Patients in a minimally conscious state (MCS) fall into a different diagnostic category than patients in the more familiar vegetative states (VS). Not only are MCS patients conscious in some sense, they have a higher chance for recovery than VS patients. Because of these differences, we ostensibly have reason to provide MCS patients with care that goes beyond what we provide to patients with some VS patients. But how to justify this differential treatment? I argue we can’t justify it solely (...) by looking to MCS patients’ actual levels of consciousness. We must look also to the ways in which these patients are potentially conscious. Specifically, I argue that certain sensible and well-regarded policy recommendations cannot be justified by looking solely to patients’ actual levels of consciousness, but that they can be justified by looking to patients’ potential for consciousness. Insofar then as we have prima facie reason to follow the recommendations, we also have prima facie reason to view the potential for consciousness as morally salient. If that is true, however, several important implications follow: first, if the potential for consciousness is morally salient, this translates into actual and pressing obligations to patients with disorders of consciousness generally. Second, if the potential for consciousness is morally salient, this has implications that go beyond our obligations to patients with disorders of consciousness. Indeed, if the potential for consciousness is morally salient, this adds an important layer of complexity to the normative landscape, a layer we may not have sufficiently noticed before. (shrink)

Lockean accounts of personhood propose that an individual is a person just in case that individual is characterized by some advanced cognitive capacity. On these accounts, human beings with severe cognitive impairment are not persons. Some accept this result—I do not. In this paper, I therefore advance and defend an account of personhood that secures personhood for human beings who are cognitively impaired. On the account for which I argue, an individual is a person just in case that individual belongs (...) to a natural kind that is normally characterized by advanced cognitive capacities. Since “human being” is just such a natural kind, individual human beings can be persons even when they do not themselves have advanced cognitive capacities. I argue, furthermore, that we have good reason to accept this account of personhood over rival accounts since it is uniquely able to accommodate the intuitive concept of an impaired person. (shrink)

Memory blunting is a pharmacological intervention that decreases the emotional salience of memories. The technique promises a brighter future for those suffering from memory-related disorders such as PTSD, but it also raises normative questions about the limits of its permissibility. So far, neuroethicists have staked out two primary camps in response to these questions. In this paper, I argue both are problematic. I then argue for an alternative approach to memory blunting, one that can accommodate the considerations that motivate rival (...) approaches even while avoiding the problems these rivals face. In addition to arguing for this primary thesis, the paper also aims to suggest something about neuroethics generally: despite what some neuroethicists claim, new discoveries in neuroscience may not typically upend traditional views of morality. Rather, discoveries in neuroscience often provide us with new occasions to reflect on enduring questions about what it means to be human. (shrink)

Jecker & Ko (2017) argue that numerical identity is not the only aspect of identity that matters to patients faced with certain neurosurgical interventions. Put differently: surviving an intervention in the numerical sense—being numerically the same person before and after the intervention—is not enough. It also matters whether an intervention preserves a patient’s narrative identity, that is, whether an intervention allows the patient’s “inner story” to continue. I agree with the authors’ conclusion. I believe, however, that further work can be (...) done to show precisely why narrative identity matters. We can accept Jecker & Ko’s conclusion, but still wonder: why should it matter to us that our inner story continues? In this response, I suggest that the reason rests on a more basic concern we have with living authentic lives. We are concerned with preserving our narrative identities because we want to live authentic lives rather than inauthentic ones. If that’s the case, however, those considering neurosurgical interventions such as deep brain stimulation and temporal lobectomy should not only pay attention to ways the interventions may support or undermine narrative identity, but also to broader considerations about the ways these interventions may support or undermine one’s living an authentic life. (shrink)

Goering and colleagues (2017) acknowledge closed-loop neural devices have the potential to undermine agency. Indeed, the authors observe that “the agent using the device may . . . sometimes doubt whether she is the author of her action, given that the device may operate in ways that are not transparent to her” (65). Still, the authors ultimately argue that closed-loop neural devices may be construed as supporting agency, especially when we view agency from a relational perspective. The reason? We often (...) manifest our agency in relation with others. For example, family and close friends sometimes step in to support us in setting and achieving our aims. In a similar way, then, the authors argue that “we can imagine [a closed-loop] device stepping in to support the user in achieving her aim” (67). Closed-loop neural devices, in other words, can be construed as supporting one’s agency in much the same way as other people can be seen as supporting one’s agency. The authors thus conclude that when we view agents from a relational perspective, closed-loop neural devices may be viewed as supporting rather than undermining agency. I largely agree with the authors’ conclusion. I also believe, however, that their discussion can be clarified by distinguishing three kinds of agency and viewing closed-loop neural devices from the perspective of each. By thinking carefully about agency, we can see more clearly the ways in which it is undermined by closed-loop neural devices, as well as the way in which these devices may support agency. (shrink)

Some psychologists and philosophers have argued that neuroscience is importantly relevant to our moral responsibility practices, especially to our practices of praise and blame. For consider: on an unprecedented scale, contemporary neuroscience presents us with a mechanistic account of human action. Furthermore, in uential studies – most notoriously, Libet et al. (1983) – seem to show that the brain decides to do things (so to speak) before we consciously make a decision. In light of these ndings, then – or so (...) some have argued – we ought to revise our practices of praise and blame. In the current paper, I argue that this conclusion is unwarranted. The reason is that the argument for it depends on controversial non-empirical premises, premises we need not accept. I suggest, however, that neuroscience does bear on our moral responsibility practices in one important, if less revisionary, way. In particular, neuroscience o ers a new kind of evidence for determining when agents should be held exempt from our normal moral responsibility practices. (shrink)

Understanding the difference between conscious and unconscious states is important for making sense of human cognition. Consider: your perception of these words is currently conscious while the feeling of the floor beneath your left foot presumably is not. But what does the difference between these states consist in? Contemporary philosophers disagree about how to answer this kind of question. Extrinsic theorists claim states are conscious because of how they are related to other states, entities, or processes. Intrinsic theorists deny this (...) by claiming that consciousness is internal to states. As it stands, debates about consciousness are thus stuck at an impasse.^ So I approach things differently. In this dissertation, I argue there is a way to overcome the gridlock that plagues contemporary debates about consciousness, and to accommodate the considerations that motivate both intrinsic and extrinsic theorists. The way forward lies in developing a robust account of causal powers. Causal powers, on my view, correspond to dispositions things have. For example, salt’s disposition to dissolve in water corresponds to a power salt has: its solubility. Causal powers, moreover, can help us account for how things behave, for how and why things interact with each other in the ways they do. For example, we can account for salt’s dissolving in water by studying when and why salt manifests its power of solubility. ^ And we can also account for our conscious experiences in reference to causal powers. Indeed, I argue that just as salt manifests one of its powers when it dissolves in water, so too humans manifest one of their powers when they have conscious experiences—our conscious experiences can be understood in reference to the causal powers we have, and in reference to how and why we manifest these powers. Just as importantly, if we use causal powers as a basis for a theory of consciousness, we can overcome the current opposition between extrinsic and intrinsic theories, and in doing so, open up avenues for theorizing about consciousness anew. (shrink)