Abstract
The previous chapters were primarily concerned with when personhood begins: i.e., at what point in his development an individual ought to begin to receive full moral consideration. In this chapter I will examine the other side of that question. At what point does an individual stop being a person: i.e., when are we justified in ceasing to treat him or her with full moral consideration? I shall argue that this occurs when we can be certain that the individual has no interests now and never will have any in the future. This is the state commonly thought of as death. Yet as we shall see, there are individuals who appear to be permanently devoid of interests, but who are not dead in the currently accepted sense. Furthermore, these individuals have been accepted heretofore as persons; to count them as dead and to treat them in ways that we would think it wrong to treat a person would involve shrinking the boundaries of personhood. This, as I argued in Chapter 8 (p. 102), is a grave step that requires major justification. I shall argue that such justification is possible in the case of those who will never have interests again.
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Notes
Rem B. Edwards & Glenn C. Graber, Bioethics (San Diego: Harcourt Brace Jovanovich Publishers, 1988), introduction to Chapter 7.
See President’s Commission for Ethical Problems in Medicine, Defining Death, Washington, D. C: Government Printing Office, 1981. See also Julius Korein, The Problem of Brain Death: Development and History,’ in Brain Death: Interrelated Medical and Social Issues, Julius Korein, ed., Annals of the New York Academy of Sciences, 575(1978): 19–38
Roland Puccetti, ‘the Life of a Person,’ in Abortion and the Status of the Fetus, William B. Bondeson, H. Tristram Engelhardt, Jr., Stuart F. Spicker, and Daniel H. Winship, eds. (Dordrecht: Reidel, 1983), 176–177. Not everyone has agreed that the definition of death as total brain death is acceptable. Hans Jonas maintains that this redefinition was only a ploy to ease our consciences about using brain dead bodies for transplanted organs [‘Against the Stream: Comments on the Definition and Redefinition of Death,’ in Philosophical Essays: From Ancient Creed to Technological Man (Englewood Cliffs, NJ: Prentice-Hall, 1974), 132–140].
Jonas, as well as Alexander M. Capron and Leon R. Kass [‘A Statutory Definition of the Standards for Determining Human Death: an Appraisal and a Proposal,’ The Pennsylvania Law Review, 727(1972): 87–88, 102–118].
Michael B. Green and Daniel Wikler, [‘Brain Death and Personal Identity,’ in Medicine and Moral Philosophy, Marshall Cohen, Thomas Nagel, and Thomas Scanlon, eds. (Princeton: Princeton University Press, 1981), 49–77], ask us to distinguish the question of when death occurs from that of what one is allowed to do to a human entity in a given condition.
See Puccetti, ‘fThe Life of a Person,’ 177–179.
See, for example, H. Tristram Englehardt, Jr., The Principles of Bioethics (New York: Oxford University Press, 1986), 207–216.
It is important, however, as Dan W. Brock has pointed out, to distinguish between the definition of death and the criterion of death [‘Death and Dying,’ in Medical Ethics, Robert M. Veatch, ed. (Boston: Jones & Bartlett, 1989), 332)]. There seems to be less controversy over the former; a person is dead when she has no interests and there is no chance of her having any interests in the future. But by what criterion shall we know this? At present we know her to be dead when the brain has totally ceased to function. There is also no possibility that she will have interests when only the brainstem is still functioning, but there are intermediate cases in which we are less certain. Thus we are quite safe in accepting as a criterion of death the point at which there is no detectable brain activity, and we would most probably be justified in accepting the criterion of no activity above the brainstem, provided that this could be determined with certainty.
David Randolph Smith, ‘Issues Leading to the Notion of Neocortical Death,’ in Death: Beyond Whole-Brain Criteria, Philosophy and Medicine, 31(1988): 111–144.
Moral Matters (Peterborough, Ont: Broadview Press, 1993), 61.
Death By Choice, 149–157.
Moral Matters, 65–66.
Beauchamp, Tom L. & James F. Childress, Principles of Biomedical Ethics, 4th ed. (New York: Oxford University Press, 1994), 197–199.
‘Active and Passive Euthanasia,’ New England Journal of Medicine, 292(1975): 78–80. Others who have held this view are Dan Brock, ‘Death and Dying,’ 329–356, and Anthony Flew, ‘the Principle of Euthanasia’ in Ethical Issues in Modern Medicine, John Arras & Robert Hunt, eds. (Mountain View, CA: Mayfield, 1979), 225–239.
Ruth Macklin, Enemies of Patients (New York: Oxford University Press, 1993), 175–182.
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Forrester, M.G. (1996). The end of Personhood and Cessation of Medical Procedures. In: Persons, Animals, and Fetuses. Philosophical Studies Series, vol 66. Springer, Dordrecht. https://doi.org/10.1007/978-94-009-1633-3_17
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