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Joseph J. Fins calls for a reconsideration of severe brain injury treatment, including discussion of public policy and physician advocacy.
Modern medicine enables us to keep many people alive after they have suffered severe brain damage and show no reliable outward signs of consciousness. Many such patients are misdiagnosed as being in a permanent vegetative state when they are actually in a minimally conscious state. This mistake has far-reaching implications for treatment and prognosis. To alleviate this problem, neuroscientists have recently developed new brain-scanning methods to detect consciousness in some of these patients and even to ask them questions, including "Do you want to stay alive?" Finding Consciousness: The Neuroscience, Ethics, and Law of Severe Brain Damage addresses many questions regarding these recent neuroscientific methods: Is what these methods detect really consciousness? Do patients feel pain? Should we decide whether or not to let them die or are they competent to decide for themselves? And which kinds of treatment should governments and hospitals make available? This edited volume provides contextual information, surveys the issues and positions, and takes controversial stands from a wide variety of prominent contributors in fields ranging from neuroscience and neurology to law and policy to philosophy and ethics. Finding Consciousness should interest not only neuroscientists, clinicians, and ethicists but anyone who might suffer brain damage, which includes us all.
[Note: The slide presentation and video are not available from this event.] Over the past two decades neuroimaging has revealed the possibility of covert consciousness in patients once thought vegetative. This knowledge coupled with the ability of drugs, devices and neuroprosthetics to restore functional communication in patients with disorders of consciousness has the potential to reintegrate patients into the nexus of family and community. A worthy scientific pursuit, I will argue that this effort is a moral imperative which links respect for persons with the reemergence of voice out of covert consciousness. As I describe in my recently published book, "Rights Come to Mind: Brain Injury, Ethics and the Struggle for Consciousness" (Cambridge University Press, 2015), this is a human rights issue for a population too long marginalized. For rights to come to mind, patients will need greater access to medical care and research, the skilled engagement of the clinical community, and fuller protections under of the law.
Inhaltsübersicht: Vorwort, Im Theater des Bewusstseins, 1. Bewusstsein als Variable, 2. Die Theaterbühne besitzt begrenzte Kapazität, ermöglicht aber grenzenlosen Zugang, 3. Auf der Bühne: Empfindungen, Vorstellungen und Ideen, 4. Der Scheinwerfer: Aufmerksamkeit, Absorption und Konstruktion der Wirklichkeit, 5. Hinter den Kulissen: Die Kontexte, die unsere Erfahrung prägen, 6. Der Wille: bewusste Handlungskontrolle, 7. Der Regisseur: das Selbst als der vereinheitlichende Bewusstseinskontext, 8. Wozu nützt das alles? Die Funktion des Bewusstseins, 9. Epilog: Ein klein bisschen Philosophie, Anhang, Ausgewählte Literatur, Bildnachweis, Register.
Abstract: In the 2015 David Kopf Lecture on Neuroethics of the Society for Neuroscience, Dr. Joseph Fins presents his work on neuroethics and disorders of consciousness through the experience of Maggie and Nancy Worthen, a young woman who sustained a severe brain injury and her mother who cared for her. The central protagonists in his book, Rights Come to Mind: Brain Injury, Ethics and the Struggle for Consciousness (Cambridge University Press, 2015), their experience is emblematic of the challenges faced by families touched by severe brain injury and the possibility for improved diagnosis and treatment offered by progress in neuroscience. By telling their story, and those of other families interviewed as part of the research for Rights Come to Mind, Fins calls for improved care for this population arguing that this is both an access to care issue and a civil and disability rights issue worthy of greater societal attention.
Was passiert in unserem Gehirn, wenn wir Kunst betrachten? Nobelpreisträger Eric Kandel hat mit »Das Zeitalter der Erkenntnis« ein brillantes Buch geschrieben, das uns in das Wien Sigmund Freuds, Gustav Klimts und Arthur Schnitzlers entführt. Dort setzten um 1900 die angesehensten Köpfe der Naturwissenschaft, Medizin und Kunst eine Revolution in Gang, die den Blick auf den menschlichen Geist und seine Beziehung zur Kunst für immer verändern sollte.

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