Postmodern personhood: a matter of consciousness

The concept of person is integral to bioethical discourse because persons are the proper subject of the moral domain. Nevertheless, the concept of person has played no role in the prevailing formulation of human death because of a purported lack of consensus concerning the essential attributes of a person. Beginning with John Locke's fundamental proposition that person is a 'forensic term', I argue that in Western society we do have a consensus on at least one necessary condition for personhood, and that is the capacity for conscious experience. When we consider the whole brain formulation of death, and the most prominent defense of it by the President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research, we can readily identify the flaws that grow out of the failure to define human death as the permanent loss of the capacity for conscious experience. Most fundamental among these flaws is a definition of human death that reduces persons to the capacity of the brain to regulate purely physiological functioning. Such a formulation would, in theory, apply to any member of the animal kingdom. I suggest that an appropriate concept of death should capture what it is about a particular living being that is so essential to it that the permanent loss of that thing constitutes death. What is essential to being a human being is living the life of a person, which derives from the capacity for conscious experience.     

Adequate conscious life and age-related need: F.M. Kamm's approach to patient selection

Kamm's approach to patient selection qualifies the notion that fairness makes need for scarce, transplantable organs inversely proportional to age. She defines need as how much adequate conscious life a person will have had before death. Length of adequate conscious life correlates highly with age. If so, then younger persons are usually needier than older ones. Since Kamm allows for past periods of non-adequate conscious life, I argue that this correlation may be neither as close, nor as easy to apply, as she wants it to be. Fairness should require assessment of experiential content in determining how long one's life has been adequately conscious. I argue that such assessments involve some of the goods of experience and quality of life judgements that Kamm thinks a reliance on adequate conscious life will avoid.     

The metaphysics of brain death

The dominant conception of brain death as the death of the whole brain constitutes an unstable compromise between the view that a person ceases to exist when she irreversibly loses the capacity for consciousness and the view that a human organism dies only when it ceases to function in an integrated way. I argue that no single criterion of death captures the importance we attribute both to the loss of the capacity for consciousness and to the loss of functioning of the organism as a whole. This is because the person or self is one thing and the human organism is another. We require a separate account of death for each. Only if we systematically distinguish between persons and human organisms will we be able to provide plausible accounts both of the conditions of our ceasing to exist and of when it is that we begin to exist. This paper, in short, argues for a form of mind-body dualism and draws out some of its implications for various practical moral problems.     

Making the case for human life extension: personal arguments

In the close to medium future, the life sciences might permit a vast extension of the human life span. I will argue that this is a very desirable development for the individual person. The question whether death is a harm to the dying is irrelevant here. All it takes is that being alive is good for the living person and not being alive is not good for anyone. Thus, living persons who expect to live on happily are rationally required to want to stay alive. Eventual uncertainty whether it will be possible to be happy in the future provides no objection, but rather an incentive to try. This view, however, may be naive in assuming that persons are unchanging entities that exist separately from their psychological information. Objections have been derived from reductionistic views that value our future experiences in a way that declines with time, so that there will be a future point beyond which only negligible value accrues. If we adopt such a view, then we cannot now be concerned to have experiences beyond that point. I argue that these arguments fail to take into account all the reasons we might have to be concerned for the future and all kinds of such concern that come from them. The adoption of a plausible reductionistic account can arguably weaken our concern for the future and certainly change its quality in important ways. But this provides no objection to the desire to live forever, nor to live at all.     

Biotechnology and human rights.

Biotechnology permits our world to progress. It's a tool to better apprehend the human being, but as well to let him go ahead. Applied to the living, biotechnologies present the same finality. But since their matter concerns effectively the living, they are the sources of specific dangers and particularly of that one to use the improvements obtained on the human to modify the human species. The right of the persons has to find its place to avoid that the fundamental rights of the human personality shall undergo harm. This mission assigned to the right of the persons is as so much invaluable that the economical stakes are particularly important in the domain of the biotechnologies.     

A solution to the human paradox: fundamental ontogenies and heterochronies

Solving the human paradox means explaining how a genetic difference of a mere 1% can be consistent with 5 million years of anatomical transformation from great apes to present-dayHomo sapiens. The solution proposed here is that of the internal history of ontogenetic change. A concept of “fundamental ontogeny” is developed and deduced from comparison between living and fossil primates. The fossil human lineage can be summarized into five fundamental ontogenies corresponding to successive skull plans (bauplans) resulting from five major phases of craniofacial contraction: prosimians (adapiforms), monkey apes (propliopithecidae), great apes (dryopithecidae), australopithecines andHomo. The morphological areas defined by these skull plans include more-or-less numerous species. This concept leads to renewed debate about (i) the relationship between speciation and bauplans, and (ii) the mechanisms involved in the successive steps of cranio-facial contraction and the correlated morphological changes. It is suggested that, from great apes to modern man, numerous heterochronies (hypermorphosis, hypomorphosis and post-displacements) have occurred during ontogeny, allowing the acquisition of permanent bipedalism inAustralopithecus andHomo, the increased cranial capacity of primitive forms ofHomo, and the disappearance of simian characters associated with renewed increase in cranial capacity inH. sapiens.     

Experimental and clinicopharmacological study of rectal absorption of chloroquine.

Chloroquine administered as a rectal suppository is resorbed both in rabbits and human volunteers. Although the chloroquine blood level in rabbit is proportional to the dose investigated, the human rectal mucosa has a limited absorption capacity of chloroquine being saturated at 15 mg/kg dose. In spite of this saturation character the chloroquine applied as rectal suppository may be a suitable formulation to treat or prevent the malarial infection for persons unable to take the drug perorally, e.g. children, or unconscious adults, or persons suffering with GI complaints after swallowing the chloroquine tablet.     

Sentient Nonpersons and the Disvalue of Death

Implicit in our everyday attitudes and practices is the assumption that death ordinarily harms a person who dies. A far more contested matter is whether death harms sentient individuals who are not persons, a category that includes many animals and some human beings. On the basis of the deprivation account of the harm of death, I argue that death harms sentient nonpersons (whenever their lives would be worth continuing). I next consider possible bases for the commonsense judgment that death ordinarily harms persons more than it harms sentient nonpersons. Contrary to what some philosophers believe, it is doubtful that the familiar resources of prudential value theory can vindicate this judgment. I show that the approach that at first glance seems most promising for supporting this judgment – namely, invoking an objective account of well‐being – faces substantial challenges, before arguing that McMahan's time‐relative interest account supplies the needed theoretical basis. I then go on to extract a significant practical implication of the first thesis, that death ordinarily harms sentient nonpersons: We should find a way to discontinue the routine killing of animal subjects following their use in experiments.     

If I Were You: Perceptual Illusion of Body Swapping

The concept of an individual swapping his or her body with that of another person has captured the imagination of writers and artists for decades. Although this topic has not been the subject of investigation in science, it exemplifies the fundamental question of why we have an ongoing experience of being located inside our bodies. Here we report a perceptual illusion of body-swapping that addresses directly this issue. Manipulation of the visual perspective, in combination with the receipt of correlated multisensory information from the body was sufficient to trigger the illusion that another person''s body or an artificial body was one''s own. This effect was so strong that people could experience being in another person''s body when facing their own body and shaking hands with it. Our results are of fundamental importance because they identify the perceptual processes that produce the feeling of ownership of one''s body.     

Dementia and legal competency

The legal competency or capability to exercise rights is level of judgment and decision-making ability needed to manage one's own affairs and to sign official documents. With some exceptions, the person entitles this right in age of majority. It is acquired without legal procedures, however the annulment of legal capacity requires a juristic process. This resolution may not be final and could be revoked thorough the procedure of reverting legal capacity - fully or partially. Given the increasing number of persons with dementia, they are often subjects of legal expertise concerning their legal capacity. On the other part, emphasis on the civil rights of mentally ill also demands their maximal protection. Therefore such distinctive issue is approached with particular attention. The approach in determination of legal competency is more focused on gradation of it's particular aspects instead of existing dual concept: legally capable - legally incapable. The main assumption represents how person with dementia is legally capable and should enjoy all the rights, privileges and obligations as other citizens do. The aspects of legal competency for which person with dementia is going to be deprived, due to protection of one's rights and interests, are determined in legal procedure and then passed over to the guardian decided by court. Partial annulment of legal competency is measure applied when there is even one existing aspect of preserved legal capability (pension disposition, salary or pension disposition, ability of concluding contract, making testament, concluding marriage, divorce, choosing whereabouts, independent living, right to vote, right to decide course of treatment ect.). This measure is most often in favour of the patient and rarely for protection of other persons and their interests. Physicians are expected to precisely describe early dementia symptoms which may influence assessment of specific aspects involved in legal capacity (memory loss, impaired task execution, language difficulties, loosing perception of time and space, changes in mood and behaviour, personality alterations, loss of interests and initiative). Towards more accurate determination of legal competency the psychometric tests are being used. The appliance of these tests must be guided with basic question during evaluation: "For what is or is not he/she capable?" In prediction of possible dementia development, the modern diagnostic procedures are used as help for potentially demented individuals in order to plan own affairs and by oneself determine future guardian. This ensures the maximal respect and protection of rights among persons with dementia in order to independently manage life one step ahead of progressive illness. Finally, it is to be distinguished medical concept of legal capacity which is universal and judicial concept which is restricted by rules of national legal system differing from country to country.     

Your flaws are my pain: linking empathy to vicarious embarrassment

People vicariously experience embarrassment when observing others' public pratfalls or etiquette violations. In two consecutive studies we investigated the subjective experience and the neural correlates of vicarious embarrassment for others in a broad range of situations. We demonstrated, first, that vicarious embarrassment was experienced regardless of whether the observed protagonist acted accidentally or intentionally and was aware or unaware that he/she was in an embarrassing situation. Second, using functional magnetic resonance imaging (fMRI), we showed that the anterior cingulate cortex and the left anterior insula, two cortical structures typically involved in vicarious feelings of others' pain, are also strongly implicated in experiencing the 'social pain' for others' flaws and pratfalls. This holds true even for situations that engage protagonists not aware of their current predicament. Importantly, the activity in the anterior cingulate cortex and the left anterior insula positively correlated with individual differences in trait empathy. The present findings establish the empathic process as a fundamental prerequisite for vicarious embarrassment experiences, thus connecting affect and cognition to interpersonal processes."When we are living with people who have a delicate sense of propriety, we are in misery on their account when anything unbecoming is committed. So I always feel for and with Charlotte when a person is tipping his chair. She cannot endure it." [Elective Affinities, J. W. Goethe].     

Gender context of personalism in bioethics

Personalism is one of the philosophical perspectives which hold that the reality in person and the human person has the highest intrinsic value. This paper makes reference to Louis Janssens' eight criteria in adequate consideration of the human person but further argues that there is need to consider people as situated agents especially within gender relational perspectives. The paper identifies gender as an important social construction that shapes the consideration of the human persons within socio-spatial spheres. The main crux of the paper is that there is a gender context of personalism and this has profound implications for bioethical agendas. Gender is part of the human condition, especially when we philosophically or sociologically engage the notion of equity and equality within the social system, because social realities in the relational perspective are not impartial, impersonal and equal. Gender does not determine morality but it plays a role in morality and expectations from moral agents. Women have been categorised as a sociological group because their integrity, freedom/autonomy and dignity (which are basic concerns of bioethics) are capable of being threatened. A gender perspective provides important incentives for moral theory which searches for possible conceptual imbalances or blind spots in ethical reflections. The paper refers to Sen's faces of gender inequality and expands on the notion that natality inequality is one of the fundamental levels of gender inequality, which in turn is the primary starting agenda in bioethics. The paper avers that the recognition of the fundamental importance of gender to the organization of social reality and the development of personal identities have important practical implications for bioethics.     

Power capacity: A key element in sustainability assessment

In the field of complex energetics, human societies to survive follow the same ‘maximum power principle’ as other living systems. In this view, human societies developed because they have been able to increase “their capacity to convert energy at a given time rate” rather than simply increase “their level of energy consumption”. This was translated into an increase of the level of ‘power capacity’ in human societies so far. Yet, one can expect that the level of power capacity will be altered in light of the unavoidable progressive depletion of fossil energy resources. The systemic study of power capacity in sustainability assessment is therefore essential for facing the external constraints ahead.Starting from the characterization commonly used in energy systems engineering, this paper seeks to clarify the concept of power capacity when used in sustainability assessment. It provides explicit methods of assessment for the different types of power capacity used by human societies. Power capacity refers to the converters transforming energy flows at a given time rate. Dealing with societal transitions therefore requires being able to characterize properly those converters in addition to the study of energy flows. However, this requires extending the timescale typically considered in conventional energy analysis which entails several epistemological problems over sustainability assessment.     

PRESIDENTIAL ADDRESS: IS THE SANCTITY OF LIFE ETHIC TERMINALLY ILL?

Our growing technical capacity to keep human beings alive has brought the sanctity of life ethic to the point of collapse. The shift to a concept of brain death was already an implicit abandonment of the traditional ethic, though this has only recently become apparent. The 1993 decision of the British House of Lords in the case of Anthony Bland is an even more decisive shift towards an ethic that does not ask or seek to preserve human life as such, but only a life that is worth living. Once this shift has been completed and assimilated, we will no longer need the concept of brain death. Instead we can face directly the real ethical issue: when may doctors intentionally end the life of a patient?     

Is the sanctity of life ethic terminally ill?

Our growing technical capacity to keep human beings alive has brought the sanctity of life ethic to the point of collapse. The shift to a concept of brain death was already an implicit abandonment of the traditional ethic, though this has only recently become apparent. The 1993 decision of the British House of Lords in the case of Anthony Bland is an even more decisive shift towards an ethic that does not ask or seek to preserve human life as such, but only a life that is worth living. Once this shift has been completed and assimilated, we will no longer need the concept of brain death. Instead we can face directly the real ethical issue: when may doctors intentionally end the life of a patient?     

In search of the missing subject: narrative identity and posthumous wronging

With the advanced methods of analysing old biological material, it is pressing to discuss what should be allowed to be done with human remains, particularly for well documented historical individuals. We argue that Queen Christina of Sweden, who challenged the traditional gender roles, has an interest in maintaining her privacy when there are continued attempts to reveal her ‘true’ gender. In the long-running philosophical debate on posthumous wronging, the fundamental question is: Who is wronged? Our aim is to find this ‘missing subject’ using narrative theory.Narrative identity emphasises the fact that no person is alone in knowing or telling their life story. People’s lives are entangled and parts of the life story of a deceased person can remain in the living realm. Since the narrative identity of a person does not necessarily end upon their death, and this narrative continues to relate directly to the person who once existed, it is the narrative subject that can continue to be posthumously wronged. Queen Christina can no longer maintain her own identity, but we maintain it by our research into her life. We propose three duties relevant for posthumous wronging: the duty of truthfulness, the duty of recognition and the duty to respect privacy.     

Human death--a view from the beginning of life

This paper presents a simple argument against definitions of the death of a human being in terms of death, or the cessation of functioning, of its brain: a human being is alive, and so is capable of dying, before it acquires a brain. Although a more accurate definition is sketched, it is stressed that it should not be taken for granted that it is ethically urgent to work out such a definition. What morally matters more than the death of a human being may be something for which its death is sufficient, but not necessary, namely the irreversible loss of its capacity for consciousness. It is when we lose this capacity that we lose our moral standing, as subjects who can be benefited and harmed, and who can have rights. But, as is also suggested, the loss of this capacity is ill suited to be what the death of a human being definitionally consists of.     

Genealogy and gene trees

Heredity can be followed in persons or in genes. Persons can be identified only a few generations back, but simplified models indicate that universal ancestors to all now living persons have occurred in the past. Genetic variability can be characterized as variants of DNA sequences. Data are available only from living persons, but from the pattern of variation gene trees can be inferred by means of coalescence models. The merging of lines backwards in time leads to a MRCA (most recent common ancestor). The time and place of living for this inferred person can give insights in human evolutionary history. Demographic processes are incorporated in the model, but since culture and customs are known to influence demography the models used ought to be tested against available genealogy. The Icelandic data base offers a possibility to do so and points to some discrepancies. Mitochondrial DNA and Y chromosome patterns give a rather consistent view of human evolutionary history during the latest 100 000 years but the earlier epochs of human evolution demand gene trees with longer branches. The results of such studies reveal as yet unsolved problems about the sources of our genome.     

Total brain death: a reply to Alan Shewmon

D. Alan Shewmon has advanced a well-documented challenge to the widely accepted total brain death criterion for death of the human being. We show that Shewmon’s argument against this criterion is unsound, though he does refute the standard argument for that criterion. We advance a distinct argument for the total brain death criterion and answer likely objections. Since human beings are rational animals--sentient organisms of a specific type--the loss of the radical capacity for sentience (the capacity to sense or to develop the capacity to sense) involves a substantial change, the passing away of the human organism. In human beings total brain death involves the complete loss of the radical capacity for sentience, and so in human beings total brain death is death.