Bioethics Discussion Blog: What is Death? (3)

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Friday, March 11, 2005

What is Death? (3)

As I noted, the issue of what is personhood and who are you and what are you worth if you don’t have personhood is contributing to the controversy of when a person is dead.
Why is personhood up for debate? Well, philosophers have felt that personhood defines who is a human person. Not just a human being or homo sapiens but a human person. What makes a human person important? Well, certain rights and legal protections are given by society to a human who is also a person that are not given to those who do not possess personhood. That means that if a human person becomes a corpse, personhood no longer exists and the rights and legal protections are gone. So what makes a person? That’s the problem and it starts from the very beginning of life, from the fertilized egg. Some view this zygote as a person and should be given all the protection that is given to an adult human. And that means it would be immoral and could be made illegal to hurt or destroy the egg. And this philosophy of personhood continues as an implanted embryo develops into a fetus. But some have suggested that those who hold this view are conflating a human being with a person. It is argued that personhood represents a being who has a conscious awareness of self so that the being can set personal values and goals. It is impossible to consider an egg or zygote or embryo or an unborn fetus to meet that criterion. So where does personhood begin? Is a newborn infant a person? One view is that it is. What about a baby at term who is yet to be born into this world? How much consciousness and self-awareness are present in those individuals? Complicating this topic further is the status of the anencephalic child.

One of the sad abnormalities that can occur is that of an anencephalic child who is born with no brain tissue where all the consciousness, awareness and all the complex interaction with the environment takes place, the cerebrum. Thus the child misses the “higher brain” as described by Kenneth Kipnis in the last posting. There is only a brain stem present which controls the vegetative mechanisms such as breathing and control of the heart and blood pressure. Should this infant be given the status of a person without the higher brain? Is this infant considered a person and is this infant considered alive? Currently, the legal answer in the U.S. is yes to both. The anencephalic doesn’t meet the criteria for brain death since a functioning brainstem is still present. As a person, the anencephalic must be given treatments if necessary in emergency room visits. As alive, vital organs necessary to maintain existence cannot be procured for transplant.

And now we must consider whether those who are apparently not aware of themselves or conscious, not just reflexly, of their environment still maintain personhood. For example, for those patients in a persistent vegetative state are they as good as dead based on the definition of personhood? They maintain brainstem function and therefore can’t qualify as dead on the basis of permanent absence of whole brain function but they might qualify if the criteria for death was the permanent absence of higher brain function and thus fail the personhood test. And then one can go on to speculate about those patients who are severely demented and what the criteria for personhood and death means for them.

As you can see by the discussion by Kenneth Kipnis in the last post and mine here that the definitions of personhood and death are not fully satisfactory to everyone. Concerns, ethical/philosophical, political, legal and religious, still remain to be resolved. Issues regarding use of embryonic stem cells, in vitro fertilization with residual embryos, treatment of the not yet born, the newborn, the anencephalics, the status of those who are severely demented or in a persistent vegetative state all remain to be examined and resolved. And these are not just theoretical issues for philosophers to contemplate but issues which all society has to contend with.. matters of what represents life of a human person and what represents that person’s death. ..Maurice.

1 Comments:

At Saturday, March 12, 2005 3:44:00 PM, Blogger Bioethics Dude said...

I liked Green and Wikler's definition of death, and find the whole tripartite examination of yours very well put. I would add that among the various aspects you noted (e.g., religious, legal, etc.) the most emphasis should be based on metaphysics --ascertaining what death is, from a round about approach by way of ascertaining what is essential for life, and then anything that takes away from that essential, moves us into "death". That is the approach used by G and W, as well as many others. Metaphysics is the key to offering a basis for other fields; as Aristotle put it "It is the first science". -BD

 

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