Not knowing why

January 17, 2018

Pär SegerdahlOften we do not know why we think as do. We may like a drawing, but we cannot say why we think it is good. We may find it unpleasant that researchers study human embryos in petri dishes and then discard them, but we cannot say why.

Personally, I find not knowing why interesting and I do not mind spending ages without being able to state a single sensible reason. There is something fruitful in it, something secretly promising. But it can also drive people crazy. The strange thing is that you easily satisfy them by giving any idiotic reason, as long as it superficially sounds like “saying why.” It satisfies the intellect, which cannot understand how anyone can think something without a reason. It reminds me of a complaint about the neighbor’s dog: it often barks without reasonable grounds.

I would not be suited to participate in a TV debate program. The strange thing is that in such debates people really do behave like barking dogs, precisely by always giving reasons: “Your opinion is idiotic, because woof-woof, woof-woof!” – Debating is most likely overrated… but why do I think so?

Immediately satisfying the demands of the intellect seems unwise. Apart from committing us to opinions that must be defended, which makes it difficult to change, we are forced to give our thoughts premature form. They are prevented from deepening and surprising us.

A Chinese philosopher said, “To pretend to know when you do not know is a disease.” But the intellect forces us to pretend to know. The intellect goes insane if we do not exhibit this insanity.

Acknowledging that you do not know, and then giving yourself time, that is wisdom.

Pär Segerdahl

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The unconscious deserves moral attention

January 10, 2018

Pär SegerdahlLast autumn, Michele Farisco wrote one of the most read posts on The Ethics Blog. The post was later republished by BioEdge.

Today, I want to recommend a recent article where Farisco develops his thinking – read it in the journal, Philosophy, Ethics, and Humanities in Medicine.

The article will certainly receive at least as much attention as the blog post did. Together with Kathinka Evers, Farisco develops a way of thinking about the unconscious that at first seems controversial, but which after careful consideration becomes increasingly credible. That combination is hard to beat.

What is it about? It is about patients with serious brain injuries, perhaps after a traffic accident. Ethical discussions about these patients usually focus on residual consciousness. We think that there is an absolute difference between consciousness and unconsciousness. Only a conscious person can experience well-being. Only a conscious person can have interests. Therefore, a patient with residual consciousness deserves a completely different care than an unconscious patient. A different attention to pain relief, peace and quiet, and stimulation. – Why create a warm and stimulating environment if the patient is completely unaware of it?

In the article, Farisco challenges the absolute difference between consciousness and unconsciousness. He describes neuroscientific evidence that indicates two often-overlooked connections between conscious and unconscious brain processes. The first is that the unconscious (at least partly) has the abilities that are considered ethically relevant when residual consciousness is discussed. The other connection is that conscious and unconscious brain processes are mutually dependent. They shape each other. Even unconsciously, the brain reacts uniquely to the voices of family members.

Farisco does not mean that this proves that we have an obligation to treat unconscious patients as conscious. However, the unconscious deserves moral attention. Perhaps we should strive to assess also retained unconscious abilities. In some cases, we should perhaps play the music the patient loved before the accident.

Pär Segerdahl

Farisco, M. and Evers, K. The ethical relevance of the unconscious. Philosophy, Ethics, and Humanities in Medicine (2017) DOI 10.1186/s13010-017-0053-9

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