Circumscribed delusional beliefs can follow brain injury. We suggest that these involve anomalous perceptual experiences created by a deficit to the person's perceptual system, and misinterpretation of these experiences due to biased reasoning. We use the Capgras delusion (the claim that one or more of one's close relatives has been replaced by an exact replica or impostor) to illustrate this argument. Our account maintains that people voicing this delusion suffer an impairment that leads to faces being perceived as drained (...) of their normal affective significance, and an additional reasoning bias that leads them to put greater weight on forming beliefs that are observationally adequate rather than beliefs that are a conservative extension of their existing stock. We show how this position can integrate issues involved in the philosophy and psychology of belief, and examine the scope for mutually beneficial interaction. (shrink)
The aim of this paper was to explore the issue of consent when considering the use of a life saving but not necessarily restorative surgical intervention for severe traumatic brain injury. A previous study has investigated the issue amongst 500 healthcare workers by using a two-part structured interview to assess opinion regarding decompressive craniectomy for three patients with varying injury severity. A visual analogue scale was used to assess the strengths of their opinions both before and after being (...) shown objective outcome data. Opinions were assessed in a number of scenarios, one of which was that the participants themselves were the injured party. The implication, which was clearly stated, was whether they would provide consent for the procedure to be performed. The study demonstrated that participants were relatively risk aversive in regards to survival with severe disability especially when the injury was severe and there was high probability of that outcome occurring. This finding was not however universal and a minority of participants would provide consent even when the possibility of survival with severe disability was very high. The obvious difficulty comes when considering consent in patients who are unable to express their wishes. In order to address this issue we propose a model of consent based on a balance of the various factors that seem to be of material relevance. These include the severity of the injury, the willingness or otherwise to accept survival with severe disability and the willingness to “risk” the possibility of an unacceptable outcome in order to achieve an acceptable outcome. (shrink)
Many people who believe that abortion may often be justiﬁed by appeal to the pregnant woman’s interests also believe that a woman’s inﬂiction of signiﬁcant but nonlethal injury on her fetus can seldom be justiﬁed by appeal to her interests. Yet the second of these beliefs can seem to cast doubt on the ﬁrst. For the view that the inﬂiction of prenatal injury is seriously morally objectionable may seem to presuppose a view about the status of the fetus (...) that challenges the permissibility of abortion. The fear of being interpreted as implicitly endorsing such a view has thus led some defenders of abortion to be reluctant for tactical reasons to condemn the inﬂiction of prenatal injury. In this they are encouraged by those who exploit the issue of prenatal injury in their campaign against abortion. When, for example, the House and Senate in 2004 passed legislation recognizing two victims of an assault against a pregnant woman, many viewed this as a tactic in a larger strategy to restrict access to abortion. This tactic is potentially effective. For people may ﬁnd it compelling to infer that, if injuring a fetus is seriously objectionable, abortion must be even more objectionable, since killing is normally more seriously objectionable than merely injuring. (shrink)
Psychiatric patients may try (or express a desire) to injure themselves in hospital in order to cope with overwhelming emotional pain. Some health care practitioners and patients propose allowing a controlled amount of self-injury to occur in inpatient facilities, so as to prevent escalation of distress. Is this approach an example of professional assistance with harm? Or, is the approach more likely to minimise harm, by ensuring safer self-injury? In this article, I argue that health care practitioners who (...) use harm-minimisation can be considered to be helping physical injury to occur, although they do not encourage the act. I consider why there are compelling reasons to believe that a patient who self-injures is not maximally autonomous in relation to that choice. However, I then move onto argue that allowing a degree of self-injury may enable engagement with psychotherapy (enhancing autonomy) and behavioural change. In these circumstances, allowing injury (with precautions) may not be harm, all things considered. (shrink)
This study examined more than 2,500 war images from U.S. television news, newspapers, news magazines, and online news sites during the first five weeks of the U.S.-led invasion of Iraq in 2003 and found that only 10% showed injury or death. The paper analyzes which media platforms were most willing to show casualties and offers insights on when journalists should use gruesome war images or keep them secret.
To what extent is imagination dependent on embodied experience? In attempting to answer such questions I consider the experiences of those who have to come to terms with altered neurological function, namely those with spinal cord injury at the neck. These people have each lost all sensation and movement below the neck. How might these new ways of living affect their imagination?
Informed by the critical humanisms of Hannah Arendt, Frantz Fanon, and Paul Gilroy, the authors argue for an orientation to teaching and learning that troubles the continuing effects of dehumanizing race logic. Reflecting on Paul Haggis's Oscar award winning film Crash from 2004, they suggest that the metaphor of racial 'crashing' captures what happens when we act out from experiences of racial injury instead of being touched by it. They propose a psychoanalytic pedagogy of emotions as a method for (...) reading representation beyond the limits of detached rational critique. Learning from the affect of racial injury as it is made manifest in representation, they suggest, is an important ethical starting point for generating new insights into what it might mean to live within and beyond contemporary legacies of racial hatred. (shrink)
This paper explicates a conception of injury as right-violation, which allows us to distinguish between setbacks to interests that should, and should not, be the concern of theories of justice. It begins by introducing a hybrid theory of rights, grounded in (a) the mobilisation of our moral equality to (b) protect our most important interests, and shows how violations of rights are the concern of justice, while setbacks where one of the twin grounds of rights is defeated are not. (...) It then looks more closely at the substantive moral components of injury, namely harm—damage to one’s interests—and wrong—disrespect for one’s moral equality. It argues that, on the hybrid conception of rights, harm and wrong are individually necessary and jointly sufficient components of injury, and the disvalue of neither is reducible to the other—in particular, it is a mistake to construe the disrespect identified by wrong as another damaged interest. Finally, it distinguishes between the public and private dimensions of harm and wrong, and makes some preliminary suggestions as to whether the remedy for these different dimensions should lie in criminal, distributive, or corrective justice. (shrink)
Recent research suggests that spiritual experiences are related to increased physiological activity of the frontal and temporal lobes and decreased activity of the right parietal lobe. The current study determined if similar relationships exist between self-reported spirituality and neuropsychological abilities associated with those cerebral structures for persons with traumatic brain injury (TBI). Participants included 26 adults with TBI referred for neuropsychological assessment. Measures included the Core Index of Spirituality (INSPIRIT); neuropsychological indices of cerebral structures: temporal lobes (Wechsler Memory Scale-III), (...) right parietal lobe (Judgment of Line Orientation), and frontal lobes (Trail Making Test, Controlled Oral Word Association Test). As hypothesized, spirituality was significantly negatively correlated with a measure of right parietal lobe functioning and positively correlated (nonsignificantly) with measures of left temporal lobe functioning. Contrary to hypotheses, correlations between spirituality and measures of frontal lobe functioning were zero or negative (and nonsignificant). The data support a neuropsychological model that proposes that spiritual experiences are related to decreased activity of the right parietal lobe, which may be associated with decreased awareness of the self (transcendence) and increased activity of the left temporal lobe, which may be associated with the experience of specific religious archetypes (religious figures and symbols). (shrink)
Geron recently announced that it had begun enrolling patients in the world's first-in-human clinical trial involving cells derived from human embryonic stem cells (hESCs). This trial raises important questions regarding the future of hESC-based therapies, especially in spinal cord injury (SCI) patients. We address some safety and efficacy concerns with this research, as well as the ethics of fair subject selection. We consider other populations that might be better for this research: chronic complete SCI patients for a safety trial, (...) subacute incomplete SCI patients for an efficacy trial, and perhaps primary progressive multiple sclerosis (MS) patients for a combined safety and efficacy trial. (shrink)
The principle of non-injury toward all living beings (ahimsā) in India was originally a rule restraining human interaction with the natural environment. I compare two discourses on the relationship between humans and the natural environment in ancient India: the discourse of the priestly sacrificial cult and the discourse of the renunciants. In the sacrificial cult, all living beings were conceptualized as food. The renunciants opposed this conception and favored the ethics of non-injury toward all beings (plants, animals, etc.), (...) which meant that no living being should be food for another. The first represented an ethics modeled on the power that the eater has over the eaten while the second attempted to overturn this food chain ethics. The ethics of non-injury ascribed ultimate value to every individual living being. As a critique of the individualistic ethics of noninjury, a holistic ethics was developed that prescribed the unselfish performance of one’s duties for the sake of the functioning of the natural system. Vegetarianismbecame a popular adaptation of the ethics of non-injury. These dramatic changes in ethics in ancient India are suggestive for the possibility of dramatic changes in environmental ethics today. (shrink)
: The effects of head injury, even mild traumatic brain injury, are wide-ranging and profound. Persons with adult-onset head injury offer feminist philosophers important perspectives for philosophical methodology and philosophical research concerning personal identity, mind-body theories, and ethics. The needs of persons with head injury require the expansion of typical teaching strategies, and such adaptations appear beneficial to both disabled and non-disabled students.
We show that the existence of a recursively enumerable set whose Turing degree is neither low nor complete cannot be proven from the basic axioms of first order arithmetic (P -) together with Σ 2 -collection (BΣ 2 ). In contrast, a high (hence, not low) incomplete recursively enumerable set can be assembled by a standard application of the infinite injury priority method. Similarly, for each n, the existence of an incomplete recursively enumerable set that is neither low n (...) nor high n - 1 , while true, cannot be established in P - + BΣ n + 1 . Consequently, no bounded fragment of first order arithmetic establishes the facts that the high n and low n jump hierarchies are proper on the recursively enumerable degrees. (shrink)
Working in the language of first-order arithmetic we consider models of the base theory P - . Suppose M is a model of P - and let M satisfy induction for σ 1 -formulas. First it is shown that the Friedberg-Muchnik finite injury argument can be performed inside M, and then, using a blocking method for the requirements, we prove that the Sacks splitting construction can be done in M. So, the "amount" of induction needed to perform the known (...) finite injury priority arguments is Σ 1 -induction. (shrink)
It is the persistence of social suffering in a world in which it could be eliminated that for Adorno is the source of the need for critical reflection, for philosophy. Philosophy continues and gains its cultural place because an as yet unbridgeable abyss separates the social potential for the relief of unnecessary human suffering and its emphatic continuance. Philosophy now is the culturally bound repository for the systematic acknowledgement and articulation of the meaning of the expanse of human suffering within (...) technologically advanced societies that are already committed to liberal ideals of freedom and equality. (shrink)
The value of resting electroencephalogram (EEG) in revealing neural constitutes of consciousness (NCC) was examined. We quantified the dynamic repertoire, duration and oscillatory type of EEG microstates in eyes-closed rest in relation to the degree of expression of clinical self-consciousness. For NCC a model was suggested that contrasted normal, severely disturbed state of consciousness and state without consciousness. Patients with disorders of consciousness were used. Results suggested that the repertoire, duration and oscillatory type of EEG microstates in resting condition quantitatively (...) related to the level of consciousness expression in brain-damaged patients and healthy-conscious subjects. Specifically, results demonstrated that (a) decreased number of EEG microstate types was associated with altered states of consciousness, (b) unawareness was associated with the lack of diversity in EEG alpha-rhythmic microstates, and (c) the probability for the occurrence and duration of delta-, theta- and slow-alpha-rhythmic microstates were associated with unawareness, whereas the probability for the occurrence and duration of fast-alpha-rhythmic microstates were associated with consciousness. In conclusion, resting EEG has a potential value in revealing NCC. This work may have implications for clinical care and medical–legal decisions in patients with disorders of consciousness. (shrink)
In early 2009, President Obama overturned the ban on federal funding for research involving the derivation of human embryonic stem cells (hESC). The Food and Drug Administration (FDA) also approved Geron’s first-in-human hESC trial for spinal cord injury (SCI) patients. We anticipate an increase in both research in the United States to derive hESC and applications to the FDA for approval of clinical trials involving transplantation of hESCs. An increase of such clinical trials will require a concomitant increase in (...) the number of preceding preclinical assays. We examine important issues concerning the use of animals in SCI stem cell research that require a reevaluation of the moral permissibility of studies such as Geron’s. (shrink)
Road traffic injury and deaths (RTID) are an important public health problem in Kenya, primarily affecting uneducated and disenfranchised people from lower socioeconomic groups. Studies conducted by Kenyan experts from police reports and surveys have shown that pedestrian and driver behaviors are the most important proximal causes of crashes, signifying that the occurrence of crashes results directly from human action. However, behaviors and risk factors do not fully explain the magnitude of RTID neither does it account for socioeconomic gradient (...) in RTID. Instead, a social justice approach to RTID highlights the need for emphasizing distal causal factors. They allow us to understand how social inequities determine risk for RTID. Hence, designing policies that focus on behaviors will simply mask the underlying systemic causes of this growing phenomenon. To eradicate the RTID and address the gradient, a broader policy framework that includes the social dimension of injury, a strong political will to address the underlying causes of RTID and an effective partnership with stakeholders needs to be developed. (shrink)
The ethical challenge is squarely focused on the question of what is owed to participants of vaccine trials who happen to become infected during the course of the trial. Not surprisingly, given the prominence of HIV/AIDS in many parts of the developing world, HIV vaccine trials have become the focal point of this debate. It is worth noting from the outset, however, that the same arguments that apply to HIV vaccines would apply to any number of microbicide trials aimed at (...) protecting women against a large variety of sexually transmitted illnesses.1 One of the controversial questions in this debate has been the issue of whether or not an infection acquired by vaccine trial participants during the course of the trial can reasonably be considered a trial related injury that ought to be subject to compensation (in the form of access to good quality AIDS treatments, including antiretrovirals). (shrink)
Disclosing the ontology of sports injuries by looking closer at their meaning provides us with insight into the professional ethics of the sports medicine specialist. The aim of this article is twofold: to disclose the “the ontology of sports injuries,” and to use the disclosure as an insightful perspective for dwelling on the ethics of sports medicine. Because of the unique nature of sports, the standard ethical prescriptions usually associated with medical ethics are of little use for the sports medicine (...) specialist in treating sport injuries. In spelling out the special ethical context of sports medicine, this paper suggests several distinctions. I propose several models, which provide different conceptions of what constitutes a sport injury: (1) The Medical Model; (2) The Normative Model; (3) The Liberal Model; (4) The Phenomenological Model. The implications of each of these models for sports medicine is assessed, and through them the concept of a sports injury is clarified in a way that can assist us in inferring what is to be done from an ethical point of view. (shrink)