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Defining Death with Aristotle and Aquinas

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Part of the book series: Philosophy and Medicine ((CSBE,volume 127))

Abstract

D. Alan Shewmon’s earlier publications regarding the determination of death in human beings defended, on supposedly Aristotelian-Thomistic grounds, a version of the “brain death” criterion. Within a few years, however, he had rejected that criterion, largely because of his encounter with what appeared to him to be a living, although brain dead, human being. The philosophical basis of this new position remained, however, the same as that which underlay his earlier position. The present essay argues that Shewmon’s understanding of the relevant Aristotelian-Thomistic ideas was flawed right from the beginning. He, for example, wrongly identifies as a substantial change the change that occurs when new substances are generated from substances of the same sort—as happens, for instance, when planaria are split. A proper understanding of these and other related Aristotelian ideas provides a firm philosophical basis for defending the validity of the brain death criterion—although that criterion itself remains subject to empirical falsification. The essay also acknowledges the presence in Aquinas’s writings of a remark that might seem to support Shewmon’s later position; it argues, however, that that remark cannot be so used.

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Notes

  1. 1.

    The phrase “irreversible...” comes from the Uniform Determination of Death Act [UDDA]. The events and discoveries that led to Shewmon’s change of mind actually began in the late 1980s (Shewmon 1997, pp. 57–69).

  2. 2.

    This text is discussed below. I hasten to add here, however, that I do not believe that Thomas means to say that the higher level soul gives way to a lower level soul .

  3. 3.

    See, for instance Aquinas (1941, Summa theologiae [ST] I, q. 119, a. 2), where he speaks of generating one animal from another by division. Thomas opposes in this article the idea that generation by semen is simply a matter of division; but he acknowledges that generation by division is what happens when certain very simple animals are divided.

  4. 4.

    See ST I, q. 78, a. 4; Aquinas , 1970–1976, Quaestiones disputatae de veritate, q. 22, a. 7; Aquinas 1969, Sententia libri Ethicorum, bk. 6, lect. 1, ll. 190-214; Aristotle 1978, De motu animalium [DMA], ch. 7, 701a32-36; 1961, De anima [DA], bk. 2, ch. 2, 413b16-24; Hasse 2000, pp. 70, 130–32.

  5. 5.

    Avicenna 1968–1972, Liber de anima, 1.5 (86, 89), 4.1 (7), 4.3 (38).

  6. 6.

    Patrick Lee and Germain Grisez (2012, p. 278) are, I believe, making at least partial reference to the cogitative sense/particular reason (or the estimative power) when they speak of sentience as including “such functions as seeing, hearing, feeling pain and pressure, perceiving, imagining, remembering, desiring, fearing, being angry, and so forth.”

  7. 7.

    Shewmon (1985, p. 59) also say that Smith will die “as soon as the association cortices are destroyed.” In an appendix (entitled, “Answers to objections”), Shewmon (1985, p. 73) does, however, say that “we do not even know with certainty what the neuroanatomical substrate of the cogitative sense is.”

  8. 8.

    Shewmon (1997, p. 54; 1988, p. 42) has issued cautions regarding the implementation in practice of “the notion of ‘cortical death.’”

  9. 9.

    The full passage reads as follows: “What matters is that there be no integrative unity at the level of the organism, one manifestation of which is the need for constant, multiple, highly sophisticated medical interventions to maintain the nonneural organs. To be sure, in a technologically supported, brain-destroyed body some degree of physiological interaction does occur among the various nonneural organs; but this is not essentially different from the mutual interactions that would presumably transpire among the same organs if hypothetically explanted and connected by plastic tubes. To constitute a higher-level unity, an ensemble of organs must possess some gestalt property(ies) that cannot be reduced to the mere sum of the components—and in a post-embryonic body this requires a brain.”

  10. 10.

    See DA, bk. 2, ch. 2, 413b16-24; and Aristotle 1957, Metaphysics [M], bk. 7, ch. 16, 1040b13-14; see also Aristotle 1955b, De longevitate, ch. 6, 467a27-30; 1955b, De juventute, ch. 2, 468b9-15; 2002, Historia animalium, bk. 4, ch. 7, 531b30-532a5; and 1913, De incessu animalium, ch. 7, 707a23-b4. All translations of Aristotle are from Barnes (1984).

  11. 11.

    For the heart as the central controlling organ, see DMA, ch. 7, 701b24-32; and Aristotle , 1965, De generatione animalium, bk. 2, ch. 6, 742a27-32 and 742b33-743a1.

  12. 12.

    SCG, bk. 2, ch. 86, para. 1708.

  13. 13.

    SCG, bk. 2, ch. 86, para. 1708. Even in “annulose animals” the division of the soul is per accidens, since what is divided is not the soul but rather the body, with the result that multiple souls are generated.

  14. 14.

    Aquinas 1929–1947, Scriptum super libros Sententiarum, bk. 2, dist. 18, q. 2, a. 3.

  15. 15.

    I would agree with Patrick Lee and Germain Grisez (2012, pp. 277, 281–2) that thought-experiments, such as that regarding “Smith,” are relevant to the questions at hand.

  16. 16.

    Shewmon also suggests that the California “boy” could later develop brain functions, just as the body can develop sight even though the eye is destroyed. Regarding sight, a futuristic medical community could “develop specially engineered neuroblasts which, upon implantation in the damaged brain (and perhaps stimulated by appropriate growth factors) would multiply, establish appropriate synaptic connections and reconstitute a functional visual cortex” (Shewmon 1997, p. 73). He then argues: “Theoretically, if brains could be reconstituted (e.g., through implanted futuristically transformed neuroblasts), a ‘brain-dead’ person could be made to regain consciousness and other human functions, although perhaps with a clean mnemonic slate and new personality traits (depending on the details of the new synaptic network)” (Shewmon 1997, p. 74). But this is question-begging on Shewmon’s part. He has not shown that the soul has not departed with total-brain death. Presuming that death has occurred, the futuristic thinker of this new thought-experiment would be a freshly generated human person.

  17. 17.

    M, bk. 7., ch. 16, 1040b6-10. Ross (1953, v. 2, p. 219) explains that the word pettein, appearing in line 1040b9 is also used by Aristotle when speaking of the “maturing or working up” of “parts of the body.” Aristotle has in mind in this passage complex animals such as cannot be divided in the way simple animals (such as planaria) can be, for he goes on (1040b13-16) to discuss these latter as among a handful of separate cases. But, as he acknowledges, even divided simple animals contain separate beings only potentially.

  18. 18.

    Aquinas 1950, In duodecim libros Metaphysicorum Aristotelis expositio [In M], bk. 7, lect. 16, para. 1633.

  19. 19.

    For the expression ‘compound substance’ (sunolos ousia), see M, bk. 7, ch. 11, 1037a25-33.

  20. 20.

    M, bk. 7, ch. 10, 1035b22-27; see also In M, bk. 7, lect. 10, paras 1487–89.

  21. 21.

    Aristotle , 1965, De generatione et corruptione, bk. 1, ch. 5, 321b28-32; the terms ‘non-homoeomeries,’ ‘homoeomeries,’ etc., go back to Anaxagoras. See Aristotle , 1955a, De caelo, bk. 3, ch. 3, 302a31-b1: “His [Anaxagoras’s] elements are the homoeomerous things, viz. flesh, bone, and the like.” See also M, bk. 1, ch. 3, 984a14.

  22. 22.

    Aquinas , 1952, In librum primum Aristotelis de generatione et corruptione expositio, bk. 1, lect. 15, para. 5.

  23. 23.

    The passage in Thomas, which has attracted considerable scholarly attention recently, is discussed in, for instance, Hershenov (2008) and, more recently, in Toner (2015). For the Aristotelian biology behind Thomas’s position, see Flannery (2003).

  24. 24.

    Aquinas , 1954, Super librum de causis expositio, prop. 1, paras. 4–6.

  25. 25.

    ST I-II, q. 67, a. 5, obj. and ad 1. ST I-II was composed in 1271. Torrell (1996, pp. 333, 344–6) gives as the date for the composition of the commentary on Metaphysics, bk. 7, after the middle of 1271; he gives as the date for the commentary on the Liber de causis “the first half of 1272”; he says that the commentary on De generatione et corruptione was composed “in 1272 or 1273.”

  26. 26.

    For the cat, see https://www.youtube.com/watch?v=wPiLLplofYw; Shewmon (1997, p. 70) offers this description of the Lazarus sign. He acknowledges that the latter could depend on active elements in the lower brain stem.

  27. 27.

    See Aquinas , 1969, Sententia libri Ethicorum, bk. 6, lect. 1, ll. 190–214. As noted above, in man the estimative power is called ratio particularis or vis cogitativa; Thomas says in this passage that it is collativa intentionum particularium. At ST I-II, q. 51, a. 3, Thomas speaks of the ratio particularis or vis cogitativa as Aristotle’s passive intellect, which dies when the human person dies [DA, bk. 3, a. 5, 430a24-25]. On these matters, see Klubertanz (1952, pp. 33–4, 243 n. 62).

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Correspondence to Kevin L. Flannery S.J. .

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Flannery, K.L. (2017). Defining Death with Aristotle and Aquinas. In: Eberl, J. (eds) Contemporary Controversies in Catholic Bioethics. Philosophy and Medicine(), vol 127. Springer, Cham. https://doi.org/10.1007/978-3-319-55766-3_26

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