowing and reckless collateral damage. Objecting mainstream versions of the doctrine of double effect, the article argues that in order for any collateral damage to be morally permissible, (...) violent agents must comply with high standards of care. In order for incidental harm to be permissible, an agent must take pains to avoid such harm even at higher cost to him- or herself. It is argued that accidentally but negligently caused collateral damage may be just as difficult to excuse as incidental harm. Only if high precautionary standards of care are met, can unintended harm to innocents – incidental or accidental – be permissible. In practice, such a strong commitment to avoiding harm to civilians may well lead us to question more generally and rethink more radically how violent conflicts ought to be fought, how military violence ought to be used and whether there are better ways of achieving those aims that we think are legitimate than those we are currently using. (shrink)

From schools advertising McDonald's, Nike, and Shell oil to military generals appointed as superintendents; from corporate CEOs hailed as education experts to students suspended for wearing Pepsi tee shirts on Coke day; Collateral Damage sifts through a wide range of incidents to reveal how the rising corporatization of public schools needs to be understood as a part of a broader attack on the public sector. Uniquely, Collateral Damage considers the privatization of public education in relation to both globalization (...) and local struggles over curriculum, schools, and culture. (shrink)

It was thus the combination of observational and experimental approaches that ultimately led to confirmation of the outgrowth theory. The observational method was essential for defining various possible methods of nerve fiber development. The multicellular, protoplasmic bridge and outgrowth theories were each postulated to explain purely observational evidence. However, the lack of truly suitable equipment and techniques to study the developing nervous system made it impossible to agree on a single theory on this basis alone. The experimental method provided (...) a means of choosing between these theories. Without the preceding observations that had led to the formulation of various hypotheses, however, the experimental approach might not have been so successful, for the power of this method is more of selection than of generation.Therefore it is impossible to weigh separately the contributions of the observational and experimental approaches to the question of nerve fiber development. Both were necessary for the ultimate acceptance of the outgrowth theory. *** DIRECT SUPPORT *** A8402051 00004. (shrink)

While jurisprudence in the United States has been cast in the general mode of the English common law, modifications over time have produced enough significant variations that American law has a distinctive quality. To illustrate: The exclusionary rule in criminal cases prohibiting the use of evidence (even from reliable witnesses) acquired through illegal search, is not followed in Britain—or, for that matter, in Canada, Germany, and Israel. The punitive-damage concept (PD) in tort law is also a jurisprudential novelty. Punitive (...) damages are imposed in addition to compensatory awards given to tort victims to warn manufacturers and sellers to be careful in their safety and marketing practices. PDs are society's warning signals: Seller beware! Because they are one of society's ways to protect itself, PDs have recently been considered as fines which, to prevent excesses, should be under the rubric of the Eighth Amendment.This essay introduces new elements into the discussion on torts by hypothesizing (1) PDs are fines which belong to the public purse; (2) that expenditures from the public purse should be given to local organizations (like orphanages and inner-city hospitals) which provide vital services for those unable to pay; and (3) that the victim (or the victim's survivor) has a right to designate what local organizations should benefit from his or her punitive-damage awards.The hypotheses require reexamination of the concepts of citizenship, community, and work, respectively.Tort law is an integral part of the American law of injuries, a body of judicial doctrine and legislation and a set of legal arrangements that also include compensation systems and safety legislation. It would have been unthinkable as recently as twenty-five years ago that the tort system would become a source of bitter contention. Today, however, it generates sharp rhetoric and dramatic proposals for change to address its contested problems, as well as strong views in favor of continuing the system essentially intact so as not to disturb its contended benefits. (shrink)

I explore how considerations about psychological damage connect with moral theories.

In this essay I examine Margaret Edson’s Pulitzer prizewinning play, Wit, to explore the numerous connections drawn there between damage to bodies and damage to identities. In the course of this exploration I aim to get clearer about the kinds of illness, injury, or medical interventions that damage patients’ identities; how the damage is inflicted; and what might be done to repair identities that have been damaged in these ways. I argue that just as bodily illness (...) and injury can damage the identity-constituting narratives by which we understand ourselves and others, so too (as the play demonstrates) injurious identity-constituting narratives can result in bodily harm. Because identities are narrative constructions, the damage inflicted on them requires narrative repair. The defective stories must be uprooted and replaced, but the success of the repair depends on both the soundness of the replacement story and the willingness of others to take up the new story. (shrink)

For a little more than a decade, professional organizations and healthcare institutions have attempted to develop guidelines and policies to deal with seemingly intractable conflicts that arise between clinicians and patients (or their proxies) over appropriate use of aggressive life-sustaining therapies in the face of low expectations of medical benefit. This article suggests that, although such efforts at conflict resolution are commendable on many levels, inadequate attention has been given to their potential negative effects upon particular groups of patients/proxies. Based (...) on the well-documented tendency among many African Americans to prefer more aggressive end-of-life medical interventions, it is proposed that the use of institutional policy to break decision making impasse in cases for which aggressive treatment is deemed "medically inappropriate" will fall disproportionately on that group. Finally, it is suggested that the development and application of institutional conflict-resolution policies should be evaluated in the context of historical and current experiences of marginalization and disempowerment, lest such policies exacerbate that experience. (shrink)

What does it mean to look? How does looking relate to damage? These are the fundamental questions addressed in Overlooking Damage. From the Roman triumph to the iconoclasm of ISIS and the Taliban to the aerial views of looted landscapes and destroyed temples visible on Google, the relationship between beauty and violence is far more intimate than we sometimes acknowledge. Jonah Siegel makes the daring argument that a thoughtful reaction to images of damage need not stop at (...) melancholy, but can lead us to a new reckoning. Would the objects we admire be more beautiful if they were not injured or displaced, if they did not remind us of unbearable violence? Siegel takes up writers from the time of the French Revolution to today who have reacted to the depredations of revolutionary iconoclasm, colonial looting, and industrial capitalism, and proposes that in these authors we may find resources with which to navigate our contemporary situation. Deftly bringing the methods of literary studies to bear on important debates in the study of heritage, archaeology, and visual culture, Overlooking Damage reflects on the ways in which concepts of beauty intersect with periods of epochal violence in an attempt to resist the separation of broken things from the worlds in which they have come to be embedded. (shrink)

We present a case study of two scientific perspectives on the phenomenon of nerve signal propagation, a bio-electric and a thermodynamic perspective, and compare this case with two accounts of scientific perspectivism: those of Michela Massimi and Juha Saatsi, respectively. We demonstrate that the interaction between the bio-electric perspective and the thermodynamic perspective can be captured in Saatsi’s terms of progress in explanatory understanding. Using insights from our case study, we argue that both the epistemic and pragmatic dimensions of (...) scientific understanding are important for increasing explanatory understanding of phenomena. The epistemic dimension of understanding is important for increasing the number of actually answered what-if-things-had-been-different questions about a phenomenon, the pragmatic dimension for pointing out the potentially answerable what-if questions that have been overlooked or purposefully neglected thus far. Exposing the limitations of the acquired understanding within a particular perspective can be achieved by criticizing the assumptions that have been adopted to make models of the perspective intelligible, but that are considered problematic from a rival perspective. (shrink)