Abstract:This paper, presented as the 2019 Cambridge Quarterly Neuroethics NetworkCharcot Lecture, traces the nosology of disorders of consciousness in light of 2018 practice guidelines promulgated by the American Academy of Neurology, the American College of Rehabilitation Medicine and the National Institute on Disability, Independent Living and Rehabilitation Research. By exploring the ancient origins of Jennett and Plum’s persistent vegetative state and subsequent refinements in the classification of disorders of consciousness—epitomized by the minimally conscious state, cognitive motor dissociation, and the (...) recently described chronic vegetative state—the author argues that there is a counter-narrative to the one linking these conditions to the right to die. Instead, there is a more nuanced schema distinguishing futility from utility, informed by technical advances now able to identify covert consciousness contemplated by Jennett and Plum. Their prescience foreshadows recent developments in the disorders of consciousness literature yielding a layered legacy with implications for society’s normative and legal obligations to these patients. (shrink)

Ford, Norman In 1972 Brian Jennett and Fred Plum recommended the term 'persistent vegetative state' to describe a state of continuing 'wakefulness without awareness', which can follow a variety of severe insults to the brain. Their description of the syndrome has stood the test of time, but PVS continues to be a source of medical, legal, and ethical debate.

While neuroethics is generally thought to be a modern addition to the broader field of bioethics, this subdiscipline has existed in clinical practice throughout the course of the 20th century. In this essay, Fins describes an older tradition of clinical neuroethics that featured such physician-humanists as Sir William Osler, Wilder Penfield, and Fred Plum, whose work and legacy exploring disorders of consciousness is highlighted. Their normative work was clinically grounded and focused on the needs of patients, in contrast (...) to modern neuroethics, which is more speculative and distant from the lived reality of the clinic. Using recent developments in the diagnosis and treatment of disorders of consciousness, and the history of the vegetative and minimally conscious states, Fins asks why modern neuroethics has taken this turn and what can be done to restore clinical neuroethics to a more proportionate place in the field. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Minding Brain Injury, Consciousness, and Ethics: Discourse and DeliberationsJoseph J. Fins (bio) and James Giordano (bio)The annual John Collins Harvey Lecture at the Georgetown University’s Pellegrino Center for Clinical Bioethics is a forum for addressing contemporary topics at the intersection of medicine and bioethics. This year, in marking the decadal anniversary of the launch of the Brain Research through Advancing Innovative Neurotechnology (BRAIN) Initiative, the Harvey Lecture provided an (...) interactive discussion with renowned clinician, researcher, scholar, and author, Joseph J. Fins, MD—who is the E. William Davis, Jr., MD Professor of Medical Ethics, Chief of the Division of Medical Ethics, and a Professor of Medicine at Weill Cornell Medical College—conducted by James Giordano, PhD, MPhil—who is a Professor of Neurology and Biochemistry, and Chief of the Pellegrino Center’s Neuroethics Studies Program at the Georgetown University Medical Center. The discourse focused upon the topic of covert consciousness, and the ways in which current and developing brain science technologies, together with revised practices of medicine, in general, may afford new opportunities in patient care, but may also give rise to issues, questions, challenges, and opportunities for neuroethics.Prof. James GIORDANO:Prof. Fins, your most recent book, Rights Come to Mind: Brain Injury, Ethics, and the Struggle for Consciousness (Fins 2015), addresses your ongoing work to employ current and emerging neurological approaches to reveal conscious functions in patients with profound brain injury and disease. To be sure, the destination—if you will—is to talk about covert consciousness. But in commencing this discussion, I’d like to propose a route, which traces your professional journey to this point in your career, and how it led you on your search to reveal consciousness in those patients who lack expressive capability. You went into palliative care first, and that brought you to where you are today. [End Page 227]Prof. Joseph J. FINS:First, let me thank you and the Pellegrino Center for the honor of giving the John Harvey Collins Lecture in such an interactive manner. The forefront of neurological care—and the neuroethical issues and methods focal to such practice—wasn’t what I initially intended to do professionally, but I think that therein is a good lesson for young people’s career aspirations. Simply put, one doesn’t always know where they’ll end up at the beginning of the journey, and as Kierkegaard said, life is lived forward, but is understood backwards (Kierkegaard 1843).In the nineties and the early 2000s, I was trying to help improve the quality of care of people at the end of life, and I wrote a book, entitled The Palliative Ethic of Care: Clinical Wisdom at Life’s End (Fins 2006), in which I addressed notions of phronesis—practical wisdom—in integrating theory and practice toward improving how people die. I became interested in the Quinlan case (Quinlan 1976), and the right to die, and around the same time, I ran into a colleague of mine at Cornell: Dr. Nicholas D. Schiff. Dr. Schiff is a neurologist, who was a protégé of Fred Plum, who was the originator of the concept of the vegetative state with Bryan Jennett, back in 1972. Fred was both of our teachers here at Cornell. Niko (Dr. Schiff) was interested in patients with disorders of consciousness, and was beginning to envision doing work—that ultimately, we did—using deep brain stimulation (DBS) to try to treat patients in the minimally conscious state, a category that was subsequently codified in 2002.I realized that a whole population of people—with these disorders of consciousness—had been somewhat marginalized, and their neglect essentially devolves back to the considerations of the right to die. The right to die was established in the Quinlan case because Judge Hughes—the presiding chief judge of the New Jersey Supreme Court—talked about Ms. Quinlan’s loss of a cognitive, sapient state as being the moral warrant for her right to die, given the fact that it was viewed as a futile situation. I recognized, over the ensuing years—from my background in palliative and end-of-life care—[1] that we had over-generalized notions of futility... (shrink)

In this provocative book, Fred Dretske argues that to achieve an understanding of the mind it is not enough to understand the biological machinery by means of...

Among philosophers, there are at least two prevalent views about the core concept of intentional action. View I (Adams 1986, 1997; McCann 1986) holds that an agent S intentionally does an action A only if S intends to do A. View II (Bratman 1987; Harman 1976; and Mele 1992) holds that there are cases where S intentionally does A without intending to do A, as long as doing A is foreseen and S is willing to accept A as a consequence (...) of S’s action. Joshua Knobe (2003a) presents intriguing data that may be taken to support the second view.1 Knobe’s data show an asymmetry in folk judgements. People are more inclined to judge that S did A intentionally, even when not intended, if A was perceived as causing a harm (e.g. harming the environment). There is an asymmetry because people are not inclined to see S’s action as intentional, when not intended, if A is perceived as causing a benefit (e.g. helping the environment). In this paper we will discuss Knobe’s results in detail. We will raise the question of whether his ordinary language surveys of folk judgments have accessed core concepts of intentional action. We suspect that instead Knobe’s surveys are tapping into pragmatic aspects of intentional language and its role in moral praise and blame. We will suggest alternative surveys that we plan to conduct to get at this difference, and we will attempt to explain the pragmatic usage of intentional language. (shrink)

Tracking theories of knowledge are widely known to have the consequence that knowledge is not closed. Recent arguments by Vogel and Hawthorne claim both that there are no legitimate examples of knowledge without closure and that the costs of theories that deny closure are too great. This paper considers the tracking theories of Dretske and Nozick and the arguments by Vogel and Hawthorne. We reject the arguments of Vogel and Hawthorne and evaluate the costs of closure denial for tracking theories (...) of knowledge. (shrink)

Sven Bernecker develops a theory of propositional memory that is at odds with the received epistemic theory of memory. On Bernecker’s account the belief that is remembered must be true, but it need not constitute knowledge, nor even have been true at the time it was acquired. I examine his reasons for thinking the epistemic theory of memory is false and mount a defense of the epistemic theory.

For T any completion of Peano Arithmetic and for n any positive integer, there is a model of T of size $\beth_n$ with no (n + 1)-length sequence of indiscernibles. Hence the Hanf number for omitting types over T, H(T), is at least $\beth_\omega$ . (Now, using an upper bound previously obtained by Julia Knight H (true arithmetic) is exactly $\beth_\omega$ ). If T ≠ true arithmetic, then $H(T) = \beth_{\omega1}$ . If $\delta \not\rightarrow (\rho)^{ , then any completion of (...) Peano Arithmetic has a model of size δ with no set of indiscernibles of size ρ. There are similar results for theories strongly resembling Peano Arithmetic, e.g., ZF + V = L. (shrink)

In my essay I look at the specifics of the dispute between the Scottish metaphysician Andrew Baxter and the mathematician Colin MacLaurin in an attempt to identify the source or sources of their contradictory, yet in both cases Newtonian, positions regarding occasionalism. After some general introductory remarks about each thinker, I examine the metaphysical implications that Baxter sees as following from Newton's concept of vis inertiæ. Following this, I look at MacLaurin's commitment to the role of sense experience in natural (...) philosophy. Finally, I discuss the different passages from Newton's Opticks on which the two thinkers focus. (shrink)

Inter-cultural dialog is frequently treated as either unnecessary or else impossible. It is said to be unnecessary, because we all are the same or share the same ‘human nature'; it is claimed to be impossible because cultures seen as language games or forms or life are so different as to be radically incommensurable. The paper steers a course between absolute universalism and particularism by following the path of dialog and interrogation - where dialog does not mean empty chatter but the (...) exploration of the ‘otherness’ of interlocutors on the far side of either assimilation or exclusion. Such dialog is the heart of hermeneutics as formulated by Hans-Georg Gadamer. The paper explores the question whether hermeneutical interpretation can be transferred from textual readings to the domain of cross-cultural encounters. After discussing both the historical development and the basic meaning of contemporary hermeneutics, the paper draws attention to the intimate linkage between interpretive understanding and ‘application’, or ‘practical philosophy.’ Drawing on the insights of Gadamer and some more overtly political thinkers, the paper then shows the relevance of hermeneutics for cross-cultural studies, as an antidote to the looming ‘clash of civilizations.’ It turns to some writings by Maurice Merleau-Ponty in order to emphasize the necessary linkage between interactive dialog and concrete embodied engagement. Undercutting purely mentalist or ‘idealist’ misconstruals of dialog, this linkage shows the mutual compatibility between Gadamerian hermeneutics and existential phenomenology. Keywords: hermeneutics; dialogue; praxis; cross-cultural understanding; Gadamer; Merleau-Ponty (Published: 10 March 2009) Citation: Ethics & Global Politics. DOI: 10.3402/egp.v2i1.1937. (shrink)

This chapter contains sections titled: Overview A Medium for Thought Naturalization Mechanisms of Meaning Fodor's Meaning Mechanisms Dretske's Meaning Mechanisms Objections Conclusion.

The neuropsychology of religious activity in normal and selected clinical populations is reviewed. Religious activity includes beliefs, experiences, and practice. Neuropsychological and functional imaging findings, many of which have derived from studies of experienced meditators, point to a ventral cortical axis for religious behavior, involving primarily the ventromedial temporal and frontal regions. Neuropharmacological studies generally point to dopaminergic activation as the leading neurochemical feature associated with religious activity. The ventral dopaminergic pathways involved in religious behavior most closely align with the (...) action-extrapersonal system in the model of 3-D perceptual–motor interactions proposed by Previc . These pathways are biased toward distant space and also mediate related extrapersonally dominated brain functions such as dreaming and hallucinations. Hyperreligiosity is a major feature of mania, obsessive-compulsive disorder, schizophrenia, temporal-lobe epilepsy and related disorders, in which the ventromedial dopaminergic systems are highly activated and exaggerated attentional or goal-directed behavior toward extrapersonal space occurs. The evolution of religion is linked to an expansion of dopaminergic systems in humans, brought about by changes in diet and other physiological influences. (shrink)

The prelims comprise: Introduction Dretske's Adaptation of Information Theory to Knowledge Interesting Open Questions Current Philosophical Debates.

Are there universal values of right and wrong, good and bad, shared by virtually every human? The tradition of natural law argues that there is. Drawing on the work of psychoanalyst Melanie Klein, whose analyses have touched upon issues related to original sin, trespass, guilt, and salvation through reparation, in this 2006 book C. Fred Alford adds an extra dimension to this argument: we know natural law to be true because we have hated before we have loved and have (...) wished to destroy before we have wanted to create. Natural law is built upon the desire to make reparation for the goodness we have destroyed, or have longed to destroy. Through reparation, we earn salvation from the most hateful part of ourselves, that which would destroy what we know to be good. (shrink)

A message from the stars -- A dispute over buoyancy -- Inertia, Empiricism, and spots on the sun -- Science and religion -- Troubles in Rome: 1615-1616 -- Mathematics and the book of nature -- Showdown -- Matter and motion.

Since Kripke's attack on Nozick's Tracking Theory of knowledge, there has been strong suspicion that tracking theories are false. We think that neither Kripke's arguments and examples nor other recent attacks in the literature show that the tracking theories are false. We cannot address all of these concerns here, but we will show why some of the most discussed examples from Kripke do not demonstrate that the tracking theories are false.

Descartes’s First Meditation employs a series of arguments designed to generate the worry that the senses might not provide sufficient evidence to justify one’staking as certain one’s beliefs about the way the world is. As the meditator considers what principle describes the conditions under which it is possible to attain certain knowledge, one after another doubt-generating device is ushered in, until at last he finds himself like someone caught in a whirlpool, able neither to stand firm nor to swim out. (...) In this paper, I examine one of those devices, namely, what is often referred to as the Madness Argument. In particular, I want to discuss its relation to the Dream Argument and its function in the Meditations as a whole. My position stands in contrast to the interpretations of Anthony Kenny, Margaret Wilson, Michael Williams, and, more recently, Janet Broughton and Catherine Wilson. (shrink)

Among the French Cartesians of the second half of the seventeenth century, Géraud de Cordemoy stands out as the most radical. He was one of the first to argue that Cartesian metaphysics imply occasionalism, and he was alone in arguing that those same metaphysical commitments lead to atomism. This paper addresses the second of these positions. Following a discussion of what is taken to be the strongest version of his argument for atomism, consideration will turn to an objection against Cordemoy, (...) one that was raised in his own day by Gottfried Leibniz and more recently by Steven Nadler. The paper concludes with a response offered on Cordemoy's behalf. (shrink)

In that it holds God to be the only true efficient cause, Malebranche’s occasionalism would seem to deny human freedom and to make God responsible for our sins. I argue that Malebranche’s occasionalism must be considered within its Cartesian framework; once one understands what it is to be an occasional cause in this context, Malebranche can be seen as saving a place for human freedom, and he can consistently hold that we are morally responsible for our actions.

This volume consists of papers originally presented at the international conference "Occasionalism: History and Problems," held in Venice in 2015; it contains twelve chapters, nine of which are in English, three in French. In their introduction, the editors describe occasionalism as a theory that was viewed by Medieval Christian philosophers as a "dangerous and treacherous" threat, only later to be "proudly asserted" in the post-Descartes era. This raises the question of to what degree this transition should be seen as a (...) result of interpretations of the commitments of Cartesian metaphysics, particularly with regard to questions concerning mind-body interaction. Many scholars have pointed out that to view... (shrink)

This book consists of an edited collection of original essays of the highest academic quality by seasoned experts in their fields of cognitive science. The essays are interdisciplinary, drawing from many of the fields known collectively as “the cognitive sciences.” Topics discussed represent a significant cross-section of the most current and interesting issues in cognitive science. Specific topics include matters regarding machine learning and cognitive architecture, the nature of cognitive content, the relationship of information to cognition, the role of language (...) and communication in cognition, the nature of embodied cognition, selective topics in visual cognition, brain connectivity, computation and simulation, social and technological issues within the cognitive sciences, and significant issues in the history of neuroscience. This book will be of interest to both professional researchers and newer students and graduate students in the fields of cognitive science—including computer science, linguistics, philosophy, psychology and neuroscience. The essays are in English and are designed to be as free as possible of technical jargon and therefore accessible to young scholars and to scholars who are new to the cognitive neurosciences. In addition to several entries by single authors, the book contains several interesting roundtables where researchers contribute answers to a central question presented to those in the focus group on one of the core areas listed above. This exciting approach provides a variety of perspectives from across disciplines on topics of current concern in the cognitive sciences. (shrink)

I challenge Jackendoff's claim that semantics should not be paralyzed by a failure to solve Brentano's problem of intentionality. I argue that his account of semantics is in fact paralyzed because it fails to live up to his own standards of naturalization, has no account of falsity, and gives the wrong semantic objects for words and thoughts.

We introduce a natural generalization of Borel's Conjecture. For each infinite cardinal number $\kappa$, let ${\sf BC}_{\kappa}$ denote this generalization. Then ${\sf BC}_{\aleph_0}$ is equivalent to the classical Borel conjecture. Assuming the classical Borel conjecture, $\neg{\sf BC}_{\aleph_1}$ is equivalent to the existence of a Kurepa tree of height $\aleph_1$. Using the connection of ${\sf BC}_{\kappa}$ with a generalization of Kurepa's Hypothesis, we obtain the following consistency results: 1. If it is consistent that there is a 1-inaccessible cardinal then it is (...) consistent that ${\sf BC}_{\aleph_1}$.2. If it is consistent that ${\sf BC}_{\aleph_1}$, then it is consistent that there is an inaccessible cardinal.3. If it is consistent that there is a 1-inaccessible cardinal with $\omega$ inaccessible cardinals above it, then $\neg{\sf BC}_{\aleph_{\omega}} + (\forall n < \omega){\sf BC}_{\aleph_n}$ is consistent.4. If it is consistent that there is a 2-huge cardinal, then it is consistent that ${\sf BC}_{\aleph_{\omega}}$.5. If it is consistent that there is a 3-huge cardinal, then it is consistent that ${\sf BC}_{\kappa}$ for a proper class of cardinals $\kappa$ of countable cofinality. (shrink)

Addis (1981) has criticized a proposal of ours (Wilson [1969b]) for analysing disposition predications in terns of the horseshoe of material implication, and has proposed a related but significantly different analysis. This paper restates the original proposal, and defends it against Addis's criticisms. It is further argued that his proposal will not do as a general account of disposition predications; that, however, if it is suitably qualified, then it does account for certain special sorts of disposition predication; but that so (...) understood, it can be seen to be but a special case of ours. (shrink)

In 1996, the U.S. Congress passed the Personal Responsibility and Work Opportunities Reconciliation Act that ended the entitlement of poor families to government assistance. The debate leading up to that transformation in welfare policy occurred in the shadow of Speenhamland—an episode in English Poor Law history. This article revisits the Speenhamland episode to unravel its tangled history. Drawing on four decades of recent scholarship, the authors show that Speenhamland policies could not have had the consequences that have been attributed to (...) them. The article ends with an alternative narrative that seeks to explain how the Speenhamland story became so deeply entrenched. (shrink)

This paper examines ethical, legal and economic dimensions of the decision facing employers regarding whether it is appropriate to monitor the electronic mail (e-mail) communications of its employees. We review the question of whether such monitoring is lawful. Recent e-mail monitoring cases are viewed as a progression from cases involving more established technologies (i.e., phone calls, internal memoranda, faxes and voice mail).The central focus of the paper is on the extent to which employer monitoring of employee e-mail presents a structure (...) of costs and benefits to the employer which are unlikely to make such a practice profitable or practical to the employer. The practice of employer monitoring to detect illicit employee behavior (e.g., fraud, harassment of fellow employees, industrial espionage) is considered. (shrink)

Some philosophers argue that the state and its citizens stand in a morally privileged position vis-à-vis one another but not towards other states or citizens. However, many of those people, particularly philosophical liberals, also hold that morally insignificant differences, such as place of birth, sex, or ethnicity, should not affects rights, liberties, and life prospects. On the face of it, these two sets of ideas appear incompatible and point to a conflict in some liberal thought. Liberal philosophers, like John Rawls, (...) have attempted to reconcile these conflicting ideas. His attempt has attracted a great deal of criticism, especially from those liberals attracted to a more cosmopolitan point of view. In this paper, we use Aristotelian virtue ethics as the basis upon which to reconcile liberalism and patriotism. We argue that the state should be understood as an agent that stands in a special relationship to its citizens (of philia). The state’s virtue depends, in part, on it giving those citizens preferential treatment with regard to justice compared to citizens of other countries. Similarly, if the citizen is to be just in her relations with her own state, she must behave in special ways towards that state as compared to other states. Certain forms of justice only arise in relationships of particular kinds. (shrink)

Edited by Ivette Fred-Rivera and Jessica Leech. What is the relationship between ontology and modality: between what there is, and what there could be, must be, or might have been? Throughout a distinguished career, Bob Hale’s work has addressed this question on a number of fronts, through the development of a Fregean approach to ontology, an essentialist theory of modality, and in his work on neo-logicism in the philosophy of mathematics. This collection of new essays engages with these themes (...) in Hale’s work in order to make further progress in our understanding of ontology, modality, and the relations between them. Some essays directly address questions in modal metaphysics, drawing on ontological concerns. Others raise questions in modal epistemology and its links to matters of ontology, such as the challenge to give an epistemology of essence. There are also several essays engaging with questions of what might be called ‘modal ontology’: the study of whether and what things exist necessarily or contingently. Such issues can be raised and addressed directly, but they also have an important bearing on the kinds of semantic commitments engendered in logic and mathematics, e.g., to the existence of sets, or numbers, or properties, and so on. It is thus explored in some chapters to what extent one’s ontology—and indeed, one’s ontology of necessary beings—interacts with other plausible assumptions and commitments. (shrink)