Finding Consciousness: The Neuroscience, Ethics, and Law of Severe Brain Damage (Oxford Series in Neuroscience, Law, and Philosophy)

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. The Prominent Contributors Provide Background Information, Survey The Issues And Positions, And Take Controversial Stands From A Wide Variety Of Perspectives, Including Neuroscience And Neurology, Law And Policy, And Philosophy And Ethics. Finding Consciousness : An Introduction / By Meghan Brayton And Walter Sinnott-armstrong -- Discussion With A Caring Father / By Ken Diviney And Katherine Grichnik -- The Geography Of Unconsciousness : From Apparent Death To The Minimally Conscious State / By Jeffrey Baker -- Consciousness And Death : The Whole-brain Formulation Of Death / By James L. Bernat -- Modes Of Consciousness / By Tim Bayne And Jakob Hohwy -- What Is It Like To Be In A Disorder Of Consciousness / By Caroline Schnakers -- Decoding Thoughts In Behaviorally Non-responsive Patients / By Adrian Owen And Lorina Naci. Persistent Vegetative State, Akinetic Mutism, And Consciousness / By Will Davies And Neil Levy -- Lay Attitudes To Withdrawal Of Treatment In Disorders Of Consciousness And Their Normative Significance / By Jacob Gipson, Guy Kahane, And Julian Savulescu -- Moral Conflict In The Minimally Conscious State / By Joshua Shepherd -- What's Good For Them? Best Interests And Severe Disorders Of Consciousness / By Jennifer Hawkins -- Minimally Conscious States And Pain : A Different Approach To Patient Ethics / By Valerie Gray Hardcastle -- The Legal Circle Of Life / By Nita Farahany And Rachel Zacharias -- Guardianship And The Injured Brain : Representation And The Rights Of Patients And Families / By Joseph Fins And Barbara Pohl. Edited By Walter Sinnott-armstrong. Includes Bibliographical References And Index. 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. Finding consciousness : an introduction / by Meghan Brayton and Walter Sinnott-Armstrong Discussion with a caring father / by Ken Diviney and Katherine Grichnik The geography of unconsciousness : from apparent death to the minimally conscious state / by Jeffrey P. Baker Consciousness and death : the whole-brain formulation of death / by James L. Bernat Modes of consciousness / by Tim Bayne and Jakob Hohwy What is it like to be in a disorder of consciousness / by Caroline Schnakers Decoding thoughts in behaviorally non-responsive patients / by Adrian M. Owen and Lorina Naci Persistent vegetative state, akinetic mutism, and consciousness / by Will Davies and Neil Levy Lay attitudes to withdrawal of treatment in disorders of consciousness and their normative significance / by Jacob Gipson, Guy Kahane, and Julian Savulescu Moral conflict in the minimally conscious state / by Joshua Shepherd What is good for them? Best interests and severe disorders of consciousness / by Jennifer Hawkins Minimally conscious states and pain : a different approach to patient ethics / by Valerie Gray Hardcastle The legal circle of life / by Nita A. Farahany and Rachel Zacharias Guardianship and the injured brain : representation and the rights of patients and families / by Joseph J. Fins and Barbara Pohl. Cover 1 Series 3 Finding Consciousness 4 Copyright 5 Contents 10 Contributors 12 1 Finding Consciousness: An Introduction 14 2 Discussion with a Caring Father 25 PART I Consciousness 32 3 The Geography of Unconsciousness: From Apparent Death to the Minimally Conscious State 34 4 Consciousness and Death: The Whole-Brain Formulation of Death 51 5 Modes of Consciousness 70 PART II Diagnosis 94 6 What Is It Like To Be in a Disorder of Consciousness? 96 7 Decoding Thoughts in Behaviorally Nonresponsive Patients 113 8 Persistent Vegetative State, Akinetic Mutism, and Consciousness 135 PART III Ethics 148 9 Lay Attitudes to Withdrawal of Treatment in Disorders of Consciousness and Their Normative Significance 150 10 Moral Conflict in the Minimally Conscious State 173 11 What Is Good for Them? Best Interests and Severe Disorders of Consciousness 193 12 Minimally Conscious States and Pain: A Different Approach to Patient Ethics 220 PART IV Law 240 13 The Legal Circle of Life 242 14 Guardianship and the Injured Brain: Representation and the Rights of Patients and Families 259 Index 272