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Neural Voices of Patients with Severe Brain Injury?
Camb Q Healthc Ethics
January 2025
Center for Consciousness Science, University of Michigan, Ann Arbor, MI, USA.
Studies have shown that some covertly conscious brain-injured patients, who are behaviorally unresponsive, can reply to simple questions via neuronal responses. Given the possibility of such neuronal responses, Andrew Peterson et al. have argued that there is warrant for some covertly conscious patients being included in low-stakes medical decisions using neuronal responses, which could protect and enhance their autonomy.
View Article and Find Full Text PDFA neuroethical approach to human life, identity, and liberty of schizophrenic patients.
CNS Spectr
December 2024
Faculty of Philosophy and Neurobioethics Research Group (GdN), Pontifical Athenaeum Regina Apostolorum (APRA), Rome, Italy.
This article presents a comprehensive neuroethical framework that seeks to deepen our understanding of human consciousness and free will, particularly in the context of psychiatric and neurological disorders. By integrating insights from neuroscience with philosophical reflections on freedom and personal identity, the paper examines how various states of consciousness from interoception to self-awareness influence an individual's autonomy and decision-making capabilities. The discussion utilizes a multidimensional, bottom-up approach to explore how neurobiological processes underlie different levels of conscious experience and their corresponding types of freedom, such as "intero-freedom" related to internal bodily states and "self-freedom" associated with higher self-awareness.
View Article and Find Full Text PDFModulation of cardiac autonomic activity across consciousness states and levels of sleep depth in individuals with sleep complaints and bipolar disorder or unipolar depressive disorders.
J Psychosom Res
November 2024
School of Psychology, University of Ottawa, Canada; Sleep Research Unit, The University of Ottawa Institute of Mental Health Research at The Royal, Canada. Electronic address:
Objective: Autonomic nervous system dysfunction and reduced heart rate variability (HRV) often co-exist with mood disorders, a phenomenon likely influenced by sleep disturbances. This study investigated heart rate (HR) and HRV across wake, rapid eye movement (REM) sleep, and non-REM (NREM) sleep in individuals with sleep complaints and bipolar or unipolar depressive disorder.
Methods: Polysomnographic data was retrospectively collated for 120 adult patients with sleep complaints and depressive symptoms [60 diagnosed with bipolar disorder, 60 diagnosed with a unipolar depressive disorder], and 60 healthy controls.
Ethically Translating Advanced Neurotechnologies for Disorders of Consciousness: A Survey of Clinicians' Perspectives.
Neurocrit Care
October 2024
Center for Neurotechnology and Neurorecovery, Department of Neurology, Massachusetts General Hospital and Harvard Medical School, 55 Fruit St., Boston, MA, 02114, USA.
Although evaluation of disorders of consciousness (DoC) following brain injury has traditionally relied on bedside behavioral examination, advances in neurotechnology have elucidated novel approaches to detecting and predicting recovery of consciousness. Professional society guidelines now recommend that clinicians integrate these neurotechnologies into clinical practice as part of multimodal evaluations for some patients with DoC but have not crafted concrete protocols for this translation. Little is known about the experiences and ethical perspectives held by key stakeholder groups around the clinical implementation of advanced neurotechnologies to detect and predict recovery of consciousness.
View Article and Find Full Text PDFDelineating the Hurtful, Engaging, Emotive, and Directive (HEED) Dimensions of Pain. Characterization for Clinical Relevance.
Pain Physician
September 2024
Philosophy, Politics, and Economics Program, Bowie State University, Bowie, MD.
Pain is an objective, natural reality among sentient creatures that possess cognition and mobility sufficient for apprehending and acting upon its full significance. Defining pain mostly in mental terms makes sense for self-conscious psychology and vocabulary. Pain as a natural capacity among animals did not evolve merely to be aligned with human semantics and intuitions.
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