This paper discusses the ways in which anesthetic agents can be used to investigate the role of awareness in learning and memory. It reviews research into learning during light, subclinical anesthesia, termedhypesthesia.This research suggests that the effects of anesthetics on implicit and explicit memory are roughly comparable, although implicit memory for simple stimuli may resist the effects of very low doses of anesthetic. In addition, this paper reports experimental data demonstrating that long-term retention of information is prevented by doses (...) of anesthetic that are low enough to permit awareness and even short-term memory of auditory stimuli. Overall, these findings are consistent with the hypothesis that frontal lobe function is particularly sensitive to anesthetics. They raise theoretical and practical questions about the necessity of consciousness for learning and about interpretation of the evidence for learning during surgery under general anesthesia. (shrink)

The potential anesthetic neurotoxicity on the neonate is an important focus of research investigation in the field of pediatric anesthesiology. It is essential to understand how these anesthetics may affect the development and growth of neonatal immature and vulnerable brains. Functional magnetic resonance imaging has suggested that using anesthetics result in reduced functional connectivity may consider as core sequence for the neurotoxicity and neurodegenerative changes in the developed brain. Anesthetics either directly impact the primary structures and functions (...) of the brain or indirectly alter the hemodynamic parameters that contribute to cerebral blood flow in neonatal patients. We hypothesis that anesthetic agents may either decrease the brain functional connectivity in neonatal patients or animals, which was observed by fMRI. This review will summarize the effect and mechanism of anesthesia on the rapid growth and development infant and neonate brain with fMRI through functional connectivity. It is possible to provide the new mechanism of neuronal injury induced by anesthetics and objective imaging evidence in animal developing brain. (shrink)

It is argued here that the practice of medical students performing pelvic exams on women who are under anesthetic and have not consented is immoral and indefensible. This argument begins by laying out the ethical justification for the practice of informed consent, which can be found in autonomy and basic rights. Foregoing the process of consent within medicine can result in violations of both autonomy and basic rights, as well as trust, forming the basis of the wrong of unauthorized pelvic (...) examinations. Several objections to this argument are considered, all of which stem from the idea that this practice constitutes an exception to the general requirement of informed consent. These objections suggest that nonconsensual pelvic examinations on women under anesthetic are ethically acceptable on utilitarian grounds, in that they offer benefits either to the patient or to society, or on the grounds of triviality, in that consent is already presumed, or the practice is insignificant. Each of these objections is rejected and the practice is deemed indefensible. (shrink)

Different anesthetics are known to modulate different types of membrane-bound receptors. Their common mechanism of action is expected to alter the mechanism for consciousness. Consciousness is hypothesized as the integral of all the units of internal sensations induced by reactivation of inter-postsynaptic membrane functional LINKs during mechanisms that lead to oscillating potentials. The thermodynamics of the spontaneous lateral curvature of lipid membranes induced by lipophilic anesthetics can lead to the formation of non-specific inter-postsynaptic membrane functional LINKs by different (...) mechanisms. These include direct membrane contact by excluding the inter-membrane hydrophilic region and readily reversible partial membrane hemifusion. The constant reorganization of the lipid membranes at the lateral edges of the postsynaptic terminals (dendritic spines) resulting from AMPA receptor-subunit vesicle exocytosis and endocytosis can favor the effect of anesthetic molecules on lipid membranes at this location. Induction of a large number of non-specific LINKs can alter the conformation of the integral of the units of internal sensations that maintain consciousness. Anesthetic requirement is reduced in the presence of dopamine that causes enlargement of dendritic spines. Externally applied pressure can transduce from the middle ear through the perilymph, cerebrospinal fluid, and the recently discovered glymphatic pathway to the extracellular matrix space, and finally to the paravenular space. The pressure gradient reduce solubility and displace anesthetic molecules from the membranes into the paravenular space, explaining the pressure reversal of anesthesia. Changes in membrane composition and the conversion of membrane hemifusion to fusion due to defects in the checkpoint mechanisms can lead to cytoplasmic content mixing between neurons and cause neurodegenerative changes. The common mechanism of anesthetics presented here can operate along with the known specific actions of different anesthetics. (shrink)

Studies investigating memory for events during anesthesia show a confusing pattern of positive and negative results. To establish whether there are any consistent patterns of findings across studies, we conducted a meta-analysis of the data from 2517 patients in 44 studies. The meta-analysis included two measures of the effects of positive suggestions on postoperative recovery: the duration of postoperative hospitalization and the amount of morphine administered via patient-controlled anesthesia, as well as two measures of memory for specific information presented during (...) anesthesia: direct tests and indirect tests. The meta-analysis indicated that positive suggestions presented during anesthesia have little or no effect on postoperative recovery. On the other hand, the meta-analysis showed that specific information is remembered following surgery, as long as testing is not delayed longer than 36 h. Studies of memory for events during anesthesia provide a useful avenue for exploring unconscious cognition. (shrink)

Continuous recordings of brain electrical activity were obtained from a group of 176 patients throughout surgical procedures using general anesthesia. Artifact-free data from the 19 electrodes of the International 10/20 System were subjected to quantitative analysis of the electroencephalogram (QEEG). Induction was variously accomplished with etomidate, propofol or thiopental. Anesthesia was maintained throughout the procedures by isoflurane, desflurane or sevoflurane (N = 68), total intravenous anesthesia using propofol (N = 49), or nitrous oxide plus narcotics (N = 59). A set (...) of QEEG measures were found which reversibly displayed high heterogeneity of variance between four states as follows: (1) during induction; (2) just after loss of consciousness (LOC); (3) just before return of consciousness (ROC); (4) just after ROC. Homogeneity of variance across all agents within states was found. Topographic statistical probability images were compared between states. At LOC, power increased in all frequency bands in the power spectrum with the exception of a decrease in gamma activity, and there was a marked anteriorization of power. Additionally, a significant change occurred in hemispheric relationships, with prefrontal and frontal regions of each hemisphere becoming more closely coupled, and anterior and posterior regions on each hemisphere, as well as homologous regions between the two hemispheres, uncoupling. All of these changes reversed upon ROC. Variable resolution electromagnetic tomography (VARETA) was performed to localize salient features of power anteriorization in three dimensions. A common set of neuroanatomical regions appeared to be the locus of the most probable generators of the observed EEG changes. (shrink)

In this paper, I investigate the origins of banality and the reasons why some phenomena appear banal to us. I discuss the issue by analysing three interrelated areas of aesthetic investigation: artworks, everyday objects, and banal things. By identifying the source of banality, my goal is to understand what makes banal things different from other kinds of things. I consider the following questions: 1) when, why, and how does an object become banal?; 2) what happens when something becomes banal?; 3) (...) are banal things aesthetically appealing? Drawing on Wolfgang Welsch’s notion of anesthetization and Walter Benjamin’s account of aura, I argue that banality consists in the absence of both an ontological and an axiological character in objects, which makes them appear trivial or insignificant to us. I conclude by showing that although art, everydayness, and banality represent different aesthetic dimensions, objects constantly move from one of these dimensions to the other. (shrink)

A unifying theory of general anesthetic-induced unconsciousness must explain the common mechanism through which various anesthetic agents produce unconsciousness. Functional-brain-imaging data obtained from 11 volunteers during general anesthesia showed specific suppression of regional thalamic and midbrain reticular formation activity across two different commonly used volatile agents. These findings are discussed in relation to findings from sleep neurophysiology and the implications of this work for consciousness research. It is hypothesized that the essential common neurophysiologic mechanism underlying anesthetic-induced unconsciousness is, as with (...) sleep-induced unconsciousness, a hyperpolarization block of thalamocortical neurons. A model of anesthetic-induced unconsciousness is introduced to explain how the plethora of effects anesthetics have on cellular functioning ultimately all converge on a single neuroanatomic/neurophysiologic system, thus providing for a unitary physiologic theory of narcosis related to consciousness. (shrink)

Possible systemic effects of general anesthetic agents on neural information processing are discussed in the context of the thalamocortical suppression hypothesis presented by Drs. Alkire, Haier, and Fallon (this issue) in their PET study of the anesthetized state. Accounts of the neural requisites of consciousness fall into two broad categories. Neuronal-specificity theories postulate that activity in particular neural populations is sufficient for conscious awareness, while process-coherence theories postulate that particular organizations of neural activity are sufficient. Accounts of anesthetic narcosis, on (...) the other hand, explain losses of consciousness in terms of neural signal-suppressions, transmission blocks, and the disruptions of signal interpretation. While signal-suppression may account for the actions of some anesthetic agents, the existence of anesthetics, such as choralose, that cause both loss of consciousness and elevated discharge rates, is problematic for a general theory of narcosis that is based purely on signal suppression and transmission-block. However, anesthetic agents also alter relative firing rates and temporal discharge patterns that may disrupt the coherence of neural signals and the functioning of the neural networks that interpret them. It is difficult at present, solely on the basis of regional brain metabolic rates, to test process-coherence hypotheses regarding organizational requisites for conscious awareness. While these pioneering PET studies have great merit as panoramic windows of mind-brain correlates, wider ranges of theory and empirical evidence need to be brought into the formulation of truly comprehensive theories of consciousness and anesthesia. (shrink)

Once anesthetized, patients are inherently “compliant” with surgical interventions because they can no longer intervene on their own behalf. In their target article, Minkoff et al. (2024) reasonabl...

There is converging evidence that high doses of hallucinogenic drugs can produce significant alterations of self-experience, described as the dissolution of the sense of self and the loss of boundaries between self and world. This article discusses the relevance of this phenomenon, known as “drug-induced ego dissolution (DIED)”, for cognitive neuroscience, psychology and philosophy of mind. Data from self-report questionnaires suggest that three neuropharmacological classes of drugs can induce ego dissolution: classical psychedelics, dissociative anesthetics and agonists of the kappa (...) opioid receptor (KOR). While these substances act on different neurotransmitter receptors, they all produce strong subjective effects that can be compared to the symptoms of acute psychosis, including ego dissolution. It has been suggested that neuroimaging of DIED can indirectly shed light on the neural correlates of the self. While this line of inquiry is promising, its results must be interpreted with caution. First, neural correlates of ego dissolution might reveal the necessary neurophysiological conditions for the maintenance of the sense of self, but it is more doubtful that this method can reveal its minimally sufficient conditions. Second, it is necessary to define the relevant notion of self at play in the phenomenon of DIED. This article suggests that DIED consists in the disruption of subpersonal processes underlying the “minimal” or “embodied” self, i.e., the basic experience of being a self rooted in multimodal integration of self-related stimuli. This hypothesis is consistent with Bayesian models of phenomenal selfhood, according to which the subjective structure of conscious experience ultimately results from the optimization of predictions in perception and action. Finally, it is argued that DIED is also of particular interest for philosophy of mind. On the one hand, it challenges theories according to which consciousness always involves self-awareness. On the other hand, it suggests that ordinary conscious experience might involve a minimal kind of self-awareness rooted in multisensory processing, which is what appears to fade away during DIED. (shrink)

Several general anesthetics produce their sedative effect by activating endogenous sleep pathways. We propose that general anesthesia is a two‐step process targeting sleep circuits at low doses, and synaptic release mechanisms across the entire brain at the higher doses required for surgery. Our hypothesis synthesizes data from a variety of model systems, some which require sleep (e.g. rodents and adult flies) and others that probably do not sleep (e.g. adult nematodes and cultured cell lines). Non‐sleeping systems can be made (...) insensitive (or hypersensitive) to some anesthetics by modifying a single pre‐synaptic protein, syntaxin1A. This suggests that the synaptic release machinery, centered on the highly conserved SNARE complex, is an important target of general anesthetics in all animals. A careful consideration of SNARE architecture uncovers a potential mechanism for general anesthesia, which may be the primary target in animals that do not sleep, but a secondary target in animals that sleep. (shrink)

The Inner Touch presents the archaeology of a single sense: the sense of being sentient. Aristotle was perhaps the first to define this faculty when in his treatise On the Soul he identified a sensory power, irreducible to the five senses, by which animals perceive that they are perceiving: the simple "sense," as he wrote, "that we are seeing and hearing." After him, thinkers returned, time and again, to define and redefine this curious sensation. The classical Greek and Roman philosophers (...) as well as the medieval Arabic, Hebrew, and Latin thinkers who followed them all investigated a power they called "the common sense," which one ancient author likened to "a kind of inner touch, by which we are able to grasp ourselves." Their many findings were not lost with the waning of the Middle Ages. From Montaigne and Francis Bacon to Locke, Leibniz, and Rousseau, from nineteenth-century psychiatry and neurology to Proust and Walter Benjamin, the writers and thinkers of the modern period have turned knowingly and unknowing to the terms of older traditions in exploring the perception that every sensitive being possesses of its life.The Inner Touch reconstructs and reconsiders the history of this perception. In twenty-five concise chapters that move freely among ancient, medieval, and modern cultures, Daniel Heller-Roazen investigates a set of exemplary phenomena that have played central roles in philosophical, literary, psychological, and medical accounts of the nature of animal existence. Here sensation and self-sensation, sleeping and waking, aesthetics and anesthetics, perception and apperception, animal nature and human nature, consciousness and unconsciousness, all acquire a new meaning.The Inner Touch proposes an original, elegant, and far-reaching philosophical inquiry into a problem that has never been more pressing: what it means to feel that one is alive.Winner of the Aldo and Jeanne Scaglione Prize for Comparative Literary Studies. (shrink)

Teaching ethics poses a dilemma for professors of business. First, they have little or no formal training in ethics. Second, they have established ethical values that they may not want to impose upon their students. What is needed is a well-recognized, yet non-sectarian model to facilitate the clarification of ethical questions. Gestalt theory offers such a framework. Four Gestalt principles facilitate ethical clarification and another four Gestalt principles anesthetize ethical clarification. This article examines each principle, illustrates that principle through current (...) business examples, and offers exercises for developing each principle. (shrink)

In this paper we discuss the two-system framework, examine its strengths, point out a fundamental weakness concerning the unity of conscious experience, and then propose a new hypothesis that avoids that weakness and other related concerns. According to our strong emergence hypothesis, what emerges are not merely mental properties in specialized, distributed neural areas, but also a new, irreducibly singular entity that functions in a recurrent manner to integrate its mental properties and to rewire its brain. We argue that the (...) former function is suggested, in part, by the effects of anesthetics on sensory integration, and that the latter function is suggested by evidence garnered from the neuroscience of mindfulness, constraint-induced movement therapy for stroke, and neuroimaging data surrounding mental illness. We then discuss how our strong emergence hypothesis relates to the description and treatment of neuropsychiatric disorders. Finally, potential objections are addressed. (shrink)

I argue that if minds supervene on the intrinsic physical properties of things like brains, then typical human brains host many minds at once. Support comes from science-nonfiction realities that, unlike split-brain cases, have received little direct attention from philosophers. One of these realities is that some patients are functioning (albeit impaired) and phenomenally conscious by all medical and commonsense accounts despite the fact that they have undergone a hemispherectomy: an entire brain hemisphere has been fully detached. Another is the (...) Wada test, in which a patient has each hemisphere anesthetized, one after the other, while the other hemisphere is awake and functioning—again, phenomenally conscious by any standard. I will argue that hemispherectomies, Wada tests, and related procedures each present cases in which the minds that exist after the detachment (or anesthetization) of a hemisphere are surviving minds which must be associated with the surviving (or un-anesthetized) hemisphere. I will argue that such surviving minds existed before the medical procedure, instantiated by the then-intact hemisphere that was due to survive the loss of its complementary hemisphere. If so, then the typical subject has at least three minds: a “left hemisphere mind”, a “right hemisphere mind”, and a “whole brain mind”. But the argument generalizes to cases in which smaller portions of the brain are lost, yielding a great number of additional minds, some overlapping. Some important ethical implications are raised and briefly examined. (shrink)

This article summarizes a variety of current as well as previous research in support of a new theory of consciousness. Evidence has been steadily accumulating that information about a stimulus complex is distributed to many neuronal populations dispersed throughout the brain and is represented by the departure from randomness of the temporal pattern of neural discharges within these large ensembles. Zero phase lag synchronization occurs between discharges of neurons in different brain regions and is enhanced by presentation of stimuli. This (...) evidence further suggests that spatiotemporal patterns of coherence, which have been identified by spatial principal component analysis, may encode a multidimensional representation of a present or past event. How such distributed information is integrated into a holistic percept constitutes the binding problem. How a percept defined by a spatial distribution of nonrandomness can be subjectively experienced constitutes the problem of consciousness. Explanations based on a discrete connectionistic network cannot be reconciled with the relevant facts. Evidence is presented herein of invariant features of brain electrical activity found to change reversibly with loss and return of consciousness in a study of 176 patients anesthetized during surgical procedures. A review of relevant research areas, as well as the anesthesia data, leads to a postulation that consciousness is a property of quantumlike processes, within a brain field resonating within a core of structures, which may be the neural substrate of consciousness. This core includes regions of the prefrontal cortex, the frontal cortex, the pre- and paracentral cortex, thalamus, limbic system, and basal ganglia. (shrink)

Anesthetic gas molecules are recognized to act by van der Waals (London dispersion) forces in hydrophobic pockets of select brain proteins to ablate consciousness. Enigmatic features of consciousness have defied conventional neurophysiological exp lanations and prompted suggestions for supplemental occurrence of macroscopic quantum coherent states and quantum computation in the brain. Are these feasible? During conscious (non-anesthetic) conditions, endogenous Van der Waals London dispersion forces occur among non-polar amino acid groups in hydrophobic pockets of neural proteins and help regulate their (...) conformation/function. London forces are weak instantaneous couplings between pairs of electron induced dipoles (e.g. between adjacent non-polar amino acid groups), and are quantum mechanical effects capable of supporting quantum superposition/computation and macroscopic quantum coherence. Quantum effects mediated by endogenous London forces in hydrophobic pockets of select neural proteins may be necessary for consciousness. The mechanism of anesthetics may be to inhibit (by exogenous London forces) the necessary quantum states. (shrink)

Unconsented intimate exams on men and women are known to occur for training purposes and diagnostic reasons, mostly during gynecological surgeries but also during prostate examinations and abdominal surgeries. UIEs most often occur on anesthetized patients but have also been reported on conscious patients. Over the last 30 years, several parties—both within and external to medicine—have increasingly voiced opposition to these exams. Arguments from medical associations, legal scholars, ethicists, nurses, and some physicians have not compelled meaningful institutional change. Opposition is (...) escalating in the form of legislative bans and whistleblower reports. Aspiring to professional and scientific detachment, institutional consent policies make no distinction between intimate exams and exams on any other body part, but patients do not think of their intimate regions in a detached or neutral way and believe intimate exams call for special protections. UIEs are found to contribute to moral erosion and moral distress of medical students and compromise the sacred trust between the medical community and the general public. This paper refutes the main arguments in favor of the status quo, identifies a series of harms related to continuing the current practice, and proposes an explicit consent policy for intimate exams along with specific changes to medical school curriculum and institutional culture. Because patients are the rights-holders of their bodies, consent practices should reflect and uphold patient values which call for explicit consent for intimate exams. (shrink)

I propose that primary conscious awareness arises from synchronized activity in dendrites of neurons in dorsal thalamic nuclei, mediated particularly by inhibitory interactions with thalamic reticular neurons. In support, I offer four evidential pillars: consciousness is restricted to the results of cortical computations; thalamus is the common locus of action of brain injury in vegetative state and of general anesthetics; the anatomy and physiology of the thalamus imply a central role in consciousness; neural synchronization is a neural correlate of (...) consciousness. (shrink)

Neuronal aggregates involved in conscious awareness are not evenly distributed throughout the CNS but comprise key components referred to as the neural network correlates of consciousness (NNCC). A critical node in this network is the posterior cingulate, precuneal, and retrosplenial cortices. The cytological and neurochemical composition of this region is reviewed in relation to the Brodmann map. This region has the highest level of cortical glucose metabolism and cytochrome c oxidase activity. Monkey studies suggest that the anterior thalamic projection likely (...) drives retrosplenial and posterior cingulate cortex metabolism and that the midbrain projection to the anteroventral thalamic nucleus is a key coupling site between the brainstem system for arousal and cortical systems for cognitive processing and awareness. The pivotal role of the posterior cingulate, precuneal, and retrosplenial cortices in consciousness is demonstrated with posterior cingulate epilepsy cases, midcingulate lesions that de-afferent this region and are associated with unilateral sensory neglect, observations from stroke and vegetative state patients, alterations in blood flow during sleep, and the actions of general anesthetics. Since this region is critically involved in self reflection, it is not surprising that it is similarly a site for the NNCC. Interestingly, information processing during complex cognitive tasks and during aversive sensations such as pain induces efforts to terminate self reflection and result in decreased processing in posterior cingulate and precuneal cortices. (shrink)

Cellular circadian clocks represent ancient anticipatory systems which co‐evolved with the first cells to safeguard their survival. Cyanobacteria represent one of the most ancient cells, having essentially invented photosynthesis together with redox‐based cellular circadian clocks some 2.7 billion years ago. Bioelectricity phenomena, based on redox homeostasis associated electron transfers in membranes and within protein complexes inserted in excitable membranes, play important roles, not only in the cellular circadian clocks and in anesthetics‐sensitive cellular sentience (awareness of environment), but also in (...) the coupling of single cells into tissues and organs of unitary multicellular organisms. This integration of cellular circadian clocks with cellular basis of sentience is an essential feature of the cognitive CBC‐Clock basis of cellular life. (shrink)

Evidence coming from several studies into memory and awareness during general anesthesia suggests that in surgical patients who seem to be adequately anesthetized , some form of cognitive functioning is preserved. This finding has important implications both for clinical practice and for memory research. In order to give the methodological background of the present situation in this field of research, this article deals, on the basis of recent experiments, with important methodological aspects of studies into perception and memory during general (...) anesthesia. (shrink)

There is evidence from neuropsychological and psychophysical measurements that conscious sensory information is processed in discrete time segments. The segmentation process may be described as neuronal activity at a frequency of 40 Hz. Stimulus-induced neuronal activities of this frequency are found in the middle latency range of the auditory evoked potential . First, we have studied the effects of different general anesthetics on MLAEP and auditory evoked 40-Hz activity. Second, we investigated MLAEP and explicit and implicit memory for information (...) presented during cardiac anesthesia. In the awake patients peak latencies of the MLAEP were in the normal range. An auditory evoked 40-Hz activity was present 20–100 ms poststimulus. Under nonspecific anesthetics MLAEP and the 40-Hz activity were suppressed, and under receptor-specific agents MLAEP and the 40-Hz activity were partly preserved. None of the cardiac patients had conscious explicit recall of the intraoperative events, whereas some patients showed unconscious implicit memory for an intraoperative tape message. The implicit memory could be related to midlatency auditory evoked potentials. No implicit memory was detectable when MLAEP and the primary cortical processing of the auditory stimuli and 40-Hz activity were blocked. Implicit memory could be detected in more than 50% of the cases when MLAEP, a 30-Hz activity, and the primary cortical stimulus processing were preserved. In conclusion, our observations support the view that a high frequency oscillatory mechanisms, recorded as a grouped neuronal activity in the MLAEP, may be part of a basic neuronal program for conscious sensory information processing. (shrink)

The death penalty by lethal injection is a legal punishment in the United States. Sodium Thiopental, once used in the death penalty cocktail, is no longer available for use in the United States as a consequence of this association. Anesthesiologists possess knowledge of Sodium Thiopental and possible chemical alternatives. Further, lethal injection has the look and feel of a medical act thereby encouraging physician participation and comment. Concern has been raised that the death penalty by lethal injection, is cruel. Physicians (...) are ethically directed to prevent cruelty within the doctor-patient relationship and ethically prohibited from participation in any component of the death penalty. The US Supreme Court ruled that the death penalty is not cruel per se and is not in conflict with the 8th amendment of the US constitution. If the death penalty is not cruel, it requires no further refinement. If, on the other hand, the death penalty is in fact cruel, physicians have no mandate outside of the doctor patient relationship to reduce cruelty. Any intervention in the name of cruelty reduction, in the setting of lethal injection, does not lead to a more humane form of punishment. If physicians contend that the death penalty can be botched, they wrongly direct that it can be improved. The death penalty cocktail, as a method to reduce suffering during execution, is an unverifiable claim. At best, anesthetics produce an outward appearance of calmness only and do not address suffering as a consequence of the anticipation of death on the part of the condemned. (shrink)

Poovey has argued that the anesthetized “unresisting body” can offer no impediment to a doctor's interpretation of its conduct. In contrast, drawing on ethnographic data of anesthetic practice, this article suggests that the technological augmentation of the body required by present-day anesthesia enhances the ability of an unconscious body to convey its needs and shape the course of the anesthetic. In analyzing the expressions of anesthesia's cyborgs, the author draws on Haraway, Latour, and Suchman to reconsider the characteristics of agency (...) and how an unconscious body might “resist” or inform a doctor's interpretation. This attempt to explore the nature and distribution of agency within a collective is intended as a contribution to the debates surrounding medical dominance and those theorizing the role of technology in health care. (shrink)

Taken from a published report on wound ballistics research during World War II, Figure 1 depicts the abdomen of a cat that has been shaved, anesthetized, marked with a grid, and shot. The individual squares are frames, the caption says, “ from a high speed motion picture of a cat’s abdomen, showing the volume changes and movements caused by a 6/32nd inch steel sphere.” We can recognize in this image the conventions of scientific inscription. The technologies are sophisticated, quantitative, impressive. (...) The image speaks for itself. Or does it? What exactly is happening when an anesthetized cat with a shaved abdomen painted with a grid gets shot, in a laboratory, and when that event is hyper-documented in high speed photographs, and deployed in a range of texts as evidence? And what do these human creations — these highly quantified experimental wounds — tell us about the culture and practice of twentieth-century science? (shrink)

Anatomical studies propose that the primate auditory cortex contains more fields than have actually been functionally confirmed or described. Spatially resolved functional magnetic resonance imaging (fMRI) with carefully designed acoustical stimulation could be ideally suited to extend our understanding of the processing within these fields. However, after numerous experiments in humans, many auditory fields remain poorly characterized. Imaging the macaque monkey is of particular interest as these species have a richer set of anatomical and neurophysiological data to clarify the source (...) of the imaged activity. We functionally mapped the auditory cortex of behaving and of anesthetized macaque monkeys with high resolution fMRI. By optimizing our imaging and stimulation procedures, we obtained robust activity throughout auditory cortex using tonal and band-passed noise sounds. Then, by varying the frequency content of the sounds, spatially specific activity patterns were observed over this region. As a result, the activity patterns could be assigned to many auditory cortical fields, including those whose functional properties were previously undescribed. The results provide an extensive functional tessellation of the macaque auditory cortex and suggest that 11 fields contain neurons tuned for the frequency of sounds. This study provides functional support for a model where three fields in primary auditory cortex are surrounded by eight neighboring ‘‘belt’’ fields in non-primary auditory cortex. The findings can now guide neurophysiological recordings in the monkey to expand our understanding of the processing within these fields. Additionally, this work will improve fMRI investigations of the human auditory cortex. (shrink)

In philosophy of emerging media, several scholars have insisted on the fact that the “new” of new technologies does not have much to do with communication, but rather with the exponential growth of recording. In this paper, instead, the thesis advanced is that digital technologies do not concern memory, but imagination, and more precisely, what philosophers from Kant onwards have called productive imagination. In this paper, however, the main reference will not be Kant, but Paul Ricoeur, who explicitly refers to (...) the Kantian productive imagination in his works, but also offered an externalized, semioticized, and historicized interpretation of it. The article is developed in three steps. In the first section, it deals with Ricoeur’s theory of narrative, based on the notions of mimesis and mythos. In the second section, it is first argued that human imagination is always-already extended. Second, it will be shown how mimesis and mythos are precisely the way software works. In the third section, the specificity of big data is introduced. Big data is the promise of giving our actions and existences a meaning that we are incapable of perceiving, for lack of sensibility and understanding. Scholars have used the Foucauldian concepts of panopticon and confession for describing the human condition in the digital age. In the conclusion, it is argued that big data makes any form of disclosure unnecessary. Big data is an ensemble of technological artifacts, methods, techniques, practices, institutions, and forms of knowledge aiming at taking over the way someone narratively accounts for himself or herself before the others. Hence, another Foucauldian notion is representative of this age: the parrhesia, to speak candidly, and to take a risk in speaking the truth, insofar as such a possibility is anesthetized. (shrink)

"Spanning many historical and literary contexts, Moral Imagination brings together a dozen recent essays by one of America's premier cultural critics. David Bromwich explores the importance of imagination and sympathy to suggest how these faculties may illuminate the motives of human action and the reality of justice. These wide-ranging essays address thinkers and topics from Gandhi and Martin Luther King on nonviolent resistance, to the dangers of identity politics, to the psychology of the heroes of classic American literature. Bromwich demonstrates (...) that moral imagination allows us to judge the right and wrong of actions apart from any benefit to ourselves, and he argues that this ability is an innate individual strength, rather than a socially conditioned habit. Political topics addressed here include Edmund Burke and Richard Price's efforts to define patriotism in the first year of the French Revolution, Abraham Lincoln's principled work of persuasion against slavery in the 1850s, the erosion of privacy in America under the influence of social media, and the use of euphemism to shade and anesthetize reactions to the global war on terror. Throughout, Bromwich considers the relationship between language and power, and the insights language may offer into the corruptions of power.Moral Imagination captures the singular voice of one of the most forceful thinkers working in America today"--. (shrink)

The cognitive unbinding paradigm suggests that the synthesis of neural information is attenuated by general anesthesia. Here, we analyzed the functional organization of brain activities in the conscious and anesthetized states, based on functional segregation and integration. Electroencephalography recordings were obtained from 14 subjects undergoing induction of general anesthesia with propofol. We quantified changes in mean information integration capacity in each band of the EEG. After induction with propofol, mean information integration capacity was reduced most prominently in the γ band (...) of the EEG . Furthermore, we demonstrate that loss of consciousness is reflected by the breakdown of the spatiotemporal organization of γ waves. We conclude that induction of general anesthesia with propofol reduces the capacity for information integration in the brain. These data directly support the information integration theory of consciousness and the cognitive unbinding paradigm of general anesthesia. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Kennedy Institute of Ethics Journal 11.1 (2001) 91-112 [Access article in PDF] Scope Note 40 Animals in Research and Education: Ethical Issues Laura Jane Bishop and Anita Lonnes Nolen Scientific enquiry is inexorably tied to animal experimentation in the popular imagination and human history. Many, if not most, of the spectacular innovations in the medical understanding and treatment of today's human maladies have been based on research using animals. (...) However, the use of animals in research and experimentation has been debated, defended, and protested by both individuals and organizations at various levels. Responses range from personal lifestyle decisions and fervent philosophical treatises to strident arguments, violent demonstrations, and direct action. The continuum of attitudes about animals and the human relationship with animals spans the range between those who support no regulation of the human use of animals and those who advocate absolute animal liberation from all human use (see II, Orlans 1993, p. 22). History The first recorded experimentation on animals occurred in ancient Rome, but not until the Renaissance did scholars begin serious study of how the body works. Leonardo da Vinci (1452-1519) and other artists and anatomists pursued anatomical investigations of muscle and bone structure. William Harvey (1578-1657) discovered the circulation of the blood via his experiments on live deer. During this period, much live animal experimentation both in England and France was based on the view of French philosopher René Descartes (1596-1650) that animals are incapable of feeling pain. Jeremy Bentham (1748-1832), the English utilitarian philosopher, thought otherwise. In his "Introduction to the Principles of Morals and Legislation" in 1789, Bentham declared, "The question is not, can they reason? Nor, can they talk? But can they suffer? Despite Bentham and others, the belief that animals could not perceive pain persisted in many quarters into the twentieth century. Nineteenth century French physiologist Claude Bernard [End Page 91] (1813-1878)-and his teacher, François Magendie (1783-1855)-conducted wide-ranging animal experiments including surgery, use of drugs, and removal of body parts from many species. Bernard argued that while no amount of benefit could justify any harm to human research subjects, even extreme harm and pain for animal research subjects could be justified by the potential benefit to human beings. Although he did use anesthetics in his work after their discovery in 1847, even Bernard's later work was controversial because of the numbers of animals used and the repetitive nature of his research. The experiments of Magendie and Bernard both laid the foundations for animal experimentation as a practice for scientific advance and contributed in large measure to the emergence of the anti-vivisection movement. Public protests over animal experiments conducted in France and the fear that these might come to England led to the passage of the first law controlling animal experimentation, the "1876 Cruelty to Animals Act" in England. This history and the dynamic tension between scientific inquiry and public concern set the stage for the activism and scholarship of the twentieth century.Since the 1960s, the amount of attention, activism, and scholarship related to animal use has increased at a rapid pace. The modern animal protection movement, led by the Australian philosopher Peter Singer in his book, Animal Liberation (II, 1975), based its advocacy on animals' ability to experience pain and suffering (Bentham's argument). Singer's book and other investigations into animal research, such as LIFE magazine's photojournalism piece on pet theft, animal cruelty, and animal experimentation (Concentration Camps for Dogs. LIFE (4 February 1966), pp. 22-29), brought the use of animals in research, testing, and education to the attention of the general public. Activists, advocates, laypersons, scientists, lawmakers, and animals themselves, have created the interesting, complicated, and complex history of animal rights and animal welfare over the last several decades. Current Statistics Worldwide, approximately 35 million animals are used in research each year; the United States alone uses 12 million animals annually--more than any other country. In 1998, the official number of research animals recorded in the United States was 1... (shrink)

Research on learning under anesthesia has focused on showing that learning is possible in the absence of awareness. However, a simple dissociation between learning and awareness is conclusive only under strong additional assumptions, and the actual state of consciousness of an anesthetized person is difficult to determine. Instead of trying to establish complete unconsciousness, one might employ gradual anesthesia to experimentally vary the level of consciousness in a controlled fashion, checking whether cognitive processes exist that can change in opposite direction (...) to measures of awareness. (shrink)

BackgroundA patient who fulfils the due diligence requirements for euthanasia, and is medically suitable, is able to donate his organs after euthanasia in Belgium, the Netherlands and Canada. Since 2012, more than 70 patients have undergone this combined procedure in the Netherlands. Even though all patients who undergo euthanasia are suffering hopelessly and unbearably, some of these patients are nevertheless willing to help others in need of an organ. Organ donation after euthanasia is a so-called donation after circulatory death (DCD), (...) Maastricht category III procedure, which takes place following cardiac arrest, comparable to donation after withdrawal of life sustaining therapy in critically ill patients. To minimize the period of organ ischemia, the patient is transported to the operating room immediately after the legally mandated no-touch period of 5 min following circulatory arrest. This means that the organ donation procedure following euthanasia must take place in the hospital, which appears to be insurmountable to many patients who are willing to donate, since they already spent a lot of time in the hospital. Case presentationThis article describes the procedure of organ donation after euthanasia starting at home (ODAEH) following anesthesia in a former health care professional suffering from multiple system atrophy. This case is unique for at least two reasons. He spent his last conscious hours surrounded by his family at home, after which he underwent general anaesthesia and was intubated, before being transported to the hospital for euthanasia and organ donation. In addition, the patient explicitly requested the euthanasia to be performed in the preparation room, next to the operating room, in order to limit the period of organ ischemia due to transport time from the intensive care unit to the operating room. The medical, legal and ethical considerations related to this illustrative case are subsequently discussed.ConclusionsOrgan donation after euthanasia is a pure act of altruism. This combined procedure can also be performed after the patient has been anesthetized at home and during transportation to the hospital. (shrink)

It is no accident that white privilege designed to be both be invisible and weightless to white people. Alison Bailey’s “On White Privilege and Anesthesia: Why Does Peggy McIntosh’s Knapsack Feel Weightless?” extends a weighty invitation white readers to complete the unpacking task McIntosh (1988) began when she compared white privilege to an “invisible and weightless knapsack.” McIntosh focuses primarily making white privilege visible to white people. Bailey’s project continues the conversation by extending a ‘weighty invitation’ to white readers to (...) explore why the metaphorical knapsack, despite the weight of its contents, feels weightless. Here’s the short answer. The knapsack only feels weightless because white people have become anesthetized us to our own brokenness. We are more comfortable considering what white privilege does for us than what it does to us. People of color feel the weight of whiteness every day. The weighty invitation invites white readers to become sensitive to our own insensitivity. To do this Bailey (1) explores white resistance to unpacking the weight; (2) people of color’s testimonies to the daily impact of the weight on their bodies; and (3) how the anesthesia of white privilege distorts our humanity. The article concludes with a McIntosh style list of that the anesthesia of privilege distorts white people’s humanity. (shrink)

Kierkegaard's relation to Luther and Lutheranism varied drastically according to his different authorial goals. In general, Kierkegaard employed Luther and the Lutheran doctrines of justification by grace and kenosis positively when he wanted to comfort believers or to prod partially sympathetic devout individuals toward a more authentic faith. However, he sharply critiqued Luther when he intended to challenge the basic premises of a spiritually anesthetized Christendom that took grace for granted. Consequently, the dialectic of rigor and leniency that Kierkegaard sometimes (...) discerned in Luther was reflected in Kierkegaard's own appropriation of Luther. (shrink)

One of the most essential characteristics of living material—indeed, according to many, its most essential characteristic—is the fact that it is irritable. A living cell responds to sudden environmental changes, and typically a cell of a given sort responds in a definite and particular way no matter what the nature of the stimulation. Thus when a muscle cell is exposed to sudden heat, to sudden cold, to a sharp mechanical impact, to ultraviolet radiation, or to an electric current, it shortens. (...) Similarly, a nerve fiber responds in its own characteristic way, and this response is independent of the nature of the stimulation. In general, mechanical impacts, ultraviolet radiation, electric shocks, and certain types of chemical substances are stimulating agents for many diverse types of protoplasm and they serve to arouse it to activity. The response of protoplasm to stimulation may be prevented by anesthetics. These are substances which nullify the effect of a stimulus without killing or seriously injuring the protoplasm. The remarkable fact is that there are general anesthetics, substances which in much the same concentration can prevent protoplasmic activity in widely different protoplasmic systems. Many fat solvents, such as ether, are general anesthetics. Magnesium salts also behave as anesthetics for many different types of cells. (shrink)

Among the many words Heidegger explores in order to elucidate his primary matter for thought, one would not likely expect Schmerz (“pain”) to play a prominent role. And yet, in a selection of notes recently published in a limited German edition under the title Uber den Schmerz (On Pain), Heidegger goes so far as to claim that pain is beyng itself. In this paper I analyze Heidegger’s ontological treatment of pain and his etymology of its Greek counterpart, asking whether he (...) does not ultimately anesthetize his readers to pain’s most rending effects. (shrink)

Frontoparietal connectivity has been suggested to be important in conscious processing and its interruption is thought to be one mechanism of general anesthesia. Data in animals demonstrate that feedforward processing of information may persist during the anesthetized state, while feedback processing is inhibited. We investigated the directionality and functional organization of frontoparietal connectivity in 10 human subjects anesthetized with propofol on two separate occasions. Multichannel electroencephalography and a computational method of assessing directed functional connectivity were employed. We demonstrate that directed (...) feedback connectivity is diminished with loss of consciousness and returns with responsiveness to verbal command. We also applied the Dendrogram classification method to assess the global organization of directed functional connectivity during consciousness and anesthesia. We demonstrate a state-specific hierarchy and subject-specific subhierarchy in functional organization. These data support the hypothesis that specific states of human consciousness are defined by specific states of frontoparietal connectivity. (shrink)

In his critical response to our skeptical inquiry, “Does Culture Evolve?” , W. G. Runciman affirms that “Culture Does Evolve.” However, we find nothing in his essay that convinces us to alter our initial position. And we must confess that in composing an answer to Runciman, our first temptation was simply to urge those interested to read our original article—both as a basis for evaluating Runciman’s attempted refutation of it and as a framework for reading this essay, which addresses in (...) greater detail issues we have already raised. Runciman views the “selectionist paradigm” as a “scientific” “puzzle-solving device” now validated by an “expanding literature” that has successfully modeled social and cultural change as “evolutionary.” All paradigms, however, including scientific ones, give rise to self-validating “normal science.” The real issue, accordingly, is not whether explanations can be successfully manufactured on the basis of paradigmatic assumptions, but whether the paradigmatic assumptions are appropriate to the object of analysis. The selectionist paradigm requires the reduction of society and culture to inheritance systems that consist of randomly varying, individual units, some of which are selected, and some not; and with society and culture thus reduced to inheritance systems, history can be reduced to “evolution.” But these reductions, which are required by the selectionist paradigm, exclude much that is essential to a satisfactory historical explanation—particularly the systemic properties of society and culture and the combination of systemic logic and contingency. Now as before, therefore, we conclude that while historical phenomena can always be modeled selectionistically, selectionist explanations do no work, nor do they contribute anything new except a misleading vocabulary that anesthetizes history. (shrink)