Based on self-reports of people with magnet implants, I investigate a pair of correlational questions: “How do technologically modified humans signify their new experience?” and “How do we, non-modified readers, become able to conceive it?”. In answering the first question I start with biosemiotics. It considers signs being embedded in the morphology of an organism. On the one side, a magnet becomes a part of a human morphology and bodily schema; on the other — unlike most living (...) organisms, humans can vary signs arbitrarily. I switch the theoretical exposition of the relation between signs, the human body, and technology to Merleau-Ponty’s phenomenology of perception, based on whose work Ihde conducted a phenomenological analysis of 4 regimes of technological mediations within the “I — World” correlation. His scheme was extended by Verbeek, who adds “cyborg relation” to the list. In the second part of the paper, I apply a vocabulary of material semiotics to the analysis of the “I/magnet” association. I separate quotes of MI-agents into several stages of existence of the association in question: emergence; interactions with constant magnets; interactions with electromagnetic devices; learning through others; actual non-expected associations; sense-formation; new risks of disruption of associations; normalization. I conclude with an attempt to answer 2nd initial question, about our (readers) conceivability by appealing to Barsalou’s “perceptual symbol systems” approach, with the help of which I correlate synesthesia of MI-agents and semiosis — which transforms the field of meaning for a non-modified person. (shrink)

ABSTRACT I argue that this examination and appreciation for the shift to abductive reasoning should be extended to the intersection of neuroscience and novel brain-computer interfaces too. This paper highlights the implications of applying abductive reasoning to personalized implantable neurotechnologies. Then, it explores whether abductive reasoning is sufficient to justify insurance coverage for devices absent widespread clinical trials, which are better applied to one-size-fits-all treatments. INTRODUCTION In contrast to the classic model of randomized-control trials, often with a large number of (...) subjects enrolled, precision medicine attempts to optimize therapeutic outcomes by focusing on the individual.[i] A recent publication highlights the strengths and weakness of both traditional evidence-based medicine and precision medicine.[ii] Plus, it outlines a tension in the shift from evidence-based medicine’s inductive reasoning style (the collection of data to postulate general theories) to precision medicine’s abductive reasoning style (the generation of an idea from the limited data available).[iii] The paper’s main example is the application of precision medicine for the treatment of cancer.[iv] I argue that this examination and appreciation for the shift to abductive reasoning should be extended to the intersection of neuroscience and novel brain-computer interfaces too. As the name suggests, brain-computer interfaces are a significant advancement in neurotechnology that directly connects someone’s brain to external or implanted devices.[v] Among the various kinds of brain-computer interfaces, adaptive deep brain stimulation devices require numerous personalized adjustments to their settings during the implantation and computation stages in order to provide adequate relief to patients with treatment-resistant disorders. What makes these devices unique is how adaptive deep brain stimulation integrates a sensory component to initiate the stimulation. While not commonly at the level of sophistication as self-supervising or generative large language models,[vi] they currently allow for a semi-autonomous form of neuromodulation. This paper highlights the implications of applying abductive reasoning to personalized implantable neurotechnologies. Then, it explores whether abductive reasoning is sufficient to justify insurance coverage for devices absent widespread clinical trials, which are better applied to one-size-fits-all treatments.[vii] ANALYSIS I. The State of Precision Medicine in Oncology and the Epistemological Shift While a thorough overview of precision medicine for the treatment of cancer is beyond the scope of this article, its practice can be roughly summarized as identifying clinically significant characteristics a patient possesses (e.g., genetic traits) to land on a specialized treatment option that, theoretically, should benefit the patient the most.[viii] However, in such a practice of stratification patients fall into smaller and smaller populations and the quality of evidence that can be applied to anyone outside these decreases in turn.[ix] As inductive logic helps to articulate, the greater the number of patients that respond to a particular therapy the higher the probability of its efficacy. By straying from this logical framework, precision medicine opens the treatment of cancer to more uncertainty about the validity of these approaches to the resulting disease subcategories.[x] Thus, while contemporary medical practices explicitly describe some treatments as “personalized”, they ought not be viewed as inherently better founded than other therapies.[xi] A relevant contemporary case of precision medicine out of Norway focuses on the care of a patient with cancer between the ventricles of the heart and esophagus, which had failed to respond to the standard regimen of therapies over four years.[xii] In a last-ditch effort, the patient elected to pay out-of-pocket for an experimental immunotherapy (nivolumab) at a private hospital. He experienced marked improvements and a reduction in the size of the tumor. Understandably, the patient tried to pursue further rounds of nivolumab at a public hospital. However, the hospital initially declined to pay for it given the “lack of evidence from randomised clinical trials for this drug relating to this [patient’s] condition.”[xiii] In rebuttal to this claim, the patient countered that he was actually similar to a subpopulation of patients who responded in “open‐label, single arm, phase 2 studies on another immune therapy drug” (pembrolizumab).[xiv] Given this interpretation of the prior studies and the patient’s response, further rounds of nivolumab were approved. Had the patient not had improvements in the tumor’s size following a round of nivolumab, then pembrolizumab’s prior empirical evidence in isolation would have been insufficient, inductively speaking, to justify his continued use of nivolumab.[xv] The case demonstrates a shift in reasoning from the traditional induction to abduction. The phenomenon of ‘cancer improvement’ is considered causally linked to nivolumab and its underlying physiological mechanisms.[xvi] However, “the weakness of abductions is that there may always be some other better, unknown explanation for an effect. The patient may for example belong to a special subgroup that spontaneously improves, or the change may be a placebo effect. This does not mean, however, that abductive inferences cannot be strong or reasonable, in the sense that they can make a conclusion probable.”[xvii] To demonstrate the limitations of relying on the abductive standard in isolation, commentators have pointed out that side effects in precision medicine are hard to rule out as being related to the initial intervention itself unless trends from a group of patients are taken into consideration.[xviii] As artificial intelligence (AI) assists the development of precision medicine for oncology, this uncertainty ought to be taken into consideration. The implementation of AI has been crucial to the development of precision medicine by providing a way to combine large patient datasets or a single patient with a large number of unique variables with machine learning to recommend matches based on statistics and probability of success upon which practitioners can base medical recommendations.[xix] The AI is usually not establishing a causal relationship[xx] – it is predicting. So, as AI bleeds into medical devices, like brain-computer interfaces, the same cautions about using abductive reasoning alone should be carried over. II. Responsive Neurostimulation, AI, and Personalized Medicine Like precision medicine in cancer treatment, computer-brain interface technology similarly focuses on the individual patient through personalized settings. In order to properly expose the intersection of AI, precision medicine, abductive reasoning, and implantable neurotechnologies, the descriptions of adaptive deep brain stimulation systems need to deepen.[xxi] As a broad summary of adaptive deep brain stimulation, to provide a patient with the therapeutic stimulation, a neural signal, typically referred to as a local field potential,[xxii] must first be detected and then interpreted by the device. The main adaptive deep brain stimulation device with premarket approval, the NeuroPace Responsive Neurostimulation system, is used to treat epilepsy by detecting and storing “programmer-defined phenomena.”[xxiii] Providers can optimize the detection settings of the device to align with the patient’s unique electrographic seizures as well as personalize the reacting stimulation’s parameters.[xxiv] The provider adjusts the technology based on trial and error. One day machine learning algorithms will be able to regularly aid this process in myriad ways, such as by identifying the specific stimulation settings a patient may respond to ahead of time based on their electrophysiological signatures.[xxv] Either way, with AI or programmers, adaptive neurostimulation technologies are individualized and therefore operate in line with precision medicine rather than standard treatments based on large clinical trials. Contemporary neurostimulation devices are not usually sophisticated enough to be prominent in AI discussions where the topics of neural networks, deep learning, generative models, and self-attention dominate the conversation. However, implantable high-density electrocorticography arrays (a much more sensitive version than adaptive deep brain stimulation systems use) have been used in combination with neural networks to help patients with neurologic deficits from a prior stroke “speak” through a virtual avatar.[xxvi] In some experimental situations, algorithms are optimizing stimulation parameters with increasing levels of independence.[xxvii] An example of neurostimulation that is analogous to the use of nivolumab in Norway surrounds a patient in the United States who was experiencing both treatment-resistant OCD and temporal lobe epilepsy.[xxviii]Given the refractory nature of her epilepsy, implantation of an adaptive deep brain stimulation system was indicated. As a form of experimental therapy, her treatment-resistant OCD was also indicated for the off-label use of an adaptive deep brain stimulation set-up. Another deep brain stimulation lead, other than the one implanted for epilepsy, was placed in the patient’s right nucleus accumbens and ventral pallidum region given the correlation these nuclei had with OCD symptoms in prior research. Following this, the patient underwent “1) ambulatory, patient-initiated magnet-swipe storage of data during moments of obsessive thoughts; (2) lab-based, naturalistic provocation of OCD-related distress (naturalistic provocation task); and (3) lab-based, VR [virtual reality] provocation of OCD-related distress (VR provocation task).”[xxix] Such signals were used to identify when to deliver the therapeutic stimulation in order to counter the OCD symptoms. Thankfully, following the procedure and calibration the patient exhibited marked improvements in their OCD symptoms and recently shared her results publicly.[xxx] In both cases, there is a similar level of abductive justification for the efficacy of the delivered therapy. In the case study in which the patient was treated with adaptive deep brain stimulation, they at least had their neural activity tested in various settings to determine the optimum parameters for treatment to avoid them being based on guesswork. Additionally, the adaptive deep brain stimulation lead was already placed before the calibration trials were conducted, meaning that the patient had already taken on the bulk of the procedural risk before the efficacy could be determined. Such an efficacy test could have been replicated in the first patient’s cancer treatment, had it been biopsied and tested against the remaining immunotherapies in vitro. Yet, in the case of cancer with few options, one previous dose of a drug that appeared to work on the patient may justify further doses. However, as the Norwegian case presents, corroboration with known responses to a similar drug (from a clinical trial) could be helpful to validate the treatment strategy. (It should be noted that both patients were resigned to these last resort options regardless of the efficacy of treatment.) There are some elements of inductive logic seen with adaptive deep brain stimulation research in general. For example, abductively the focus could be that patient X’s stimulation parameters are different from patient Y’s and patient Z’s. In contrast, when grouped as subjects who obtained personalized stimulation, patients X, Y, and Z demonstrate an inductive aspect to this approach’s safety and/or efficacy. The OCD case holds plenty of abductive characteristics in line with precision medicine’s approach to treating cancer and as more individuals try the method, there will be additional data. With the gradual integration of AI into brain-computer interfaces in the name of efficacy, this reliance on abduction will continue, if not grow, over time. Moving forward, if a responsive deep brain stimulation treatment is novel and individualized (like the dose of nivolumab) and there is some other suggestion of efficacy (like clinical similarities to other patients in the literature), then it may justify insurance coverage for the investigative intervention, absent other unrelated reasons to deny it. III. Ethical Implications and Next Steps While AI’s use in oncology and neurology is not yet as prominent as its use in other fields (e.g., radiology), it appears to be on the horizon for both.[xxxi] AI can be found in both the functioning of the neurotechnologies as well as the implementation of precision medicine. The increasing use of AI may serve to further individualize both oncologic and neurological therapies. Given these implications and the handful of publications cited in this article, it is important to have a nuanced evaluation of how these treatments, which heavily rely on abductive justification, ought to be managed. The just use an abductive approach may be difficult as AI infused precision medicine is further pursued. At baseline, such technology relies on a level of advanced technology literacy among the general public and could exclude populations who lack access to basic technological infrastructure or know-how from participation.[xxxii] Even among nations with adequate infrastructure, as more patients seek out implantable neurotechnologies, which require robust healthcare resources, the market will favor patient populations that can afford this complex care.[xxxiii] If patients already have the means to pay for an initial dose/use of a precision medicine product out of pocket, should insurance providers be required to cover subsequent treatments?[xxxiv] That is, if a first dose of a cancer drug or a deep brain stimulator over its initial battery life is successful, patients may feel justified in having the costs of further treatments covered. The Norwegian patient’s experience implies there is a precedent for the idea that some public insurance companies ought to cover successful cancer therapies, however, insurance companies may not all see themselves as obligated to cover neurotechnologies that rely on personalized settings or that are based on precision/abductive research more than on clinical trials. CONCLUSION The fact that the cases outlined above rely on abductive style of reasoning implies that there may not be as strong a justification for coverage by insurance, as they are both experimental and individualized, when compared to the more traditional large clinical trials in which groups have the same or a standardized protocol (settings/doses). If a study is examining the efficacy of a treatment with a large cohort of patients or with different experimental groups/phases, insurance companies may conclude that the resulting symptom improvements are more likely to be coming from the devices themselves. A preference for inductive justification may take priority when ruling in favor of funding someone’s continued use of an implantable neurostimulator. There are further nuances to this discussion surrounding the classifications of these interventions as research versus clinical care that warrant future exploration, since such a distinction is more of a scale[xxxv] than binary and could have significant impacts on the “right-to-try” approach to experimental therapies in the United States.[xxxvi] Namely, given the inherent limitations of conducting large cohort trials for deep brain stimulation interventions on patients with neuropsychiatric disorders, surgically innovative frameworks that blend abductive and inductive methodologies, like with sham stimulation phases, have traditionally been used.[xxxvii] Similarly, for adaptive brain-computer interface systems, if there are no large clinical trials and instead only publications that demonstrate that something similar worked for someone else, then, in addition to the evidence that the first treatment/dose worked for the patient in question, the balance of reasoning would be valid and arguably justify insurance coverage. As precision approaches to neurotechnology become more common, frameworks for evaluating efficacy will be crucial both for insurance coverage and for clinical decision making. ACKNOWLEDGEMENT This article was originally written as an assignment for Dr. Francis Shen’s “Bioethics & AI” course at Harvard’s Center for Bioethics. I would like to thank Dr. Shen for his comments as well as my colleagues in the Lázaro-Muñoz Lab for their feedback. - [i] Jonathan Kimmelman and Ian Tannock, “The Paradox of Precision Medicine,” Nature Reviews. Clinical Oncology 15, no. 6 (June 2018): 341–42, https://doi.org/10.1038/s41571-018-0016-0. [ii] Henrik Vogt and Bjørn Hofmann, “How Precision Medicine Changes Medical Epistemology: A Formative Case from Norway,” Journal of Evaluation in Clinical Practice 28, no. 6 (December 2022): 1205–12, https://doi.org/10.1111/jep.13649. [iii] David Barrett and Ahtisham Younas, “Induction, Deduction and Abduction,” Evidence-Based Nursing 27, no. 1 (January 1, 2024): 6–7, https://doi.org/10.1136/ebnurs-2023-103873. [iv] Vogt and Hofmann, “How Precision Medicine Changes Medical Epistemology,” 1208. [v] Wireko Andrew Awuah et al., “Bridging Minds and Machines: The Recent Advances of Brain-Computer Interfaces in Neurological and Neurosurgical Applications,” World Neurosurgery, May 22, 2024, S1878-8750(24)00867-2, https://doi.org/10.1016/j.wneu.2024.05.104. [vi] Mark Riedl, “A Very Gentle Introduction to Large Language Models without the Hype,” Medium (blog), May 25, 2023, https://mark-riedl.medium.com/a-very-gentle-introduction-to-large-language-models-without-the-hype-5 f67941fa59e. [vii] David E. Burdette and Barbara E. Swartz, “Chapter 4 - Responsive Neurostimulation,” in Neurostimulation for Epilepsy, ed. Vikram R. Rao (Academic Press, 2023), 97–132, https://doi.org/10.1016/B978-0-323-91702-5.00002-5. [viii] Kimmelman and Tannock, 2018. [ix] Kimmelman and Tannock, 2018. [x] Simon Lohse, “Mapping Uncertainty in Precision Medicine: A Systematic Scoping Review,” Journal of Evaluation in Clinical Practice 29, no. 3 (April 2023): 554–64, https://doi.org/10.1111/jep.13789. [xi] Kimmelman and Tannock, “The Paradox of Precision Medicine.” [xii] Vogt and Hofmann, 1206. [xiii] Vogt and Hofmann, 1206. [xiv] Vogt and Hofmann, 1206. [xv] Vogt and Hofmann, 1207. [xvi] Vogt and Hofmann, 1207. [xvii] Vogt and Hofmann, 1207. [xviii] Vogt and Hofmann, 1210. [xix] Mehar Sahu et al., “Chapter Three - Artificial Intelligence and Machine Learning in Precision Medicine: A Paradigm Shift in Big Data Analysis,” in Progress in Molecular Biology and Translational Science, ed. David B. Teplow, vol. 190, 1 vols., Precision Medicine (Academic Press, 2022), 57–100, https://doi.org/10.1016/bs.pmbts.2022.03.002. [xx] Stefan Feuerriegel et al., “Causal Machine Learning for Predicting Treatment Outcomes,” Nature Medicine 30, no. 4 (April 2024): 958–68, https://doi.org/10.1038/s41591-024-02902-1. [xxi] Sunderland Baker et al., “Ethical Considerations in Closed Loop Deep Brain Stimulation,” Deep Brain Stimulation 3 (October 1, 2023): 8–15, https://doi.org/10.1016/j.jdbs.2023.11.001. [xxii] David Haslacher et al., “AI for Brain-Computer Interfaces,” 2024, 7, https://doi.org/10.1016/bs.dnb.2024.02.003. [xxiii] Burdette and Swartz, “Chapter 4 - Responsive Neurostimulation,” 103–4; “Premarket Approval (PMA),” https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpma/pma.cfm?id=P100026. [xxiv] Burdette and Swartz, “Chapter 4 - Responsive Neurostimulation,” 104. [xxv] Burdette and Swartz, 126. [xxvi] Sean L. Metzger et al., “A High-Performance Neuroprosthesis for Speech Decoding and Avatar Control,” Nature 620, no. 7976 (August 2023): 1037–46, https://doi.org/10.1038/s41586-023-06443-4. [xxvii] Hao Fang and Yuxiao Yang, “Predictive Neuromodulation of Cingulo-Frontal Neural Dynamics in Major Depressive Disorder Using a Brain-Computer Interface System: A Simulation Study,” Frontiers in Computational Neuroscience 17 (March 6, 2023), https://doi.org/10.3389/fncom.2023.1119685; Mahsa Malekmohammadi et al., “Kinematic Adaptive Deep Brain Stimulation for Resting Tremor in Parkinson’s Disease,” Movement Disorders 31, no. 3 (2016): 426–28, https://doi.org/10.1002/mds.26482. [xxviii] Young-Hoon Nho et al., “Responsive Deep Brain Stimulation Guided by Ventral Striatal Electrophysiology of Obsession Durably Ameliorates Compulsion,” Neuron 0, no. 0 (October 20, 2023), https://doi.org/10.1016/j.neuron.2023.09.034. [xxix] Nho et al. [xxx] Nho et al.; Erik Robinson, “Brain Implant at OHSU Successfully Controls Both Seizures and OCD,” OHSU News, accessed March 3, 2024, https://news.ohsu.edu/2023/10/25/brain-implant-at-ohsu-successfully-controls-both-seizures-and-ocd. [xxxi] Awuah et al., “Bridging Minds and Machines”; Haslacher et al., “AI for Brain-Computer Interfaces.” [xxxii] Awuah et al., “Bridging Minds and Machines.” [xxxiii] Sara Green, Barbara Prainsack, and Maya Sabatello, “The Roots of (in)Equity in Precision Medicine: Gaps in the Discourse,” Personalized Medicine 21, no. 1 (January 2024): 5–9, https://doi.org/10.2217/pme-2023-0097. [xxxiv] Green, Prainsack, and Sabatello, 7. [xxxv] Robyn Bluhm and Kirstin Borgerson, “An Epistemic Argument for Research-Practice Integration in Medicine,” The Journal of Medicine and Philosophy: A Forum for Bioethics and Philosophy of Medicine 43, no. 4 (July 9, 2018): 469–84, https://doi.org/10.1093/jmp/jhy009. [xxxvi] Vijay Mahant, “‘Right-to-Try’ Experimental Drugs: An Overview,” Journal of Translational Medicine 18 (June 23, 2020): 253, https://doi.org/10.1186/s12967-020-02427-4. [xxxvii] Michael S. Okun et al., “Deep Brain Stimulation in the Internal Capsule and Nucleus Accumbens Region: Responses Observed during Active and Sham Programming,” Journal of Neurology, Neurosurgery & Psychiatry 78, no. 3 (March 1, 2007): 310–14, https://doi.org/10.1136/jnnp.2006.095315. (shrink)

In this paper we consider the creative realisation of new beings — namely, cyborgs. These can be brought about in a number of ways, and several versions are discussed. A key feature is merging biological and technological sections into an overall living operational whole. A practical look is taken at how the use of implant and electrode technology can be employed to open up new paths between humans/animals and technology, especially linking the brain directly with external entities. Actual experimentation in (...) each of the different cyborg forms perhaps defines the paper’s contents more than anything else. Considered are RFID implants, magnet implants, deep brain stimulation, Braingate implants and growing biological brains in robot bodies. (shrink)

As cognitive neuroscience has advanced, the list of prospective internal, biological enhancements has steadily expanded. Education and training, as well as the use of external information‐processing devices, may be labeled as “conventional” means of cognition enhancement (CE). They are often well established and culturally accepted. By contrast, methods of enhancing cognition through “unconventional” means, such as ones involving deliberately created nootropic drugs, gene therapy, or neural implants, are nearly all to be regarded as experimental at the present time. Transcranial (...) magnetic stimulation (TMS), genetic interventions, brain‐computer interfaces and new senses are highly experimental and unlikely to be important over the next 15 years. Many of the concerns about enhancement are nonspecific to the tools used to achieve it, which means that enhancement–ethic scrutiny should also apply to nonbiological external enhancements. (shrink)

Implanting deep brain stimulation (DBS) electrodes in patients with Parkinson’s disease often results in the appearance of a non-infectious, delayed-onset edema that disappears over time. However, the time window between the DBS electrode and DBS stimulating device implant is often used to record local field potentials (LFPs) which are used both to better understand basal ganglia pathophysiology and to improve DBS therapy. In this work, we investigated whether the presence of post-surgery edema correlates with the quality of LFP recordings in (...) eight patients with advanced Parkinson’s disease implanted with subthalamic DBS electrodes. The magnetic resonance scans of the brain after 8.5 ± 1.5 days from the implantation surgery were segmented and the peri-electrode edema volume was calculated for both brain hemispheres. We found a correlation (ρ = −0.81, p < 0.0218, Spearman’s correlation coefficient) between left side local field potentials of the low beta band (11–20 Hz) and the edema volume of the same side. No other significant differences between the hemispheres were found. Despite the limited sample size, our results suggest that the effect on LFPs may be related to the edema localization, thus indicating a mechanism involving brain networks instead of a simple change in the electrode-tissue interface. (shrink)

This article contributes to Science and Technology Studies on vulnerability by putting cyborgs at center stage. What vulnerabilities emerge when technologies move under the skin? I argue that cyborgs face new forms of vulnerability because they have to live with a continuous, inextricable intertwinement of technologies and their bodies. Inspired by recent feminist studies on the lived intimate relationships between bodies and technologies, I suggest that sensory experiences, material practices, and cartographies of power are important heuristic tools to understand the (...) vulnerabilities of hybrid bodies. Based on an analysis of how patients in the Netherlands and the United States cope with appropriate and inappropriate implantable cardioverter defibrillator shocks, I describe how defibrillators introduce two new kinds of vulnerabilities: vulnerability as an internal rather than an external threat, and as harm you may try to anticipate but can never escape. Despite these vulnerabilities, some heart patients don’t position themselves as passive victims of faulty machines. They actively engage in material practices of resilience by using magnets to stop inappropriate shocks. I conclude that anticipating and taming the improper working of technologies inside bodies constitutes a new form of invisible labor that is crucial to diminishing the existential uncertainties of cyborgs. (shrink)

Psychiatric electroceutical interventions (PEIs) use electrical or magnetic stimulation to treat psychiatric conditions. For depression therapy, PEIs include both approved treatment modalities, such as electroconvulsive therapy (ECT) and repetitive transcranial magnetic stimulation (rTMS), and experimental neurotechnologies, such as deep brain stimulation (DBS) and adaptive brain implants (ABIs). We present results from a survey-based experiment in which members of four relevant stakeholder groups (psychiatrists, patients with depression, caregivers of adults with depression, and the general public) assessed whether treatment with one (...) of four PEIs (ECT, rTMS, DBS, or ABIs) was better or worse than living with treatment-resistant depression (TRD) and then provided a narrative explanation for their assessment. Overall, the prevalence of many narrative themes differed substantially by stakeholder group—with psychiatrists typically offering different reasons for their assessment than non-clinicians—but much less so by PEI modality. A large majority of all participants viewed their assigned PEI as better than living with TRD, with their reasons being a mix of positive views about the treatment and negative views about TRD. The minority of all participants who viewed their assigned PEI as worse than living with TRD tended to express negative affect toward it as well as emphasize its riskiness, negative side effects, and, to a lesser extent, its invasiveness. The richness of these narrative explanations enabled us to put in context and add depth to key patterns seen in recent survey-based research on PEIs. (shrink)

Wireless ad hoc communication on the nanoscale will require thinking outside of the traditional radio spectrum. New applications will utilize new forms of wireless communication channels. For example, nanoscale communication will enable precise mechanisms for directly interacting with cells in vivo. Information may be sent to and from specific cells within the body, allowing detection and healing of diseases on the cellular scale. From a medical standpoint, the use of current wireless techniques to communicate with implants is unacceptable for (...) many reasons, including bulky size, inability to use magnetic resonance imaging after implantation, potential radiation damage, surgical invasiveness, need to recharge/replace power, post-operative pain and long recovery times, and reduced quality of life for the patient. Better, more humane in vivo implant communication is needed. Development of both biological and engineered nanomachines is progressing; such machines will need to communicate [1]. Unfortunately, networking vast collections of nanoscale sensors and robots using current techniques, including wireless techniques, is not possible without communication mechanisms that exceed nanoscale volumes. (shrink)

The possibility of enhancing human abilities often raises public concern about equality and social impact. This chapter aims at one particular group of technologies, cognitive enhancement, and one particular fear, that enhancement will create social divisions and possibly expanding inequalities. The chapter argues that cognitive enhancements could offer significant social and economic benefits. The basic forms of internal cognitive enhancement technologies foreseen today are pharmacological modifications, genetic interventions, transcranial magnetic stimulation, and neural implants. Cognitive enhancements can influence the economy (...) through reduction of losses, individual economic benefits, and society‐wide benefits. The strongest objection to the introduction of any enhancement technology is that it will create inequality, injustice, and unfairness. While there are clear economic and social benefits to cognitive enhancement, there exist anumber of obstacles to its development and use. One obstacle is the present system for licensing drugs and medical treatments. (shrink)

Subthalamic nucleus deep brain stimulation is an established therapy for Parkinson’s disease motor symptoms. The ideal site for implantation within STN, however, remains controversial. While many argue that placement of a DBS lead within the sensorimotor territory of the STN yields better motor outcomes, others report similar effects with leads placed in the associative or motor territory of the STN, while still others assert that placing a DBS lead “anywhere within a 6-mm-diameter cylinder centered at the presumed middle of the (...) STN produces similar clinical efficacy.” These discrepancies likely result from methodological differences including targeting preferences, imaging acquisition and the use of brain atlases that do not account for patient-specific anatomic variability. We present a first-in-kind within-patient demonstration of severe mood side effects and minimal motor improvement in a Parkinson’s disease patient following placement of a DBS lead in the limbic/associative territory of the STN who experienced marked improvement in motor benefit and resolution of mood side effects following repositioning the lead within the STN sensorimotor territory. 7 Tesla magnetic resonance imaging data were used to generate a patient-specific anatomical model of the STN with parcellation into distinct functional territories and computational modeling to assess the relative degree of activation of motor, associative and limbic territories. (shrink)

Face recognition is impaired in patients with prosopagnosia, which may occur as a side effect of neurosurgical procedures. Face selective regions on the ventral temporal cortex have been localized with electrical cortical stimulation, electrocorticography, and functional magnetic resonance imagining. This is the first group study using within-patient comparisons to validate face selective regions mapping, utilizing the aforementioned modalities. Five patients underwent surgical treatment of intractable epilepsy and joined the study. Subdural grid electrodes were implanted on their ventral temporal cortices to (...) localize seizure foci and face selective regions as part of the functional mapping protocol. Face selective regions were identified in all patients with fMRI, four patients with ECoG, and two patients with ECS. From 177 tested electrode locations in the region of interest, which is defined by the fusiform gyrus and the inferior temporal gyrus, 54 face locations were identified by at least one modality in all patients. fMRI mapping showed the highest detection rate, revealing 70.4% for face selective locations, whereas ECoG and ECS identified 64.8 and 31.5%, respectively. Thus, 28 face locations were co-localized by at least two modalities, with detection rates of 89.3% for fMRI, 85.7% for ECoG and 53.6 % for ECS. All five patients had no face recognition deficits after surgery, even though five of the face selective locations, one obtained by ECoG and the other four by fMRI, were within 10 mm to the resected volumes. Moreover, fMRI included a quite large volume artifact on the ventral temporal cortex in the ROI from the anatomical structures of the temporal base. In conclusion, ECS was not sensitive in several patients, whereas ECoG and fMRI even showed activation within 10 mm to the resected volumes. Considering the potential signal drop-out in fMRI makes ECoG the most reliable tool to identify face selective locations in this study. A multimodal approach can improve the specificity of ECoG and fMRI, while simultaneously minimizing the number of required ECS sessions. Hence, all modalities should be considered in a clinical mapping protocol entailing combined results of co-localized face selective locations. (shrink)

Background Psychiatric electroceutical interventions (PEIs) use electrical or magnetic stimulation to treat mental disorders and may raise different ethical concerns than other therapies such as medications or talk therapy. Yet little is known about stakeholders’ perceptions of, and ethical concerns related to, these interventions. We aimed to better understand the ethical concerns of a variety of stakeholder groups (patients with depression, caregivers of patients, members of the public, and psychiatrists) regarding four PEIs: electroconvulsive therapy (ECT), repetitive transcranial magnetic stimulation (rTMS), (...) deep brain stimulation (DBS), and adaptive brain implants (ABI). Methods We conducted a national survey of these four stakeholder groups, using an embedded video vignette experiment depicting a patient with treatment-resistant depression and her psychiatrist discussing the possibility of treatment with one of the four PEIs. Results Participants’ ethical concerns varied by stakeholder group, by PEI, and by the interaction of the two. The three non-clinician groups tended to have similar ethical concerns, but to differ from psychiatrists. Similar concerns were raised with regard to the two implantable technologies, DBS and ABI. Overall, there was relatively little concern about the involuntary use of PEIs, though some expressed concern about the adequacy of information provided during the consent process. There was also significant concern that patients may not receive helpful therapies. Conclusions To our knowledge, this is the first national survey that includes multiple stakeholder groups and multiple PEI modalities. A better understanding of the ethical concerns of stakeholders can help to shape clinical practice and health care policy regarding PEIs. (shrink)

Transcutaneous auricular vagus nerve stimulation, a non-invasive alternative to vagus nerve stimulation with implantable devices, has shown promise in treating disorders such as depression, migraine, and insomnia. Studies of these disorders with resting-state functional magnetic resonance imaging have found sustained changes in resting-state functional connectivity in patients treated with low frequency taVNS. A recent study has reported reductions in pain scores in patients with rheumatoid arthritis after a 12-week treatment of high-frequency sub-threshold taVNS. However, no studies to date have examined (...) the effects of high-frequency sub-threshold taVNS on rsFC. The objective of this study was to determine whether high-frequency sub-threshold taVNS induces changes in rsFC using seed regions from the cingulate cortex and insula, brain regions that play a key role in interoception and processing of pain. With a single-blind placebo-controlled repeated measures experimental design, rsfMRI scans were acquired before and after 15 min of either sub-threshold taVNS treatment or a sham control. Significant taVNS-related changes in functional connections to the cingulate cortex were detected between the anterior cingulate cortex and right superior temporal gyrus and between the midcingulate cortex and right inferior parietal lobule. In addition, significant changes in functional connections to the insula were detected between the posterior insula and right precuneus and between the anterior insula and right cuneus gyrus. These results suggest that high-frequency sub-threshold taVNS can lead to sustained effects on the rsFC of brain regions involved in interoception and processing of pain in a cohort of healthy subjects. This study lays the foundation for future rsfMRI studies of high-frequency sub-threshold taVNS in clinical populations. (shrink)

This book begins well. Blank first gives, for the benefit of lay readers and those unfamiliar with the area of neuroscience, a brief but informative description of the structure and workings of the brain itself. He then goes on to offer an overview of the current state of brain intervention ranging from direct brain intervention (electroconvulsive therapy, electronic and magnetic stimulation, psychosurgery and neural implants), psychotropic drugs, the use of virtual reality, nootropics and neurogenetics. Blank offers a concise summary (...) and evaluation of each of these methods, outlining both potential benefits and risks. He makes the important point that most of these methods, however, do not present a cure, but rather are aimed at altering behaviour, raising the important question as the ethics of behavioural control for social convenience – particularly in relation to the vulnerable, such as the management of children with ADHD.Blank then offers a well-researched and balanced overview .. (shrink)

Enhancing brain activity and function is a very ancient practice which is usually accomplished by taking illegal drugs. Prescription medication is becoming more commonly used as a means of enhancing mood, and recently, it has become possible to modulate mood by applying magnetic or electrical current to the brain or by training the brain to work at predetermined oscillations. A summary of the available neuromodulation techniques will be presented associated with data from human subjects implanted with cortical and/or subcutaneous electrodes (...) that demonstrate the potential for electrical neuro-enhancement. (shrink)

En el presente artículo abordamos la confrontación que ciertos autores pertenecientes al llamado marxismo occidental mantuvieron con la concepción de la vida cotidiana de “término medio” (Durchschnittlichkeit) de "Ser y tiempo" (1927). Nos centramos principalmente en la obra del filósofo checo Karel Kosík (1926-2003), quien, a lo largo de su trayectoria intelectual, llevó a cabo una recepción crítica de la analítica existencial heideggeriana, así como también en los aspectos divergentes y convergentes entre la concepción de la cotidianidad de Martin Heidegger (...) y de György Lukács. En la última sección, se apuntan las posibles sendas de encuentro para un develamiento fenomenológico-marxista de la “verdad” de la cotidianidad. (shrink)

El presente artículo pretende dilucidar los motivos fundamentales de la recepción de F. W. J. Schelling en los jóvenes hegelianos (I), el marxismo (II) y la Teoría Crítica (III) estableciendo ciertos paralelismos y divergencias respecto al modo en que fue acogida su obra en el seno de estas tres tradiciones. En el primer apartado se toma en consideración el alcance de este influjo en la obra de L. Feuerbach, así como en algunos escritos de juventud de F. Engels. A continuación, (...) se examinan los aspectos centrales de su recepción en G. Lukács y, en menor medida, en la obra de otros autores como E. Bloch o E. Dussel. Por último, vienen a apuntarse las temáticas principales de esa recepción en la Teoría Crítica, especialmente allí donde es más pronunciada, en los casos de H. Marcuse, J. Habermas y Th. W. Adorno. (shrink)

En el primer apartado del artículo nos ocupamos de la relación que Karl Korsch mantuvo con el Instituto de Investigación Social y con sus figuras más representativas, desde sus primeros años de funcionamiento en Frankfurt hasta el exilio en los Estados Unidos (1). En la segunda parte se lleva a cabo un contraste entre lo que Korsch y la primera Teoría Crítica entendían por ‘realización de la filosofía’ (2). Se añade un apéndice estructurado en tres temáticas suplementarias: la recepción del (...) positivismo en la obra de Korsch (a), su vinculación con el leninismo (b) y sus críticas a la ‘teoría del colapso’ (Zusammenbruchstheorie) (c). (shrink)

El influjo de temáticas heideggerianas en la obra tardía de H. Marcuse, todavía implícito en 'Eros y civilización' (1955) ante al peso determinante del psicoanálisis freudiano (1), reaparece de modo explícito en 'El hombre unidimensional' (1964). Ello acontece en dos planos mutuamente interdependientes: el análisis de la reificación en las sociedades unidimensionales de posguerra (2) y la crítica de la racionalidad tecnológica (4). Algunas debilidades conceptuales de ambas obras, derivadas en gran parte de esta recepción de Heidegger, ya fueron subrayadas (...) en su momento por autores pertenecientes a la llamada izquierda husserliana (P. A. Rovatti y P. Piccone, etc.) (3). (shrink)

La crítica de Horkheimer al empirismo lógico del Círculo de Viena en su ensayo “El último ataque a la metafísica” (1937) motivó la respuesta de Neurath, principal blanco de las críticas, con la redacción del texto “Ciencia unificada y empirismo lógico: una réplica” (1937). En el presente artículo nos ocupamos de dilucidar el contexto de la polémica entre la Teoría Crítica y el empirismo lógico. Tomamos como eje argumental de nuestra exposición el conjunto de temáticas sobre las que Horkheimer fundamentó (...) sus críticas, así como las distintas respuestas que ofreció Neurath ante tales invectivas. Asimismo, se muestran los paralelismos existentes que vinculan esta primera polémica con la “disputa sobre el positivismo” (Positivismusstreit). (shrink)

El fermento psicológico del fascismo en las sociedades capitalistas tardías aparece vinculado al proceso de debilitamiento del yo y al necesario entrelazamiento de las disposiciones subjetivas con factores situacionales. Desentrañar los mecanismos que inciden en la expansión del carácter potencialmente fascista requiere de un análisis de las tendencias de la personalidad que favorecen su arraigo y cómo se ven fomentadas por determinados procesos sociales. El presente artículo se centra en el influjo y la interacción de tres factores objetivos y tres (...) factores subjetivos. Para ello nos apoyamos principalmente en los estudios sobre la propaganda fascista y la cultura de masas llevados a cabo por los autores de la primera Teoría Crítica. (shrink)

El presente artículo aborda la recepción de los 'Manuscritos de economía y filosofía' (1844) de K. Marx en la obra de H. Marcuse. En sus ensayos «Nuevas fuentes para la fundamentación del materialismo histórico» (1932) y «Sobre los fundamentos filosóficos del concepto científico-económico de trabajo» (1933), Marcuse empieza a tomar distancia respecto de su anterior pretensión de hallar un soporte ontológico para el materialismo histórico recurriendo exclusivamente a la fenomenología existencial de Heidegger. A partir de la primera publicación de los (...) 'Manuscritos de economía y filosofía' en 1932, el autor berlinés buscará fundamentar ontológicamente el materialismo histórico con el recurso a la obra juvenil de Marx. (shrink)

El artículo aborda el itinerario biográfico e intelectual del primer Marcuse con el trasfondo del influjo de la Lebensphilosophie diltheyana, la analítica ontológica del Dasein y la hermenéutica de la facticidad heideggerianas en su pensamiento. Hasta su entrada en el Institut für Sozialforschung en 1932, la obra de Marcuse aspira a combinar la ontología fundamental de la historicidad con una antropología filosófica de inspiración marxiana. Sin embargo, Marcuse va a ir abandonando progresivamente cualquier pretensión de fundamentar ontológicamente el materialismo histórico (...) y se orientará hacia el desarrollo de una teoría dialéctica de la sociedad ónticamente situada. (shrink)

La crítica de Horkheimer al empirismo lógico del Círculo de Viena en su ensayo “El último ataque a la metafísica” (1937) motivó la respuesta de Neurath, principal blanco de las críticas, con la redacción del texto “Ciencia unificada y empirismo lógico: una réplica” (1937). En el presente artículo nos ocupamos de dilucidar el contexto de la polémica entre la Teoría Crítica y el empirismo lógico. Tomamos como eje argumental de nuestra exposición el conjunto de temáticas sobre las que Horkheimer fundamentó (...) sus críticas, así como las distintas respuestas que ofreció Neurath ante tales invectivas. Asimismo, se muestran los paralelismos existentes que vinculan esta primera polémica con la “disputa sobre el positivismo” (Positivismusstreit). (shrink)

Coincidiendo con su entrada como miembro del equipo de trabajo del Institut für Sozialforschung, Herbert Marcuse comienza a desarrollar una teoría materialista de la sociedad alejada del heideggerianismo de su juventud. Durante el período comprendido entre 1933 y 1936, el autor berlinés escribe una serie de artículos cuestionando la deriva política de la filosofía existencial en Alemania. En ellos se confronta con las versiones vulgarizadas de la Lebensphilosophie y de la fenomenología -encabezadas por Heidegger- que proveyeron una suerte de fundamentación (...) filosófica a la “concepción del mundo” (Weltanschauung) del realismo heroico y a las políticas socio-económicas del Estado total-autoritario. (shrink)

Im besonderen philosophischen Kontext des Zwischenkriegsdeutschlands entwickelte der junge Marcuse eine originelle Rezeption in marxistischer Perspektive der existenziellen Phänomenologie und der Lebensphilosophie (I). In seinen ersten Aufsätzen »Beiträge zu einer Phänomenologie des Historischen Materialismus« (1928) und »Über konkrete Philosophie« (1929) orientierte sich diese Rezeption am Projekt der Erarbeitung einer dialektischen Phänomenologie und in Verbindung damit an dem Versuch, die radikale Tat auf den ontologischen Begriff der Geschichtlichkeit zu gründen, ohne eine materielle Komponente zu vernachlässigen (II, III, IV). In der Auseinandersetzung (...) mit dem fundamentalontologisch anmutenden ›Verfall‹ des Daseins entwarf Marcuse überdies die Grundlagen seiner konkreten Philosophie der Praxis (V). (shrink)

Partiendo de un análisis introductorio en torno a las diversas interpretaciones del concepto de historicidad (Geschichtlichkeit) en las obras de W. Dilthey, P. Yorck von Wartenburg y M. Heidegger, se considera seguidamente el modo como esta polémica fue recepcionada por el joven H. Marcuse (1). En discusión con la sociología alemana de su época (K. Mannheim, S. Landshut, H. Freyer), Marcuse pretende continuar el proyecto de inclusión de la historicidad en las ciencias del espíritu iniciado por Dilthey con una orientación (...) ontológica procedente de Heidegger (2). Si primero interpreta a G. W. F. Hegel desde parámetros próximos a la filosofía de la vida (Dilthey) y a la ontología fundamental (Heidegger), a medida que se acerca a la obra de K. Marx el enfoque ontológico y vitalista deja paso a una aproximación materialista, donde conceptos como razón, mediación, libertad y actualidad adquieren un papel preponderante (3). (shrink)

El filósofo checo Karel Kosík (1926-2003) desempeñó un rol prominente en el seno del movimiento de oposición a los regímenes de Novotný y Husák, contribuyendo tanto a la gestación como a la pervivencia de los anhelos expresados por la población checoslovaca durante la Primavera de Praga. Junto a la contextualización histórica de su obra, se pone también de manifiesto cómo Marx y Heidegger incidieron con igual relevancia en la conformación de su pensamiento. La filosofía de Kosík reviste por ello una (...) singularidad propia que la aleja de las versiones tradicionales del humanismo marxista predominantes a mediados del siglo pasado en el bloque oriental y occidental. (shrink)

El concepto de “maquinación” (Machenschaft) ocupa un lugar central en la obra de Heidegger durante el período comprendido entre 1936 y 1940. En su análisis de la esencia de la época moderna, el filósofo checo de orientación marxista Karel Kosík se apropia de importantes elementos conceptuales procedentes de esta etapa del pensamiento de Heidegger. En concreto, emplea nociones análogas a la de “maquinación”, como “sistema de manipulabilidad”. Ponemos de relieve las semejanzas y puntos de fricción en la descripción de la (...) esencia de la época moderna de ambos pensadores, así como sus respectivas propuestas para poner coto a la primacía técnica y al pensamiento calculador y las resonancias políticas derivadas de sus análisis. (shrink)

El afán de hallar un soporte antropológico u ontológico fundamental capaz de otorgar validez normativa a la crítica de la sociedad devino un recurso filosófico habitual en las contribuciones teóricas de numerosos autores a lo largo de los siglos XIX y XX. En contraste con la crítica inmanente, que se esfuerza por localizar en la propia realidad social los parámetros normativos y las posibilidades históricas para la crítica y la transformación de esa misma realidad, la crítica antropológica tomaba como criterio (...) para la crítica y la transformación social la remisión a parámetros normativos externos, en concreto la referencia a un concepto de esencia o naturaleza humana ubicado en un nivel ontológico o antropológico fundamental. La facticidad histórica del capitalismo se cuestionaba porque invertía la esencia genérica (Gattungswesen) del ser humano, o bien porque obstaculizaba su adecuada plasmación en el plano óntico de la realidad. Se trataba, en definitiva, de crear las condiciones oportunas para una apropiación por parte del ser humano de su propia naturaleza, de su verdadera esencia. (shrink)

El filósofo checo Karel Kosík (1926-2003) llevó a cabo en su obra una recepción crítica del pensamiento de Martin Heidegger. En determinados capítulos de "Dialéctica de lo concreto" (1963), así como en otros ensayos tardíos, elaboró una crítica de la analítica existencial heideggeriana, principalmente a la concepción de la estructura del ser del Dasein como “preocupación” o “cuidado” (Sorge). Nos ocupamos aquí de dilucidar el sentido y el alcance de esta crítica a "Ser y tiempo" (1927).

La interpretación de la dialéctica hegeliana que el joven Marcuse lleva a cabo en sus escritos tempranos «Sobre el problema de la dialéctica I y II» (1930-1931) y «Ontología de Hegel y teoría de la historicidad» (1932) contrarresta las críticas de Heidegger a la dialéctica de Hegel. La lectura de ambos autores también diverge en su comprensión acerca del estatuto y el alcance del fenómeno de la temporalidad en la filosofía hegeliana. Sin embargo, cuando dilucida el concepto de historicidad (Geschichtlichkeit) (...) en Hegel, Marcuse advierte la tensión existente en su sistema entre el concepto ontológico de «vida» y la idea del «saber absoluto». A partir de su entrada en el Institut für Sozialforschung, el autor berlinés abandonará la tematización del concepto de historicidad —tarea que había ocupado un lugar central en sus primeros escritos— por considerar que dicho concepto, demasiado distorsionado por la tradición ontológico-existencial, es inconciliable con la dialéctica materialista. (shrink)

Loneliness is intimately related to the ongoing epidemics of systemic forms of oppression, including white supremacy, capitalism, heteropatriarchy and settler colonialism. The epidemic of loneliness has only intensified and grown during the isolation engendered by the COVID-19 pandemic. In this article, we aim to think about how children's picturebooks wrestle with explaining loneliness and its antidotes and how these picturebooks are themselves manifestations of ongoing conversations related to Emotional Justice. We conclude by reviewing a number of children's books in order (...) to think about how the picturebook might itself be an artifact that helps to fight feelings of loneliness as well as teaching children and adults alike about the importance of connection. (shrink)

En el particular contexto filosófico de la Alemania de entreguerras, el joven H. Marcuse llevó a cabo una original recepción en clave marxista de la fenomenología existencial y de la Lebensphilosophie (I). En sus primeros artículos, «Contribuciones a una fenomenología del materialismo histórico» (1928) y «Sobre filosofía concreta» (1929), esa recepción se orientó al proyecto de elaboración de una fenomenología dialéctica y, vinculado con ello, al intento de fundamentar la acción radical en el concepto ontológico de historicidad (Geschichtlichkeit) sin descuidar (...) su componente material (II, III, IV). Asimismo, en la situación de caída (Verfallen) del Dasein, Marcuse va a otorgar una misión primordial a la filosofía concreta (V). (shrink)

Writing about loneliness has been a struggle in the midst of the pandemic. Characterized by loneliness, isolation, anxiety, and fear, the COVID-19 pandemic is an exceptionally challenging time. At various points while navigating this loneliness project amid a particularly lonely time, we lamented the seeming futility of it all. A main goal of developing a Feminist Loneliness Studies in this introduction is to understand the ways that systems of oppression – white supremacy, settler colonialism, anti-queer bias, misogyny, neoliberal capitalism, and (...) so on – create our lonely world. To date, there remains no comprehensive feminist analysis of the structural conditions that both produce and intensify experiences of loneliness. We aim to remedy this gap. That is, we seek to address what a Feminist Loneliness Studies can contribute to understanding the complexities of this complicated emotion. For example, what is the unique loneliness of the feminist killjoy who calls out, or calls in, existing forms of queerphobia, racism, and sexism? What does it mean to be a politicized person and how does that result in both alienation and isolation? What might the relationship be between white supremacy and loneliness? How is loneliness both individual and systemic, and what is the relationship between the two? What distinctive forms of loneliness are created by ableism, sanism, neoliberalism, capitalism, globalization, and the gig economy? Ought loneliness be avoided at all costs? What are the ethics of loneliness? In our introduction to this special issue, we unpack and theorize the potential perils and generative possibilities offered up by this profound emotion. Establishing a Feminist Loneliness Studies provides us with the space we need to begin addressing and comprehending loneliness. (shrink)

Con la obra de los jóvenes hegelianos (Junghegelianer) concluye el período clásico de la filosofía alemana. Bruno Bauer (1809-1882) fue uno de sus máximos exponentes, considerado en muchos aspectos como mentor del movimiento. En el primer apartado del presente artículo, se contextualiza la figura de Bauer en el trasfondo de las disputas generadas en el seno de la escuela hegeliana. A continuación, se analizan con mayor detenimiento dos nociones centrales en su pensamiento, especialmente durante el período comprendido entre 1829 y (...) 1848: su dialéctica de la autoconciencia infinita (unendlichen Selbstbewußtsein) y la forma adoptada por su crítica pura. (shrink)

: Because I reject the notion that physical characteristics constitute cultural membership, I argue that, even if the claim were persuasive that deafness is a culture rather than a disability, there is no reason to fault hearing parents who choose cochlear implants for their deaf children.

Implant ethics is defined here as the study of ethical aspects of the lasting introduction of technological devices into the human body. Whereas technological implants relieve us of some of the ethical problems connected with transplantation, other difficulties arise that are in need of careful analysis. A systematic approach to implant ethics is proposed. The major specific problems are identified as those concerning end of life issues (turning off devices), enhancement of human capabilities beyond normal levels, mental changes and (...) personal identity, and cultural effects. (shrink)

Biomedical engineering technologies such as brain–machine interfaces and neuroprosthetics are advancements which assist human beings in varied ways. There are exciting yet speculative visions of how the neurosciences and bioengineering may influence human nature. However, these could be preparing a possible pathway towards an enhanced and even posthuman future. This article seeks to investigate several ethical themes and wider questions of enhancement, transhumanism and posthumanism. Four themes of interest are: autonomy, identity, futures, and community. Three larger questions can be asked: (...) will everyone be enhanced? Will we be “human” if we are not, one day, transhuman? Should we be enhanced or not? The article proceeds by concentrating on a widespread and sometimes controversial application: the cochlear implant, an auditory prosthesis implanted into Deaf patients. Cochlear implantation and its reception in both the deaf and hearing communities have a distinctive moral discourse, which can offer surprising insights. The paper begins with several points about the enhancement of human beings, transhumanism’s reach beyond the human, and posthuman aspirations. Next it focuses on cochlear implants on two sides. Firstly, a shorter consideration of what technologies may do to humans in a transhumanist world. Secondly, a deeper analysis of cochlear implantation’s unique socio-political movement, its ethical explanations and cultural experiences linked with pediatric cochlear implantation—and how those wary of being thrust towards posthumanism could marshal such ideas by analogy. As transhumanism approaches, the issues and questions merit continuing intense analysis. (shrink)

SINGLE MAGNETIC NORTHPOLES AND SOUTPOLESAND THEIR IMPORTANCE FOR SCIENCETen lectures delivered at the University of Viennaduring the summer semester of 1947byDr. Felix EhrenhaftU. S. Visiting Profe...

Magnetic resonance imaging (MRI) can provide a number of measurements relevant to sport-related concussion (SRC) symptoms; however, most studies to date have used a single MRI modality and whole-brain exploratory analyses in attempts to localize concussion injury. This has resulted in highly variable findings across studies due to wide ranging symptomology, severity and nature of injury within studies. A multimodal MRI, symptom-guided region-of-interest (ROI) approach is likely to yield more consistent results. The functions of the cerebellum and basal ganglia transcend (...) many common concussion symptoms, and thus these regions, plus the white matter tracts that connect or project from them, constitute plausible ROIs for MRI analysis. We performed diffusion tensor imaging (DTI), resting-state functional MRI, quantitative susceptibility mapping (QSM), and cerebral blood flow (CBF) imaging using arterial spin labeling (ASL), in youth aged 12-18 years following SRC, with a focus on the cerebellum, basal ganglia and white matter tracts. Compared to controls similar in age, sex and sport (N= 20), recent SRC youth (N= 29; MRI at 8 ± 3 days post injury) exhibited increased susceptibility in the cerebellum (p= 0.032), decreased functional connectivity between the caudate and each of the pallidum (p= 0.035) and thalamus (p= 0.021), and decreased diffusivity in the mid-posterior corpus callosum (p< 0.038); no changes were observed in recovered asymptomatic youth (N= 16; 41 ± 16 days post injury). For recent symptomatic-only SRC youth (N= 24), symptom severity was associated with increased susceptibility in the superior cerebellar peduncles (p= 0.011) and reduced activity in the cerebellum (p= 0.013). Fewer days between injury and MRI were associated with reduced cerebellar-parietal functional connectivity (p< 0.014), reduced activity of the pallidum (p= 0.002), increased CBF in the caudate (p= 0.005), and reduced diffusivity in the central corpus callosum (p< 0.05). Youth SRC is associated with acute cerebellar inflammation accompanied by reduced cerebellar activity and cerebellar-parietal connectivity, as well as structural changes of the middle regions of the corpus callosum accompanied by functional changes of the caudate, all of which resolve with recovery. Early MRI post-injury is important to establish objective MRI-based indicators for concussion diagnosis, recovery assessment and prediction of outcome. (shrink)

In a world surrounded by smart objects from sensors to automated medical devices, the ubiquity of ‘smart’ seems matched only by its lack of clarity. In this article, we use our discussions with expert stakeholders working in areas of implantable medical devices such as cochlear implants, implantable cardiac defibrillators, deep brain stimulators and in vivo biosensors to interrogate the difference facets of smart in ‘implantable smart technologies’, considering also whether regulation needs to respond to the autonomy that such artefacts (...) carry within them. We discover that when smart technology is deconstructed it is a slippery and multi-layered concept. A device’s ability to sense and transmit data and automate medicine can be associated with the ‘sting’ of autonomy being disassociated from human control as well as affecting individual, group, and social environments. (shrink)

Objective : Pre-implantation genetic diagnosis (PGD) has been utilized by assisted reproductive technology (ART) to genetically screen embryos before placement in the uterus. However, many objections have been raised against the genetic screening of embryos, giving the practice an uncertain ethical, legal, and social status. Our aim was, therefore, to survey the possible presence and compliance to any legislation for PGD in the existing 60 in vitro fertilization (IVF) centres in the Gulf Cooperative Council (GCC) countries as well as the (...) availability of such a technological service. Methods : The study was performed in the department of biochemistry at King Faisal University between the periods Mar 2006 to Nov 2007. A questionnaire, in the form of a table, was sent to responsible persons of all 60 IVF centres and health authorities in the GCC countries. The collected data about the regulations and guidelines for the PGD program was analyzed using SPSS software package version 12.0 and the level of significance was set at P Results: 18 respondents, 16 IVF centres and 2 health authorities (26.87% of total) participated in the survey. The PGD techniques, mainly FISH analyses, were practiced in three centres in Saudi Arabia and one centre in the UAE. The major provider of PGD was King Faisal Specialist Hospital and Research Centre in Riyadh where more than 300 PGD tests had been performed. Whilst some regulations and guidelines have been introduced to IVF centres in all GCC countries, their implementations were left to the discretion of the treating centre. Conclusions : PGD services in the GCC countries were under-utilized due to the high cost of tests, the sophisticated technology involved and the poor returns of the investment. As a result of some deficiencies in the legislations which regulated PGD, the medical teams involved often faced difficulties on what rights to exercise in various PGD cases. (shrink)