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The Consciousness Dilemma: Feel or Feel of Feeling?

The Consciousness Dilemma: Feel or Feel of Feeling? We would like to comment on the work by Owen et al1 on the usefulness of functional magnetic resonance imaging to detect covert awareness in the vegetative state. Functional neuroimaging techniques can provide substantial contributions to a better understanding of the complex pathophysiology of disorders of consciousness. In the article, Owen and colleagues suggest that functional magnetic resonance imaging provides a new means for detecting conscious awareness when a standard clinical approach is unable to provide that information. However, we have 2 main concerns. First, the approach may fall into the well-known logical fallacy post hoc, ergo propter hoc. In fact, activation of some specific isolated brain areas does not unequivocally imply their involvement in the hypothetical neural network underlying consciousness.2 Why can't the reported activation be considered an implicit preconscious neural response? Processing a stimulus does not necessarily imply being conscious of it. As suggested by Damasio,3 consciousness exists in the relationship between an organism and environmental stimuli in a feel of feeling continuous experience underlying subjectivity. Second, if the conclusion of the article will be more broadly confirmed by further clinical studies, a new clinical condition would be recognized in which thinking and acting are mutually independent, so endorsing the Descartes error.4 Finally, we are concerned about the possible confounding consequences of such an approach on the health community and on relatives of patients with disorders of consciousness. Correspondence: Dr Sarà, Casa di Cura San Raffaele, via Gaetano di Biasio 1, 03043 Cassino (FR), Italia (marco.sara@sanraffaele.it). Financial Disclosure: None reported. Additional Contributions: Michele Torroni provided help in editing the manuscript. References 1. Owen AMColeman MRBoly MDavis MHLaureys SPickard JD Using functional magnetic resonance imaging to detect covert awareness in the vegetative state. Arch Neurol 2007;64 (8) 1098- 1102PubMedGoogle ScholarCrossref 2. Silvert LDelplanque SBouwalerh HVerpoort CSequeira H Autonomic responding to aversive words without conscious valence discrimination. Int J Psychophysiol 2004;53 (2) 135- 145PubMedGoogle ScholarCrossref 3. Damasio A The Feeling of What Happens: Body and Emotion in the Making of Consciousness. New York, NY Harcourt Inc1999; 4. Damasio A Descartes' Error: Emotion, Reason, and the Human Brain. New York, NY Penguin2005; http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Neurology American Medical Association

The Consciousness Dilemma: Feel or Feel of Feeling?

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References (5)

Publisher
American Medical Association
Copyright
Copyright © 2008 American Medical Association. All Rights Reserved.
ISSN
0003-9942
eISSN
1538-3687
DOI
10.1001/archneur.65.3.418-a
Publisher site
See Article on Publisher Site

Abstract

We would like to comment on the work by Owen et al1 on the usefulness of functional magnetic resonance imaging to detect covert awareness in the vegetative state. Functional neuroimaging techniques can provide substantial contributions to a better understanding of the complex pathophysiology of disorders of consciousness. In the article, Owen and colleagues suggest that functional magnetic resonance imaging provides a new means for detecting conscious awareness when a standard clinical approach is unable to provide that information. However, we have 2 main concerns. First, the approach may fall into the well-known logical fallacy post hoc, ergo propter hoc. In fact, activation of some specific isolated brain areas does not unequivocally imply their involvement in the hypothetical neural network underlying consciousness.2 Why can't the reported activation be considered an implicit preconscious neural response? Processing a stimulus does not necessarily imply being conscious of it. As suggested by Damasio,3 consciousness exists in the relationship between an organism and environmental stimuli in a feel of feeling continuous experience underlying subjectivity. Second, if the conclusion of the article will be more broadly confirmed by further clinical studies, a new clinical condition would be recognized in which thinking and acting are mutually independent, so endorsing the Descartes error.4 Finally, we are concerned about the possible confounding consequences of such an approach on the health community and on relatives of patients with disorders of consciousness. Correspondence: Dr Sarà, Casa di Cura San Raffaele, via Gaetano di Biasio 1, 03043 Cassino (FR), Italia (marco.sara@sanraffaele.it). Financial Disclosure: None reported. Additional Contributions: Michele Torroni provided help in editing the manuscript. References 1. Owen AMColeman MRBoly MDavis MHLaureys SPickard JD Using functional magnetic resonance imaging to detect covert awareness in the vegetative state. Arch Neurol 2007;64 (8) 1098- 1102PubMedGoogle ScholarCrossref 2. Silvert LDelplanque SBouwalerh HVerpoort CSequeira H Autonomic responding to aversive words without conscious valence discrimination. Int J Psychophysiol 2004;53 (2) 135- 145PubMedGoogle ScholarCrossref 3. Damasio A The Feeling of What Happens: Body and Emotion in the Making of Consciousness. New York, NY Harcourt Inc1999; 4. Damasio A Descartes' Error: Emotion, Reason, and the Human Brain. New York, NY Penguin2005;

Journal

Archives of Neurology – American Medical Association

Published: Mar 1, 2008

Keywords: consciousness related finding

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