Rocco J. Gennaro

As explained in the previous chapter, human brain organoids are organoids that resemble parts or aspects of the human brain, and human cerebral organoids (HCOs) are one type of brain organoid that mimics the cerebrum. They can be described as miniature 3D biological models of the cerebrum derived from human embryonic or induced pluripotent stem cells. Insofar as these organoids accurately resemble the cerebrum in early development, they can advance our understanding of how this part of the human brain develops and propel neurological progress. But given that they resemble a part of the human brain thought to corresponds to consciousness, the research development and use of HCOs elicit a question with substantial ethical implications: Can these brain organoids become conscious? Whether HCOs could become conscious depends on two factors. The first factor, which was addressed in the previous chapter, is how consciousness relates to the brain. The second factor, which is addressed in this chapter, is whether or not the neurobiological conditions for consciousness are present in the organoids. To this second factor, Owen et al. (2024) applied three neurobiological theories of consciousness: the Temporal Circuit Hypothesis, the Global Neuronal Workspace Theory, and the Integrated Information Theory. This chapter extends their work by applying several additional theoretical frameworks: Higher-Order Thought Theory, the Attention Schema Theory, as well as Predictive Processing and Neurorepresentationalism. After introducing each theory, we consider what it implies about the neurobiological conditions that HCOs need to meet in order to become conscious.

Dialogues on Minds, Machines, and AI invites readers into a series of thought-provoking debates among three college seniors bound for graduate school: Sue, completing her double major in philosophy and cognitive science; John, a computer engineering specialist; and Amy, a psychology major. Through five engaging lunchtime conversations, these students bring their diverse perspectives to fundamental questions about consciousness, artificial intelligence, and the nature of mind. The dialogues seamlessly blend discussions of popular science fiction films with critical examinations of recent AI developments, including ChatGPT, deep fakes, and other emerging technologies. Readers will explore foundational concepts at the intersection of human consciousness and machine learning: Alan Turing's influential "imitation game," John Searle's provocative "Chinese room argument," computational theories of mind, robot creativity, and the modularity of mind hypothesis. Rather than advocating for any particular viewpoint, these conversations illuminate the strengths, weaknesses, and implications of each perspective. Perfect for undergraduate students and curious minds from all backgrounds, this accessible introduction to cognitive science requires no prior knowledge of philosophy or technical subjects. The book includes a comprehensive glossary and thoughtful study questions to enhance understanding, while a carefully curated bibliography enables readers to explore specific topics in greater depth.

Since its publication in 1996, many thousands of students have first encountered key issues in the philosophy of mind in the pages of Rocco J. Gennaro's introductory work, _Mind and Brain: A Dialogue on the Mind-Body Problem_. In this new edition, Gennaro updates and expands the work to reflect current topics and discussions. The dialogue provides a clear and compelling overview of the mind-body problem suitable for both introductory students and those who have some background in the philosophy of mind. Topics include: Immortality Materialism Descartes’ “Divisibility Argument” for substance dualism The “Argument from Introspection” for substance dualism The main objections to dualism The interaction between mind and brain The relation between brain damage and the prospect of an afterlife Parallelism and epiphenomenalism The type/token distinction within materialism and the problem of multiple realizability Arguments against materialism and its ability to explain consciousness Property dualism and panpsychism The epistemological problem of other minds The nature of inductive knowledge Evidence for animal consciousness The problem of machine or robot minds The inverted spectrum argument Also included are a brief Introduction, a list of Study Questions designed to enhance classroom discussion and serve as a resource for the development of paper topics, a Glossary, and an Index of Key Terms.

The evolution of nursing in Albania offers a unique philosophical skylight into its transformation. Albanian nurses are rethinking nursing, bolstered by global nursing philosophy within an Albanian philosophical and cultural context. The meaning of nursing emerges from a journey of discovery that leverages a philosophical lens to harmonise global nursing philosophy with Albanian culture. Nursing philosophical discourse in Albania is proposing solutions to address challenges posed by the country's significant healthcare transitions. Albanian nurse leaders have created a fruitful dialogue between global nursing philosophical concepts and the rediscovery of Albania's cultural principles amidst their efforts to redefine nursing. Through its newly developed ‘BESA, kerING, pivetel’ philosophy, Albanian nursing enriches the country's healthcare system, imbuing it with humanised, ethical, and culturally meaningful care.

The purpose of the study was to identify the psychological causes, effects, and treatments for stress and professional burnout in future nurses. The research methodology includes questionnaires of nursing students and psychometric tests, namely, the Maslach Burnout Inventory and the Perceived Stress Scale. The study examines the psychological aspects of stress and professional burnout in nursing students, which is an urgent problem of modern medical education. The findings highlight the main reasons that contribute to the occurrence of stressful conditions in students, such as high academic load, emotional stress, practical classes in medical institutions and the need to combine study with work. The effects of stress on the mental and physical health of nursing students, including burnout symptoms, reduced academic performance, sleep disorders, and overall deterioration in quality of life, were analysed in detail. Special attention is paid to the impact of chronic stress on the professional development and career prospects of future nurses. The results obtained confirm the need for a comprehensive approach to solving the problem of stress and professional burnout in nursing students, which will help to increase their stress tolerance and professional training. Various methods of prevention and treatment of stress and professional burnout among nursing students are presented. These include cognitive behavioural therapy, meditation, relaxation techniques, exercise, and social support. Recommendations for organising the educational process, creating a favourable learning environment, and providing psychological support to students are provided.

In Gennaro (2016), I had originally replied to Fred Adams and Charlotte Shreve’s (2016) paper entitled “What Can Synesthesia Teach Us About Higher Order Theories of Consciousness?,” previously published in Symposion. I argued that H.O.T. theory does have the resources to account for synesthesia and the specific worries that they advance in their paper, such as the relationship between concepts and experience and the ability to handle instances of ‘pop-out’ experiences. They counter-reply in Adams and Shreve (2017) and also raise further objections to H.O.T. theory which go well beyond the scope of their 2016 paper. In this paper, I offer additional replies to the points they raise in Adams and Shreve (2017).

Background: Nursing continues to gain legitimation epistemologically and ontologically as a scientific discipline throughout the world. If a profession gains respect as a true autonomous scientific profession, then this recognition has to be put in practice in all environments and geographical areas. Nursing professional dignity, as a self-regarding concept, does not have a clear definition in the literature, and it has only begun to be analyzed in the last 10 years. Objectives: The purpose of this meta-synthesis was to determine the various factors that constitute the notion of nursing professional dignity. The target was to create a tentative model of the concept. Research design: The research design was a meta-synthesis (N = 15 original articles) of nursing professional dignity described in the literature, based on the guidelines by Noblit and Hare. Method and findings: Original studies were sought out from electronic databases and manual searches. The selection of literature was conducted on stages based on titles (n = 2595), abstracts (n = 70), and full-texts (n = 15) according to the inclusion and exclusion criteria. From this analysis, a clear definition of nursing professional dignity emerged that underscored two main macro-dimensions constituting this intertwined, multidimensional, and complex notion: characteristics of the human beings and workplace elements. Conclusion: The recognition of nursing professional dignity could have a positive impact on patients because the results clearly showed that nurses are more prone to foster patients’ dignity, patients’ safety, and a better quality of care if their own dignity is respected. If nurses are uncomfortable, humiliated, or not seen in their professional role, it is difficult to give to others good care, good support, or good relationships.

Background: Spirituality has always been present in the history of nursing and continues to be a topic of nursing interest. Spirituality has ancient roots. The term ‘spirituality’ is interpreted as spirit and is translated as breath and soul, whereas spirituality (immateriality) is spiritual nature. Historically, the term spirituality is associated with the term religiosity, a definition that persists today, and often the two terms are used interchangeably. In the healthcare context, the construct is still. Objective To clarify the concept of spirituality in nursing. Research design In this article spirituality was explored using Rodgers' evolutionary and inductive method of concept analysis. Participants and research context For this analysis, a sample of 71 articles published in English, from 2008 to 2018 from PubMed/Medline, CINAHL Plus with full text, PsycINFO, SciELO databases were retrieved. It was also accomplished an empirical search of dictionaries and e-books. Ethical considerations This study was conducted according to good scientific practice. Findings It emerged that “spirituality” is a dynamic process and has a range of attributes. The cultural dimensions, the religious and spiritual traditions, the ethnic diversity and the influence of the historical and social contexts represent the societal and historical conditions ingrained in the Western thought that influence the emergence of spirituality as a concept. Antecedents, attributes and onsequences appeared to inform and strengthen one another over time. Spirituality is a significant concept for the discipline of nursing with profound consequences for caring patients and for work organizations.

Higher-Order (HO) theories of consciousness have in common the idea that what makes a mental state conscious is that it is the object of some kind of higher-order representation. This volume presents fourteen previously unpublished essays both defending and criticizing this approach to the problem of consciousness. It is the first anthology devoted entirely to HO theories of consciousness. There are several kinds of HO theory, such as the HOT (higher-order thought) and HOP (higher-order perception) models, and each is discussed and debated. Part One contains essays by authors who defend some form of HO theory. Part Two includes papers by those who are critics of the HO approach. Some of the topics covered include animal consciousness, misrepresentation, the nature of pain, subvocal speech, subliminal perception, blindsight, the nature of emotion, the difference between perception and thought, first-order versus higher-order theories of consciousness, and the relationship between nonconscious and conscious mentality. (Series A)

Some contemporary Western theories of consciousness, such as the higher-order thought (HOT) theory and self-representationalism, hold that there is an implicit (pre-reflective) “self-awareness” that accompanies each conscious mental state. Important twentieth-century historical figures, such as Sartre and Brentano, have also embraced a similar position. This view, or something very close to it, can also be found centuries earlier in some Indian philosophy (such as in Dignāga) where conscious experience is thought of as “inherently reflexive” and cognition is understood to have a “dual-aspect.” In this chapter, I lay out some of the similarities and differences among these views and explain why I prefer the way that HOT theory accounts for such self-awareness as compared to the others, including HOT theory’s ability to avoid the much-discussed infinite regress threat and its more plausible explanation of introspection. I also explain how HOT theory, like many Buddhist accounts, is not logically committed to the existence of an enduring substantial “self.”

Dr. Johnson famously observed that in lapidary inscriptions a man is not upon oath. This observation applies with equal force to publishers and their advertisements for books. According to the blurb, the present volume “offers essential critical material for both novice and advanced scholars of early modern philosophy.” In fact, it would be a remarkably sophisticated novice who could derive much benefit from this anthology of essays on seventeenth-century Rationalism; not merely do the authors engage with difficult issues of interpretation but they often presuppose a detailed knowledge of the various positions in the exegetical debates. Nonetheless, the volume does live up to the second part of its billing: it offers a great deal for the specialist to get his or her teeth into. Despite the demands they make upon the reader, the contributions are of an almost uniformly high quality. The volume has its origins in a NEH Summer Seminar conducted by Jonathan Bennett, who himself contributes a characteristically elegant and lucid essay on Descartes’s theory of space. Bennett may take a justifiable pride in the accomplishments of the participants in his seminar.

I believe that there is a ubiquitous pre-reflective self-awareness accompanying first-order conscious states. However, I do not think that such self-awareness is itself typically conscious. On my view, conscious self-awareness enters the picture during what is sometimes called “introspection” which is a more sophisticated form of self-consciousness. I argue that there is a very close connection between consciousness and self-consciousness and, more specifically, between the structure of all conscious states and self-consciousness partly based on the higher-order thought theory of consciousness. A plausible notion of self-consciousness is, I think, simply having any degree of higher-order or meta-psychological thought. I argue that the connection between conscious states and self-consciousness is representational but also critically evaluate several different options. I then critique the alternative “acquaintance” theory of self-awareness and address a couple of recent criticisms of HOT theory. There is the potential danger of misrepresentation between self-awareness and conscious states which I also briefly address.

Various psychopathologies of self-awareness, such as somatoparaphrenia and thought insertion in schizophrenia, might seem to threaten the viability of the higher-order thought (HOT) theory of consciousness since it requires a HOT about one’s own mental state to accompany every conscious state. The HOT theory of consciousness says that what makes a mental state a conscious mental state is that there is a HOT to the effect that “I am in mental state M” (Rosenthal 2005, Gennaro 2012). In a previous publication (Gennaro 2015), I argued that a HOT theorist can adequately respond to this concern with respect to somatoparaphrenia. Somatoparaphrenia is a “depersonalization disorder” which is characterized by the sense of alienation from parts of one’s body. It is a bizarre type of body delusion where one denies ownership of a limb or an entire side of one’s body. My focus in the chapter, however, is on “inserted thoughts” which is a common symptom of schizophrenia, although it will also be useful to contrast it with somatoparaphrenia. Schizophrenia is a mental disorder which most commonly manifests itself through auditory hallucinations, paranoid or bizarre delusions, or disorganized speech and thinking. Thought insertion is the delusion that some thoughts are not “one’s own” in some sense or are somehow being inserted into one’s mind by someone else. Graham and Stephens (2000), for example, have suggested that thought insertion should be understood as alienated self-consciousness or meta-representation. I argue that HOT theory has nothing to fear from this phenomenon either and can consistently explain what happens in this admittedly unusual case.

Synesthesia literally means a “union of the senses” whereby two or more of the five senses that are normally experienced separately are involuntarily and automatically joined together in experience. For example, some synesthetes experience a color when they hear a sound, although many instances of synesthesia also occur entirely within the visual sense. In this paper, I first mainly engage critically with Sollberger’s view that there is reason to think that at least some synesthetic experiences can be viewed as truly veridical perceptions, and not as illusions or hallucinations. Among other things, I explore the possibility that many forms of synesthesia can be understood as experiencing what I will call “second-order secondary properties,” that is, experiences of properties of objects induced by the secondary qualities of those objects. In doing so, I shed some light on why synesthesia is typically one-directional and its relation to some psychopathologies such as autism.

In this introductory work, Mind and Brain: A Dialogue on the Mind-Body Problem, 2nd edition, Gennaro updates and expands the work to reflect current topics and discussions. The dialogue provides a clear and compelling overview of the mind-body problem suitable for both introductory students and those who have some background in the philosophy of mind. Topics include: Immortality, Materialism, Descartes' "Divisibility Argument" for substance dualism, The "Argument from Introspection" for substance dualism, The main objections to dualism, The interaction between mind and brain, The relation between brain damage and the prospect of an afterlife, Parallelism and epiphenomenalism, The type/token distinction within materialism and the problem of multiple realizability, Arguments against materialism and its ability to explain consciousness, Property dualism and panpsychism, The epistemological problem of other minds, The nature of inductive knowledge, Evidence for animal consciousness, The problem of machine or robot minds, The inverted spectrum argument. Also included are a brief Introduction, a list of Study Questions designed to enhance classroom discussion and serve as a resource for the development of paper topics, a Glossary, and an Index of Key Terms.

Various psychopathologies of self-awareness, such as somatoparaphrenia and thought insertion in schizophrenia, might seem to threaten the viability of the higher-order thought (HOT) theory of consciousness since it requires a HOT about one’s own mental state to accompany every conscious state. The HOT theory of consciousness says that what makes a mental state a conscious mental state is that there is a HOT to the effect that “I am in mental state M.” I have argued in previous work that a HOT theorist can adequately respond to this concern with respect to somatoparaphrenia and thought insertion. There is also Cotard syndrome which is a rare neuropsychiatric disorder in which people hold the delusional belief that they are dead, do not exist, or have lost their blood or internal organs. In this paper, I argue that HOT theory has nothing to fear from it either and can consistently account for what happens in such unusual cases. I analyze Cotard syndrome in light of my previous discussion of somatoparaphrenia and thought insertion, and argue that HOT theory can provide a somewhat analogous account without the worry of inconsistency. It is crucial to recognize that there are multiple “self-concepts” and levels of HOTs which can help to provide a more nuanced explanation. With regard to the connection between consciousness and self-consciousness, it is proposed that Cotard patients are indeed capable of having some “I-thoughts” about their bodies and mental states.

In Disturbed Consciousness, philosophers and other scholars examine various psychopathologies in light of specific philosophical theories of consciousness. The contributing authors—some of them discussing or defending their own theoretical work—consider not only how a theory of consciousness can account for a specific psychopathological condition but also how the characteristics of a psychopathology might challenge such a theory. Thus one essay defends the higher-order thought (HOT) theory of consciousness against the charge that it cannot account for somatoparaphrenia (a delusion in which one denies ownership of a limb). Another essay argues that various attempts to explain away such anomalies within subjective theories of consciousness fail. Other essays consider such topics as the application of a model of unified consciousness to cases of brain bisection and dissociative identity disorder; prefrontal and parietal underconnectivity in autism and other psychopathologies; self-deception and the self-model theory of subjectivity; schizophrenia and the vehicle theory of consciousness; and a shift in emphasis away from an internal (or brainbound) approach to psychopathology to an interactive one. Each essay offers a distinctive perspective from the intersection of philosophy, consciousness research, and psychiatry.

Somatoparaphrenia is a pathology of self characterized by the sense of alienaton from parts of one’s body. It is usually construed as a kind of delusional disorder caused by extensive right hemisphere lesions. Lesions in the temporoparietal junction are common in somatoparaphrenia but deep cortical regions (for example, the posterior insula) and subcortical regions (for example, the basal ganglia) are also sometimes implicated (Valler and Ronschi 2009). Patients are often described as feeling that a limb belongs to another person and thus attribute ownership of the limb and bodily sensation to someone else. There is also some question as to whether or not the higher-order thought (HOT) theory of consciousness can plausibly account for the depersonalization psychopathology of somatoparaphrenia (Liang and Lane 2009, Rosenthal 2010, Lane and Liang 2010). Liang and Lane argue that it cannot. The HOT theory of consciousness says that what makes a mental state a conscious mental state is that it is the target of a HOT to the effect that “I am in mental state M” (Rosenthal 2005, Gennaro 2012). When the HOT is itself is unconscious, the conscious state is still outer-directed. When the HOT is conscious, we have introspection and so the conscious thought is directed at the mental state. In section I, I briefly review the previous exchange between Lane and Liang and David Rosenthal. In section II, I further explore somatoparaphrenia and the nature of delusion while offering a number of additional replies to Lane and Liang. In section III, I examine the central notions of “mental state ownership” and “self-concepts” in an effort to account especially for the depersonalization aspect of somatoparaphrenia against the background of HOT theory. In section IV, I argue that to the extent that somatoparaphrenia casts doubt on the notion that some thoughts are “immune to error through misidentification” (IEM), the most fundamental aspect of IEM is still consistent with HOT theory. Overall, I argue that HOT theory is left unscathed by the pheneomenon of somatoparaphrenia and can even help to explain what happens in these cases.

My overall goal in The Consciousness Paradox: Consciousness, Concepts, and Higher-Order Thoughts is to solve what I take to be a paradox with regard to holding a series of interrelated theses, including a version of the higher-order thought theory of consciousness which says that what makes a mental state conscious is that there is a suitable higher-order thought directed at the mental state. Higher-order thoughts are metapsychological or meta-cognitive states, that is, mental states directed at other mental states. This theory is primarily concerned with explaining how conscious mental states differ from unconscious mental states. In The Consciousness Paradox I defend and further develop a metapsychological reductive representational theory of consciousness and then apply it to several importantly related problems including concept acquisition and animal consciousness.

In this chapter, I first review and assess evidence regarding brain damage or neural abnormalities associated with some psychopathologies and cognitive deficits, such as hemispatial neglect, agnosias, amnesia, somatoparaphrenia, and others. It becomes clear just how closely normal mental functioning and consciousness depend upon normal brain functioning as well as how some very specific mental changes occur when, and only when, very specific brain damage occurs. I then explore the metaphysical implications of these results with respect to the nature of mind and consciousness. In particular, I examine the plausibility of materialism, roughly the view that mental processes are brain processes, in light of the evidence discussed and in contrast to a dualist conception of the mind (whereby mental states are not physical in some sense). I also explore the prospects for a conscious afterlife based both on the brain damage evidence adduced and the metaphysical implications discussed.

An overview of higher-order representational theories of consciousness. Representational theories of consciousness attempt to reduce consciousness to “mental representations” rather than directly to neural or other physical states. This approach has been fairly popular over the past few decades. Examples include first-order representationalism (FOR) which attempts to explain conscious experience primarily in terms of world-directed (or first-order) intentional states (Tye 2005) as well as several versions of higher-order representationalism (HOR) which holds that what makes a mental state M conscious is that it is the object of some kind of higher-order mental state directed at M. The primary focus of this entry is on HOR and especially higher-order thought (HOT) theory. The key question that should be answered by any theory of consciousness is: What makes a mental state a conscious mental state? Section 1 introduces the overall representationalist approach to consciousness and briefly discuss Tye’s FOR. Section 2 presents three major versions of HOR: higher-order thought theory, dispositional higher-order thought theory, and higher-order perception theory. In section 3, a number of common and important objections and replies are presented. Section 4 briefly outlines a close connection between HOT theory and conceptualism, that is, the claim that the representational content of a perceptual experience is entirely determined by the conceptual capacities the perceiver brings to bear in her experience. Section 5 examines several hybrid higher-order and “self-representational” theories of consciousness which all hold that conscious states are self-directed in some way. Section 6 addresses the potentially damaging claim that HOT theory requires neural activity in the prefrontal cortex (PFC) in order for one to have conscious states.

In Gennaro (2016), I had originally replied to Fred Adams and Charlotte Shreve’s (2016) paper entitled “What Can Synesthesia Teach Us About Higher Order Theories of Consciousness?,” previously published in Symposion. I argued that H.O.T. theory does have the resources to account for synesthesia and the specific worries that they advance in their paper, such as the relationship between concepts and experience and the ability to handle instances of ‘pop-out’ experiences. They counter-reply in Adams and Shreve (2017) and also raise further objections to H.O.T. theory which go well beyond the scope of their 2016 paper. In this paper, I offer additional replies to the points they raise in Adams and Shreve (2017).

Consciousness entails self-consciousness. The entailment is generally denied for two reasons: some primitive forms of consciousness do not seem to require self-consciousness, and self-consciousness is regarded as a sophisticated capacity that need not accompany all conscious states. However, I show that what best explains how a mental state becomes conscious is that it is accompanied by a meta-psychological thought to the effect that one is in that mental state. I argue at some length that the meta-psychological state must specifically be a thought , and show why reductionist accounts will not yield the desired explanation. ;Self-consciousness simply involves having meta-psychological thoughts or 'awareness', and must be distinguished from 'introspection' which is a more sophisticated form of self-awareness. Thus, given an adequate theory of conscious mentality, it follows that having conscious mental states entails self-consciousness. ;After arguing that mentality per se does not require consciousness, a series of arguments for the conclusion that 'being a conscious creature or system entails being self-conscious' is explored. The arguments center around the nature of phenomenal states, de se attitudes, and episodic memory. The fundamental strategy in each case is to argue first that being a conscious system involves having a specific mental capacity , and then to show how having that capacity involves self-consciousness. Most of these arguments succeed in proving the desired conclusion