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Series:   Elements in Bioethics and Neuroethics

The Ethics of Consciousness

Published online by Cambridge University Press:  17 June 2022

Walter Glannon
Walter Glannon
Affiliation:
University of Calgary

Summary

This Element examines the main ethical aspects of consciousness  It argues that consciousness is not intrinsically valuable but has value or disvalue for individuals depending on its phenomenology (what it is like to be aware) and content (what one is aware of). These two components of awareness shape normative judgments about how ordered, disordered, altered, restored, diminished and suppressed conscious states can benefit or harm individuals. They also influence moral judgments about whether intentionally causing these states is permissible or impermissible and how these states can affect behavior. After describing its neurobiological basis, this Element discusses ethical and legal issues in six categories of consciousness: phenomenal and access consciousness; intraoperative awareness; prolonged disorders of consciousness, dissociative disorders, the role of consciousness in determining death; and altering and suppressing awareness near the end of life.
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Keywords

arousalawarenessbenefitbrain deathconsciousnesscontinuous deep sedation dissociative disordersharmprolonged disorders of consciousnessterminal anesthesia
Type
Element
Information
Series: Elements in Bioethics and Neuroethics
Online ISBN: 9781009086660
Publisher: Cambridge University Press
Print publication: 14 July 2022

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References

Avidan, Michael, Mashour, George, and Glick, David. Prevention of Awareness During General Anesthesia. F1000 Medicine Reports 1 (2009): 9. http://doi.org.10.3410/MI-9.Google Scholar
Avidan, Michael, Jacobsohn, Eric, David, Glick et al. Prevention of Intraoperative Awareness in a High-Risk Surgical Population. New England Journal of Medicine 365 (2011): 591–600.CrossRefGoogle Scholar
Baars, Bernard. A Cognitive Theory of Consciousness. Cambridge: Cambridge University Press, 1988.Google Scholar
Ballard, Elizabeth, and Zarate, Carlos. The Role of Dissociation in Ketamine’s Antidepressant Effects. Nature Communications 11 (2020): 6431. http://doi.org/10.1038/s41467-020-20190-4.CrossRefGoogle ScholarPubMed
Bassetti, Claudio. Sleepwalking: Dissociation between “Body Sleep” and “Mind Sleep.” In Laureys, Gosseries, and Tononi (eds.), 2016, pp. 129–38.Google Scholar
Baumeister, Roy, Alfred, Mele, and Vohs, Kathleen, eds. Free Will and Consciousness: How Might They Work? New York: Oxford University Press, 2010.Google Scholar
Beauchamp, Tom, and Childress, James. Principles of Biomedical Ethics, 8th ed. New York: Oxford University Press, 2019.Google ScholarPubMed
Bernat, James. The Biophilosophical Basis of Whole-Brain Death. In Paul, Miller, and Paul (eds.), 2002, pp. 324–42.CrossRefGoogle Scholar
Bernat, James. Chronic Disorders of Consciousness. The Lancet 367 (2006): 1181–92.Google Scholar
Bernat, James. How the Distinction between “Irreversible” and “Permanent” Illuminates Circulatory Respiratory Death Determination. Journal of Medicine and Philosophy 35 (2010a): 242–55.Google Scholar
Bernat, James. The Natural History of Chronic Disorders of Consciousness. Neurology 75 (2010b): 206–7.CrossRefGoogle ScholarPubMed
Bernat, James. Medical Decision Making by Patients in the Locked-In Syndrome. Neuroethics 13 (2020): 229–38.Google Scholar
James, Bernat, Charles, Culver, and Gert, Bernard. On the Definition and Criterion of Death. Annals of Internal Medicine 94 (1981): 389–94.Google Scholar
Birbaumer, Niels, Gallegos-Ayala, Guillermo, Wildgruber, Moritz et al. Direct Brain Control and Communication in Paralysis. Brain Topography 27 (2014): 4–11.Google Scholar
Block, Ned. On a Confusion About a Function of Consciousness. Behavioral and Brain Sciences 18 (1995): 227–87.CrossRefGoogle Scholar
Block, Ned. Consciousness, Accessibility and the Mesh between Psychology and Neuroscience. Behavioral and Brain Sciences 30 (2007): 481–99.Google Scholar
Blumenfeld, Hal. Neuroanatomical Basis of Consciousness. In Laureys, Gosseries, and Tononi (eds.), 2016a, pp. 3–29.CrossRefGoogle Scholar
Blumenfeld, Hal. Epilepsy and Consciousness. In Laureys, Gosseries, and Tononi (eds.), 2016b, pp. 255–70.Google Scholar
Boly, Melanie, Faymonville, Marie-Elisabeth, Schnakers, Caroline et al. Perception of Pain in the Minimally Conscious State with PET Activation: An Observational Study. The Lancet Neurology 7 (2008): 1013–20.Google Scholar
Boonin, David. Dead Wrong: The Ethics of Posthumous Harm. New York: Oxford University Press, 2019.Google Scholar
Broughton, Roger, Billings, Rodger, Cartwright, Rosalind et al. Homicidal Somnambulism: A Case Report. Sleep: Journal of Sleep Research and Sleep Medicine 17 (1994): 253–64.Google Scholar
Cai, Alice, and Bae, Charles. Parasomnias. In Cucchiara and Price (eds.), 2020, pp. 164–5.Google Scholar
Cain, Joshua, Spivak, Norman, Coetzee, John et al. Ultrasonic Thalamic Stimulation in Chronic Disorders of Consciousness. Brain Stimulation 14 (2021): 301-3Google Scholar
Robin, Carhart-Harris, Roseman, Leor, Bolstridge, Mark et al. Psilocybin for Treatment-Resistant Depression: fMRI-Measured Brain Mechanisms. Scientific Reports 7 (2017): 13187. http://doi.org/10.1035/srep41598-017-13282-7.Google Scholar
Cassell, Eric. The Nature of Suffering and the Goals of Medicine, 2nd ed. New York: Oxford University Press, 2004.Google Scholar
Cavanagh, Thomas. Double Effect: Doing Good and Avoiding Evil. Oxford: Clarendon Press, 2006.Google Scholar
Celesia, Gaston, and Sannita, Walter. Can Patients in Vegetative State Experience Pain and Have Conscious Awareness? Neurology 80 (2013): 328–9.CrossRefGoogle ScholarPubMed
Chalmers, David. Facing Up to the Problem of Consciousness. Journal of Consciousness Studies 2 (1995): 200–19.Google Scholar
Chalmers, David. The Conscious Mind: In Search of a Fundamental Theory. New York: Oxford University Press, 1996.Google Scholar
Chaudhary, Ujwal, Vlachos, Ioannis, Zimmermann, Jonas et al. Spelling Interface Using Intracortical Signals in a Completely Locked-In Patient Enabled via Auditory Neurofeedback Training. Nature Communications 13 (2022): 1236. http://doi.org/10.1038/s41467-022-288598.CrossRefGoogle Scholar
Chon, W. James, Josephson, Michelle, Gordon, Elise et al. When the Living and the Deceased Cannot Agree on Organ Donation: A Survey of US Organ Procurement Organizations (OPOs). American Journal of Transplantation 14 (2014): 172–7.Google Scholar
Chudy, Darko, Deletis, Vedran, Almahariq, Fadi et al. Deep Brain Stimulation for the Early Treatment of the Minimally Conscious State and Vegetative State: Experience in 14 Patients. Journal of Neurosurgery 128 (2018): 1189–98.CrossRefGoogle ScholarPubMed
Claassen, Jan, Doyle, Kevin, Matory, Adu et al. Detection of Brain Activation in Unresponsive Patients with Acute Brain Injury. New England Journal of Medicine 380 (2019): 2497–505.Google Scholar
Crick, Francis, and Koch, Christof. A Framework for Consciousness. Nature Neuroscience 6 (2003): 119–26.CrossRefGoogle ScholarPubMed
Cruzan v. Director, Missouri Department of Health, 1990.Google Scholar
Cucchiara, Brett, and Raymond, Price, eds. Decision-Making in Adult Neurology. Amsterdam: Elsevier, 2020.Google Scholar
Damasio, Antonio. The Feeling of What Happens: Body and Emotion in the Making of Consciousness. Orlando, FL: Harcourt Brace, 1999.Google Scholar
Dang-Vu, Thien, Zadra, Antonio, Labelle, Marc-Antoine et al. Sleep Deprivation Reveals Altered Brain Perfusion Patterns in Somnambulism. PLoS One 10 (2015): 0133474. http://doi.org/10.1371/journal.pone.0133474.Google Scholar
Deeley, Quinton, Oakley, David, Toone, Brian et al. Modulating the Default Mode Network Using Hypnosis. International Journal of Clinical and Experimental Hypnosis 60 (2012): 206–28.Google Scholar
Deeprose, Catherine, and Andrade, Jackie. Is Priming during Anesthesia Unconscious? Consciousness and Cognition 15 (2006): 1–23.Google Scholar
DeGrazia, David. Human Identity and Bioethics. New York: Cambridge University Press, 2005.Google Scholar
Sanneke, De Haan, Rietveld, Erik, and Denys, Damiaan. Being Free by Losing Control: What Obsessive-Compulsive Disorder Can Tell Us About Free Will. In Glannon (ed.), 2015, pp. 83–102.CrossRefGoogle Scholar
Dehaene, Stanislas, and Changeux, Jean-Pierre. Experimental and Theoretical Approaches to Conscious Processing. Neuron 70 (2011): 200–27.Google Scholar
Demertzi, Athena, and Laureys, Steven. Where in the Brain Is Pain? Evaluating Painful Experiences in Non-Communicative Patients. In Richmond, Rees, and Edwards (eds.), 2012, pp. 89–98.Google Scholar
Dworkin, Ronald. Life’s Dominion: An Argument About Abortion, Euthanasia, and Individual Freedom.Google Scholar
Eichenbaum, Howard. The Cognitive Neuroscience of Memory: An Introduction, 2nd ed. New York: Oxford University Press, 2012.Google Scholar
Eskandar, Emad. Thalamic Stimulation in Vegetative or Minimally Conscious Patients. Journal of Neurosurgery 128 (2018): 1187-88.CrossRefGoogle ScholarPubMed
Feinberg, Joel. Harm to Others. New York: Oxford University Press, 1984.Google Scholar
Feinberg, Todd. Altered Egos: How the Brain Creates the Self. New York: Oxford University Press, 2001.Google Scholar
Feinberg, Todd, and Mallatt, Jon. Consciousness Demystified. Cambridge, MA: MIT Press, 2018.Google Scholar
Ferzan, Kimberly, and Stephen, Morse, eds. Legal, Moral, and Metaphysical Truths: The Philosophy of Michael Moore. New York: Oxford University Press, 2016.Google Scholar
Fins, Joseph. Rethinking Disorders of Consciousness: New Research and its Implications. Hastings Center Report 35 (2) (2005): 22–4.Google Scholar
Fins, Joseph. Rights Come to Mind: Brain Injury, Ethics, and the Struggle for Consciousness. New York: Cambridge University Press, 2015.Google Scholar
Fischer, John Martin, and Ravizza, Mark. Responsibility and Control: A Theory of Moral Responsibility. New York: Cambridge University Press, 1998.Google Scholar
Fletcher, Guy. The Philosophy of Well-Being: An Introduction. New York: Routledge, 2016.Google Scholar
Fogel, Barry, and Greenberg, Donna, eds. Psychiatric Care of the Medical Patient, 3rd ed. Oxford: Oxford University Press, 2015.Google Scholar
Frankfurt, Harry. Identification and Externality. In The Important of What We Care About. New York: Cambridge University Press, 1988, pp. 58–68.Google Scholar
Freeman, Michael, ed. Law and Neuroscience. Oxford: Oxford University Press, 2010.Google Scholar
Frith, Chris. The Social Functions of Consciousness. In Weiskrantz and Davies (eds.), 2008, pp. 225–44.CrossRefGoogle Scholar
Joseph, Giacino, Stephen, Ashwal, Childs, Nancy et al. The Minimally Conscious State: Definition and Diagnostic Criteria. Neurology 58 (2002): 349–53.Google Scholar
Joseph, Giacino, John, Whyte, Emilia, Bagiella et al. Placebo-Controlled Trial of Amantadine for Severe Traumatic Brain Injury. New England Journal of Medicine 366 (2012): 819–26.Google Scholar
Joseph, Giacino, Joseph, Fins, Laureys, Steven, and Schiff, Nicholas. Disorders of Consciousness after Acquired Brain Injury: The State of the Science. Nature Reviews Neurology 10 (2014): 99–114.Google Scholar
Glannon, Walter, ed. Free Will and the Brain: Neuroscientific, Philosophical and Legal Perspectives. Cambridge: Cambridge University Press, 2015.Google Scholar
Glannon, Walter. The Value and Disvalue of Consciousness. Cambridge Quarterly of Healthcare Ethics 25 (2016): 600–12.Google Scholar
Glannon, Walter. The Neuroethics of Memory: From Total Recall to Oblivion. Cambridge: Cambridge University Press, 2019.Google Scholar
Graham, Mackenzie, and Naci, Lorina. Well-Being after Severe Brain Injury: What Counts as Good Recovery? Cambridge Quarterly of Healthcare Ethics 30 (2021): 613–22.Google Scholar
Neil, Graham, Amy, Jolly, Karl, Zimmerman et al. Diffuse Axonal Injury Predicts Neurodegeneration after Moderate-Severe Traumatic Brain Injury. Brain 143 (2020): 3685-98.Google Scholar
Greer, David, Shemie, Sam, Lewis, Ariane et al. Determination of Brain Death/Death by Neurologic Criteria: The World Brain Death Project. Journal of the American Medical Association 324 (2020): 1078–97.Google Scholar
Griffin, James. Well-Being: Its Meaning, Measurement and Moral Importance. Oxford: Clarendon Press, 1986.Google Scholar
Grob, Charles, Danforth, Alicia, Chopra, Gurpreet et al. Pilot Study of Psilocybin Treatment for Anxiety in Patients with Advanced-Stage Cancer. Archives of General Psychiatry 68 (2011): 71–8.Google Scholar
Guy’s and St. Thomas’ Children’s NHS Foundation Trust & Anor v. Knight & Anor. EWHC 25 (Fam), 2021.Google Scholar
Hallett, Michael. Volitional Control of Movement: The Physiology of Free Will. Clinical Neurophysiology 11 (2007): 79–92.Google Scholar
Hawkins, Jennifer. What Is Good for Them? Best Interests and Severe Disorders of Consciousness. In Sinnott-Armstrong (ed.), 2016, pp. 180–206.Google Scholar
Hochberg, Leigh, and Cash, Sydney. Freedom of Speech. New England Journal of Medicine 385 (2021): 278–9.Google Scholar
Hochberg, Leigh, and Cudkowicz, Merit. Locked In, but Not Out? Neurology 82 (2014): 1852–3.Google Scholar
Hosie, Annmarie, Davidson, Patricia, Agar, Meera et al. Delirium: Prevalence, Incidence, and Implications for Screening in Specialist Palliative Care Inpatient Settings: A Systematic Review. Palliative Medicine 27 (2013): 486–98.CrossRefGoogle ScholarPubMed
Huang, Andrew, and Bernat, James. The Organism as a Whole in an Analysis of Death. Journal of Medicine and Philosophy 44 (2019): 712–31.Google Scholar
Johnston, Mark. Constitution Is Not Identity. Mind 101 (1992): 89–106.Google Scholar
Johnston, Mark. Surviving Death. Princeton: Princeton University Press, 2010.Google Scholar
Kadish, Sanford, and Schulhofer, Stephen. Criminal Law and Its Processes: Cases and Materials, 8th ed. New York: Aspen, 2001.Google Scholar
Kahane, Guy, and Savulescu, Julian. Brain Damage and the Moral Significance of Consciousness. Journal of Medicine and Philosophy 34 (2009): 6–26.Google Scholar
Kamm, Frances. Intricate Ethics: Rights, Responsibility, and Permissible Harm. Oxford: Oxford University Press, 2007.Google Scholar
Kamm, Frances. Rescuing Ivan Ilych: How We Live and How We Die In Bioethical Prescriptions: To Create, End, Choose, and Improve Lives. Oxford: Oxford University Press, 2013, pp. 3–32.Google Scholar
Kamm, Frances. Almost Over: Aging, Dying, Dead. Oxford: Oxford University Press, 2020.Google Scholar
Kant, Immanuel. Groundwork of the Metaphysics of Morals, trans. H. J. Paton. New York: Harper & Row, 1785/1964.Google Scholar
Kelz, Max, Garcia, Paul, Mashour, George and Solt, Ken. Escape from Oblivion: Neural Mechanisms of Emergence from General Anesthesia. Anesthesia and Analgesia 128 (2019): 726–36.Google Scholar
Kihlstrom, John, and Cork, Randall. Consciousness and Anesthesia. In Velmans and Schneider (eds.), 2007, pp. 628–39.Google Scholar
King v. Cogdon. Supreme Court of Victoria, Australia, 1950.Google Scholar
Kocarova, Rita, Horacek, Jiri, and Carhart-Harris, Robin. Does Psilocybin Have a Transdiagnostic Action and Prophylactic Potential? Frontiers in Psychiatry 12 (2021): 233. http://doi.org/10.3389/fpsyt.2021.661233.Google Scholar
Koch, Christof. The Feeling of Life Itself: Why Consciousness Is Widespread but Can’t Be Computed. Cambridge, MA: MIT Press, 2019.CrossRefGoogle Scholar
Koch, Christof, Massimini, Marcello, Boly, Melanie, and Tononi, Giulio. Neural Correlates of Consciousness: Progress and Problems. Nature Reviews Neuroscience 17 (2016): 307–21.Google Scholar
Langsjo, Jaakko, Alkire, Michael, Kaskinoro, Kimmo et al. Returning from Oblivion: Imaging the Neural Core of Consciousness. Journal of Neuroscience 32 (2012): 4935–43.Google Scholar
Laureys, Steven, Celesia, Gastone, Cohadon, Francois et al. Unresponsive Wakefulness Syndrome: A New Name for the Vegetative State or Apallic syndrome. BMC Medicine 8 (2010): 68. http://doi.org/10.1186/1741-7015-8-68.Google Scholar
Laureys, Steven, Gosseries, Olivia, and Tononi, Giulio, eds. The Neurology of Consciousness: Cognitive Neuroscience and Neuropathology, 2nd ed. Amsterdam: Elsevier Academic Press, 2016.Google Scholar
Levy, Neil. The Importance of Awareness. Australasian Journal of Philosophy 91 (2013): 2011–29.Google Scholar
Levy, Neil. Consciousness and Moral Responsibility. Oxford: Oxford University Press, 2014.Google Scholar
Levy, Neil, and Savulescu, Julian. Moral Significance of Phenomenal Consciousness. Progress in Brain Research 177 (2009): 361–70.Google Scholar
Luppi, Andrea, Craig, Michael, Pappas, Ioannis et al. Consciousness-Specific Dynamic Interactions of Brain Integration and Functional Diversity. Nature Communications 10 (2019): 4616. http://doi.org/10.1038/s41467-019-12658-9.Google Scholar
Martin, Mahner, and Bunge, Mario. Foundations of Biophilosophy. Berlin: Springer-Verlag, 1997.Google Scholar
Maldonado, Jose. Delirium: Neurobiology, Characteristics and Management. In Fogel and Greenberg (eds.), 2015. http://doi.org/10.1093/med/9780199731855.003.0041, 1-218.Google Scholar
Martial, Charlotte, Fontaine, Geraldine, Gosseries, Olivia et al. Losing the Self in Near-Death Experiences: The Experience of Ego-Dissolution. Brain Sciences 11 (2021): 929. http://doi.org/10.3390/brainsci11070929.Google Scholar
Mashour, George, ed. Consciousness, Awareness, and Anesthesia. New York: Cambridge University Press, 2010.CrossRefGoogle Scholar
Mashour, George. Consciousness and Anesthesia. In Laureys, Gosseries, and Tononi (eds.), 2016, pp. 139–54.Google Scholar
Mashour, George, and Alkire, Michael. Consciousness, Anesthesia, and the Thalamocortical System. Anesthesiology 118 (2013): 13-15.Google Scholar
Mashour, George, and Avidan, Michael. Intraoperative Awareness: Controversies and Non-Controversies. British Journal of Anaesthesia 112 (2015): i20–i26.Google Scholar
George, Mashour, and Engelhard, Kristin, eds. Oxford Textbook of Neuroscience and Anaesthesiology. Oxford: Oxford University Press, 2019.Google Scholar
Massimini, Marcello, and Tononi, Giulio. Sizing Up Consciousness: Towards an Objective Measure of the Capacity for Experience. Oxford: Oxford University Press, 2018.Google Scholar
Mathews, Debra, Fins, Joseph, and Racine, Eric. The Therapeutic “Mis” Conception: An Examination of its Normative Assumptions and a Call for its Revision. Cambridge Quarterly of Healthcare Ethics 27 (2018): 154–62.Google Scholar
McGinn, Colin. Can We Solve the Mind-Body Problem? Mind 98 (1989): 349–66.Google Scholar
McKinstry-Wu, Andrew, and Kelz, Max. Neural Mechanisms of Anaesthetics. In Mashour and Engelhard (eds.), 2019, pp. 3–14.Google Scholar
Jeff, McMahan. The Ethics of Killing: Problems at the Margins of Life. Oxford: Oxford University Press, 2002.Google Scholar
Mele, Alfred. Autonomous Agents: From Self-Control to Autonomy. New York: Cambridge University Press, 1995.Google Scholar
Mezrich, Joshua. Altruism in Extremis – The Evolving Ethics of Organ Donation. New England Journal of Medicine 382 (2020): 493–6.Google Scholar
Miller, Franklin. Individuals Declared Brain-Dead Remain Biologically Alive. Hastings Bioethics Forum, October 28, 2021. www.thehastingscenter.org.brain-death/.Google Scholar
Miller, Franklin, and Truog, Robert. Death, Dying and Organ Transplantation: Reconstructing Medical Ethics at the End of Life. New York: Oxford University Press, 2012.Google Scholar
Miller, Franklin, Truog, Robert, and Brock, Dan. The Dead Donor Rule: Can it Withstand Critical Scrutiny? Journal of Medicine and Philosophy 35 (2010): 299–312.Google Scholar
Milliere, Raphael, Carhart-Harris, Robin, Roseman, Leor et al. Psychedelics, Meditation, and Self-Consciousness. Frontiers in Psychology 9 (2018): 1475. http://doi.org/10.3389/fpsyg.2018.01475.Google Scholar
M’Naghten’s Case. Cited in the Report of the Committee on Mentally Abnormal Offenders. London: Her Majesty’s Stationery Office, 1843/1975.Google Scholar
Model Penal Code. Official Draft and Commentaries. Philadelphia: American Law Institute, 1985.Google Scholar
Monti, Martin, Vanhaudenhuyse, Audrey, Coleman, Martin et al. Willful Modulation of Brain Activity in Disorders of Consciousness. New England Journal of Medicine 362 (2010): 579–89.Google Scholar
Moore, Michael. Law and Psychiatry: Rethinking the Relationship. New York: Cambridge University Press, 1984.Google Scholar
Moore, Michael. Causation and Responsibility: An Essay in Law, Morals, and Metaphysics. New York: Oxford University Press, 2009.Google Scholar
Moore, Michael. Mechanical Choices: The Responsibility of the Human Machine. New York: Oxford University Press, 2020.Google Scholar
Morse, Stephen. Culpability and Control. University of Pennsylvania Law Review 142 (1994): 1587–660.Google Scholar
Morse, Stephen. Lost in Translation? An Essay on Law and Neuroscience. In Freeman (ed.), 2010, pp. 529–62.Google Scholar
Morse, Stephen. Moore on the Mind. In Ferzan and Morse (eds.), 2016, pp. 233–49.Google Scholar
Moses, David, Metzger, Sean, Liu, Jessie et al. Neuroprosthesis for Decoding Speech in a Paralyzed Person with Anarthria. New England Journal of Medicine 385 (2021): 217–27.Google Scholar
Multi-Society Task Force on PVS. Medical Aspects of the Persistent Vegetative State. New England Journal of Medicine 330 (1994): 1499–508.Google Scholar
Naccache, Lionel. Why and How Access Consciousness Can Account for Phenomenal Consciousness. Philosophical Transactions of the Royal Society B: Biological Sciences 373 (2018): 357. http://doi.org/10.1098/rstb.2017.0357.Google Scholar
Neville, Iuri, Zaninotto, Ana, Hayashi, Cintya et al. Repetitive TMS Does not Improve Cognition in Patients with TBI. Neurology 93 (2019): e190–e199.Google Scholar
Northoff, Georg. Unlocking the Brain, Volume II: Consciousness. New York: Oxford University Press, 2014.Google Scholar
Northoff, Georg. The Spontaneous Brain: From the Mind-Body to the World-Brain Problem. Cambridge, MA: MIT Press, 2018.Google Scholar
Northoff, Georg. Why Is There Sentience? A Temporo-Spatial Approach to Consciousness. Journal of Consciousness Studies 28 (2021): 67–82.Google Scholar
Northoff, Georg, and Huang, Zirui. How Do the Brain’s Time and Space Mediate Consciousness and Its Different Dimensions? Temporo-Spatial Theory of Consciousness (TTC). Neuroscience & Biobehavioral Reviews 80 (2017): 630–45.Google Scholar
Nowak, Hartmuth, Zech, Nina, Asmussen, Sven et al. Effect of Therapeutic Suggestions during General Anaesthesia on Postoperative Pain and Opioid Use: Multicentre Randomised Controlled Trial. BMJ 371 (2020): m4284. http://doi.org/10.1136/bmj.m4284.Google Scholar
Oakley, David, and Halligan, Peter. Hypnotic Suggestion: Opportunities for Cognitive Neuroscience. Nature Reviews Neuroscience 14 (2013): 565–76.Google Scholar
Owen, Adrian. The Search for Consciousness. Neuron 102 (2019): 526–8.Google Scholar
Owen, Adrian, and Coleman, Martin. Functional Neuroimaging of the Vegetative State. Nature Reviews Neuroscience 9 (2008): 235–43.Google Scholar
Owen, Adrian, Coleman, Martin, Boly, Melanie et al. Detecting Awareness in the Vegetative State. Science 313 (2006): 1402.Google Scholar
Pal, Dinesh, Dean, Jon, Liu, Tiecheng et al. Differential Role of Prefrontal and Parietal Cortices in Controlling Level of Consciousness. Current Biology 28 (2018): 2145–52.Google Scholar
Pallis, Christopher. ABC of Brainstem Death: The Declaration of Death. BMJ 286 (1983): 39.Google Scholar
Parfit, Derek. Reasons and Persons. Oxford: Clarendon Press, 1984.Google Scholar
Paul, Ellen Frankel, Miller, Fred, and Paul, Jeffrey, eds. Bioethics. New York: Cambridge University Press, 2002.Google Scholar
Peterson, Andrew, Owen, Adrian, and Karlawish, Jason. Alive Inside. Bioethics 34 (2020): 295–305.Google Scholar
Plum, Fred, and Posner, Jerome. The Diagnosis of Stupor and Coma, 3rd ed. Philadelphia: F. A. Davis, 1982.Google Scholar
Posner, Jerome, Saper, Christopher, Schiff, Nicholas, and Plum, Fred. Plum and Posner’s Diagnosis of Stupor and Coma, 4th ed. New York: Oxford University Press, 2007.Google Scholar
President’s Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research (US). Defining Death: Medical, Legal and Ethical Issues in the Determination of Death. Washington, DC: US Government Printing Office, 1981.Google Scholar
R v. Parks. 2 S.C.R. 871, Supreme Court of Canada, 1992.Google Scholar
Raus, Kasper, Sterckx, Sigrid, and Mortier, Freddy. Can the Doctrine of Double Effect Justify Continuous Deep Sedation at the End of Life? In Sterckx, Raus, and Mortier (eds.), 2013, pp. 177–201.Google Scholar
Revonsuo, Antti, Kallio, Sakari, and Sikka, Pilleriin. What Is an Altered State of Consciousness? Philosophical Psychology 22 (2009): 187–204.CrossRefGoogle Scholar
Sarah, Richmond, Rees, Geraint, and Edwards, Sarah, eds. I Know What You’re Thinking: Brain Imaging and Mental Privacy. Oxford: Oxford University Press, 2012.Google Scholar
David, Rodriguez-Arias, Smith, Maxwell, and Lazar, Neil. Donation after Circulatory Death: Burying the Dead Donor Rule. American Journal of Bioethics 11 (2011): 36–43.Google Scholar
Roskies, Adina. Freedom, Neural Mechanism and Consciousness. In Baumeister, Mele, and Vohs (eds.), 2010, pp. 153–71.Google Scholar
Ross, Stephen, Bossis, Anthony, Guss, Jeffrey et al. Rapid and Sustained Symptom Reduction Following Psilocybin Treatment for Anxiety and Depression in Patients with Life-Threatening Cancer: A Randomized Controlled Trial. Journal of Psychopharmacology 30 (2016): 1165–80.Google Scholar
Royal College of Physicians. Prolonged Disorders of Consciousness Following Sudden Onset Brain Injury: National Clinical Guidelines. 2020. https://www.rcplondon.ac.uk/guidelines-policy/prolonged-disorders-consciousness-following-sudden-onset-braininjury-national-clinical-guidelines.Google Scholar
Samuel, Nir, Taub, Aryeh, Paz, Rony, and Raz, Aeyal. Implicit Aversive Memory under Anaesthesia in Animal Models: A Narrative Review. British Journal of Anaesthesia 121 (2018): 219–32.Google Scholar
Schiff, Nicholas. Cognitive Motor Dissociation Following Severe Brain Injuries. JAMA Neurology 72 (2015): 1413–15.Google Scholar
Schiff, Nicholas, Giacino, Joseph, Kalmar, Kathy et al. Behavioural Improvements with Thalamic Stimulation after Severe Traumatic Brain Injury. Nature 448 (2007): 600-3.Google Scholar
Schnakers, Caroline. What Is It Like to Be in a Disorder of Consciousness? In Sinnott-Armstrong (ed.), 2016, pp. 83–99.Google Scholar
Schnakers, Caroline, and Monti, Martin. Towards Improving Care for Disorders of Consciousness. Nature Reviews Neurology 16 (2020): 405–6.Google Scholar
Schopp, Robert. Automatism, Insanity, and the Psychology of Criminal Responsibility: A Philosophical Inquiry. New York: Cambridge University Press, 1991.Google Scholar
Scolding, Neil, Owen, Adrian, and Keown, John. Prolonged Disorders of Consciousness: A Critical Evaluation of the New UK Guidelines. Brain 144 (2021): 1655–60.Google Scholar
Searle, John. Consciousness and the Problem of Free Will. In Baumeister, Mele, and Vohs (eds.), 2010, pp. 121–34.Google Scholar
Shepherd, Joshua. Moral Conflict in the Minimally Conscious State. In Sinnott-Armstrong (ed.), 2016, pp. 160–79.Google Scholar
Shepherd, Joshua. Consciousness and Moral Status. New York: Routledge, 2018.Google Scholar
Sher, George. Who Knew? Responsibility without Awareness. New York: Oxford University Press, 2009.Google Scholar
Shewmon, Alan. Recovery from “Brain Death”: A Neurologist’s Apologia. Linacre Quarterly 64 (1997): 30–96.Google Scholar
Shewmon, Alan. The Brain and Somatic Integration: Insights into the Standard Biological Rationale for Equating “Brain Death” with Death. Journal of Medicine and Philosophy 26 (2001): 457–78.Google Scholar
Sinnott-Armstrong, Walter, ed. Finding Consciousness: The Neuroscience, Ethics and Law of Severe Brain Damage. New York: Oxford University Press, 2016.Google Scholar
Smith, William, and Sisti, Dominic. Ethics and Ego Dissolution: The Case of Psilocybin. Journal of Medical Ethics 47 (2021): 807–14.Google Scholar
Solt, Ken, and Akeju, Oluwaseun. An Altered State of Consciousness Illuminated. Nature 586 (2020): 31–2.Google Scholar
Spiegel, David, and Cardena, Etzel. Disintegrated Experience: The Dissociative Disorders Revisited. Journal of Abnormal Psychology 100 (1991): 366–78.Google Scholar
Squire, Larry, and Zola, Stuart. Structure and Function of Declarative and Non-Declarative Memory Systems. Proceedings of the National Academy of Sciences 93 (1996): 13515–22.Google Scholar
Steinbock, Bonnie, and Norcross, Alastair, eds. Killing and Letting Die, 2nd ed. New York: Fordham University Press, 1994.Google Scholar
Sigrid, Sterckx, Raus, Kasper, and Mortier, Freddy, eds. Continuous Sedation at the End of Life: Ethical, Clinical and Legal Perspectives. Cambridge: Cambridge University Press, 2013.Google Scholar
Sulmasy, Daniel. The Last Low Whispers of Our Dead: When Is it Ethically Justifiable to Render a Patient Unconscious Until Death? Theoretical Medicine and Bioethics 39 (2018): 233–63.Google Scholar
Takla, Antony, Savulescu, Julian, and Wilkinson, Dominic. A Conscious Choice: Is it Ethical to Aim for Unconsciousness at the End of Life? Bioethics 35 (2021): 284–91.Google Scholar
Tasbihgou, Setayesh, Vogels, M. F., and Absalom, Anthony. Accidental Awareness during General Anesthesia: A Narrative Review. Anaesthesia 73 (2018): 112–22.Google Scholar
Teasdale, Graham, and Jennett, Bryan. Assessment of Coma and Impaired Consciousness. The Lancet 303 (1974): 81–4.Google Scholar
The Guardian. Report on the Right-to-Die Case of LIS Patient Tony Nicklinson. August 22, 2012. http://theguardian.com/uk/2012/august/22/tony-nicklinson-right-to-die-case.Google Scholar
Thibaut, Aurore, Schiff, Nicholas, Giacino, Joseph, Laureys, Steven, and Gosseries, Olivia. Therapeutic Interventions in Patients with Prolonged Disorders of Consciousness. The Lancet Neurology 18 (2019): 600–14.Google Scholar
Tolstoy, Lev. The Death of Ivan Ilych, trans. R. Pevear and L. Volokhonsky. New York: Random House, 1884–1886/2012.Google Scholar
Tononi, Giulio. An Information Integration Theory of Consciousness. BMC Neuroscience 5 (2004): 42. http://doi.org/10.1186/1471-2202-5-42.Google Scholar
Tononi, Giulio, and Koch, Christof. The Neural Correlates of Consciousness: An Update. Annals of the New York Academy of Sciences 1124 (2008): 239–61.Google Scholar
Tononi, Giulio, and Koch, Christof. Consciousness: Here, There and Everywhere? Philosophical Transactions of the Royal Society B 370 (2015): 20140167. http://doi.org/10.1098/rstb.2014.0167.Google Scholar
Tononi, Giulio, Boly, Melanie, Gosseries, Olivia, and Laureys, Steven. The Neurology of Consciousness: An Overview. In Laureys, Gosseries, and Tononi (eds.), 2016a, pp. 407–61.Google Scholar
Tononi, Giulio, Boly, Melanie, Massimini, Marcello, and Koch, Christof. Integrated Information Theory: From Consciousness to its Physical Substrate. Nature Reviews Neuroscience 17 (2016b): 450–61.Google Scholar
Christoph, Troppmann, Santhanakrishnan, Chandrasekar, Segeshima, Junichiro et al . Barriers to Live and Deceased Kidney Donation by Patients with Chronic Neurological Diseases: Implications for Donor Selection, Donation Timing, Logistics, and Regulatory Compliance. American Journal of Transplantation 19 (2019): 2168–73.Google Scholar
Tulving, Endel, and Schacter, Daniel. Priming and Human Memory Systems. Science 247 (1990): 301–6.Google Scholar
Vanhoecke, Jonathan, and Hariz, Marwan. Deep Brain Stimulation for Disorders of Consciousness: Systematic Review of Cases and Ethics. Brain Stimulation 10 (2017): 113–23.Google Scholar
Veatch, Robert. The Death of Whole-Brain Death: The Plague of the Disaggregators, Somaticists, and Mentalists. Journal of Medicine and Philosophy 30 (2005): 353–78.Google Scholar
Robert, Veatch, and Ross, Lainie Friedman. Defining Death: The Case for Choice. Washington, DC: Georgetown University Press, 2016.Google Scholar
Velmans, Max, and Schneider, Susan, eds. The Blackwell Companion to Consciousness. Malden: Blackwell, 2007.Google Scholar
Veselis, Robert. Memory Formation During Anaesthesia: Plausibility of a Neurophysiological Basis. British Journal of Anaesthesia 115 (2015): i13-i19.Google Scholar
Vesuna, Sam, Kauvar, Isaac, Richman, Ethan et al. Deep Posteromedial Cortical Rhythm in Dissociation. Nature 586 (2020): 87–94.Google Scholar
Vincent, Nicole. Responsibility, Dysfunction and Capacity. Neuroethics 1 (2008): 199–204.Google Scholar
Vincent, Nicole. Blame, Desert and Compatibilist Capacity: A Diachronic Account of Moderateness in Regard to Reasons-Responsiveness. Philosophical Explorations 6 (2013): 178–94.Google Scholar
W v. M. EWHC 2443 (Fam), 2011.Google Scholar
Wade, Derick. Back to the Bedside? Making Clinical Decisions in Patients with Prolonged Unconsciousness. Journal of Medical Ethics 43 (2017): 439–45.Google Scholar
Walsh, Fergus. Vegetative Patient Scott Routley Says, “I’m not in Pain.” BBC News, November 12, 2012. www.bbc.uk/news/health-20268044?print=true.Google Scholar
Weiskrantz, Lawrence, and Davies, Martin, eds. Frontiers of Consciousness. Oxford: Oxford University Press, 2008.Google Scholar
Wiffen, Philip, Derry, Sheena, and Moore, R. Andrew. Impact of Morphine, Fentanyl, Oxycodone or Codeine on Patient Consciousness, Appetite and Thirst When Used to Treat Cancer Pain. Cochrane Database of Systematic Reviews 5 (2014): CD011056. Cited by Takla, Savulescu, and Wilkinson, 2021, p. 285, n. 12.Google Scholar
Wilkinson, Dominic. Dissonance and Consonance about Death. Journal of Medical Ethics 47 (2021): 231–2.Google Scholar
Wilkinson, Dominic, and Savulescu, Julian. Should We Allow Organ Donation Euthanasia? Alternatives for Maximizing the Number and Quality of Organs for Transplantation. Bioethics 26 (2012): 32–48.Google Scholar
Wilkinson, Dominic, and Savulescu, Julian. Is it Better to be Minimally Conscious than Vegetative? Journal of Medical Ethics 39 (2013): 557–8.Google Scholar
Winkfield v. Children’s Hospital Oakland. Case No. C13-5993, US District Court, Northern District of California, Oakland, filed December 30, 2013.Google Scholar
Wittgenstein, Ludwig. Tractatus Logico-Philosophicus, trans. D. F. Pears and B. F. McGuinness. London: Routledge, 1921/1974.Google Scholar
Wittmann, Marc. The Inner Sense of Time: How the Brain Creates a Representation of Duration. Nature Reviews Neuroscience 14 (2013): 217–23.Google Scholar
Wittmann, Marc. Felt Time: The Science of How We Experience Time, trans. E. Butler. Cambridge, MA: MIT Press, 2016.Google Scholar
Wittmann, Marc. Altered States of Consciousness: Experiences Out of Time and Self, trans. P. Hurd. Cambridge, MA: MIT Press, 2018.Google Scholar
Woodward, Paul, ed. The Doctrine of Double Effect: Philosophers Debate a Controversial Moral Principle. Notre Dame: Notre Dame University Press, 2001.Google Scholar
Young, Michael, Bodien, Yelena, Giacino, Joseph et al. The Neuroethics of Disorders of Consciousness: A Brief History of Evolving Ideas. Brain 144 (2021): 3291–3310.Google Scholar
Young, Michael, Bodien, Yelena, and Edlow, Brian. Ethical Considerations in Clinical Trials for Disorders of Consciousness. Brain Sciences 12 (2022): 211. http: doi.org/10.3390/brainsci12020211.Google Scholar
Zadra, Antonio, Desautels, Alex, Petit, Dominique, and Montplaisir, Jacques. Somnambulism: Clinical Aspects and Pathophysiological Hypotheses. The Lancet Neurology 12 (2013): 285–94.Google Scholar
Zeman, Adam. Does Consciousness Spring from the Brain? Dilemmas of Awareness in Practice and in Theory. In Weiskrantz and Davies (eds.), 2008, pp. 289–322.Google Scholar

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