Although there is great concern about protecting those who participate in research, little if any concern has been expressed in the literature about protecting “decliners”—individuals who were invited to participate, but did not. However, there are several situations in which potential participants may experience negative consequences if they choose not to participate—for example, the prison setting, where the power imbalance is obvious and the history of research is not a positive one. We offer several options to protect decliners from possible (...) adverse consequences. (shrink)

A neurosurgical view of consciousness is presented. It is biased by our need to deal with coma. The concept of primary or neurosurgical consciousness is discussed, and the anatomy, physiology, pathology and clinical features described in a simple a way. It is suggested that the dynamic interaction between the reticular activating system and the cerebral cortex is the anatomic and physiologic basis for primary consciousness. It is emphasised that this in no way diminishes the role of the cortex in either (...) primary or higher-order consciousness. In essence, a presentation is made of the neurosurgical view of cortex-brainstem inter- relationships, and the importance of this interrelationship to consciousness. (shrink)