In this article we will draw on experiences from our own research on deep brain stimulation of the central thalamus in the minimally conscious state. We describe ethical challenges faced in clinical research involving medical devices and offer several cautionary notes about its funding and the interplay of market forces and scientific inquiry and suggest some reforms.

Northoff provides a compelling argument supporting a kind of “double dissociation” of Parkinson's disease and catatonia. We discuss a related form of akinetic mutism linked to mesodiencephalic injuries and suggest an alternative to the proposed “horizontal” versus “vertical” modulation distinction. Rather than a “directional” difference in patterned neuronal activity, we propose that both disorders reflect hypersynchrony within typically interdependent but segregated networks facilitated by a common thalamic gating mechanism.

This is the first article in a two-part series describing subject and family perspectives from the central thalamic deep brain stimulation for the treatment of traumatic brain injury using the Medtronic PC + S first-in-human invasive neurological device trial to achieve cognitive restoration in moderate to severe traumatic brain injury, with subjects who were deemed capable of providing voluntary informed consent. In this article, we report on interviews conducted prior to surgery wherein we asked participants about their experiences recovering from (...) brain injury and their perspectives on study enrollment and participation. We asked how risks and benefits were weighed, what their expectations and fears were, and how decisions were reached about trial participation. We found that informed consent and enrollment decisions are fraught. Subjects and families were often split, with subjects more focused on putative benefits and families concerned about incremental risk. Both subjects and families viewed brain injury as disruptive to personal identity and relationships. As decisions were made about study enrollment, families struggled with recognizing the re-emergent agency of subjects and ceding decision-making authority to subjects who had previously been dependent upon them for protection and guidance. Subjects and family members reported a hope for the relief of cognitive disabilities, improved quality of life, normalization of interpersonal interactions, and a return to work or school as reasons for study participation, along with altruism and a desire to advance science. Despite these aspirations, both subjects and families appreciated the risks of the intervention and did not suffer from a therapeutic misconception. A second essay to be published in the next issue of Cambridge Quarterly of Healthcare Ethics—Clinical Neuroethics will describe interviews conducted after surgery, the effects of cognitive restoration for subjects, families, and challenges presented to the social structures they will call upon to support them through recovery. This subsequent article will be available online prior to its formal publication in October 2023. (shrink)

This is the second paper in a two-part series describing subject and family perspectives from the CENTURY-S (CENtral Thalamic Deep Brain Stimulation for the Treatment of Traumatic Brain InjURY-Safety) first-in-human invasive neurological device trial to achieve cognitive restoration in moderate to severe traumatic brain injury (msTBI). To participate, subjects were independently assessed to formally establish decision-making capacity to provide voluntary informed consent. Here, we report on post-operative interviews conducted after a successful trial of thalamic stimulation. All five msTBI subjects met (...) a pre-selected primary endpoint of at least a 10% improvement in completion time on Trail-Making-Test Part B, a marker of executive function. We describe narrative responses of subjects and family members, refracted against that success. Interviews following surgery and the stimulation trial revealed the challenge of adaptation to improvements in cognitive function and emotional regulation as well as altered (and restored) relationships and family dynamics. These improvements exposed barriers to social reintegration made relevant by recoveries once thought inconceivable. The study’s success sparked concerns about post-trial access to implanted devices, financing of device maintenance, battery replacement, and on-going care. Most subjects and families identified the need for supportive counseling to adapt to the new trajectory of their lives. (shrink)

DBS Think Tank IX was held on August 25–27, 2021 in Orlando FL with US based participants largely in person and overseas participants joining by video conferencing technology. The DBS Think Tank was founded in 2012 and provides an open platform where clinicians, engineers and researchers can freely discuss current and emerging deep brain stimulation technologies as well as the logistical and ethical issues facing the field. The consensus among the DBS Think Tank IX speakers was that DBS expanded in (...) its scope and has been applied to multiple brain disorders in an effort to modulate neural circuitry. After collectively sharing our experiences, it was estimated that globally more than 230,000 DBS devices have been implanted for neurological and neuropsychiatric disorders. As such, this year’s meeting was focused on advances in the following areas: neuromodulation in Europe, Asia and Australia; cutting-edge technologies, neuroethics, interventional psychiatry, adaptive DBS, neuromodulation for pain, network neuromodulation for epilepsy and neuromodulation for traumatic brain injury. (shrink)

The chapter outlines Nietzsche's view of decadence, its history and effects. The philosopher held decadence to be any condition, deceptively thought good, which limits what something or someone can be. This concept informs his critical and affirmative projects, acting as a versatile tool to identify and overcome his own decadence and to resist the decadence of Western culture. Decadence appears in five major areas of concern to Nietzsche: physiology; psychology; art and artists; politics; and philosophy. Physical and mental phenomena provide (...) the substrate of his understanding, but they manifest in cultural, political, and philosophical forms that, in turn, affect the body and mind. In each of the five areas, the concept of decadence for Nietzsche serves 1) to unmask valued cultural phenomena as corrupt, 2) to name and analyze degenerate effects, and 3) to spur reflection on how to respond. (shrink)

Socrates is one of the most important yet enigmatic philosophers of all time; his fame has endured for centuries despite the fact that he never actually wrote anything. In 399 B.C.E., he was tried on the charge of impiety by the citizens of Athens, convicted by a jury, and sentenced to death (ordered to drink poison derived from hemlock). About these facts there is no disagreement. However, as the sources collected in this book and the scholarly essays that follow them (...) show, several of even the most basic facts about these events were controversial in antiquity, and the questions persist today: How and why was Socrates brought to trial? Why did the jurors, members of the world's first democracy, find him guilty? When he was given an opportunity to escape execution, why did he refuse to do so and instead accept the punishment that he and his friends agreed was unjustly assigned to him? How exactly did Socrates die? Differences of opinion on these and other issues continue to arouse our curiosity and to challenge new generations of students and scholars. The Trial and Execution of Socrates: Sources and Controversies is the first work to collect in one place all of the major ancient sources on Socrates' death--those of both his critics and his defenders--as well as recent scholarly views. Part I includes new translations of Plato's Euthyphro, Apology, Crito, and the death scene from Phaedo, as well as other ancient sources that shed light on Socrates' trial and execution. Part II features some of the most influential recent scholarship on this historically momentous event with work by M. F. Burnyeat, Robert Parker, Mark L. McPherran, Thomas C. Brickhouse and Nicholas D. Smith, Richard Kraut, Christopher Gill, and Enid Bloch (whose essay is published here for the first time). Ideal for undergraduate surveys of ancient Greek philosophy and upper-level courses on Socrates and Socratic philosophy, this unique collection provides an unprecedented look into the many perplexing questions surrounding the trial and execution of this remarkable man. (shrink)

Name der Zeitschrift: Journal of Ancient History Jahrgang: 5 Heft: 2 Seiten: 280-303.

This article aims to give an analysis of the phenomena of unjust misappropriation of marginalised groups’ terms online, using the example misappropriation of ‘woke’ from the Black community on Twitter. I argue that using terms such as these outside their original context warps their meaning, decreasing the intelligibility of the experiences of the marginalised agents who use them when attempting to express themselves both within their community and without. I intend to give an analysis of this phenomena, with the expectation (...) that understanding it better will provide a crucial step in combatting it. To this end, I argue it can be understood as a specialised form of what Kristie Dotson calls ‘contributory injustice’, injustices which involve the suppression of a marginalised community’s existing hermeneutical resources, combined with a specific consequence of what Boyd and Marwick call ‘context collapse’, the removal of social norms created through the homogenising effect of social media sites like Twitter. The result is a novel misappropriation phenomenon, I label ‘Context-Collapsed Contributory Injustice’ or ‘CC.CI’. This type of misappropriation is particularly harmful due to it being faster-acting than historical varieties of misappropriation. Furthermore, unchecked continual cases of CC.CI can cause a novel from of what Miranda Fricker calls ‘hermeneutical injustice’, which is demarcated from standard cases by its ability to reintroduce conceptual lacunas through undermining existing hermeneutical resources. I finish by disambiguating cases of CC.CI from natural meaning change and critically analysing some existing philosophical treatments of “woke”. (shrink)

Nicholas D. Smith considers an original interpretation of the Republic, presenting it as a work about knowledge and education. Smith pays particular attention to Plato's use of images as representations of higher realities in education, as well as the power of knowledge in the Republic.

Nietzsche's Ecce Homo was published posthumously in 1908, eight years after his death, and has been variously described ever since as useless, mad, or merely inscrutable. Against this backdrop, Nicholas D. More provides the first complete and compelling analysis of the work, and argues that this so-called autobiography is instead a satire. This form enables Nietzsche to belittle bad philosophy by comic means, attempt reconciliation with his painful past, review and unify his disparate works, insulate himself with humor from (...) the danger of 'looking into abysses', and establish wisdom as a special kind of 'good taste'. After showing how to read this much-maligned book, More argues that Ecce Homo presents the best example of Nietzsche making sense of his own intellectual life, and that its unique and complex parody of traditional philosophy makes a powerful case for reading Nietzsche as a philosophical satirist across his corpus. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Plato on Knowledge as a Power1Nicholas D. SmithAt 471C4 in Plato’s Republic, the argument takes a sudden turn when Glaucon becomes impatient with all of the specific prescriptions Socrates has been making, and asks to return to the issue Socrates had earlier set aside—whether or not the city he was describing could ever be brought into being. In response to Glaucon’s impatient question, Socrates articulates his “third wave of (...) paradox” (472ag–7), namely, that the ills of the cities will never be ended until either philosophers become rulers or rulers become philosophers (473c11–d6). Glaucon immediately responds that such a view is likely to be greeted with violence and scorn (473e6–474a4), and so Socrates must hasten to explain his odd claim. His explanation, it turns out, is that true philosophers have an enormous cognitive advantage over non-philosophers—philosophers have and use knowledge (ἐπιστήμη), whereas non-philosophers have and use only opinion (δόξα).2 This distinction, between επιστήμη and δόξα, turns out: to be a distinction between two different cognitive powers (δυνάμεις—477d7–e3). And different powers, Plato clearly tells us, apply to or take as their objects (Plato says they are “ἐπί”) different things (477dl).In this paper, I shall argue that the relationship between the cognitive powers and their various objects has been fundamentally misunderstood, which has led scholars into one or more misinterpretations of important and explicit features of the text. At the heart of these misunderstandings, I claim, is [End Page 145] their shared misconception of the relation between the cognitive power and its objects as interpretable in terms of the relationship between a cognitive stale and what the content of that state is of or about.3 One consequence of the view for which I shall argue is that what has come to be known as the “two-worlds theory”4 of Plato’s epistemology is seriously mistaken, but no less mistaken than the alternatives given by its recent critics. Another consequence that I shall draw from my argument is that Plato should be understood neither as a kind of foundationalist with regard to knowledge and warrant, as some have supposed him to be,5 nor as a coherentist, as others have supposed,6 but, rather, as a kind of causal reliabilist. [End Page 146]1. KNOWLEDGE AS A POWERScholarly interpretations of Plato’s epistemology have routinely sought to understand the relationships between each cognitive power of Republic Book V and the objects of the ἐφ’ ᾦ (“what it is related to”) condition by which it is differentiated from other δυνάμεις as Plato’s way of telling us what each sort of cognition is of or aboul. 7 So, for example, we find Gail Fine using the expressions “belief [δόξα] is set over [Fine’s translation of Plato’s ἐπί] …” and “knowledge is set over …” interchangeably with “belief is of …” or “belief is about…” and “knowledge is of …” or “knowledge is about …”8 Against the “two-worlds theory,” Fine argues that, for Plato, there can be knowledge of sensibles and beliefs about Forms. Accordingly, since she assimilates the power-ἐπί-object set of relations to the cognilion-of/about-object relation, she concludes—in order to account for knowledge of sensibles and beliefs about Forms—that the objects of knowledge and opinion must be propositions. Plato’s claims that knowledge is ἐπί what is, whereas opinion is ἐπί what is and is not, Fine understands as, “One can only know true propositions; one can believe both true and false propositions.”9 We shall see later that this “veridical” understanding of what Plato means to identify as “what is,” and “what is and is not” fails to account for important and explicit elements of Plato’s exposition of the epistemological and metaphysical distinctions he is making. For now, it is enough to note that Fine understands the ἐφ’ᾦ) relation in terms of our cognition-of/about-object relation. One finds the same assimilation made by those who advance existential readings of Plato’s “is” and “is not,”10 as [End Page 147] well as those who have urged that we adopt predicative readings of “is” and “is not.”11But I think there are very serious problems with this assimilation. Plato is very... (shrink)

This volume brings together mostly previously unpublished studies by prominent historians, classicists, and philosophers on the roles and effects of religion in Socratic philosophy and on the trial of Socrates. Among the contributors are Thomas C. Brickhouse, Asli Gocer, Richard Kraut, Mark L. McPherran, Robert C. T. Parker, C. D. C. Reeve, Nicholas D. Smith, Gregory Vlastos, Stephen A. White, and Paul B. Woodruff.

What model of knowledge does Plato's Socrates use? In this book, Nicholas D. Smith argues that it is akin to knowledge of a craft which is acquired by degrees, rather than straightforward knowledge of facts. He contends that a failure to recognize and identify this model, and attempts to ground ethical success in contemporary accounts of propositional or informational knowledge, have led to distortions of Socrates' philosophical mission to improve himself and others in the domain of practical ethics. He (...) shows that the model of craft-knowledge makes sense of a number of issues scholars have struggled to understand, and makes a case for attributing to Socrates a very sophisticated and plausible view of the improvability of the human condition. (shrink)

Thomas Brickhouse and Nicholas Smith offer a comprehensive historical and philosophical interpretation of, and commentary on, one of Plato's most widely read works, the Apology of Socrates. Virtually every modern interpretation characterizes some part of what Socrates says in the Apology as purposefully irrelevant or even antithetical to convincing the jury to acquit him at his trial. This book, by contrast, argues persuasively that Socrates offers a sincere and well-reasoned defense against the charges he faces. First, the authors establish (...) a consensus of ancient reports about Socrates ' moral and religious principles and show that these prohibit him from needlessly risking the condemnation of the jury. Second, they consider each specific claim made by Socrates in the Apology and show how each can be construed as an honest effort to inform the jurors of the truth and to convince them of his blamelessness. The arguments of this book are informed by a critical review of the scholarly literature and careful attention to the philosophy expressed in Plato's other early dialogues. (shrink)

The writer responds to the commentary “Physician Burnout Calls for Legal Intervention,” by Sharona Hoffman, in the November‐December 2019 issue of the Hastings Center Report.

Why would God make us ask for some good He might supply, and why would it be right for God to withhold that good unless and until we asked for it? We explain why present defences of petitionary prayer are insufficient, but argue that a world in which God makes us ask for some goods and then supplies them in response to our petitions adds value to the world that would not be available in worlds in which God simply supplied (...) such goods without our asking for them. This added value, we argue, is what we call ‘partnership with God’. (shrink)

Socrates' moral psychology is widely thought to be 'intellectualist' in the sense that, for Socrates, every ethical failure to do what is best is exclusively the result of some cognitive failure to apprehend what is best. Until publication of this book, the view that, for Socrates, emotions and desires have no role to play in causing such failure went unchallenged. This book argues against the orthodox view of Socratic intellectualism and offers in its place a comprehensive alternative account that explains (...) why Socrates believed that emotions, desires and appetites can influence human motivation and lead to error. Thomas C. Brickhouse and Nicholas D. Smith defend the study of Socrates' philosophy and offer an alternative interpretation of Socratic moral psychology. Their novel account of Socrates' conception of virtue and how it is acquired shows that Socratic moral psychology is considerably more sophisticated than scholars have supposed. (shrink)

Recent advances in molecular biology and microanatomy have supported homologies of body parts between vertebrates and extant invertebrate chordates, thus providing insights into the body plan of the proximate ancestor of the vertebrates. For example, this ancestor probably had a relatively complex brain and a precursor of definitive neural crest. Additional insights into early vertebrate evolution have come from recent discoveries of Lower Cambrian soft body fossils of Haikouichthys and Myllokunmingia (almost certainly vertebrates, possibly related to modern lampreys) and Yunnanozoon (...) and Haikouella (evidently stem-group vertebrates). The earliest vertebrates had an unequivocally marine origin, probably evolved mineralised pharyngeal denticles before the dermal skeleton, and evidently utilised elastic recoil of the visceral arch skeleton for suction feeding. Moreover, the new data emphasise that the advent of definitive neural crest was supremely important for the evolutionary origin of the vertebrates. BioEssays 23:142–151, 2001. © 2001 John Wiley & Sons, Inc. (shrink)

Socrates' moral psychology is widely thought to be 'intellectualist' in the sense that, for Socrates, every ethical failure to do what is best is exclusively the result of some cognitive failure to apprehend what is best. Until publication of this book, the view that, for Socrates, emotions and desires have no role to play in causing such failure went unchallenged. This book argues against the orthodox view of Socratic intellectualism and offers in its place a comprehensive alternative account that explains (...) why Socrates believed that emotions, desires and appetites can influence human motivation and lead to error. Thomas C. Brickhouse and Nicholas D. Smith defend the study of Socrates' philosophy and offer an alternative interpretation of Socratic moral psychology. Their novel account of Socrates' conception of virtue and how it is acquired shows that Socratic moral psychology is considerably more sophisticated than scholars have supposed. (shrink)

In this paper we explore plato's paradoxical remarks about the philosophical rulers' use of dishonesty in the "republic"--Rulers who, On the one hand, Are said to love truth above all else, But on the other hand are encouraged to make frequent use of "medicinal lies." we establish first that plato's remarks are in fact consistent, According to the relevant platonic theories too often forgotten by both critics and defenders of plato. Finally, We reformulate the underlying moral issue of the purported (...) right not to be lied to, And its alternative in platonic political philosophy: paternalism. (shrink)

As a cognitivist about emotions, Socrates takes the fear of death to be a belief that death is a bad thing for the one who dies. Socrates, however, thinks there are reasons for thinking death is not a bad thing at all, and might even be a blessing. So the question considered in this paper is: how would Socrates explain the fact that so many people believe death is bad?