BackgroundUnderstanding representations of disease in various art genres provides insights into how patients and health care providers view the diseases. It can also be used to enhance patient care and stimulate patient self-management.MethodsThis paper reviews how cardiovascular diseases are represented in novels, films, and paintings: myocardial infarction, aneurysm, hypertension, stroke, heart transplantation, Marfan’s disease, congestive heart failure. Various search systems and definitions were used to help identify sources of representations of different cardiovascular diseases. The representations of the different diseases were (...) considered separately. The Common Sense Model was used a theoretical model to outline illness perceptions and self-management in the various identified novels, films, and paintings.ResultsMyocardial infarction followed by stroke were the most frequently detailed diseases in all three art genres. This reflects their higher prevalence. Representations ranged from biomedical details through to social and psychological consequences of the diseases.ConclusionsArtistic representations of cardiovascular diseases reflect cognitions, emotions, and images of prevalent disease. These representations shape views and behaviour of ill and healthy persons regarding heart diseases. As these representations are amenable to change, they deserve further research, which may be instrumental in improving the quality of life of persons struck by cardiovascular diseases. Changing illness perceptions appears to be a method to improve self-management and thereby quality of life in patients with various cardiovascular diseases. (shrink)

In everyday life, situations in which we act adequately yet entirely without deliberation are ubiquitous. We use the term “situated normativity” for the normative aspect of embodied cognition in skillful action. Wittgenstein’s notion of “directed discontent” refers to a context-sensitive reaction of appreciation in skillful action. Extending this notion from the domain of expertise to that of adequate everyday action, we examine phenomenologically the question of what happens when skilled individuals act correctly with instinctive ease. This question invites exploratory contributions (...) from a variety of perspectives complementary to the philosophical/ phenomenological one, including cognitive neuroscience, neurodynamics and psychology. Along such lines we try to make the normative aspect of adequate immediate action better accessible to empirical research. After introducing the idea that “valence” is a forerunner of directed discontent, we propose to make progress on this by first pursuing a more restricted exploratory question, namely, ‘what happens in the first few hundred milliseconds of the development of directed discontent?’. (shrink)

Brain–computer interfacing (BCI) aims at directly capturing brain activity in order to enable a user to drive an application such as a wheelchair without using peripheral neural or motor systems. Low signal to noise ratio’s, low processing speed, and huge intra- and inter-subject variability currently call for the addition of intelligence to the applications, in order to compensate for errors in the production and/or the decoding of brain signals. However, the combination of minds and machines through BCI’s and intelligent devices (...) (IDs) can affect a user’s sense of agency. Particularly confusing cases can arise when the behavioral control switches implicitly from user to ID. I will suggest that in such situations users may be insecure about the extent to which the resulting behavior, whether successful or unsuccessful, is genuinely their own. Hence, while performing an action, a user of a BCI–ID may be uncertain about being the agent of the act. Several cases will be examined and some implications for (legal) responsibility (e.g. establishing the presence of a ‘guilty mind’) are discussed. (shrink)

In recent years the cognitive science community has witnessed the rise of a new, dynamical approach to cognition. This approach entails a framework in which cognition and behavior are taken to result from complex dynamical interactions between brain, body, and environment. The advent of the dynamical approach is grounded in a dissatisfaction with the classical computational view of cognition. A particularly strong claim has been that cognitive systems do not rely on internal representations and computations. Focusing on this claim, we (...) take as a starting point a question recently raised by Cliff and Noble: " if evolution did produce a design that used internal representations, how would we recognize it?" (Knowledge-based vision and simple visual machines, Philosophical Transactions of the Royal Society: Biological Sciences, 352 , 1165-1175, 1997). We will argue that cognitive science lacks a proper operationalization of the notion of representation, and therefore is unable to fruitfully discuss whether a particular system has representations or not. A basic method to detect representations in a physical system, grounded in isomorphism, turns out to be quite unconstrained. We will look at a practical example of this problem by examining the debate on whether or not van Gelder's (What might cognition be, if not computation? Journal of Philosophy, 92 , 345-381, 1995) controversial example of the Watt Governor is representational. We will conclude that cognitive science, as of yet, has no empirically applicable means to answer Cliff and Noble's question unequivocally. This makes the recent representationalism vs. anti-representationalism debate a debate for the sake of appearance. (shrink)

The struggles against extractivist developments have been a constant during the past 50 years of accelerated social transformation of the Galizan rural landscape. From the 1970s As Encrobas and Triacastela struggles against open pit coal and limestone mining to recent mass movements against the Corcoesto, San Finx and Touro metal mining developments, a common pattern emerges of emancipatory rural action to defend lands and livelihoods from the ruling Partido Popular slogan “Galiza is a mine”. Renewed interest for mining developments in (...) the 2010s following growing metal prices, EU policies on ‘critical raw materials’ and corporate interest in investment alternatives after the collapse of the Spanish property bubble has fuelled levels of social contestation unseen for decades in the traditional strongholds of Galizan local power-brokers. Drawing on historical and participatory action research, this paper examines contemporary forms of nonviolent contestation and explores their capacity to build emancipatory alternatives. (shrink)

Currently, patients are expected to take control over their health and their life and act as independent users and consumers. Simultaneously, health care policy demands patients are expected to self manage their disease. This article critically questions whether this is a realistic expectation. The paper presents the auto-ethnographic narrative of the first author, which spans a period of 27 years, from 1985 to 2012. In total nine episodes were extracted from various notes, conversations and discussions in an iterative process. Each (...) of these episodes was condensed around a ‘critical moment’ as perceived by the “self”. The critical moments in the illness process vary between newly encountered problems with basic needs and mourning, to renewed strength and the desire to grow, embracing new situations. Being confronted with and living with a chronic illness involves periods of anxiety and self centredness alternating with strength and advocating the interests of peer-patients. These episodes of emotion, confusion and refinding a balance have a cyclic pattern. The narrative illustrates the vulnerability and dependency of a patient with a chronic disease. The discussion relates this to mainstream dominant views on patients ‘in control of their own life’. The narrative illustrates, that the vulnerability and dependency of the patient are key factors to take into account in health care policy. The narrative provides a counter story, challenging current thinking in terms of strength, selfmanagement, patients’ own control and independent role. (shrink)

This study aims to understand how and why emerging adults come into contact with food media messages, and what they perceive as positive and negative outcomes related to food literacy. Seven focus groups, stratified by gender and socio-economic status, with 37 emerging adults aged between 18 and 25 were conducted. Photovoice was used to reflect on participants’ real-life food media experiences. Findings reveal that food media consumption is a combination of actively searching and incidentally encountering. The results suggest that food (...) media messages attract emerging adults’ attention by bringing content in an entertaining, engaging, and appealing way, and featuring popular food personalities. Finally, food media messages were perceived to both enhance and distort food literacy. The results show how food media messages for food literacy interventions can be designed in order to attract emerging adults’ attention and fulfill their specific needs. (shrink)

An authoethnography explores the lived experiences of patients being in control and self-managing their chronic illness among their families and friends. Findings show that the current health discourse narrows down people to mere patients and gives rise to tensions. This article indicates that people with one or several chronic illnesses or disabilities are first of all full citizens with needs, values, and drives seeking a meaningful life. Fair possibilities ought to exist to satisfy their needs to belong, to care for (...) and to matter to others since these constitute an essential aspect of being human. (shrink)

We propose that virtue ethics can be used to address ethical issues central to discussions about sex robots. In particular, we argue virtue ethics is well equipped to focus on the implications of sex robots for human moral character. Our evaluation develops in four steps. First, we present virtue ethics as a suitable framework for the evaluation of human–robot relationships. Second, we show the advantages of our virtue ethical account of sex robots by comparing it to current instrumentalist approaches, showing (...) how the former better captures the reciprocal interaction between robots and their users. Third, we examine how a virtue ethical analysis of intimate human–robot relationships could inspire the design of robots that support the cultivation of virtues. We suggest that a sex robot which is equipped with a consent-module could support the cultivation of compassion when used in supervised, therapeutic scenarios. Fourth, we discuss the ethical implications of our analysis for user autonomy and responsibility. (shrink)

Brain–computer interfacing technologies are used as assistive technologies for patients as well as healthy subjects to control devices solely by brain activity. Yet the risks associated with the misuse of these technologies remain largely unexplored. Recent findings have shown that BCIs are potentially vulnerable to cybercriminality. This opens the prospect of “neurocrime”: extending the range of computer-crime to neural devices. This paper explores a type of neurocrime that we call brain-hacking as it aims at the illicit access to and manipulation (...) of neural information and computation. As neural computation underlies cognition, behavior and our self-determination as persons, a careful analysis of the emerging risks of malicious brain-hacking is paramount, and ethical safeguards against these risks should be considered early in design and regulation. This contribution is aimed at raising awareness of the emerging risk of malicious brain-hacking and takes a first step in developing an ethical and legal reflection on those risks. (shrink)

For the past several years patients have been expected to play a key role in their recovery. Self management and disease management have reached a hype status. Considering these recent trends what does this mean for the division of responsibilities between doctors and patients? What kind of role should healthcare providers play? With findings based on a qualitative research project of an innovative practice for people with Chronic Obstructive Pulmonary Disease (COPD) we reflect on these questions. In-depth interviews conducted with (...) people with COPD, physiotherapists and a pulmonologist show that shifting responsibilities require a supportive attitude from healthcare providers and a dialogical communication between patients and professionals. Our findings show more is needed in order to motivate people with COPD to take responsibility and become co-owners in a process of recovery. The case example illustrates that people with COPD need support from fellow patients to learn to accept their disabilities. Awareness that COPD is more than just a lack of air, that mind and body interact, is a first step to investigate other potential problems and to enhance one’s quality of life. (shrink)

English: In this paper I indicate why I consider 'experimental philosophy' to be good news, though not as good as it could be, and not as all that new. I'll argue that there is no need to restrict experimental philosophy to eliciting intuitions through questionnaires. I'll indicate that good examples of experimental philosophy already exist in Artificial Intelligence and Cognitive Neuroscience. Dutch: Hieronder wil ik proberen aan te geven waarom ik de experimentele filosofie weliswaar als goed nieuws beschouw, maar niet (...) half zo goed als zou kunnen, en ook niet als echt nieuw. Qua filosofische experimenten beperkt de XF-beweging zich vooralsnog onnodig door haar focus op het eliciteren van intuïties, terwijl er reeds lang diverse goede voorbeelden van XF bestaan op het gebied van de kunstmatige intelligentie en de cognitieve neurowetenschap. (shrink)

Our think tank tasked by the Dutch Health Council, consisting of Radboud University Nijmegen Honours Academy students with various backgrounds, investigated the implications of Deep Brain Stimulation for psychiatric patients. During this investigation, a number of methodological, ethical and societal difficulties were identified. We consider these difficulties to be a reflection of a still fragmented field of research that can be overcome with improved organization and communication. To this effect, we suggest that it would be useful to found a centralized (...) DBS organization. Such an organization makes it possible to 1) set up and maintain a repository, 2) facilitate DBS studies with a larger sample size, 3) improve communication amongst researchers, clinicians and ethical committees, and 4) improve communication between DBS experts and the public at large. (shrink)

I present experimental and computational research, inspired by the perspective of Embodied Embedded Cognition, concerning various aspects of language as supporting Everett’s interactionist view of language. Based on earlier and ongo- ing work, I briefly illustrate the contribution of the environment to the syste- maticity displayed in linguistic performance, the importance of joint attention for the development of a shared vocabulary, the role of (limited) traveling for language diversification, the function of perspective taking in social communica- tion, and the bodily (...) nature of understanding of meaning. (shrink)

Human decisions are increasingly supported by decision support systems (DSS). Humans are required to remain “on the loop,” by monitoring and approving/rejecting machine recommendations. However, use of DSS can lead to overreliance on machines, reducing human oversight. This paper proposes “reflection machines” (RM) to increase meaningful human control. An RM provides a medical expert not with suggestions for a decision, but with questions that stimulate reflection about decisions. It can refer to data points or suggest counterarguments that are less compatible (...) with the planned decision. RMs think against the proposed decision in order to increase human resistance against automation complacency. Building on preliminary research, this paper will (1) make a case for deriving a set of design requirements for RMs from EU regulations, (2) suggest a way how RMs could support decision-making, (3) describe the possibility of how a prototype of an RM could apply to the medical domain of chronic low back pain, and (4) highlight the importance of exploring an RM’s functionality and the experiences of users working with it. (shrink)

Deep brain stimulation is a well-accepted treatment for movement disorders and is currently explored as a treatment option for various neurological and psychiatric disorders. Several case studies suggest that DBS may, in some patients, influence mental states critical to personality to such an extent that it affects an individual’s personal identity, i.e. the experience of psychological continuity, of persisting through time as the same person. Without questioning the usefulness of DBS as a treatment option for various serious and treatment refractory (...) conditions, the potential of disruptions of psychological continuity raises a number of ethical and legal questions. An important question is that of legal responsibility if DBS induced changes in a patient’s personality result in damage caused by undesirable or even deviant behavior. Disruptions in psychological continuity can in some cases also have an effect on an individual’s mental competence. This capacity is necessary in order to obtain informed consent to start, continue or stop treatment, and it is therefore not only important from an ethical point of view but also has legal consequences. Taking the existing literature and the Dutch legal system as a starting point, the present paper discusses the implications of DBS induced disruptions in psychological continuity for a patient’s responsibility for action and competence of decision and raises a number of questions that need further research. (shrink)

Contemporary brain reading technologies promise to provide the possibility to decode and interpret mental states and processes. Brain reading could have numerous societally relevant implications. In particular, the private character of mind might be affected, generating ethical and legal concerns. This paper aims at equipping ethicists and policy makers with conceptual tools to support an evaluation of the potential applicability and the implications of current and near future brain reading technology. We start with clarifying the concepts of mind reading and (...) brain reading, and the different kinds of mental states that could in principle be read. Subsequently, we devise an evaluative framework that is composed of five criteria-accuracy, reliability, informativity, concealability and enforceability-aimed at enabling a clearer estimation of the degree to which brain reading might be realistically deployed in contexts where mental privacy could be at stake. While accuracy and reliability capture how well a certain method can access mental content, informativity indicates the relevance the obtainable data have for practical purposes. Concealability and enforceability are particularly important for the evaluation of concerns about potential violations of mental privacy and civil rights. The former concerns the degree with which a brain reading method can be concealed from an individual’s perception or awareness. The latter regards the extent to which a method can be used against somebody’s will. With the help of these criteria, stakeholders can orient themselves in the rapidly developing field of brain reading. (shrink)

This article discusses the final purpose of the Cribratio Alkorani by Nicholas of Cusa. He offered it to pope Pius II as an instrument for the conversion of the Muslims. In conversation with Juan de Segovia, Nicholas developed the idea to «show the truth of the Gospel from the Qur’an» by giving a theological interpretation of this book that remained faithful to the principal tenets of the Christian faith while at the same time doing justice to the God-centeredness of the (...) Qur’an. (shrink)

Infinite Awareness pairs Woollacott’s research as a neuroscientist with her self-revelations about the her mind’s spiritual power. Between the scientific and spiritual worlds, she breaks open the definition of human consciousness to investigate the existence of a non-physical mind.

Recent Libet-style experiments are of limited relevance to the debate about free action and free will, and should be understood as investigations of arbitrary actions or guesses. In Libet-style experiments, the concept of 'free action' is commonly taken to refer to a 'self-initiated voluntary act', where the self prompts an action without being prompted. However, this idea is based on the problematic assumption that the conscious self needs to be free from every constraint in order to be actually free. We (...) maintain that a fundamental condition for free action is the presence of reasons to act responsibly. By analyzing a recent neuroscientific experiment, we indicate how its results could be interpreted as indicating how free action operationalization is inappropriately focusing on arbitrary actions. Hence, the way free action has been experimentally studied may have had a misleading influence on the debate about free will. (shrink)

The target article presented a plausible argument that females' susceptibility to threats might be self-protection for staying alive, but some evidence requires scrutiny. We need to consider the biases of narrative reviews, subjective life quality, and the shadow side of extreme reactions to threats before concluding that females' threat-based response is a self-protection mechanism that promotes survival.

In this article first some general aspects of near-death experience will be discussed, followed by questions about consciousness and its relation to brain function. Details will be described from our prospective study on near-death experience in survivors of cardiac arrest in the Netherlands, which was published in the Lancet in 2001. In this study it could not be shown that physiological, psychological, or pharmacological factors caused these experiences after cardiac arrest. Neurophysiology in cardiac arrest and in a normal functioning brain (...) will be explained. Finally, implications for consciousness studies will be discussed, and how it could be possible to explain the continuity of our consciousness. Scientific study of NDE pushes us to the limits of our medical and neurophysiologic ideas about the range of human consciousness and mind-brain relation. (shrink)

In this article a concept of non-local consciousness will be described, based on recent scientific research on near-death experiences . Since the publication of several prospective studies on NDEs in survivors of cardiac arrest, with strikingly similar results and conclusions, the phenomenon of the NDE can no longer be scientifically ignored. In the last thirty years several theories have been proposed to explain an NDE. The challenge to find a common explanation for the cause and content of an NDE is (...) complicated by the fact that an NDE can be experienced during various circumstances, such as severe injury of the brain as in cardiac arrest to conditions when the brain seems to function normally. The NDE is an authentic experience which cannot be simply reduced to imagination, fear of death, hallucination, psychosis, the use of drugs, or oxygen deficiency. Patients appear to be permanently changed by an NDE during a cardiac arrest of only some minutes duration. According to these aforementioned studies, the current materialistic view of the relationship between consciousness and the brain as held by most physicians, philosophers, and psychologists is too restricted for a proper understanding of this phenomenon. There are good reasons to assume that our consciousness does not always coincide with the functioning of our brain: enhanced or non-local consciousness can sometimes be experienced separately from the body. (shrink)