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Pigorini A, Avanzini P, Barborica A, Bénar CG, David O, Farisco M, Keller CJ, Manfridi A, Mikulan E, Paulk AC, Roehri N, Subramanian A, Vulliémoz S, Zelmann R. Simultaneous invasive and non-invasive recordings in humans: a novel Rosetta stone for deciphering brain activity. J Neurosci Methods 2024:110160. [PMID: 38734149 DOI: 10.1016/j.jneumeth.2024.110160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 04/10/2024] [Accepted: 05/01/2024] [Indexed: 05/13/2024]
Abstract
Simultaneous noninvasive and invasive electrophysiological recordings provide a unique opportunity to achieve a comprehensive understanding of human brain activity, much like a Rosetta stone for human neuroscience. In this review we focus on the increasingly-used powerful combination of intracranial electroencephalography (iEEG) with scalp electroencephalography (EEG) or magnetoencephalography (MEG). We first provide practical insight on how to achieve these technically challenging recordings. We then provide examples from clinical research on how simultaneous recordings are advancing our understanding of epilepsy. This is followed by the illustration of how human neuroscience and methodological advances could benefit from these simultaneous recordings. We conclude with a call for open data sharing and collaboration, while ensuring neuroethical approaches and argue that only with a true collaborative approach the promises of simultaneous recordings will be fulfilled.
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Affiliation(s)
- Andrea Pigorini
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy; UOC Maxillo-facial Surgery and dentistry, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, Milan, Italy.
| | - Pietro Avanzini
- Institute of Neuroscience, Consiglio Nazionale delle Ricerche, Parma, Italy
| | | | - Christian-G Bénar
- Aix Marseille Univ, Inserm, U1106, INS, Institut de Neurosciences des Systèmes, Marseille, France
| | - Olivier David
- Aix Marseille Univ, Inserm, U1106, INS, Institut de Neurosciences des Systèmes, Marseille, France
| | - Michele Farisco
- Centre for Research Ethics and Bioethics, Department of Public Health and Caring Sciences, Uppsala University, P.O. Box 256, Uppsala, SE-751 05, Sweden; Science and Society Unit Biogem, Biology and Molecular Genetics Institute, Via Camporeale snc, Ariano Irpino (AV) 83031, Italy
| | - Corey J Keller
- Department of Psychiatry & Behavioral Sciences, Stanford University Medical Center, Stanford, CA, 94305, USA; Wu Tsai Neurosciences Institute, Stanford University Medical Center, Stanford, CA, 94305, USA; Veterans Affairs Palo Alto Healthcare System, and the Sierra Pacific Mental Illness, Research, Education, and Clinical Center (MIRECC), Palo Alto, CA, 94394, USA
| | - Alfredo Manfridi
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Ezequiel Mikulan
- Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - Angelique C Paulk
- Department of Neurology and Center for Neurotechnology and Neurorecovery, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Nicolas Roehri
- EEG and Epilepsy Unit, Dpt of Clinical Neurosciences, Geneva University Hospitals and University of Geneva, Switzerland
| | - Ajay Subramanian
- Department of Psychiatry & Behavioral Sciences, Stanford University Medical Center, Stanford, CA, 94305, USA; Wu Tsai Neurosciences Institute, Stanford University Medical Center, Stanford, CA, 94305, USA; Veterans Affairs Palo Alto Healthcare System, and the Sierra Pacific Mental Illness, Research, Education, and Clinical Center (MIRECC), Palo Alto, CA, 94394, USA
| | - Serge Vulliémoz
- EEG and Epilepsy Unit, Dpt of Clinical Neurosciences, Geneva University Hospitals and University of Geneva, Switzerland
| | - Rina Zelmann
- Department of Neurology and Center for Neurotechnology and Neurorecovery, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
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Evers K, Farisco M, Pennartz CMA. Assessing the commensurability of theories of consciousness: On the usefulness of common denominators in differentiating, integrating and testing hypotheses. Conscious Cogn 2024; 119:103668. [PMID: 38417198 DOI: 10.1016/j.concog.2024.103668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 02/07/2024] [Accepted: 02/12/2024] [Indexed: 03/01/2024]
Abstract
How deep is the current diversity in the panoply of theories to define consciousness, and to what extent do these theories share common denominators? Here we first examine to what extent different theories are commensurable (or comparable) along particular dimensions. We posit logical (and, when applicable, empirical) commensurability as a necessary condition for identifying common denominators among different theories. By consequence, dimensions for inclusion in a set of logically and empirically commensurable theories of consciousness can be proposed. Next, we compare a limited subset of neuroscience-based theories in terms of commensurability. This analysis does not yield a denominator that might serve to define a minimally unifying model of consciousness. Theories that seem to be akin by one denominator can be remote by another. We suggest a methodology of comparing different theories via multiple probing questions, allowing to discern overall (dis)similarities between theories. Despite very different background definitions of consciousness, we conclude that, if attention is paid to the search for a common methological approach to brain-consciousness relationships, it should be possible in principle to overcome the current Babylonian confusion of tongues and eventually integrate and merge different theories.
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Affiliation(s)
- K Evers
- Centre for Research Ethics and Bioethics, Uppsala University, Uppsala, Sweden.
| | - M Farisco
- Centre for Research Ethics and Bioethics, Uppsala University, Uppsala, Sweden; Bioethics Unit, Biogem, Molecular Biology and Molecular Genetics Research Institute, Ariano Irpino (AV), Italy
| | - C M A Pennartz
- Department of Cognitive and Systems Neuroscience, Swammerdam Institute for Life Sciences, University of Amsterdam, Amsterdam, Netherland; Research Priority Area, Brain and Cognition, University of Amsterdam, Amsterdam, Netherlands
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Farisco M, Formisano R, Gosseries O, Kato Y, Koboyashi S, Laureys S, Lejeune N, Martial C, Matar A, Morrisey AM, Schnakers C, Yakufujiang M, Yamaki T, Veeramuthu V, Zandalasini M, Zasler N, Magliacano A, Estraneo A. International survey on the implementation of the European and American guidelines on disorders of consciousness. J Neurol 2024; 271:395-407. [PMID: 37740739 PMCID: PMC10770208 DOI: 10.1007/s00415-023-11956-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 08/17/2023] [Accepted: 08/18/2023] [Indexed: 09/25/2023]
Abstract
Diagnostic, prognostic, and therapeutic procedures for patients with prolonged disorders of consciousness (pDoCs) vary significantly across countries and clinical settings, likely due to organizational factors (e.g., research vs. non-academic hospitals), expertise and availability of resources (e.g., financial and human). Two international guidelines, one from the European Academy of Neurology (EAN) and one from the American Academy of Neurology (AAN) in collaboration with the American Congress of Rehabilitation Medicine (ACRM) and the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR), were developed to facilitate consistent practice among professionals working with this challenging patient population. While the recommendations of both guidelines agree in principle, it remains an open issue how to implement them into clinical practice in the care pathway for patients with pDoCs. We conducted an online survey to explore health professional clinical practices related to the management of patients with pDoCs, and compare said practices with selected recommendations from both the guidelines. The survey revealed that while some recommendations are being followed, others are not and/or may require more honing/specificity to enhance their clinical utility. Particular attention should be given to the implementation of a multimodal assessment of residual consciousness, to the detection and treatment of pain, and to the impact of restrictions imposed by COVID-19 pandemics on the involvement of patients' families/representatives.
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Affiliation(s)
- Michele Farisco
- Centre for Research Ethics and Bioethics, Uppsala University, Uppsala, Sweden.
- Biogem, Biology and Molecular Genetics Research Institute, Ariano Irpino, AV, Italy.
| | | | - Olivia Gosseries
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium
- Centre du Cerveau, University Hospital of Liège, Liège, Belgium
| | - Yoko Kato
- Department of Neurosurgery, Fujita Health University Bantane Hospital, Nagoya, Aichi, Japan
| | - Shigeki Koboyashi
- Division of Neurosurgery, Rehabilitation Center for Traumatic Apallics Chiba, National Agency for Automotive Safety and Victims' Aid, 3-30-1 Isobe, Mihamaku, Chibashi, Chiba, 261-0012, Japan
| | - Steven Laureys
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium
- Centre du Cerveau, University Hospital of Liège, Liège, Belgium
- CERVO Brain Research Center, University of Laval, Québec, QC, Canada
| | - Nicolas Lejeune
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium
- CHN William Lennox, Ottignies-Louvain-La Neuve, Belgium
- Institute of NeuroScienceUCLouvain, Ottignies-Louvain-La Neuve, Belgium
| | - Charlotte Martial
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium
- Centre du Cerveau, University Hospital of Liège, Liège, Belgium
| | - Amal Matar
- Centre for Research Ethics and Bioethics, Uppsala University, Uppsala, Sweden
| | - Ann-Marie Morrisey
- School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Caroline Schnakers
- Research Institute, Casa Colina Hospital and Centers for Healthcare, Pomona, CA, USA
| | - Maidinamu Yakufujiang
- Division of Neurosurgery, Rehabilitation Center for Traumatic Apallics Chiba, National Agency for Automotive Safety and Victims' Aid, 3-30-1 Isobe, Mihamaku, Chibashi, Chiba, 261-0012, Japan
| | - Tomohiro Yamaki
- Division of Neurosurgery, Rehabilitation Center for Traumatic Apallics Chiba, National Agency for Automotive Safety and Victims' Aid, 3-30-1 Isobe, Mihamaku, Chibashi, Chiba, 261-0012, Japan
| | | | - Matteo Zandalasini
- Unità Spinale, Neuroriabilitazione E Medicina Riabilitativa Intensiva, Dipartimento Di Medicina Riabilitativa, Azienda USL Di Piacenza, Piacenza, Italy
| | - Nathan Zasler
- Concussion Care Centre of Virginia, LTD, Henrico, VA, 23233, USA
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA, 23298, USA
| | - Alfonso Magliacano
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Florence and Sant'Angelo dei Lombardi, AV, Italy
| | - Anna Estraneo
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Florence and Sant'Angelo dei Lombardi, AV, Italy
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Farisco M, Formisano R, Gosseries O, Kato Y, Koboyashi S, Laureys S, Lejeune N, Martial C, Matar A, Morrisey AM, Schnakers C, Yakufujiang M, Yamaki T, Veeramuthu V, Zandalasini M, Zasler N, Magliacano A, Estraneo A. Correction to: International survey on the implementation of the European and American guidelines on disorders of consciousness. J Neurol 2024; 271:408-409. [PMID: 37991607 PMCID: PMC10769971 DOI: 10.1007/s00415-023-12083-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2023]
Affiliation(s)
- Michele Farisco
- Centre for Research Ethics and Bioethics, Uppsala University, Uppsala, Sweden.
- Biogem, Biology and Molecular Genetics Research Institute, Ariano Irpino, AV, Italy.
| | | | - Olivia Gosseries
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium
- Centre du Cerveau, University Hospital of Liège, Liège, Belgium
| | - Yoko Kato
- Department of Neurosurgery, Fujita Health University Bantane Hospital, Nagoya, Aichi, Japan
| | - Shigeki Koboyashi
- Division of Neurosurgery, Rehabilitation Center for Traumatic Apallics Chiba, National Agency for Automotive Safety and Victims' Aid, 3-30-1 Isobe, Mihamaku, Chibashi, Chiba, 261-0012, Japan
| | - Steven Laureys
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium
- Centre du Cerveau, University Hospital of Liège, Liège, Belgium
- CERVO Brain Research Center, University of Laval, Québec, QC, Canada
| | - Nicolas Lejeune
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium
- CHN William Lennox, Ottignies-Louvain-La Neuve, Belgium
- Institute of NeuroScienceUCLouvain, Ottignies-Louvain-La Neuve, Belgium
| | - Charlotte Martial
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium
- Centre du Cerveau, University Hospital of Liège, Liège, Belgium
| | - Amal Matar
- Centre for Research Ethics and Bioethics, Uppsala University, Uppsala, Sweden
| | - Ann-Marie Morrisey
- School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Caroline Schnakers
- Research Institute, Casa Colina Hospital and Centers for Healthcare, Pomona, CA, USA
| | - Maidinamu Yakufujiang
- Division of Neurosurgery, Rehabilitation Center for Traumatic Apallics Chiba, National Agency for Automotive Safety and Victims' Aid, 3-30-1 Isobe, Mihamaku, Chibashi, Chiba, 261-0012, Japan
| | - Tomohiro Yamaki
- Division of Neurosurgery, Rehabilitation Center for Traumatic Apallics Chiba, National Agency for Automotive Safety and Victims' Aid, 3-30-1 Isobe, Mihamaku, Chibashi, Chiba, 261-0012, Japan
| | | | - Matteo Zandalasini
- Unità Spinale, Neuroriabilitazione E Medicina Riabilitativa Intensiva, Dipartimento Di Medicina Riabilitativa, Azienda USL Di Piacenza, Piacenza, Italy
| | - Nathan Zasler
- Concussion Care Centre of Virginia, LTD, Henrico, VA, 23233, USA
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA, 23298, USA
| | | | - Anna Estraneo
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Florence, Italy
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Evers K, Guerrero M, Farisco M. Neuroethics & Bioethics: Distinct but Not Separate. AJOB Neurosci 2023; 14:414-416. [PMID: 37856345 DOI: 10.1080/21507740.2023.2257162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2023]
Affiliation(s)
| | | | - M Farisco
- Uppsala University
- Biogem, Biology and Molecular Genetics Institute
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6
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Farisco M, Changeux JP. About the compatibility between the perturbational complexity index and the global neuronal workspace theory of consciousness. Neurosci Conscious 2023; 2023:niad016. [PMID: 37342235 PMCID: PMC10279414 DOI: 10.1093/nc/niad016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 04/18/2023] [Accepted: 05/31/2023] [Indexed: 06/22/2023] Open
Abstract
This paper investigates the compatibility between the theoretical framework of the global neuronal workspace theory (GNWT) of conscious processing and the perturbational complexity index (PCI). Even if it has been introduced within the framework of a concurrent theory (i.e. Integrated Information Theory), PCI appears, in principle, compatible with the main tenet of GNWT, which is a conscious process that depends on a long-range connection between different cortical regions, more specifically on the amplification, global propagation, and integration of brain signals. Notwithstanding this basic compatibility, a number of limited compatibilities and apparent differences emerge. This paper starts from the description of brain complexity, a notion that is crucial for PCI, to then summary of the main features of PCI and the main tenets of GNWT. Against this background, the text explores the compatibility between PCI and GNWT. It concludes that GNWT and PCI are fundamentally compatible, even though there are some partial disagreements and some points to further examine.
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Affiliation(s)
- Michele Farisco
- *Corresponding author. Centre for Research Ethics & Bioethics (CRB), Uppsala University, Box 564, Uppsala SE-751 22. E-mail:
| | - Jean-Pierre Changeux
- Neuroscience Department, Institut Pasteur, 25-28 Rue du Dr Roux, Paris 75015, France
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Farisco M. The Ethical Spectrum of Consciousness. AJOB Neurosci 2023; 14:55-57. [PMID: 37097853 DOI: 10.1080/21507740.2023.2188312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
Affiliation(s)
- Michele Farisco
- Centre for Research Ethics and Bioethics, Uppsala University
- Biogem, Biology and Molecular Genetics Research Institute
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Farisco M, Zecchino I, Capasso G. The need for a multi-disciplinary reflection about frailty and cognitive impairment in chronic kidney disease. Nephrol Dial Transplant 2022; 38:1064-1066. [PMID: 36549657 PMCID: PMC10157765 DOI: 10.1093/ndt/gfac334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Indexed: 12/24/2022] Open
Affiliation(s)
- Michele Farisco
- Biogem, Biology and Molecular Genetics Institute, Ariano Irpino (AV), Italy.,Centre for Research Ethics and Bioethics, Uppsala University, Uppsala, Italy
| | - Irene Zecchino
- Department of Science and Technology, University of Sannio, Benevento, Italy
| | - Giovambattista Capasso
- Biogem, Biology and Molecular Genetics Institute, Ariano Irpino (AV), Italy.,Department Translational Medical Science, University Campania Luigi Vanvitelli, Naples, Italy
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9
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Schnakers C, Bauer C, Formisano R, Noé E, Llorens R, Lejeune N, Farisco M, Teixeira L, Morrissey AM, De Marco S, Veeramuthu V, Ilina K, Edlow BL, Gosseries O, Zandalasini M, De Bellis F, Thibaut A, Estraneo A. What names for covert awareness? A systematic review. Front Hum Neurosci 2022; 16:971315. [PMID: 35992948 PMCID: PMC9389234 DOI: 10.3389/fnhum.2022.971315] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 07/15/2022] [Indexed: 12/14/2022] Open
Abstract
Background With the emergence of Brain Computer Interfaces (BCI), clinicians have been facing a new group of patients with severe acquired brain injury who are unable to show any behavioral sign of consciousness but respond to active neuroimaging or electrophysiological paradigms. However, even though well documented, there is still no consensus regarding the nomenclature for this clinical entity. Objectives This systematic review aims to 1) identify the terms used to indicate the presence of this entity through the years, and 2) promote an informed discussion regarding the rationale for these names and the best candidates to name this fascinating disorder. Methods The Disorders of Consciousness Special Interest Group (DoC SIG) of the International Brain Injury Association (IBIA) launched a search on Pubmed and Google scholar following PRISMA guidelines to collect peer-reviewed articles and reviews on human adults (>18 years) published in English between 2006 and 2021. Results The search launched in January 2021 identified 4,089 potentially relevant titles. After screening, 1,126 abstracts were found relevant. Finally, 161 manuscripts were included in our analyses. Only 58% of the manuscripts used a specific name to discuss this clinical entity, among which 32% used several names interchangeably throughout the text. We found 25 different names given to this entity. The five following names were the ones the most frequently used: covert awareness, cognitive motor dissociation, functional locked-in, non-behavioral MCS (MCS*) and higher-order cortex motor dissociation. Conclusion Since 2006, there has been no agreement regarding the taxonomy to use for unresponsive patients who are able to respond to active neuroimaging or electrophysiological paradigms. Developing a standard taxonomy is an important goal for future research studies and clinical translation. We recommend a Delphi study in order to build such a consensus.
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Affiliation(s)
- Caroline Schnakers
- Research Institute, Casa Colina Hospital and Centers for Healthcare, Pomona, CA, United States
- *Correspondence: Caroline Schnakers
| | - Chase Bauer
- College of Osteopathic Medicine, Western University of Health Sciences, Pomona, CA, United States
| | | | - Enrique Noé
- Vithas Neuro Rehab Human Brain, Fundación Hospitales Vithas, Valencia, Spain
| | - Roberto Llorens
- Vithas Neuro Rehab Human Brain, Fundación Hospitales Vithas, Valencia, Spain
- Neurorehabilitation and Brain Research Group, Instituto de Investigación e Innovación en Bioingeniería, Universitat Politècnica de València, Valencia, Spain
| | - Nicolas Lejeune
- Centre Hospitalier Neurologique William Lennox, Ottignies-Louvain-la-Neuve, Belgium
- GIGA-Consciousness, Coma Science Group, University of Liège, Liege, Belgium
| | - Michele Farisco
- Centre for Research Ethics and Bioethics, Uppsala University, Uppsala, Sweden
- Science and Society Unit, Biogem, Biology and Molecular Genetics Research Institute, Ariano Irpino, Italy
| | - Liliana Teixeira
- Center for Innovative Care and Health Technology, School of Health Sciences, Polytechnic of Leiria, Leiria, Portugal
| | - Ann-Marie Morrissey
- Ageing Research Centre, School of Allied Health, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Sabrina De Marco
- Clínica Universitaria Reina Fabiola, Universidad Católica de Córdoba, Córdoba, Argentina
| | | | - Kseniya Ilina
- Research Center of Neurology, Moscow, Russia
- Faculty of Fundamental Medicine, Lomonosov Moscow State University, Moscow, Russia
| | - Brian L. Edlow
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Olivia Gosseries
- GIGA-Consciousness, Coma Science Group, University of Liège, Liege, Belgium
- Centre du Cerveau, University Hospital of Liege, Liege, Belgium
| | - Matteo Zandalasini
- Unità Spinale, Neuroriabilitazione e Medicina Riabilitativa Intensiva, Dipartimento di Medicina Riabilitativa, Azienda USL di Piacenza, Piacenza, Italy
| | | | - Aurore Thibaut
- GIGA-Consciousness, Coma Science Group, University of Liège, Liege, Belgium
- Centre du Cerveau, University Hospital of Liege, Liege, Belgium
| | - Anna Estraneo
- IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy
- Neurology Unit, SM della Pietà General Hospital, Nola, Italy
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10
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Affiliation(s)
- Michele Farisco
- Centre for Research Ethics & Bioethics, Uppsala University, Uppsala, Sweden (Drs Farisco and Salles); Science and Society Unit, Biogem, Biology and Molecular Genetics Institute, Via Camporeale, Ariano Irpino (AV), Italy (Dr Farisco); and Programa de Neuroetica, Centro de Investigaciones Filosoficas, Buenos Aires, Argentina (Dr Salles)
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11
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Farisco M, Pennartz C, Annen J, Cecconi B, Evers K. Indicators and criteria of consciousness: ethical implications for the care of behaviourally unresponsive patients. BMC Med Ethics 2022; 23:30. [PMID: 35313885 PMCID: PMC8935680 DOI: 10.1186/s12910-022-00770-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 03/13/2022] [Indexed: 11/24/2022] Open
Abstract
Background Assessing consciousness in other subjects, particularly in non-verbal and behaviourally disabled subjects (e.g., patients with disorders of consciousness), is notoriously challenging but increasingly urgent. The high rate of misdiagnosis among disorders of consciousness raises the need for new perspectives in order to inspire new technical and clinical approaches.
Main body We take as a starting point a recently introduced list of operational indicators of consciousness that facilitates its recognition in challenging cases like non-human animals and Artificial Intelligence to explore their relevance to disorders of consciousness and their potential ethical impact on the diagnosis and healthcare of relevant patients. Indicators of consciousness mean particular capacities that can be deduced from observing the behaviour or cognitive performance of the subject in question (or from neural correlates of such performance) and that do not define a hard threshold in deciding about the presence of consciousness, but can be used to infer a graded measure based on the consistency amongst the different indicators. The indicators of consciousness under consideration offer a potential useful strategy for identifying and assessing residual consciousness in patients with disorders of consciousness, setting the theoretical stage for an operationalization and quantification of relevant brain activity. Conclusions Our heuristic analysis supports the conclusion that the application of the identified indicators of consciousness to its disorders will likely inspire new strategies for assessing three very urgent issues: the misdiagnosis of disorders of consciousness; the need for a gold standard in detecting consciousness and diagnosing its disorders; and the need for a refined taxonomy of disorders of consciousness.
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Affiliation(s)
- Michele Farisco
- Centre for Research Ethics and Bioethics, Uppsala University, Uppsala, Sweden. .,Science and Society Unit, Biogem, Biology and Molecular Genetics Research Institute, Ariano Irpino, AV, Italy.
| | - Cyriel Pennartz
- Department of Cognitive and Systems Neuroscience, Swammerdam Institute for Life Sciences, University of Amsterdam, Amsterdam, The Netherlands.,Research Priority Area, Brain and Cognition, University of Amsterdam, Amsterdam, The Netherlands
| | - Jitka Annen
- Coma Science Group, GIGA-Consciousness, University of Liege, Liege, Belgium.,Centre du Cerveau, University Hospital of Liege, Liege, Belgium
| | - Benedetta Cecconi
- Coma Science Group, GIGA-Consciousness, University of Liege, Liege, Belgium.,Centre du Cerveau, University Hospital of Liege, Liege, Belgium
| | - Kathinka Evers
- Centre for Research Ethics and Bioethics, Uppsala University, Uppsala, Sweden
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Abstract
The recently published BRAIN 2.0 Neuroethics Report offers a very helpful overview of the possible ethical, social, philosophical, and legal issues raised by neuroscience in the context of BRAIN's research priorities thus contributing to the attempt to develop ethically sound neuroscience. In this article, we turn to a running theme of the document: the need for an ethical framework for the BRAIN Initiative and for further integration of neuroethics and neuroscience. We assess some of the issues raised and provide an explanation of how we have addressed them in the Human Brain Project. We offer our experience in the HBP as a potential contribution to the international debate about neuroethics in the big brain initiatives. Our hope is that among other things, the type of exchange proposed by this AJOB special issue will prove productive in further identifying and discussing the issues and in inspiring appropriate solutions.
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Affiliation(s)
- Arleen Salles
- Uppsala University.,Centro de Investigaciones Filosoficas
| | - Michele Farisco
- Uppsala University.,Biogem, Biology and Molecular Genetics Institute
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13
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Abstract
AI research is growing rapidly raising various ethical issues related to safety, risks, and other effects widely discussed in the literature. We believe that in order to adequately address those issues and engage in a productive normative discussion it is necessary to examine key concepts and categories. One such category is anthropomorphism. It is a well-known fact that AI's functionalities and innovations are often anthropomorphized (i.e., described and conceived as characterized by human traits). The general public's anthropomorphic attitudes and some of their ethical consequences (particularly in the context of social robots and their interaction with humans) have been widely discussed in the literature. However, how anthropomorphism permeates AI research itself (i.e., in the very language of computer scientists, designers, and programmers), and what the epistemological and ethical consequences of this might be have received less attention. In this paper we explore this issue. We first set the methodological/theoretical stage, making a distinction between a normative and a conceptual approach to the issues. Next, after a brief analysis of anthropomorphism and its manifestations in the public, we explore its presence within AI research with a particular focus on brain-inspired AI. Finally, on the basis of our analysis, we identify some potential epistemological and ethical consequences of the use of anthropomorphic language and discourse within the AI research community, thus reinforcing the need of complementing the practical with a conceptual analysis.
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Affiliation(s)
- Arleen Salles
- Uppsala University.,Centro de Investigaciones Filosoficas (CIF)
| | | | - Michele Farisco
- Uppsala University.,Biogem, Biology and Molecular Genetics Institute
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Abstract
Ethical reflection on Artificial Intelligence (AI) has become a priority. In this article, we propose a methodological model for a comprehensive ethical analysis of some uses of AI, notably as a replacement of human actors in specific activities. We emphasize the need for conceptual clarification of relevant key terms (e.g., intelligence) in order to undertake such reflection. Against that background, we distinguish two levels of ethical analysis, one practical and one theoretical. Focusing on the state of AI at present, we suggest that regardless of the presence of intelligence, the lack of morally relevant features calls for caution when considering the role of AI in some specific human activities.
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Affiliation(s)
- Michele Farisco
- Centre for Research Ethics and Bioethics, Uppsala University, Box 564, 751 22, Uppsala, Sweden.
- Science and Society Unit, Biogem, Biology and Molecular Genetics Institute, Via Camporeale, Ariano Irpino, AV, Italy.
| | - Kathinka Evers
- Centre for Research Ethics and Bioethics, Uppsala University, Box 564, 751 22, Uppsala, Sweden
| | - Arleen Salles
- Centre for Research Ethics and Bioethics, Uppsala University, Box 564, 751 22, Uppsala, Sweden
- Programa de Neuroetica, Centro de Investigaciones Filosoficas, Buenos Aires, Argentina
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15
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Salles A, Bjaalie JG, Evers K, Farisco M, Fothergill BT, Guerrero M, Maslen H, Muller J, Prescott T, Stahl BC, Walter H, Zilles K, Amunts K. The Human Brain Project: Responsible Brain Research for the Benefit of Society. Neuron 2019; 101:380-384. [PMID: 30731062 DOI: 10.1016/j.neuron.2019.01.005] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 12/19/2018] [Accepted: 12/29/2018] [Indexed: 02/06/2023]
Abstract
Recognizing that its research may raise various ethical, social, and philosophical issues, the HBP has made the identification, examination, and management of those issues a top priority. The Ethics and Society subproject is part of the core research project.
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Affiliation(s)
- Arleen Salles
- Centre for Research Ethics and Bioethics, Uppsala University, Uppsala, Sweden; Centro de Investigaciones Filosóficas (CIF), Buenos Aires, Argentina.
| | - Jan G Bjaalie
- Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Kathinka Evers
- Centre for Research Ethics and Bioethics, Uppsala University, Uppsala, Sweden
| | - Michele Farisco
- Centre for Research Ethics and Bioethics, Uppsala University, Uppsala, Sweden; Science and Society Unit, Biogem, Biology and Molecular Genetics Institute, Via Camporeale, Ariano Irpino (AV), Italy
| | - B Tyr Fothergill
- Centre for Computing and Social Responsibility, De Montfort University, Leicester, UK
| | - Manuel Guerrero
- Centre for Research Ethics and Bioethics, Uppsala University, Uppsala, Sweden; Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Sweden; Department of Bioethics and Medical Humanities, University of Chile, Chile
| | - Hannah Maslen
- The Oxford Uehiro Centre for Practical Ethics, University of Oxford, Oxford, UK
| | - Jeffrey Muller
- Human Brain Project, École Polytechnique Fédérale de Lausanne (EPFL), Campus Biotech, Batiment B1, Chemin des Mines 9, CH-1202 Geneva, Switzerland
| | - Tony Prescott
- Department of Computer Science and Sheffield Robotics, The University of Sheffield, Sheffield, UK
| | - Bernd C Stahl
- Centre for Computing and Social Responsibility, De Montfort University, Leicester, UK
| | - Henrik Walter
- Division of Mind and Brain Research, Department of Psychiatry and Psychotherapy CCM, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Karl Zilles
- Institute for Neuroscience and Medicine, INM-1, Structural and Functional Organisation of the Brain, Forschungszentrum Juelich, GmbH D, 52425 Juelich, Germany
| | - Katrin Amunts
- Institute for Neuroscience and Medicine, INM-1, Structural and Functional Organisation of the Brain, Forschungszentrum Juelich, GmbH D, 52425 Juelich, Germany; Cecile und Oskar Vogt Institute for Brain Research, Heinrich Heine University Duesseldorf, University Hospital Duesseldorf, Germany.
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16
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Pennartz CMA, Farisco M, Evers K. Indicators and Criteria of Consciousness in Animals and Intelligent Machines: An Inside-Out Approach. Front Syst Neurosci 2019; 13:25. [PMID: 31379521 PMCID: PMC6660257 DOI: 10.3389/fnsys.2019.00025] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Accepted: 06/24/2019] [Indexed: 01/02/2023] Open
Abstract
In today's society, it becomes increasingly important to assess which non-human and non-verbal beings possess consciousness. This review article aims to delineate criteria for consciousness especially in animals, while also taking into account intelligent artifacts. First, we circumscribe what we mean with "consciousness" and describe key features of subjective experience: qualitative richness, situatedness, intentionality and interpretation, integration and the combination of dynamic and stabilizing properties. We argue that consciousness has a biological function, which is to present the subject with a multimodal, situational survey of the surrounding world and body, subserving complex decision-making and goal-directed behavior. This survey reflects the brain's capacity for internal modeling of external events underlying changes in sensory state. Next, we follow an inside-out approach: how can the features of conscious experience, correlating to mechanisms inside the brain, be logically coupled to externally observable ("outside") properties? Instead of proposing criteria that would each define a "hard" threshold for consciousness, we outline six indicators: (i) goal-directed behavior and model-based learning; (ii) anatomic and physiological substrates for generating integrative multimodal representations; (iii) psychometrics and meta-cognition; (iv) episodic memory; (v) susceptibility to illusions and multistable perception; and (vi) specific visuospatial behaviors. Rather than emphasizing a particular indicator as being decisive, we propose that the consistency amongst these indicators can serve to assess consciousness in particular species. The integration of scores on the various indicators yields an overall, graded criterion for consciousness, somewhat comparable to the Glasgow Coma Scale for unresponsive patients. When considering theoretically derived measures of consciousness, it is argued that their validity should not be assessed on the basis of a single quantifiable measure, but requires cross-examination across multiple pieces of evidence, including the indicators proposed here. Current intelligent machines, including deep learning neural networks (DLNNs) and agile robots, are not indicated to be conscious yet. Instead of assessing machine consciousness by a brief Turing-type of test, evidence for it may gradually accumulate when we study machines ethologically and across time, considering multiple behaviors that require flexibility, improvisation, spontaneous problem-solving and the situational conspectus typically associated with conscious experience.
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Affiliation(s)
- Cyriel M. A. Pennartz
- Department of Cognitive and Systems Neuroscience, Swammerdam Institute for Life Sciences, University of Amsterdam, Amsterdam, Netherlands
- Research Priority Area, Brain and Cognition, University of Amsterdam, Amsterdam, Netherlands
| | - Michele Farisco
- Centre for Research Ethics and Bioethics, Uppsala University, Uppsala, Sweden
- Biogem, Biology and Molecular Genetics Institute, Ariano Irpino, Italy
| | - Kathinka Evers
- Centre for Research Ethics and Bioethics, Uppsala University, Uppsala, Sweden
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17
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Affiliation(s)
- Arleen Salles
- a Uppsala University
- b Centro de Investigaciones Filosoficas
| | | | - Michele Farisco
- a Uppsala University
- c Biogem, Biology and Molecular Genetics Institute
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18
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Larrivee D, Farisco M. Realigning the Neural Paradigm for Death. J Bioeth Inq 2019; 16:259-277. [PMID: 31161308 DOI: 10.1007/s11673-019-09915-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Accepted: 05/08/2019] [Indexed: 06/09/2023]
Abstract
Whole brain failure constitutes the diagnostic criterion for death determination in most clinical settings across the globe. Yet the conceptual foundation for its adoption was slow to emerge, has evoked extensive scientific debate since inception, underwent policy revision, and remains contentious in praxis even today. Complications result from the need to relate a unitary construal of the death event with an adequate account of organismal integration and that of the human organism in particular. Advances in the neuroscience of higher human faculties, such as the self, personal identity, and consciousness, and dynamical philosophy of science accounts, however, are yielding a portrait of higher order global integration shared between body and brain. Such conceptual models of integration challenge a praxis relying exclusively on a neurological criterion for death.
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Affiliation(s)
- Denis Larrivee
- Loyola University Chicago, 1320 West Sheridan Rd, Chicago, IL, USA.
- Mind and Brain Institute, University of Navarra, Pamplona, Spain.
| | - Michele Farisco
- Centre for Research Ethics and Bioethics, Uppsala University, Uppsala, Sweden
- Science and Society Unit, Biology and Molecular Genetics Institute, Ariano Irpino, AV, Italy
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Farisco M, Kotaleski JH, Evers K. Large-Scale Brain Simulation and Disorders of Consciousness. Mapping Technical and Conceptual Issues. Front Psychol 2018; 9:585. [PMID: 29740372 PMCID: PMC5928391 DOI: 10.3389/fpsyg.2018.00585] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Accepted: 04/06/2018] [Indexed: 11/15/2022] Open
Abstract
Modeling and simulations have gained a leading position in contemporary attempts to describe, explain, and quantitatively predict the human brain's operations. Computer models are highly sophisticated tools developed to achieve an integrated knowledge of the brain with the aim of overcoming the actual fragmentation resulting from different neuroscientific approaches. In this paper we investigate the plausibility of simulation technologies for emulation of consciousness and the potential clinical impact of large-scale brain simulation on the assessment and care of disorders of consciousness (DOCs), e.g., Coma, Vegetative State/Unresponsive Wakefulness Syndrome, Minimally Conscious State. Notwithstanding their technical limitations, we suggest that simulation technologies may offer new solutions to old practical problems, particularly in clinical contexts. We take DOCs as an illustrative case, arguing that the simulation of neural correlates of consciousness is potentially useful for improving treatments of patients with DOCs.
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Affiliation(s)
- Michele Farisco
- Centre for Research Ethics and Bioethics, Uppsala University, Uppsala, Sweden
- Science and Society Unit, Biogem Genetic Research Centre, Ariano Irpino (AV), Italy
| | - Jeanette H. Kotaleski
- Science for Life Laboratory, School of Computer Science and Communication, KTH Royal Institute of Technology, Stockholm, Sweden
- Department of Neuroscience, Karolinska Institute, Solna, Sweden
| | - Kathinka Evers
- Centre for Research Ethics and Bioethics, Uppsala University, Uppsala, Sweden
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Abstract
In the present paper, we suggest a potential new ethical analysis of addiction focusing on the relationship between aware and unaware processing in the brain. We take the case of the opioids epidemics to argue that a consideration of both aware and unaware processing provides a more comprehensive ethical framework to discuss the ethical issues raised by addiction. Finally, our hypothesis is that in addition to identified Central Nervous System's neuronal/neurochemical factors contributing to addictive dynamics, the socio-economic status plays a causal role through epigenetic processes, originating the need for additional reward in the brain. This provides a strong base for a socio-political form of responsibility for preventing and managing addiction crisis.
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Affiliation(s)
- Michele Farisco
- Centre for Research Ethics and Bioethics, Uppsala University, Uppsala, Sweden.,Science and Society Unit, Biogem, Biology and Molecular Genetics Institute, Ariano Irpino, Italy
| | - Kathinka Evers
- Centre for Research Ethics and Bioethics, Uppsala University, Uppsala, Sweden
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21
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Abstract
BACKGROUND Ethical analyses of disorders of consciousness traditionally focus on residual awareness. Going one step further, this paper explores the potential ethical relevance of the unawareness retained by patients with disorders of consciousness, focusing specifically on the ethical implications of the description of the unconscious provided by recent scientific research. METHODS A conceptual methodology is used, based on the review and analysis of relevant scientific literature on the unconscious and the logical argumentation in favour of the ethical conclusions. RESULTS Two conditions (experiential wellbeing and having interests) that are generally considered critical components in the ethical discussion of patients with disorders of consciousness might arguably be both conscious and unconscious. CONCLUSIONS The unconscious, as well as consciousness, should be taken into account in the ethical discussions of patients with disorders of consciousness.
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Affiliation(s)
- Michele Farisco
- Centre for Research Ethics and Bioethics, Uppsala University, Uppsala, Sweden.
- Brain Project Sub-Project 12, Uppsala University, Uppsala, Sweden.
- Biogem, Genetic Research Centre, Ariano Irpino, (AV), Italy.
| | - Kathinka Evers
- Centre for Research Ethics and Bioethics, Uppsala University, Uppsala, Sweden
- Brain Project Sub-Project 12, Uppsala University, Uppsala, Sweden
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Racine E, Dubljević V, Jox RJ, Baertschi B, Christensen JF, Farisco M, Jotterand F, Kahane G, Müller S. Can Neuroscience Contribute to Practical Ethics? A Critical Review and Discussion of the Methodological and Translational Challenges of the Neuroscience of Ethics. Bioethics 2017; 31:328-337. [PMID: 28503831 DOI: 10.1111/bioe.12357] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2016] [Revised: 09/02/2016] [Accepted: 11/10/2016] [Indexed: 06/07/2023]
Abstract
Neuroethics is an interdisciplinary field that arose in response to novel ethical challenges posed by advances in neuroscience. Historically, neuroethics has provided an opportunity to synergize different disciplines, notably proposing a two-way dialogue between an 'ethics of neuroscience' and a 'neuroscience of ethics'. However, questions surface as to whether a 'neuroscience of ethics' is a useful and unified branch of research and whether it can actually inform or lead to theoretical insights and transferable practical knowledge to help resolve ethical questions. In this article, we examine why the neuroscience of ethics is a promising area of research and summarize what we have learned so far regarding its most promising goals and contributions. We then review some of the key methodological challenges which may have hindered the use of results generated thus far by the neuroscience of ethics. Strategies are suggested to address these challenges and improve the quality of research and increase neuroscience's usefulness for applied ethics and society at large. Finally, we reflect on potential outcomes of a neuroscience of ethics and discuss the different strategies that could be used to support knowledge transfer to help different stakeholders integrate knowledge from the neuroscience of ethics.
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Abstract
UNLABELLED DIFFICULTIES OF BEHAVIORAL ASSESSMENT OF CONSCIOUSNESS: An astonishingly high rate of misdiagnosis between vegetative state/unresponsive wakefulness syndrome and minimally conscious state has been detected. This raises the issue of the adequacy of the consciousness' assessment in patients with disorders of consciousness. The behavioral assessment of consciousness could be not able to detect covert awareness, which is increasingly identified by the instrumental assessment. ANCILLARY METHODS: Neurotechnology, particularly neuroimaging, provides relevant data concerning the neurological underlying condition of patients with DOCs, but the instrumental approach has still to assess some technical issues. ETHICAL CONSIDERATIONS A correct diagnosis of a DOC is not only an instrumental issue, but also an ethically relevant demand to the scientific community. Finally, an integration between behavioral and instrumental assessments seems to be the most adequate strategy in order to decrease the rate of misdiagnosis.
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Affiliation(s)
- Michele Farisco
- Centre for Research Ethics and Bioethics, Uppsala, Sweden. E-mail:
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24
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Farisco M, Evers K, Petrini C. Biomedical research involving patients with disorders of consciousness: ethical and legal dimensions. Ann Ist Super Sanita 2016; 50:221-8. [PMID: 25292269 DOI: 10.4415/ann_14_03_04] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
THE DIRECTIVE 2001/20/UE AND THE RESEARCH INVOLVING PATIENTS WITH DOCS: Research involving patients with disorders of consciousness (DOCs) deserves special ethical and legal attention because of its Janus-faced nature. On the one hand, it raises concerns about the risk to expose the involved subjects to disproportionate risks not respecting their individual dignity, particularly their right to be cared for; on the other hand, research is an essential tool in order to improve the clinical condition of patients with DOCs. The present paper concerns the ethical and legal dimensions of biomedical research involving patients with disorders of consciousness. In particular, it focuses on informed consent to experimental treatments, which is a challenging issue both from an ethical and legal point of view. The first part reads the Directive 2001/20/EU in the light of the experimentation of patients with DOCs, and suggests a revision in order to better assess the issue of informed consent. THE PARTICULAR CASE OF INFORMED CONSENT FOR OBSERVATIONAL STUDIES OF NON-COMMUNICATIVE PATIENTS: The second part presents an informed consent form for studies through video-recording of patients unable to communicate their own consent. This form has been elaborated by the bioethics unit of the project "Review of the nosography of vegetative states: application of methods of behavioral analysis to individuals in coma or vegetative state" developed at the Italian National Institute of Health. RELEVANCE OF THE SUGGESTED FORM: The paper describes the conceptual framework of the form for informed consent to studies through video-recoding, which is a relevant example of what issues should be included in an informed consent for any type of studies through video-recording of patients unable to express their own consent. The article has been sent on November the 7th 2013, before the adoption of the Regulation (EU) no. 536/2014 (and consequent abrogation of the Directive 2001/20/EU) and the release of the new edition of the Italian Code of Medical Ethics.
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Affiliation(s)
- Michele Farisco
- Centre for Research Ethics and Bioethics, Uppsala, Sweden. E-mail:
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25
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Bjugn R, Farisco M, Høstmælingen N, Simeon-Dubach D, Petrini C. What Are Some of the ELSI Challenges of International Collaborations Involving Biobanks, Global Sample Collection, and Genomic Data Sharing and How Should They Be Addressed? Biopreserv Biobank 2015; 13:70-1. [DOI: 10.1089/bio.2015.1323] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
| | - Michele Farisco
- Biogem Research Centre, Ariano Irpino, Italy and Centre for Research Ethics and Bioethics, Uppsala University, Uppsala, Sweden
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Farisco M, Ferrigno L, Petrini C, Rosmini F. [Codes, guidelines and guidance of ethics of research: the issue of quality]. Epidemiol Prev 2014; 38:268-272. [PMID: 25115481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
After an overview of the evolution of ethics laws for medical activities, we suggest a possible classification of documents regarding the ethical conduct of scientific research with human beings. The authors outline the necessity to define formal criteria for the development and the implementation of ethics standards.
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Abstract
The paper starts by analyzing recent advancements in neurotechnological assessment of residual consciousness in patients with disorders of consciousness and in neurotechnology-mediated communication with them. Ethical issues arising from these developments are described, with particular focus on informed consent. Against this background, we argue for the necessity of further scientific efforts and ethical reflection in neurotechnological assessment of consciousness and 'cerebral communication' with verbally non-communicative patients.
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Affiliation(s)
- Michele Farisco
- Centre for Research Ethics and Bioethics, Uppsala University, Uppsala, Sweden,
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Farisco M, Alleva E, Chiarotti F, Macri S, Petrini C. Clinicians’ Attitudes toward Patients with Disorders of Consciousness: A Survey. NEUROETHICS-NETH 2013. [DOI: 10.1007/s12152-013-9185-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Petrini C, Farisco M. Informed consent for cord blood donation. A theoretical and empirical study. Blood Transfus 2011; 9:292-300. [PMID: 21251456 PMCID: PMC3136597 DOI: 10.2450/2010.0083-10] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/17/2010] [Accepted: 10/19/2010] [Indexed: 11/21/2022]
Abstract
BACKGROUND AND OBJECTIVES Umbilical cord blood (CB) banking and therapeutic use raise several ethical issues: medical indications, legal framework, public versus private biobanks, autologous versus allogeneic use, ownership, commercialisation, quality assurance and many others. Surrogate informed consent is one of the most notable controversial ethical issues. The aim of this study was to analyse and compare informed consent forms for CB collection, storage and use in the 18 accredited biobanks of the Italian Network. MATERIAL AND METHODS The first part of the article gives a brief overview of the scientific framework, the comparison of allogeneic and autologous use and Italian regulations. In the second part the contents of the consent forms from the 18 Italian biobanks are compared with the "NetCord-FACT International Standards for Cord Blood Collection, Banking, and Release for Administration". RESULTS Most of the Italian consent forms differ significantly from the NetCord-FACT Standards, with regards both to formal and substantial aspects. CONCLUSION Italian forms for CB collection, storage and use need standardisation to meet international criteria.
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Affiliation(s)
- Carlo Petrini
- Bioethics Unit, Office of the President, Italian National Institute of Health, Rome
| | - Michele Farisco
- Biogem IRGS, Institute of Research “Gaetano Salvatore”, Ariano Irpino (AV), Italy
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