Kurthen M, Moskopp D, Linke D B, Reuter B M
Department of Neurosurgery, University Hospital, Bonn, FRG.
Theor Med. 1991 Mar;12(1):69-79. doi: 10.1007/BF02134779.
In this paper, the problem of correct ascriptions of consciousness to patients in neurological intensive care medicine is explored as a special case of the general philosophical 'other minds problem'. It is argued that although clinical ascriptions of consciousness and coma are mostly based on behavioral evidence, a behaviorist epistemology of other minds is not likely to succeed. To illustrate this, the so-called 'total locked-in syndrome', in which preserved consciousness is combined with a total loss of motor abilities due to a lower ventral brain stem lesion, is presented as a touchstone for behaviorism. It is argued that this example of consciousness without behavioral expression does not disprove behaviorism specifically, but rather illustrates the need for a non-verificationist theory of other minds. It is further argued that a folk version of such a theory already underlies our factual ascriptions of consciousness in clinical contexts. Finally, a non-behaviorist theory of other minds for patients with total locked-in syndrome is outlined.
在本文中,作为一般哲学“他人心灵问题”的一个特殊案例,探讨了神经重症监护医学中对患者意识的正确归因问题。有人认为,尽管对意识和昏迷的临床归因大多基于行为证据,但关于他人心灵的行为主义认识论不太可能成功。为了说明这一点,提出了所谓的“完全闭锁综合征”,即由于低位脑干腹侧病变,保留的意识与运动能力完全丧失相结合,以此作为行为主义的试金石。有人认为,这种没有行为表现的意识例子并没有特别反驳行为主义,而是说明了需要一种非证实主义的他人心灵理论。进一步有人认为,这样一种理论的民间版本已经构成了我们在临床环境中对意识进行事实归因的基础。最后,概述了一种针对完全闭锁综合征患者的非行为主义他人心灵理论。