Talking to the Absent?

Dr. Adrian M. Owen, a British neuroscientist currently working at the University of Western Ontario, recently presented his research at the University of Alberta.  The research team at UWO, led by Damian Cruse and Adrian M. Owen, claims to have found a way to test for consciousness in patients utterly unresponsive.  Using an fMRI scan to take images of patients’ brains while asking them to imagine certain things (either playing tennis or walking through a house) as a means of responding “yes” or “no” to questions, revealed, according to Dr. Owen, that at least 20% of patients labelled as being in vegetative states are in fact conscious (at least some of the time), but merely unable to communicate with the outside world that they in fact are conscious.  Because the mental states associated with playing tennis are consistently and ubiquitously correlated with a distinctly different part of the brain than mental states associated with spatial location, the UWO team deemed the “tennis-playing” and “house-walking” thoughts to be perfectly suited to code for such distinct responses as affirming or negating something.

The problem with assessing whether or not someone is conscious is that short of asking, all we have at our disposal is diagnoses made based on behavioural outputs (one such output being an affirmative verbal response to the question “are you conscious?”).  However, assessing the level of consciousness of a patient incapable of outward communication of any sort becomes quite difficult.  According to Dr. Owen, 20% of patients previously labelled as being in vegetative states showed signs of consciousness precisely because, thanks to the fMIR scans and the questioning techniques used by the UWO team, they were able to acknowledge their awareness by correctly responding to questions about their personal lives (i.e. questions regarding the names of a parent, the location of their last vacation prior to the accident, etc.).

Such a breakthrough, according to Dr. Owen, could potentially help clinicians make more accurate diagnoses (he cited a current 45% occurrence of misdiagnosis of patients with severe brain damage) and, perhaps even more importantly, it could help shape policies regarding the passive euthanasia of patients like Terri Schiavo.  Here is a New York Times article directly related to Dr. Owen’s research.

There are several questions, in light of Dr. Owen’s research, that come to mind: Is there a problem with passive euthanasia if a patient like Terri could have been asked?  Was there a problem with it (in the case of Terri) regardless of such a possibility?  What if once assessed as conscious and subsequently asked, a patient expressed a wish to be euthanised, but not passively euthanised because of the long and cruel nature of death by starvation and dehydration?  If 20% of patients in Dr. Owen’s study showed signs of consciousness, could there be more?  What should we make of the moral status of individuals who’s mental lives weave in and out of consciousness or consist of some very faint traces of consciousness?  What “amount” of identifiable signs of consciousness is enough?  Is it appropriate at all that consciousness is, as it seems to have become, the moral threshold between life and death?  There are many interesting questions that emerge from this issue more generally as well as the research at UWO more specifically.  For now, as I continue to digest Dr. Owen’s talk, I just pose some of these questions in their raw and unpolished forms, hopefully to get some insightful comments, concerns, other questions, etc., which will certainly aid in my thinking through such issues.

Defining Autism

The New York Times recently published an article on the medical debate over the definition of autism — whether it has been defined too loosely, and needs to be narrowed. The article  explores some of the potential consequences that the outcome of this debate could have, and looks to the anger and fear that has been generated amongst many parents with children currently defined as autistic. Amy Harmon writes,

A study reported on Thursday found that proposed revisions to theAmerican Psychiatric Association’s definition would exclude about three-quarters of those now diagnosed with milder forms of autism called Asperger syndrome or “pervasive developmental disorder, not otherwise specified,” also known as P.D.D.-N.O.S. These are people who have difficulties with social interaction but do not share the most severe impairments of children with classic autism.

Some parents fear that children deemed “on the edge” of autism will have their treatment options limited with the proposed narrowing of the definition. In contrast, some parents with severely autistic children support narrowing the definition.

“Everyone on the spectrum benefits when money and services available are applied more specifically and appropriately to the individual needs of each person affected,” said Mark L. Olson, of Henderson, Nev., whose daughter, 16, does not speak. Mr. Olson has argued on hisblog that those with more severe needs have been overshadowed by people with the Asperger diagnosis, who have typical intelligence and language development.

The article goes on to discuss the implications that labelling a child with ‘autism’ has on that child. On the one hand, it often opens up the opportunity for treatment, while on the other, the child is deemed abnormal.

Court Decision Could Have Implications for the Living Archives Project

A decision by a Federal Court judge last week could have implications for the Living Archives project.

The decision, which can be found in its entirety here, gives Library and Archives Canada 90 days to reconsider its decision to withhold parts of a secret RCMP dossier on Tommy Douglas that was requested by journalist, Jim Bronskill, over 6 years ago.

For more on this, check out the Canadian Press article printed in The Toronto Star and available here.

In his decision, Justice Simon Noel notes that “this case highlights the importance of transferring information to the public domain for the benefit of present and future Canadians as well as our collective knowledge and memory as a country.”

It’s unlikely that this decision will have an immediate impact on the way those who control access to the information about our past will operate, but it sets a significant precedent that recognizes the importance of maintaining and building collective knowledge and memory about the past.

Hat-tip to Baldwin Reichwein for bringing this story to our attention.

Call for Submissions – The Collective Memory Project: Responses to Eugenics in Alberta

Pasted below is the text from this call for submissions for an art exhibit to be held in Edmonton and to run from late October through November of this year.

Anne Pasek, the principal force behind this initiative, is an intern on the Living Archives project this summer. As part of her internship, and with support from several other interns, she has arranged for the upcoming exhibition.

Please circulate this call for submissions, and be sure to attend the exhibition later this year. Also, note the pre-exhibit workshops being held the last Tuesday of July, August, and September, as you may be interested in attending some or all of these as well.

Call for Submissions
The Collective Memory Project:
Responses to Eugenics in Alberta

Artists and community members are invited to submit artwork to a forthcoming exhibition addressing the legacy and future inheritance of eugenic ideas in Alberta. Exploring forgotten narratives, lost histories, and contemporary anxieties, The Collective Memory Project will investigate and make visible the process through which personhood is unequally distributed in society.

Continue reading

Added support for compensation and public acknowledgment for eugenics victims in North Carolina

h/t Doug Wahlsten.

North Carolina state flag

North Carolina state flag

The state of North Carolina has recently been revisiting its extensive eugenic past, and the latest move is a statement of support for compensation for sterilization victims from the director of Legal and Regulatory Studies at the John Locke Foundation.  Eugenic sterilization legislation was in place in NC until 1979; there are slightly fewer than 3000 living survivors of the regime of sterilization that was in place in NC until that time.

The full story is in the Lincoln Tribune.

Facing Uncertainty: Who is Destined for Alzheimer’s Disease?

A talk by Margaret Lock, McGill University with Respondent: Alex Choby, University of Alberta. Thursday 24 March 2011 at 3.30pm at ETLC E1 003 (right behind Assiniboia Hall on the University of Alberta campus far North West end. Nearest parking is Windsor parkade) with a reception to follow. A SSHRC Gold Medal Winner Margaret Lock is a Professor Emeritus in Social Studies in Medicine, and is affliated with the Department of Social Studies of Medicine and the Department of Athropology at McGill University. The abstract of the talk: Continue reading

Marwencol

 

I went to see the film Marwencol last night at the Metro Cinema; if you’re in Edmonton, you can catch it Sunday and Monday nights at either 7 or 9pm.  And if you are in St. Elsewhere, check it out when it does the rounds.  It is breath-takingly good.

 

The one sentence reason why?  Marwencol avoids freakification, sensationalism, and victimization in telling a powerful story that invites all three.

 

Dialogue of the Domestic reveals the hidden parts of humankind

In Dialogue of the Domestic, University of Alberta graduate student Anna House says she tries to show how, by arranging items in homes, occupants tell stories about themselves and leave out disturbing details they prefer kept out of the spotlight. She says that domestic interior tells a story about relationships and human character.

Continue reading

Philosophy TV. Really.

Philosophy TV. It’s new. It’s real. It’s coming … actually, it has come … to a computer near you. Be scared. Be very scared. Congratulations to Brynn Welch et al. for getting this off the ground, and to Tamar Gendler and Eric Schwitzgebel for taking the first, brave steps. To infinity … and beyond.

Tamar Gendler and Eric Schwitzgebel on Implicit associations and belief.

Coming up on Philosophy TV next week or so: Peter Singer and Michael Slot.

Templeton Positive Neuroscience Awards

Apparently, I’m an “honorary distinguished senior advisor” to this project, where I assume that “honorary” means “unpaid”, “distinguished” is a typo, “dis” for “ex”, and “senior” means “old”.  The complete information on the award recipient projects may be of interest to some readers of the blog. Congratulations to Laurie Santos especially for her grant on the origins of altruism!

Positive Neuroscience, U of Penn

Positive Neuroscience / Psychology

Award-winning researchers to explore human flourishing
from neural networks to social networks

The Positive Psychology Center of the University of Pennsylvania and the John Templeton Foundation (www.templeton.org) have announced the recipients of the Templeton Positive Neuroscience Awards. The project will grant $2.9 million in award funding to 15 new research projects at the intersection of Neuroscience and Positive Psychology.

The winning projects will help us understand how the brain enables human flourishing. They explore a range of topics, from the biological bases of altruism to the effects of positive interventions on the brain.

The Positive Neuroscience Project (www.posneuroscience.org) was established in 2008 by Professor Martin E.P. Seligman, Director of the Penn Positive Psychology Center, with a $5.8 million grant from the John Templeton Foundation. In 2009, the project announced the Templeton Positive Neuroscience Awards competition to bring the tools of neuroscience to bear on advances in Positive Psychology. Seligman founded the quickly-growing field of Positive Psychology in 1998 based on the simple yet radical notion that what is good in life is as worthy of scientific study as what is disabling in life.  Read the full press release from the PNP website.

Experimenting on the vulnerable at Columbia University

Last week the New York Times and LA Times reported violations of FDA mandated dosage levels in the chemicals used in clinical PET (positron emission tomography) studies at a major lab, the Kreitchman PET Center, at the Columbia University Medical Center.

Most people who participate in experimental studies of drug treatments are vulnerable–either via poverty, mental illness, other disability, race–and while they consent to participate.  That consent carries with it an acknowledgment of a higher risk, but it’s also based on the basic trust that the studies are at least in accord with federal and other regulations (e.g., university research ethics boards approvals, when done in university environments).

The practice of chasing “willing subjects” to all corners of the globe became widespread as these approvals onshore became harder to gain for domestic populations, a story told in The Constant Gardener that had at least one kind of less-than-fully-evil outcome, as reported last year by The Independent.

So what is going on at Columbia University? (apart from damage control by their administration)  Below the fold is the LA Times article; here’s the link to the original article, and here’s a h/t link to the AHRP blog post by Vera on this story. Continue reading

What sorts on psychiatry

Here are a few What sorts posts on psychiatry

Does anyone remember “lobotomy”?

Is your dog on prozac?

Marcia Angell on Big Pharma

NYT on DSM-V

Defending Electroshock

What sorts of people?  Empathy deficit disorder–do you suffer from it?

Pride in maddness–the new visibility

God as one’s moral compass

Creating God in One’s Own Image is great post from Ed Young at Not Exactly Rocket Science on Nicholas Epley’s just published PNAS paper reporting a scientific study of what happens when God talks to some people, perhaps even YOU

God speaks to George W. Bush

Right Here, Lord.

For many religious people, the popular question “What would Jesus do?” is essentially the same as “What would I do?” That’s the message from an intriguing and controversial new study by Nicholas Epley from the University of Chicago. Through a combination of surveys, psychological manipulation and brain-scanning, he has found that when religious Americans try to infer the will of God, they mainly draw on their own personal beliefs. Read the full post from NERS right here.

Human Kinds: Introduction

Over the next few weeks, we will run videocasts from in invited symposium panel that I organized at the Pacific Division meeting of American Philosophical Association in April, 2009, held in Vancouver. The panel was on human kinds, and topics that we discussed ranged from transhumanism through to disability and sub-normalcy and gay rights and gay marriage. The speakers, in the order in which they spoke, were:

Natasha Vita-More

Gregor Wolbring

Nick Agar

Ed Stein

The talks are relatively short, and we’ll run about 1 per week before linking them all up together. No captioning yet, but we hope to have captioning done by the time the series has run.

The introduction talks a little bit more generally about the panel and the What Sorts Network. You can also watch the videos directly on Youtube, by searching for videos by Rapunzelish. Really.

The new growth attenuation paper by Dr. Diekema, Dr. Fost with others

I read the full text of the growth-attenuation paper written by Dr. Diekema and Dr. Fost with others in the June issue of the Pediatrics. So many questions and mysteries again. I will point out some of them here for now. Some of the questions and mysteries will be reviewed more closely in my future posts.

1. The authors’ definition of profound cognitive disability “for purpose of growth-attenuation therapy” is not totally about cognitive disabilities but mostly about physical disabilities. It disguises the fact that growth attenuation is in fact a therapy that addresses problems caused by severe physical disabilities, not by cognitive disabilities, which they have been using as a convenient excuse for justification. But maybe we should also note that the authors didn’t forget to add “for present time” when they wrote that it should be limited to children with profound cognitive disability.

2. Their justification for excluding hysterectomy and breast bud removal from discussion is something like this: Criticism was mostly targeted at hysterectomy and breast bud removal in the Ashley case controversy in 2007 (implying maybe that growth attenuation was not all that criticized and pretty much approved?), and in addition, growth attenuation does not necessarily accompany the other two interventions. But these are lame excuses. Continue reading

Brain-Twitter

from CNN, h/t Justice for All

Adam Wilson posted two messages on Twitter on April 15. The first one, “GO BADGERS,” might have been sent by any University of Wisconsin-Madison student cheering for the school team. His second post, 20 minutes later, was a little more unusual: “SPELLING WITH MY BRAIN.”

Wilson, a doctoral student in biomedical engineering, was confirming an announcement he had made two weeks earlier — his lab had developed a way to post messages on Twitter using electrical impulses generated by thought. That’s right, no keyboards, just a red cap fitted with electrodes that monitor brain activity, hooked up to a computer flashing letters on a screen. Wilson sent the messages by concentrating on the letters he wanted to “type,” then focusing on the word “twit” at the bottom of the screen to post the message.

The development could be a lifeline for people with “locked-in syndrome” — whose brains function normally but who cannot speak or move because of injury or disease.Read the rest here.