Gil R, Arroyo-Anllo EM, Ingrand P, Gil M, Neau JP, Ornon C, Bonnaud V. Self-consciousness and Alzheimer’s disease. Acta Neurol Scand 2001: 104: 296–300. # Munksgaard 2001. Objectives – To propose a neuropsychological study of the various aspects of self-consciousness (SC) in Alzheimer’s disease. Methods – Forty-five patients with probable mild or moderate AD were included in the study. Severity of their dementia was assessed by the Mini Mental State (MMS). Fourteen questions were prepared to evaluate SC. Results – (...) No significant correlations were found between SC score and educational level, age, and duration of disease. A significant correlation was found between SC score and the severity of dementia, whereas frontal disturbances were just short of the significance threshold. The various aspects of SC were not impaired to the same degree. The most disturbed ones were awareness of cognitive deficiencies, moral judgements and prospective memory. The least disturbed aspects were awareness of identity and of mental representation of the body. Items relating to anosognosia and moral judgements were significantly correlated with the MMS score, whereas affective state, body representation disorders, prospective memory, and capacities for introspection were not related to the severity of the dementia. Consciousness of identity was sound, regardless of MMS score. Conclusions – AD clearly induces an heterogeneous impairment of SC. SC requires a convergence of many neural networks. In AD, neuronal alterations involve many cortical areas and information sent to the associative frontal cortex from memory, language and visuospatial areas is lacking or disturbed. Thus, the sequential order of successive stimuli cannot be maintained by the heteromodal associative cortex (dorsal convexity of the prefrontal cortex), and the supramodal associative cortex (located rostrally in the frontal lobes) is unable to provide reliable monitoring and assessment of simultaneous neural cognitive networks carrying insufficient and inadequate input. The core deficiency in AD patients might be impaired SC equated with the disability to maintain sequential and simultaneous ‘‘attention to life’’. The Self-Consciousness Questionnaire, a clinical scale providing multidimensional measurement, indicates that different aspects of consciousness are not correlated with overall cognitive deficiency as determined by the MMSE. (shrink)

Objectives: To determine the effects of risk and payment on subjects’ willingness to participate, and to examine how payment influences subjects’ potential behaviours and risk evaluations.Methods: A 3 × 3 , between subjects, completely randomised factorial design was used. Students enrolled at one of five US pharmacy schools read a recruitment notice and informed consent form for a hypothetical study, and completed a questionnaire. Risk level was manipulated using recruitment notices and informed consent documents from hypothetical biomedical research projects. Payment (...) levels were determined using the payment models evaluated by Dickert and Grady as a guide. Five dependent variables were assessed in the questionnaire: willingness to participate, willingness to participate with no payment, propensity to neglect to tell about restricted activities, propensity to neglect to tell about negative effects, and risk rating.Results: Monetary payment had positive effects on respondents’ willingness to participate in research, regardless of the level of risk. However, higher monetary payments did not appear to blind respondents to the risks of a study. Payment had some influence on respondents’ potential behaviours regarding concealing information about restricted activities. However, payment did not appear to have a significant effect on respondents’ propensity to neglect to tell researchers about negative effects.Conclusions: Monetary payments appear to do what they are intended to do: make subjects more willing to participate in research. Concerns about payments blinding subjects to risks could not be substantiated in the present study. However, the findings do raise other concerns—notably the potential for payments to diminish the integrity of a study’s findings. Future research is critical to make sound decisions about the payment of research subjects. (shrink)

In The Construction of Social Reality, John Searle develops a theory of institutional facts and objects, of which money, borders and property are presented as prime examples. These objects are the result of us collectively intending certain natural objects to have a certain status, i.e. to ‘count as’ being certain social objects. This view renders such objects irreducible to natural objects. In this paper we propose a radically different approach that is more compatible with standard economic theory. We claim that (...) such institutional objects can be fully understood in terms of actions and incentives, and hence the Searlean apparatus solves a non-existent problem. (shrink)

After describing Heidegger's critique of metaphysics as ontotheology, I unpack the metaphysical assumptions of several transhumanist philosophers. I claim that they deploy an ontology of power and that they also deploy a kind of theology, as Heidegger meant it. I also describe the way in which this metaphysics begets its own politics and ethics. In order to transcend the human condition, they must transgress the human.

Background: Ethics consultation is used regularly by some doctors, whereas others are reluctant to use these services.Aim: To determine factors that may influence doctors to request or not request ethics consultation.Methods: A survey questionnaire was distributed to doctors on staff at the University Community Hospital in Tampa, Florida, USA. The responses to the questions on the survey were arranged in a Likert Scale, from strongly disagree, somewhat disagree, neither agree nor disagree, somewhat agree to strongly agree. Data were analysed with (...) the Wilcoxon test for group comparisons, the χ2 test to compare proportions and a logistic regression analysis.Results: Of the 186 surveys distributed, 121 were returned, giving a 65% response rate. Demographic data were similar between the groups saying yes and no . No statistically significant differences were observed between the user and non-user groups in terms of opinions about ethics consultants having extensive training in ethics or participating in ethics educational opportunities. On the issue “Ethics committee members or consultants cannot grasp the full picture from the outside”, the non-users were neutral, whereas the users somewhat disagreed . Even more significant was the difference between surgeons and non-surgeons, where, by logistic regression analysis, surgeons who believed that ethics consultants could not grasp the full picture from the outside were highly likely to not use . Non-users of ethics consultations thought that it was their responsibility to resolve issues with the patient or family . Users of ethics consultation believed in shared decision making or the importance of alternate points of view .Implications: Ethics consultations are used by doctors who believe in shared decision making. Doctors who did not use ethics consultation tended to think that it was their responsibility to resolve issues with patients and families and that they were already proficient in ethics. (shrink)

In the mid-1970s, the biomedical model of medicine gave way to the biopsychosocial model of medicine; it was billed as a more comprehensive and compassionate model of medicine. After more than a century of disentangling medicine from religion, the medicine and spirituality movement is attempting to bring religion and spirituality back into medicine. It is doing so under a biopsychosociospiritual model. I unpack one model for allowing religion back into medicine called the RCOPE. RCOPE is an instrument designed to categorize (...) religion and spirituality as psychological coping mechanisms. I explore how such instruments are related to the history of statistical measurement and demonstrate the political impetus that governs such enterprises. The biopsychosociospiritual medicine is billed as a more holistic and comprehensive model. This new model of medicine offers total care. However, I demonstrate how this total care becomes totalizing, indeed totalitarian, admitting religion and spirituality back into the fold of medicine under a new secularized medical control. (shrink)

Humanity does not gradually progress from combat to combat until it arrives at universal reciprocity, where the rule of law finally replaces warfare; humanity installs each of its violences in a system of rules and thus proceeds from domination to domination. (Foucault, 1984, 85)In this essay, I take a note from Michel Foucault regarding the notion of biopolitics. For Foucault, biopolitics has both repressive and constitutive properties. Foucault's claim is that with the rise of modern government, the state became exceedingly (...) concerned about the body politic, the bodies that make up the polis, including the health of those bodies. However, Giorgio Agamben claims that Foucault and all western political philosophy misses the relationship between power and Sovereignty, with disastrous results and totalizing tendencies. I explore the case of Terri Schiavo claiming that the social conservatives have attempted to politicize bare life in its legal maneuverings, but I also show how the social liberals open an uncontrollable space between life and death. Both the left and the right miss the aporia at the heart of western political philosophy, and bioethics is complicit in the totalizing effects of contemporary medicine. (shrink)

This essay places Foucault's work into a philosophical context, recognizing that Foucault is difficult to place and demonstrates that Foucault remains in the Kantian tradition of philosophy, even if he sits at the margins of that tradition. For Kant, the forms of intuition—space and time—are the a priori conditions of the possibility of human experience and knowledge. For Foucault, the a priori conditions are political space and historical time. Foucault sees political space as central to understanding both the subject and (...) objects of medicine, psychiatry, and the social sciences. Through this analysis one can see that medicine's metaphysics is a metaphysics of efficient causation, where medicine's objects are subjected to mechanisms of efficient control. (shrink)

Three experiments explore the role of working memory in motor skill acquisition and performance. Traditional theories postulate that skill acquisition proceeds through stages of knowing, which are initially declarative but later procedural. The reported experiments challenge that view and support an independent, parallel processing model, which predicts that procedural and declarative knowledge can be acquired separately and that the former does not depend on the availability of working memory, whereas, the latter does. The behaviour of these two processes was manipulated (...) by providing or withholding visual (and auditory) appraisal of outcome feedback. Withholding feedback was predicted to inhibit the use of working memory to appraise success and, thus, prevent the formation of declarative knowledge without affecting the accumulation of procedural knowledge. While the first experiment failed to support these predictions, the second and third experiments demonstrated that procedural and declarative knowledge can be acquired independently. It is suggested that the availability of working memory is crucial to motor performance only when the learner has come to rely on its use. (shrink)

Philosophy is experiencing a resurgence of property (PD) and generic substance dualism (SD). One important argument for SD that has played a role in this resurgence is some version of a modal argument. Until recently, premise (3) of the argument (Possibly, I exist, and no wholly physical objects exist.) has garnered most of the attention by critics. However, more recently, the focus has also been on (2) (Wholly physical objects are essentially, wholly, and intrinsically physical and wholly spiritual substances are (...) essentially, wholly, and intrinsically immaterial.). Andrew Bailey has provided one of the best criticisms of (2) on offer. In what follows, I present and clarify one form of the argument and defend premise (2) by responding to important defeaters proffered by Andrew Bailey and his contingent physicalism. (shrink)

Voluntary active euthanasia and physician assisted suicide should not be legalised because too much that is important about living and dying will be lostIn the first of this two part series, I unpack the historical philosophical distinction between killing and allowing a patient to die in order to clear up the confusion that exists. Historically speaking the two kinds of actions are morally distinct because of older notions of causality and human agency. We no longer understand that distinction primarily because (...) we have shifted our notions of causality from a traditional formulation to a modern formulation of causality and thus of moral assessment that focuses on the effects of an action. In this essay, I prepare the ground for a companion essay by showing that the traditional formulation allows us to maintain notions of meaning and purpose to human living and dying that are precluded in the efficiency paradigm of modernity. Taken together with the companion essay, I am claiming that voluntary active euthanasia and physician assisted suicide should not be legalised because too much that is important about dying and living will be lost.TWO LIESIt would be naïve to think that euthanasia, in either the VAE sense, or in the more passive sense of PAS, does not happen. It would even be naïve to think that it does not occur in a non-voluntary form. It would be equally naïve, however, to think it could be controlled through governmental regulation. The real question with regard to PAS/VAE, put so eloquently by Martha Minow, is which lie do you countenance: the lie that euthanasia does not already happen, or the lie that it can be controlled without having repercussions well beyond the limits of procedural mastery?1 With this two part paper series, I will argue that the …. (shrink)

Declarations like “this meeting is adjourned” make certain facts the case by representing them as being the case. Yet surprisingly little attention has been paid to the mechanism whereby the utterance of a declaration can bring about a new state of affairs. In this paper, we use the incentivization account of institutional facts to address this issue. We argue that declarations can serve to bring about new states of affairs as their utterance have game theoretical import, typically in virtue of (...) the utterer signaling a commitment to act in an incentive-changing way. (shrink)

Transcranial Magnetic Stimulation is a technique that may aid researchers in their attempts to elucidate the underlying brain functions involved in consciousness. By employing TMS along with other neuroimaging methods and case studies, researchers may be aided in addressing their various hypotheses. Employing the ‘brain as mobile’ analogy, it may be possible to determine the individual contributions of single elements of the brain without upsetting the overall balance.

Although many recent free speech skeptics claim Millian credentials, they neglect the more pessimistic elements of Mill's account of human nature. Once we recover the darker elements of Mill's thought, American-style laissez-faire in the domain of expression looks significantly more attractive. Indeed, this paper argues that if Mill is correct about human nature, we have good reason to oppose recent proposed restrictions on expression and to embrace a legal regime that tolerates much speech that is false, obscene, demeaning, and even (...) hateful. While philosophers are right to worry about the substantial moral costs of such regimes, we ought to attempt to address these costs in ways that do not amount to rejecting the regimes themselves. (shrink)

Health Savings Accounts have been marginalized in the West. In Singapore, however, they are foundational to the financing of health care. In this brief essay, I shall begin to sketch a justification for Health Savings Accounts. The family has always been thought of as a mere prolegomena to the polis and to be primarily about securing the goods of material life: food, shelter, intimacy. I shall first explore the recent scientific literature on the communal nature of human thriving and follow (...) it with a phenomenological account of human dependency. I shall claim that in securing the material means to sustain life, the family is also involved in the creation of the life-world of the child. That means that the bare necessities of life met in families are not merely about sustaining bodily life but are also part of the meaning-making aspects of life. The family then should have recourse to the material means of life-and-death decisions, because it is in these life-and-death decisions that the families’ life-world of values is to be deployed. (shrink)

The first comprehensive study of Nietzsche's earliest book, The Birth of Tragedy, this important volume by M. S. Silk and J. P. Stern examines the work in detail: its place in Nietzsche's philosophical career; its value as an account of ancient Greek culture; its place in the history of German ideas, and its value as a theory of tragedy and music. Presented in a fresh twenty-first-century series livery, and including a specially commissioned preface written by Lesley Chamberlain, illuminating its enduring (...) importance and relevance to philosophical enquiry, this accessible study has been revived for a new generation of readers. (shrink)

Construed metaphysically, the problem of individuation is the problem of offering an ontological assay of two entities that share all their pure properties in common so as to offer an account of what makes them distinct particulars. This article provides a survey of the major contemporary attempts to answer this problem. To accomplish this goal, the most important contemporary advocates of each solution is analyzed: the trope nominalism of Keith Campbell, the realism of D. M. Armstrong, the Leibnizian essence view (...) of Alvin Plantinga, and the bare particular position of Gustav Bergmann. As a secondary purpose, the article provides a brief critique of the first three solutions and a brief defense of the fourth. (shrink)

i) We show for each context-free language L that by considering each word of L as a structure in a natural way, one turns L into a finite union of classes which satisfy a finitary analog of the characteristic properties of complete universal first order classes of structures equipped with elementary embeddings. We show this to hold for a much larger class of languages which we call free local languages. ii) We define local languages, a class of languages between free (...) local and context-sensitive languages. Each local language L has a natural extension L ∞ to infinite words, and we prove a series of "pumping lemmas", analogs for each local language L of the "uvxyz theorem" of context free languages: they relate the existence of large words in L or L ∞ to the existence of infinite "progressions" of words included in L, and they imply the decidability of various questions about L or L ∞ . iii) We show that the pumping lemmas of ii) are independent from strong axioms, ranging from Peano arithmetic to ZF + Mahlo cardinals. We hope that these results are useful for a model-theoretic approach to the theory of formal languages. (shrink)

The literature on the Knowledge Argument exhibits considerable confusion about the precise nature of the argument. I contend that a clarification of the essence of self-presenting properties provides an explanation of this confusion such that the confusion itself is evidence for dualism. I also claim that Mary gains six different sorts of knowledge after gaining sight, and I show how this claim provides a response to a physicalist undercutting defeater for the Knowledge Argument. I try to show that this defeater (...) is inadequate due to its failure to capture the epistemic richness of what happens to Mary. Finally, I indicate how my enriched version of the Knowledge Argument provides grounds for rejecting those varieties of physicalism that eschew a depiction of phenomenal propertiesas intrinsic attributes a subject exemplifies in favor of a view that treats them as functional roles a subject realizes. (shrink)

The Indiana Court of Appeals, in JKB, Sr. v. Armour Pharmaceutical Co. ), held that the state's Blood Shield Act does not protect pharmaceutical companies that produce blood-derived products from product liability suits based on injuries attributable to tainted blood supplies. Blood shield statutes help to guarantee adequate blood supplies by limiting the liability of blood banks. This holding limits the defenses available to pharmaceutical companies sued under product liability theory.The defendant, Armour Pharmaceutical, produces and sells clotting factor agents, which (...) are derived through plasmapheresis. Plasmapheresis is a costly and complex donation process through which the plasma and red blood cells of a donor's blood are separated. After separation, the process returns the red blood cells to the donor but retains the plasma. (shrink)

In this paper a new property of theories, called effective retractability is introduced and used to obtain a characterization for the degrees of subtheories of arithmetic and set theory. By theory we understand theory in standard formalization as defined by Tarski [10]. The word degree refers to the Kleene-Post notion of degree of recursive unsolvability [2]. By the degree of a theory we mean, of course, the degree associated with its decision problem via Gödel numbering.