When Is A Person?
Pre-Persons & Former Persons
SYNOPSIS:
Personhood is a very important concept for medical
ethics
because we grant different rights and privileges to persons
than to pre-persons
or to former persons.
Full persons have the following 4 capacities:
consciousness, memory, language, & autonomy.
How much of each of these capacities of self
must we have in order to be full persons?
We all began life as pre-persons.
During most of our lives we are full persons.
And if we suffer mental decline before death,
we will have a period of being former persons.
How do we draw these lines?
OUTLINE:
INTRODUCTION
A. The Difficulty of Drawing Bright Lines:
When Does Childhood End and Adulthood Begin?
B. Who Draws the Lines? And Why?
I. CONSCIOUSNESS
II. MEMORY
III. LANGUAGE & COMMUNICATION
IV. AUTONOMY
PRE-PERSONS
When Is A Person?
Pre-Persons
& Former Persons
by James Park
A. The Difficulty of Drawing Bright Lines:
When Does Childhood End and Adulthood Begin?
We all understand what a child is and what an adult
is,
but we cannot as easily say
when an individual passes from childhood to adulthood.
Should we draw this line as age 7, 12, 16, 18, 21?
Likewise, it is extremely difficult to draw the line
between
an individual baby who has been a pre-person for some months
and is now entering the phase of being a full person.
At the other end of life, when some of us lose our
capacities of personhood,
it is also difficult to say just when
we have lost so much of what made
us persons
that we ought to be called former persons.
This cyber-sermon will lay out four criteria
that
might help in the difficult task
of drawing lines between pre-persons and full persons
and between full persons and former persons.
B. Who Draws the Lines? And Why?
We should resist any tendency to set up abstract
standards
that might be applied to all individuals of questionable status.
Even before we think of making distinctions,
we need to ask who is drawing the lines and for what reasons?
The same caution applies to drawing the line between
childhood and adulthood.
The people who know the child best
are in the best position to know whether this child is ready for adult
responsibilities.
And some responsibilities can be accepted earlier than others.
For example, we allow people to drive at an earlier age
than we allow them to marry
without parental permission.
With respect to the lines between pre-persons and
persons,
the obvious individuals to ask are the parents.
Does this baby have signs of consciousness, memory, language, &
autonomy?
If all four are present, then these parents
will begin to treat their child as a person.
With respect to the line between full personhood and
former personhood,
the people who have known the individual for the longest time
are in the best position to see if this individual
has lost enough of the signs of personhood
so that he or she should now be treated
in the ways most appropriate for former persons.
We can ask the same questions:
Does this individual still have consciousness, memory, language, &
autonomy?
If the relatives and friends see that some of these capacities have
disappeared,
then it is probably time to take over some of the responsibilities of
this individual.
In some sense he or she has become a former person.
I. CONSCIOUSNESS
The first and most important mark of personhood is
consciousness.
We are conscious when our five senses are working:
sight, hearing, small, taste, & touch.
We note that animals have these same five senses
because they have the same sense-organs as humans.
So merely being awake and aware is not sufficient to qualify as a
person.
Beyond awareness of the surrounding world,
human persons are conscious of themselves.
We not only notice the world around us,
but we have the capacity to notice that we notice.
We can 'step back' and become aware that we are thinking, feeling
persons.
When consciousness has become impossible for us,
we have become former persons
---either in a coma or in a persistent
vegetative state.
A baby that is aware of itself
is able to wink back when it sees
someone else wink.
But an animal does not possess enough self-awareness to wink back.
And a former person in a persistent vegetative state
is also unable to
wink back.
Perhaps the eyes are open, but the brain is not conscious.
We all know the difference between being awake and
being asleep.
This forms the background of all common-sense discussion of
consciousness.
In order to be full persons,
we must be capable of conscious thoughts
and feelings
and also have some reflective capacity
to understand our conscious
functions.
Consciousness and self-consciousness are the
foundations
of the other marks of personhood: memory, language, & autonomy.
II. MEMORY
Human persons have remarkable powers of memory.
Not only can we remember what happened to us earlier today,
but we can usually remember things that happened years ago.
In a very serious sense, when we forget who we used
to be,
we are losing such a precious part of our persons
that we have become either different
persons or former
persons.
The capacity to remember important matters of daily
life
develops slowly in children.
Thus for the first several years,
their lives must be directed by their
parents,
who do possess full and accurate memories:
Adult persons know how the world works
and how individuals fit into the on-going processes.
But if we become like children again,
not able to remember how to conduct our own lives,
then we have lost a capacity
that made us the particular persons we
were
---and possibly even so much
that made us persons
that we could be called former persons.
Unlike all other records such as writing and
computer memory,
human memories are contained in living human cells in our brains.
We do not remember as completely and accurately as written records.
And we can notice when our memories are developing gaps and holes.
We notice the absence of some memories that we used to take for
granted.
If we ever lose so much memory that we do not
remember who we are
or who the people around us are,
then our lives a functioning persons are over.
And we should leave instructions (written while we were still full
persons)
that say how we should be treated
if and when we lose so much memory that we have become former persons.
III. LANGUAGE & COMMUNICATION
Full human persons always have the capacity to use
abstract symbols
as a means of communicating with other persons.
Of course, language ability emerges slowly in children.
But if no ability to understand and use human language emerges,
then this child might remain a pre-person all of its life.
Most of what makes us interesting persons
involves the capacity to understand and use human language.
Our work and play revolve around listening and speaking,
reading and writing, in short, communicating with other persons.
If we permanently lose the capacity to understand
and use language,
then it is a serious question whether we are still persons.
Former persons can still be respected for the persons they used to be.
But when it comes to interacting with them, language no longer works.
So we might have to resort to using the same methods of interaction
we use with domestic animals.
Guiding by hand, showing a certain behavior, making
particular sounds
can communicate our wishes to dogs and cats,
but we should not really expect them ever to understand
anything we say that depends on abstract human symbols.
And if a human individual never acquires a language
to interact with full persons,
perhaps that individual never becomes a person.
Likewise, if we lose the capacity
to understand what
other are saying to us,
and if we can no longer express ourselves using abstract symbols,
perhaps we have ceased to be full persons
and have become former
persons.
As medical science and technology can keep people
alive longer,
more human beings will spend significant periods of time as former
persons.
If we foresee this happening to us,
we can create written instructions now---while we are still full
persons---
explaining how we want to be treated
if ever we lose all capacity for human language and communication.
IV. AUTONOMY
The highest mark of full personhood is
autonomy---being self-governing.
We slowly develop autonomy
after we already have the first three
capacities:
consciousness, memory, & language.
To be autonomous means to have purposes and plans
for our lives
and to find ways every day to pursue these life-goals.
When we were infants, we did not have our own personal goals.
Rather we were merely trying to survive and be happy.
Gradually over many years, we become our own
persons,
guiding ourselves by pursuing our own specific meanings and values.
As we become more autonomous, we develop a full
sense of time:
We have a remembered past, an active present, & a projected future.
We remember events in our lives from days, months, or years ago.
We are actively engaged in shaping our lives today.
We learn to anticipate future events by a few days or weeks.
And as we become more fully adult,
we can embrace several years ahead in a single thought.
As autonomous persons, we no longer experience the
future
as one surprise after another.
Rather we shape our own
futures
by establishing our own goals and pursuing them.
We take moral responsibility for our own
lives.
We take charge of ourselves; we begin to 'own' our selves.
We make long-term plans intended to reach meaningful goals
---and we put these plans into action every day.
We make promises to other persons that extend into the distant future.
Some of our goals take a whole life-time to achieve.
And some will never be achieved,
but we show ourselves to be persons
when our behavior is organized and purposeful,
when we take full responsibility for what we do with our lives.
If we enter 'second childhood' in our old age,
we will no longer have any more goals than we had as infants.
Autonomy is the last mark of personhood to emerge and the first to
disappear.
But during our best years, we are probably quite
able to state our life-goals
and we are able to pursue these purposes with some effectiveness,
altho there is never any guarantee that we will fulfill our goals.
One aspect of being an autonomous person is the realistic recognition
of what we can accomplish and what is beyond our reach.
When (perhaps in the last years of our lives)
we are beginning to lose our autonomy,
we might not realize this ourselves
as clearly as it might be evident to the people around us.
They might notice that we are no longer self-starting persons.
What used to be our passion no longer matters to us.
We begin to withdraw from projects that we once found meaningful.
And we fall back into merely doing what is necessary for survival
and whatever activities still make us happy.
If we lose too much of the ability to handle our own
affairs,
others must make our decisions for us---at least the most important
decisions.
Such changes might be slow or sudden.
But as most of us are going to live longer than the previous generation,
it is more likely that we will lose some of the capacity to conduct our
own lives
in the meaningful ways we did when we were at our best.
We should prepare for this possible loss of autonomy
by laying out in writing, perhaps in a 'living will' or advance
directive for medical care
how we would like to be treated if we lose the ability to make our own
decisions.
PRE-PERSONS
We began this discussion of personhood with adult
persons
because we seem to be more rational and wise
when it comes to deciding when we ourselves and other adults close to us
might lose the
capacities that make us full persons.
When we no longer have consciousness, memory, language, & autonomy,
most of us will agree that we have become former persons.
The same questions can be asked about the beginning
of life:
Does a fetus in the womb have consciousness, memory, language, &
autonomy?
Historically speaking, most systems of morality and
law
do not give to fetuses the same rights and responsibilities
as we give to adult
persons.
When a defective baby is born, the parents are the
ones
who should ask and answer whether this baby is a person.
They will bring to this question everything from their own background.
And this might include some metaphysical principles
that say that because the fetus could become a full person,
then it should be regarded as a person from the start.
Where parents draw the line between pre-persons and
full persons
will help them to make difficult medical decisions.
And they can decide what is the proper way to respect
the life of the fetus and the life of a new-born baby.
Where would you draw the line between a
pre-person and a full
person?
How much consciousness, memory, language, & autonomy
must an individual possess in order to be regarded as a full
person?
drafted September 2005; revised 10-4-2005; revised
5-29-2006; 11-8-2006; 4-13-2007
AUTHOR:
James Park is an independent existential philosopher
with deep interest in medical ethics.
This cyber-sermon is based on a small book of the same name:
When Is A
Person? Pre-Persons & Former Persons
.
This longer version includes about 200 questions
that can be asked by health-care proxies
for individuals who might have passed over
from being persons into being former
persons.
He is also the author of another book in medical
ethics:
Your Last
Year: Creating Your Own Advance Directive for Medical Care
.
Much more information about James Park will be found
on his website:
An Existential
Philosopher's Museum
.
If you would like to read
other cyber-sermons by James Park,
go to the Cyber-Sermon List
.
See especially the section on Medical Ethics.