Conscious awareness

Its greater than you think!

Defining the phenomenon of consciousness is not a mere academic exercise. Since we are called upon from time to time to engage with the phenomenon of consciousness and possibly terminate its existence permanently, it becomes necessary to examine and squeeze out all available information from the full spectrum of life to formulate a comprehensive understanding of the phenomenon. In the clinical environment there exist the ultimate challenges in regard to the permanent termination of consciousness – disconnection from life support in an individual devoid of neurological function and termination of pregnancy.

The phenomenon of consciousness has generally been illustrated by a human being or some other animal where there is: 1) Alertness to sensory input; 2) A central processing function (reasoning in higher animal forms) intimately associated with memory and emotion (in higher forms); 3) An appropriate and effective motor response. It follows that when these functions are absent the being is termed “unconscious”. The unconscious being however will still retain normal metabolic function, temperature and autonomic nervous system function. The most unconscious state that exists in the human or the mammal therefore is when no signs exist of alertness to sensory stimulation, reasoning and where there is an absent motor response.

However, across the full spectrum of the animal kingdom as well as that of the plant kingdom, right down to unicellular organisms such as the amoeba, there is the discernible triad of consciousness activity – sensory input, central processing and motor response. Clearly, our definition of consciousness is too narrow. It becomes obvious that there exists a range of consciousness as manifest in the sophistication of the components of the triad of function. The smallest, indivisible unit of consciousness that manifests the triad of function is an enzyme – sensory stimulus, processing and motor response! Thus I would suggest that an enzyme, the fundamental unit of all living things, also represents the fundamental unit of consciousness (Enzymes have never been successfully created by man de novo).

But it doesn’t end there. Mankind has developed computer technology incorporating a sensory input, a central processing system with AI-driven, machine learning and a response arm. In the definition of consciousness that I’ve proposed, this computer technology manifests the triad of function underpinning consciousness...   

While you ponder this alarming stretch of consciousness, it becomes important to introduce the partnering concept of consciousness, awareness. Awareness reflects the level of sophistication of the sub-components of the central processing system of the triad of function, specifically the monitoring of sensory information. With an added reasoning ability and memory availability, awareness is enhanced and the motor response is more appropriate and effective. On this basis, the minimum amount of awareness exists in an enzyme and the greatest amount of awareness exists in the human being and in the AI-driven computer!

One function however selects out the human being as occupying the pinnacle of consciousness and awareness – the human uniquely is imbibed with self-awareness. Reflecting the most sophisticated of reasoning processes, drawing upon a dynamic memory system that incorporates elements of time, space and emotion, self-awareness is most sophisticated in the human. But I would suggest that it is the unequaled function of relational memory in the human that has underpinned self-awareness. Relational memory, a function of the hippocampus, integrates self, people, places, events as well as emotional memory. Relational memory is most developed in the human because the human infant at birth is the most inept and neurologically undeveloped relative to the entire animal kingdom.

The post-natal human being is totally dependent on the primary care-giver with only the autonomic nervous system ticking over on automatic. Even the immune system is still maturing. It is the need to learn all the required functions in order to attain physical independence that nurtures the human into identifying self as familiar to self and at the same time as a separate being in the extended environment. Contrasted with other beings that are birthed with most of their required functions for independence in place, self-awareness does not evolve in the face of rapid engagement with the environment. Even if nurture prevails for a lengthy period, intrinsic functionality precludes the need to learn and become familiar with all components of self. Hence self-awareness becomes a unique human feature which I suggest is integrated in relational memory.

Allied to self-awareness are the emotions related to self-preservation. I would suggest that the memory bank of experiences derived from the multiple emotional configurations of self-preservation contribute uniquely to human ideation, creativity and strategic initiative. These qualities are essential for the ongoing, successful engagement with the life trajectory. Neuroanatomically, these functions are supported by the amygdala and hippocampus situated deep in both cerebral hemispheres. It follows that AI-driven machine learning sans self-awareness and sans the self-preservation imperative will invariably be inferior to the human intellect insofar as ideation, creativity and strategic initiative are concerned.

In the course of a lifetime we permanently terminate conscious and aware entities as we navigate the terrain of life. Plants and animals are devoured as food; trees and vegetation are pruned and cleared; infecting organisms are terminated with appropriate medication; tumours are eradicated; and so the list goes on. In the context of our definition of consciousness, awareness and self-awareness, I would suggest that it is only the termination of a self-aware human being that can be categorized as murder. Permanently terminating the operating system of an AI-driven, machine learning computer is therefore not murder!

Returning to the clinical coal-face, the context needs to be broadened to the maximum: A human being undergoing a general anaesthetic with paralysing agents is temporarily on life support. Even though the individual is devoid of awareness and self-awareness (but still conscious in terms of the broad definition), full self-awareness is expected to return on reversing the anaesthetic and paralysing agents. Therefore discontinuing necessary life-support in this temporary situation is murder. At the other extreme, a human being that is certified as brain-dead in accordance with accepted medico-legal protocols may be removed from life support since the probability of regaining self-awareness is effectively zero.

Gestation begins with the fertilization of the ovum. Early on in the process a multi-cellular zygote develops. In terms of our discussion, the zygote has a level of consciousness. At 5 weeks of gestation the foetus is discernible in its human form – this is within the first trimester. At 23 weeks of gestation, auditory function is fully developed and the foetus responds to sound. At 26 weeks of gestation the cortico-thalamic connection is developed. This connects the deep structures to the cerebral cortex in a bi-directional way and is associated with the onset of awareness. But the foetus remains devoid of self-awareness.

In the context of the definitions developed in the course of this discussion, termination of the pregnancy at any stage of gestation is not murder since there is no self-awareness. However a foetus after 26 weeks of gestation has awareness and similar to the human on life-support under general anaesthetic, is expected to progress to imminent self-awareness once birthed and off life-support. Therefore my personal belief is that termination at this time should be categorized as murder.

Prior to 5 weeks of gestation, the human form is not yet fully developed and there are no signs of awareness. In the case of an unwanted pregnancy one needs to weigh up the downside of the termination against the downside of a rejected pregnancy throughout the full gestation period, into post-partum nurture. As an example, the negative effects of excessive maternal cortisol in pregnancy resulting from maternal stress on the developing foetus are well documented. All relevant issues relating to the unwanted pregnancy need also to be considered in the decision to terminate. These will include the circumstances at conception, the existence of congenital or developmental defects, the list continues.

There is a novel take-home message in all of this: We are surrounded throughout our lives by conscious entities. While our survival depends on the regular termination of conscious and aware entities, the acknowledgement of the nature of these entities will invariably result in a greater respect for ourselves, others and the greater environment.