Brain and Awareness – The Secret You (Horizon)

November 7, 2009

Mathematician Marcus du Sautoy is becoming an increasingly regular front-man for the BBC science documentary Horizon and, to date, his contributions have always been satisfyingly informative. The recent episode The Secret You is no exception.

In his quest to discover the underlying biochemistry and physiology of consciousness, du Sautoy visits a number of laboratories around the world where self-awareness and the notion of “the inner me” are being investigated. In doing so, he frequently participates in experiments; at one point he quips “another day, another scanner”(50:49).

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Marcus du Sautoy takes part in many experiments as part of his search for the basis of consciousness

There are a raft of ethical questions which arise from functional Magnetic Resonance Imaging (fMRI) and other neuroimaging methods, some of which I have written about elsewhere (see Disorders of consciousness: do state-of-the-art neuroimaging techniques shed new light on the brain-injured patient?).

For me, the most interesting ethical questions in the programme arise from the work of Professor Adrian Owen. du Sautoy and Owen discuss experiments conducted with patients in PVS, a Persistent Vegetative State (16:44 to 19:22, though the discussion makes most sense if you start at 15:30).

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Prof Adrian Owen of Cambridge University has made exciting discoveries about the awareness of a patient in PVS

Previously our abililty to tell whether or not a PVS patient was genuinely conscious was constrained by the fact that they had no physical ability to demonstrate their awareness. In ground-breaking experiments, however, Owen and his colleagues have communicated with patients by asking them to imagine performing certain tasks, for example playing tennis, and using fMRI to show that the appropriate areas of their brains are activate. By developing this further, it is possible to get the patient to imagine two different activities which are clearly distinguishable from one another in terms of brain activity. These can then serve as proxy signals as “yes” and “no” answers to questions posed.

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A patient could be trained to make certain areas of her brain active as a proxy answer to questions posed by researchers (e.g. by imaging she was playing tennis or walking around her house)

These experiments have revolutionised our understanding of brain-injured patients. In particular it brings into question the practice of withdrawing food and water from patients in PVS on the assumption that the are not aware.

Horizon: The Secret You (TRILT code 01210858) was first broadcast on BBC2 on 20th October 2009.


Blood & Guts – A History of Surgery: Fixing Faces

February 16, 2009
Michael Mosley performing a facial surgery technique on a Mannequin/dummy

Michael Mosley performing facial surgery on a mannequin/dummy

In the fourth part of the BBC 4 Blood and Guts series, Fixing Faces looks at the evolution of plastic surgery. True to form, Michael Mosley presents a graphic account of how brutal attempts to reconstruct patients’ diseased or damaged faces have led to a modern medical speciality which is now believe to be on the eve of the first full face transplant. This episode describes and illustrates the history of this area of surgery: showing the work of the 16th century Italian doctor Gasparis Taliacotii (00:05:06 – 00:18:02); the beginning of the Botox era (00:18:02 – 00:30:00); and the work of Sir Harold Gillies and Sir Archibald Mclndoe, who developed both surgical techniques and the need for psychological support for patients undergoing reconstructive facial surgery (00:30:00 – 00:50:00) (Please see this Student BMJ article – ‘A brief histoy of plastic surgery’).

This episode highlights two main ethical topics for discussion: functional Magnetic Resonance Imageing (fMRI) and Neuroethics (00: 01:54 – 00:05:06); and face transplants or facial allograft transplantation (00:50:00 – End).

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