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“Are There Some Human Beings Who Are Not Persons? A Looming Controversy in
Medical Ethics” Discussion Offered by John Kavanaugh S.J., Saint Louis University
for Philosophers in Jesuit Education, October 28th, 4:30-6:30 PM, Chase Park Plaza
Hotel, Westminster Room.
Discussion-opener text
Note: The following is an updated revision of an Ethics Column I wrote for America Magazine.
Since it elicited a number of responses from thoughtful readers, including men and women in the
legal and health care professions, I thought it might be valuable to share with professional
philosophers to invite supporting or alternative resolutions to the problem, even though it is
rather informal in places.
Persons and Functioning Brains
I received a thoughtful e-mail recently from a late 1980s graduate of a Jesuit
University. He is “strongly pro-life,” armed with 27 hours of philosophy and theology
requirements to boot, but he’s at loggerheads with some “pro-choice” friends who hold
the position that there is “a distinction between a human life and a human person.”
He faces a challenge mounted by a growing movement -- philosophical, ethical
and rhetorical -- that has as its theme: not all living humans are persons. A decade before
my friendly correspondent was taking his philosophy classes, the philosopher Mary Ann
Warren wrote in The Monist: “Some human beings are not people… A man or woman
whose consciousness has been permanently obliterated but who remains alive is a human
being which is no longer a person.” The same applied to profoundly mentally deficient
humans and fetuses who are human beings but “not yet” persons. In fact, Warren claimed
that a fully developed human fetus was “considerably less personlike” than the average
fish. The fish at least exhibited activities like the consciousness of external and internal
events, as well as primitive reasoning, both associated with the concept of personhood.
Although there have been many historical approximations of this position, the last
few decades have been marked by a more explicit application to biomedical issues. While
Elelyn Pluhar uses the “marginal human” problem to establish an argument for animal
rights in Beyond Prejudice, writers such as Jeff McMahan, in The Ethics of Killing, and
Walter Glannon in Biomedical Ethics hold that we persons are not organisms. For them,
the beginning of a human organism is not the beginning of a person and the death of a
human being may well occur long after the death of that person.
My position, with its own many ancient to contemporary advocates, is one that
seems particularly strategic in the present debate. It also impinges on our very
understanding of and acceptance of what we are.
A person is not a set of performances or activities, but a kind of being. As the
definition offered by Boethius and affirmed by Thomas Aquinas has it: a person is an
individual substance of a rational nature. While each of the four components of this
definition are contested in philosophical circles, it is not unreasonable to hold that my
nature is “what” I am, not what I do. The things I do as a human person are possible only
because I am the kind of being with the inherent powers or endowments of intellect and
will (a rational nature) making possible intelligent and free actions.
This is not “speciesism.” There might be many other kinds of persons that are not
human persons. Whoever has the personal endowments of rationality, or intellect and
will, is a personal kind of being. Thus, God, angels, or other extra-terrestrials would be
non-human persons. (Think: if you have to have a brain to be a person, where does that
leave God?) What’s special about human persons is that we are animal-persons,
embodied persons. Part of the reality of being an animal-person is that we have an
organic life that develops, thrives and diminishes over time. Our participation in
personhood begins when we as individual substances begin.
If the act of performing certain activities is what makes us persons, then indeed
chimps and dogs are more “person-like” than human fetuses or even newborns. You can
say the same thing of spiders and computers, the first, being far more clever at providing
for themselves and spinning webs than any stupid human baby; the latter triumphantly
superior to any dumb fetus in activities of calculation and translation. But this confuses
the logic of empirical discovery with the logic of reality.
If, however, being a person means that when I started to exist as a living being, I
had endowments of intellect and will, even though they might never be expressed or
discovered because of my body’s lack of development, or trauma to it, or diminishment,
then a new-born is a fragile, dependent, not very competent, little person and a
profoundly brain-damaged friend is not a vegetable, but a wounded friend.
The formation and health of a brain is, of course, required for the embodied
expression of our personal endowments. But you and I are not our brains. Brains are part
of us, part of our personal animality. Our human personhood is not something that
erupted from our brains the first time we started acting rationally. Nor is it something that
was somehow stuck on to these bodies we are attached to. It is the gift of being the kind
of beings we are, endowed not only with brains like other animals, but with powers of
intellect, open to all the truth there is to be known, and of will, open to all the good there
is to be loved.
Some Topics to Discuss:
1. Clinical Issues, especially mis-diagnoses. I would like to offer specific cases
concerning a handicapped infant patient and a mature patient declared “brain-dead.”
2. Exclusion of marginal persons from the community of human persons. Perhaps the
most pressing problem for me arises from the growing emphasis upon brain functioning
as the necessary and sufficient condition for human personhood. Does this subtly appeal
to the human tendency to reject the vulnerability of our bodies and creatureliness?
3. Philosophical Barriers and Philosophical Kin. I’ve often wondered whether the
technical aspects of philosophical discourse diminish our contributions to families (or
health-care providers) in crises concerning handicapped neonates or relatives with
profound brain damage. At the same time, I am struck by the philosophical contributions
found in the clinical writing of medical professionals like Oliver Sacks. What, then, are
the best contributions we philosophers can make to medical ethics?