When Is a Person?
Pre-Persons and Former Person
by James Park


Click any item in this Table of Contents to go directly to that section.



I. INTRODUCTION                                                                 2
     A.  When Does a Child Become an Adult?                            4


II. CONSCIOUSNESS                                                             10
     A.  The Wink Test for Infant Self-Consciousness                   11
     B.  Computers Are Not Persons.                                         15
     C.  What about a Sleeping Person?                                     16
     D.  Common-Sense Definitions of Consciousness                  17
QUESTIONS FOR PROXIES
ABOUT CONSCIOUSNESS AND SELF-CONSCIOUSNESS          18

III. MEMORY                                                                         21
     A.  Memory in the Life-Cycle:
           The Dawning and Darkening of Memory                       23
     B.  If I Lose My Memory, I Will Be Former Person.                26
QUESTIONS FOR PROXIES ABOUT MEMORY                         31

IV. LANGUAGE AND COMMUNICATION                                 32
     A.  Language Development in Children                                33
     B.  Animals Lack Full and True Languages.                          35
     C.  Computers Do Not Understand Metaphors.                     38
     D.  The Sudden Loss of Language--as by a Stroke                 39
     E.  The Gradual Loss of Language--as in Alzheimer's             43
QUESTIONS FOR PROXIES
ABOUT LANGUAGE AND COMMUNICATION                          46

V. AUTONOMY                                                                      49
     A.  The Emergence of Autonomy in Children                         50
     B.  Autonomy Includes a Meaningful Sense of Time.              50
     C.  As Adult Persons We Invent Our Own Goals
           and Develop Moral Capacity.                                         51
     D.  Children Cannot Be Trusted to Handle Money.                 51
     E.  Some Retarded Individuals Never Become
          Responsible, Autonomous Adults.                                   52
     F.  If I Enter a  Second Childhood ,
          I Will Lose My Ability to Handle My Own Affairs.              53
     G.  If I Lose My Purpose for Living                                       55
QUESTIONS FOR PROXIES ABOUT AUTONOMY                     56

VI. PRE-PERSONS                                                                    62

APPENDIX: SIMILAR ATTEMPTS TO DESCRIBE PERSONHOOD    64

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WHEN IS A PERSON?
PRE-PERSONS AND FORMER PERSONS

By James Park

          When is a person?
     We are persons when we have the following four functions:
     consciousness, memory, language, and autonomy.

I. INTRODUCTION

          If you are reading this essay
     or understanding it while it is being read to you,
     then it is fairly certain that you are a person right now.
     And the fact that I am writing the essay
     proves that I am a person.

          Only we human beings who are presently persons
     are capable of raising the question of what it means to be a person.
     As embodied personhood we ask
     what makes us different from all other objects and creatures.

          But there was a time in the life-span of each of us
     when we were not yet persons in the full sense.
     We cannot remember this time,
     since one of the marks of personhood is being able to remember.
     As full persons in the present,
     we can look back upon our biological development
     and identify a period of time when we were not yet persons.

          And even before our period of pre-personhood,
     we can name the date before which each of us did not exist at all.
     Most of us know the exact day we were born.
     And if we subtract 9 months from that date,
     we can estimate the date when we were conceived.

          But we can never be as exact about the date
     when we moved from pre-personhood to personhood
     or when we made the transition from childhood to adulthood.
     And if we decline mentally before we die physically
     ---if we slowly lose the capacities that now make us persons---
     then observers of this decline
     will not be able to name the exact date
     when we passed from being persons into being former persons.

           The same criteria by which we presently affirm
     that we are persons apply at both ends of life:
     The four marks of personhood can help us to identify the period
     when we moved from pre-personhood to personhood
     and the period when we may move from being full persons
     into being considered former persons by others.

          This essay will suggest four criteria or four sets of questions
     that will help us to draw the line between
     ourselves in our pre-personhood phase and ourselves as persons
     and later to draw the line between
     ourselves as full persons and the former persons we might become.
     We will ask these questions about ourselves
     and the people who are closest to us.
     No attempt will be made here to establish tests of personhood
     that might be applied by a group of strangers
     such as an institutional ethics committee,
     an insurance company, or a government agency.

          (Medical ethics is the context in which the question
     "When is a person?" is raised,
     but if our criteria are careful and comprehensive,
     they should also be philosophically valid
     for distinguishing persons from animals and from computers.)

          In the practice of medical ethics,
     the question "Is So-and-So still a person?"
     will be asked by persons responsible for making
     medical decisions for others who cannot decide for themselves.
     For example, is a human fetus a person?
     How that question is answered affects one's choices about abortion.
     And the millions of women who have had abortions since 1972
     (when it became legal in the United States)
     might ask themselves "what did I abort?"

          Is a newborn a person?
     Clearly most newborns will grow into persons,
     but some are born defective physically and/or mentally.
     In choosing for a defective newborn,
     should the parents consider it to be a person or a pre-person?

          And if we slip out of personhood before we die,
     others will be called upon to make all decisions for us,
     including our medical decisions
     ---which might include decisions that will end our lives.

          How do we draw the line between persons and former persons?
     In all medical decisions, keep strangers out of the loop.
     Only those persons most closely related to the human in question
     should have the responsibility to decide for that individual.
     Professional experts from all disciplines can offer their opinions,
     but the final decisions must rest with the lay persons
     who are responsible for the future of the human being in question.

          In the case of fetuses and newborns,
     the obvious persons to make medical decisions are the parents.
     And they may decide to invite other family-members or friends
     to help them make difficult choices.

          At the other end of life, the decisions-makers are not so obvious.
     Thus, I suggest that each of us (while still a full person)
     appoint a proxy, two proxies, or a committee of proxies
     to make medical decisions for us when we are no longer capable.

          The most formal way to do this
     is to appoint a Medical Care Decisions Committee (MCDC)
     in one's advance directive for medical care ('living will').
     In some states this is accomplished by designating an individual
     as one's health-care agent by giving that person
     a durable power of attorney for health care.
     ("Durable" here means that it lasts beyond the competence
     of the person who appoints the agent.)

          When we appoint our proxies or establish our MCDCs,
     we should also give them written guidance
     concerning how to make medical decisions for us.
     Since we cannot foresee all possible medical problems
     and their proposed treatments, we must rely
     on the compassionate judgment of the proxies we choose.

A. When Does a Child Become an Adult?

          Before we attempt to draw the lines between
     pre-persons/persons and between persons/former persons,
     let us turn to a more familiar distinction
     ---drawing the line between child/adult.
     If we are now adults, we were once children.
     But when did this transition occur?

          And if we become parents, we will confront the question again
     when our children claim the rights and responsibilities of adulthood.

           How we handle this more familiar distinction
     may help us to face the more difficult and unfamiliar question
     of drawing the line between pre-persons/persons
     and between full persons/former persons.
     This new distinction has become necessary
     only since the advent of modern medicine and technology.
     Only in the 20th century did it become necessary to ask
     when a human becomes a person or ceases to be a person.
     This is because many pre-persons and former persons
     can be kept 'alive' indefinitely by life-support machinery.
     In earlier centuries, most would have died
     because there was no way to sustain them
     if their bodies could not sustain themselves.

          In the process of deciding when a child becomes an adult,
     we immediately find ourselves asking two background questions:
     1. Who is drawing the line?
     2. For what purpose is the line being drawn?

          (These same questions will reappear
     when we attempt to distinguish between pre-persons/persons
     and between full persons/former persons:
     1. Who is responsible for drawing the line?
     2. Why is the distinction required?)

          Unless we know who is drawing the line and why,
     we will not be able to decide when children become adults.
     In every known culture,
     children have different rights and responsibilities from adults.
     But children enter adulthood at different ages,
     depending on the rights and responsibilities being considered.

          Here are some historical examples of drawing the line
     between the end of childhood and the beginning of adulthood:

          The end of innocence, the beginning of moral responsibility:
     When does a child become morally responsible for his/her acts?
     In the Roman Catholic tradition,
     a child is capable of committing a mortal sin at 7 years of age.
     In Judaism adulthood begins at age 13.
     Generally, we think of children becoming responsible for their acts
     somewhere between 7 and 12 years of age.

          Driving age:
     Depending on the state, we regard children as old enough to drive
     automobiles and farm machinery when they reach 15-18 years of age.

          School-leaving age:
     Children are adult enough to drop out of school at about age 16.

            Age of consent for sex:
     Children are adult enough to decide their own sexual behavior
     somewhere between 15-18 years of age.
     Thus under most state laws,
     when a child below the age of consent has sex with an adult,
     it is entirely the responsibility of the adult.
     This is "statutory rape" or child sexual abuse,
     even if the child verbally gave 'consent'.

          Drinking and smoking age:
     Each society that controls the consumption of alcohol and tobacco
     defines the age at which a person is responsible enough
     to make informed decisions about the use of these substances.
     In the United States, the drinking age is controlled by the states.
     And state legislatures have frequently changed the age,
     depending on the mood of the citizens and other social factors.
     Generally, it has been between 18 and 21 years of age.

          Voting age:
     Persons become old enough to vote when they reach 18 to 21,
     depending on the country and the period of history.

          Age of marriage without parental consent:
     Children are old enough to enter the adult institution of marriage
     when they reach 18-21, depending on the jurisdiction.
     And in some cultures (especially those with arranged marriages)
     children can be married at much younger ages,
     but they still do not become full adults until somewhat later.

          Draft age:
     Males have been deemed old enough to fight at about 18.

          Adult criminal responsibility:
     When persons are still children,
     their Parents are often held responsible for their misbehavior.
     And the criminal acts of children are dealt with in different courts
     with different rules of procedure and different penalties.
     (But sometimes the crime itself is serious enough
     for the child to be certified as an adult and tried in adult court.)
     Children found guilty are sent to juvenile correctional facilities.
     And when they become adult (at 18), they are often released.
     Newer laws keep juveniles found guilty of serious crimes
     behind bars a bit longer, even after they have become adults.

          Contract capacity:
     Generally persons are able to enter into contracts
     for work and borrowing, etc. when they reach age 18.
     (For many years in the United States, the age of majority was 21.)
     Contracts for children below the age of majority
     must be co-signed by a parent or guardian.

           Age for borrowing without a co-signer:
     When lending institutions lend large sums of money
     (for a car or a house, for instance), they generally require
     a co-signer if the borrower is younger than 20-25.
     Experience has shown lenders that young adults are poor risks.
     So they require other adult signers to back up such loans.

          Age for adult auto insurance rates:
     Insurance companies have learned that young adults are bad risks,
     because they have more accidents than older adults.
     Thus (especially males) must pay higher insurance premiums
     until they reach about age 25.

          Age for being President:
     The writers of the US Constitution decided that a man
     (later women were also allowed to vote and hold office)
     had to be 35 years of age to be mature enough to govern the country.

          The fact that the line between child and adult has been drawn
     anywhere between age 7 and age 35 shows lack of consensus
     about just when a person ceases being a child and becomes an adult.
     Much of this variation can be accounted for by the fact
     that different responsibilities are being assumed by these people.
     A child of 7 may be responsible for making personal moral decisions.
     But that person would not be trusted to make Presidential decisions.

          Each family has its own, informal turning points in a young life:
     When is a child old enough to stay out after midnight?
     When is a child old enough to wash the dishes
     and take responsibility for other household tasks?
     When is a child old enough to have sex?
     When old enough to drive the family car?
     When is a girl old enough to put on make-up and wear a bra?

          In most of these parent/child struggles,
     the parents make the final decisions.
     But they should take the maturity of each child into account.

          Courts of law also hear status questions.
     Lawyers often ask courts to make exceptions to general rules
     defining when minors become adults,
     for instance, concerning large legacies.
     At the other end of life, the mental competence of someone
     who makes a will may be challenged
     by relatives who do not agree its contents.
     The detractors may argue that the drawer was incompetent,
     under undue influence, did not know what he or she was signing, etc.

           And the state legislatures are constantly asked to change the age
     at which children become adult for various purposes.

          Seeing the difficulty of defining when a child becomes an adult,
     we should not be surprised to discover that it is even more difficult
     to draw the line between pre-persons/full persons
     and between full persons/former persons.

          Medical decisions are often more permanent than
     decisions to grant an individual adult rights and responsibilities.
     Status as an adult may be postponed if the individual does not seem
     quite mature enough for the responsibility considered,
     but such line-drawing almost never results in death.

          But when we consider whether a certain individual
     is a person or a former person,
     how we draw the line could result in a medical decision
     that will result in death rather than continued treatment.

          Various opinions about when personhood begins and ends
     probably should not be written into any guidelines or laws.
     This question is highly individual
     and deeply affected by cultural differences
     ---just like the question of when a child becomes an adult.
     Such questions will always be open to significant debate.
     And with respect to each individual,
     all relevant views should be heard.
     This is a moral rather than a legal discussion.
     And the law should remain neutral about moral matters,
     allowing each family to create its own definitions
     and to apply them to their own family members.

          Laws and formal guidelines can set the broad limits
     concerning mandatory behavior and prohibited behavior,
     but the wide area between these two
     is the area of individual medical discretion.
     All laws and guidelines are based on a broad consensus
     of the society that created them.
     But an open society such as our own
     will leave a wide range of options between the outer limits.
     (A closed society may be defined as one with no choices:
     Everything that is not mandatory is prohibited.
     But sometimes advocates of certain moral position in our own society
     would like to enshrine their own moral choice in the laws
     so that everyone would be required to behave that way.
     But open societies have successfully resisted legislating morality.

          We should also guard against the assumptions of
     generic medical ethics.
     Largely because most of us were raised with a belief
     that there must be a right or a wrong in every situation,
     we may assume this applies to medical decisions as well.
     And many writers of medical ethics assume the same thing:
     They look for a consensus among ethical thinkers
     and take that to be the correct choice for everyone.

          But as our society becomes more pluralistic and multi-cultural,
     the consensus that used to uphold generic medical ethics disappears.
     Now people approach life-and-death questions
     with diverse personal, philosophical, and religious beliefs.

          And even religious organizations that used to have rigid positions
     now realize that there should be a range of freedom within that faith.

          So the criteria to be suggested in the rest of this essay
     are presented to a pluralistic and multi-cultural world.
     Once we have received all the scientific facts and medical opinions
     relevant to the choices we must make,
     we must make our own medical dedisions
     based on our own values and beliefs.

          In each culture, the written law defines the limits of choice.
     But within these limits of what is required or prohibited,
     each group of decision-makers operates by its own moral principles.
     And precisely because of this diversity of opinion on medical matters,
     it is very important for each of us
     to create our own Medical Care Decisions Committee,
     which will have the power to make medical decisions for us
     when we are no longer able to decide for ourselves
     or when we can no longer communicate our choices.


II. CONSCIOUSNESS

          When is a person?
     We are persons when we are conscious of the world
     and conscious of ourselves.

          The consciousness that defines persons recognizes itself.
     Only when we are conscious can we ask about consciousness.
     You are conscious as you read these words.
     And I am conscious as I write them.
     Neither of us is asleep.  And neither of us is dead.

          The first level of consciousness is sense experience.
     We see what is visible around us.
     We hear whatever is loud enough to be detected by our ears.
     We smell things when enough molecules enter our noses.
     We taste things that we put into our mouths.
     And we feel whatever we touch with our skin.

          Each of these five senses happens
     because we have specialized sense organs connected to our brains.
     And our brains organize our sensory input into intelligible patterns.

          All animals have the same five senses.
     And some animals have more acute senses than we have.

          Thus when we say that consciousness is a mark of personhood,
     we must mean more than sense perception and organization.
     If being aware of the world were a sufficient definition of a person,
     then every living dog and cat would be a person.

          What marks off personal consciousness from animal awareness
     is sensitivity to ourselves---self-consciousness.
     Not only do we notice the world around us,
     but we notice that we notice.
     We experience ourselves as receivers of sense impressions
     and organizing centers for interpreting that sense data.

          We do not need to be very intelligent to respond to the world
     in ways that show that we are aware of ourselves.
     As soon as we experience our selves
     as centers of experience that can be affected by the world
     (and later as centers of activity that can affect the world)
     we have begun to emerge as self-aware personal beings.
     Our earliest manifestations of self-awareness are feelings.
     When we become aware that we are hungry, cold, hot, in pain, etc.,
     we notice ourselves as organisms separate from the rest of the world.
     Later we can experience ourselves as happy, bored, fearful, jealous.

          We have sense experiences before we understand them
     and before we have any control over what happens to us.
     But as babies we learn to cry as a way of changing the world.
     When we learn that crying is communication with others,
     we are beginning to become self-conscious.

          Later we will develop a better-organized sense of ourselves.
     We will be able to identify ourselves, to say "I am I".
     We will be able to name ourselves
     and respond when others use our names.
     We will know who we are at some rudimentary level.

A. The Wink Test for Infant Self-Consciousness.

          When does self-consciousness emerge in babies?
     Even before birth a fetus is aware of its surroundings in various ways.
     But just when a baby becomes aware of itself is not immediately clear.

          However, anyone can try this simple experiment---the wink test:
     When you have a baby's attention, wink at it.
     If the baby attempts to wink back, it must be aware that it exists
     and that it is another person like the one winking at it.

          Usually the baby will close both eyes at once,
     since it has not learned how to close one eye at a time.
     But the fact that the child has tried to wink
     shows that the baby has recognized you
     as another creature like itself, with eyes just like its own.
     The baby's mind has made the connection between
     the holes thru which it sees the world and other people's eyes.
     And the infant is attempting to imitate a behavior it has seen.

          The imitation of winking is essentially different
     from most other forms of imitation.
     When an infant attempts to imitate the actions of human hands or feet,
     it does so by seeing the hands and feet of other people
     and seeing it own hands and feet.
     The similarities of form and function soon become obvious.

          But the infant cannot see its own eyes.
     Few infants spend much time gazing into mirrors.
     And if we want to be completely scientific about this test,
     we will check infants who have never seen themselves in a mirror.
     If they still have the impulse to wink back,
     they must be aware that they also are creatures with eyes that can wink.

            If we try the wink test on household pets, we get no response.
     The dog or the cat will continue to blink spontaneously,
     but there will be no effort to respond with a wink.
     (If a movie-maker causes an animal to wink,
     the effect would be uncanny.
     We would immediately recognize self-consciousness in the animal.
     The story might be that a human person was turned into a frog.
     And the frog retains self-consciousness,
     which it communicates by winking.)

          Animals, even after many years of visual experience,
     never realize that their eyes enable them to see the world.
     Animal consciousness seems to be only consciousness of the world,
     never consciousness of itself as a self.
     (Some people will dispute this observation.
     Let them devise experiments to show that animals may be self-aware.)

          When animals see themselves in mirrors,
     they usually attempt to go behind the mirror to find the other animal.
     If an animal notices that the image in the mirror its itself,
     this shows some level of self-awareness.
     An animal might become aware that its behavior
     (as experienced from the inside as the agent of that behavior)
     is the same as the observed behavior of the animal in the mirror.
     Higher primates do understand their reflections in mirrors.
     This has been shown by putting a dab of paint on their foreheads
     (without them knowing it)
     and then watching to see how they respond
     when they see themselves in a mirror.
     If they 'instinctively' touch their own foreheads,
     we know that they have made the connection between
     the image of the animal in the mirror and their own foreheads.

          It is possible that such higher animals could be trained
     to pass the wink test by getting them to close just one eye
     when they observe such a signal from a human being,
     but this would be very different
     from an infant attempting to wink without any training.

          To understand the full significance of the wink test,
     we must make explicit the difference between winking and blinking.
     Blinking is a spontaneous reflex action,
     which takes place in all animals with eyes like ours.
     It is nature's way of keeping our eyes clear of dust, etc.
     Babies have observed blinking for as long as they have seen eyes.
     Human eyes automatically blink about once a second.
     You may have blinked at least once while reading this line.
     But because blinking happens all the time,
     you did not notice it until I brought it to your attention.

            A baby sees thousands of blinks before it sees its first wink.
     And the baby notices something different is happening:
     This time only one eye closed, not both together.
     Winking is a new and unusual phenomenon in its world.
     And if the infant is beginning to emerge as a self-aware person,
     it will attempt to do the same with its eyes.

          Animals have no such self-awareness.
     They do not notice the difference between a blink and a wink.
     You can wink at your cat all day.
     And it will only become bored and move on to something else.
     But a self-aware infant immediately recognizes the difference
     between a wink (a voluntary action)
     and a blink (an involuntary reflex).

          Passing the wink test by attempting to wink back
     shows that the infant is aware of these basic facts about itself:
     I am a being with eyes just like the person who is winking at me.
     And if this other person can close just one eye at a time, so can I.

          For most animals, winking remains just another event to observe.
     winking faces are no more notable than blinking faces.

          Since infants are blinking all the time spontaneously,
     we must be careful to observe
     if the infant is voluntarily attempting to close one eye at a time.
     Even tho it may not be able to manage to close only one eye,
     we can usually tell that it is trying
     because the effort manifest in attempting to wink
     is different from spontaneous blinking.

          Parents must be especially on their guard against self-deception.
     Most parents hope that their children will be very intelligent.
     And some pet-owners believe that their pets are very smart.
     Parents and pet-owners may see non-existent signs of intelligence.

          At first every baby is an organism, like any other animal.
     It reacts to its environment with ever-increasing complexity.
     After a while it begins to distinguish between world and me.
     For instance, when the baby plays with its fingers and toes,
     it is surprised at first to discover that these other moving objects
     are parts of the same sensory system, itself.
     The baby feels its toes from both sides.
     Thru random movements of its limbs,
     the baby gradually discovers what is me and what is not me.
     If a baby fails to develop this capacity
     to distinguish itself from others, we should be seriously concerned.
     Some babies are born defective or are later injured
     so that they never gain significant self-consciousness.

          In some extreme cases, babies are born anencephalic
     ---without most of their brains.
     They never experience a moment of consciousness.
     And such babies will never develop the other capacities of personhood,
     which depend on consciousness---memory, language, and autonomy.

          The wink test may also be useful at the other end of life
     ---when an individual may have sunk into a post-personal existence.
     Because our eyes are located in our heads,
     even if we become paralyzed below the neck,
     we will still be able to blink and wink.
     Blinking shows that we still have reflexes coming from our brain-stems.
     But if we are still able to wink,
     it means that we are still conscious and self-conscious.

          In fact, our ability to wink voluntarily
     may be one of our last means of communication.
     A former person in a persistent vegetative state
     will spend part of each day with his or her eyes open and blinking.
     But there will be no responsive winks to the winks of other persons.
     Individuals in PVS are not self-conscious.
     So they will not even be able to wink back
     when a wink takes place right in front of their eyes.

          But if a patient still has the capacity to wink voluntarily,
     then the two eyes can become a new means of communication.
     The right eye can mean "yes"; and the left eye "no".

          The patient could even learn Morse Code,
     the right eye being used for dots and the left for dashes.
     Care-givers and family would also have to learn Morse Code.
     But even this slow communication would be better than none.
     And the message should be written down as it is sent
     to confirm or correct it as it is being transmitted.

          And if the patient becomes skilled at winking communication,
     a Morse Code reader or interpreter might be needed
     for receiving and de-coding longer messages.

B. Computers Are Not Persons.

          Just as animals never become as self-conscious as persons,
     so computers do not meet the test of self-awareness either.

          A computer is an electronic machine
     that contains millions of bits of information.
     It can rearrange and deduce certain conclusions from this information.
     In fact, computers generally perform such calculative functions
     much better and faster than the human minds that invented them.

          But is a computer conscious or self-conscious?
     To be self-conscious means to be able to grasp one's being whole,
     to comprehend oneself in a moment.
     Thus understood, a computer has no self;
     it is just the sum of the information and functions it contains.
     It cannot have attitudes or feelings about itself.
     It cannot identify or name itself.
     It has no whole sense of itself that it can grasp in an instant.
     It has no emotional responses to situations in which it finds itself.
     It cannot predict its own results.
     Instead of jumping ahead to a conclusion intuitively,
     it must just go ahead with its calculations as programmed.
     A computer is not essentially changed
     when information or functions are added or taken away.
     But persons are changed by their thoughts and experiences.
     (Reading this paragraph may have changed you in some small way.)
     A computer can 'learn' from the facts that are fed into it.
     But it will never graduate from being a computer.
     Persons can rise to ever higher levels of personhood.

          A computer has no core identity as a person has.
     It is only the wiring and electronic components that make it up
     ---and the electronically encoded instructions in its memory.
     When it 'thinks', it processes one piece of information at a time,
     sometimes using parallel processors to do several things at once.
     But its 'thought' processes lack creativity and purpose.
     Its only function is to complete the project assigned.
     When that calculation is completed, it is only a machine, waiting.

          A computer has no will of its own
     to go off in different directions to explore unexpected connections,
     as happens when you read this essay.
     These side-trips happen because you are a person.
     You come to this essay with interests and purposes of your own.
     And you find connections of ideas worth pursuing
     that were not put before your eyes by these words.

C. What about a Sleeping Person?

          When we call consciousness the primary feature of personhood,
     we must insert the exception for sleeping persons.
     Normally we human beings spend 1/3 of our lives unconscious.
     Every night all of the processes of consciousness are suspended.
     Sense experience ends; all mental organizing ceases.
     But when we awake in the morning,
     we can continue the same thoughts we had the day before.
     We remember who we are and what day of the week it is.
     And we begin to think of the activities of the forthcoming day.

          However, if a person falls asleep and never awakens,
     then that permanent unconsciousness will eventually be considered
     as the death of that person for all practical purposes.

          I have instructed my Medical Care Decisions Committee
     to regard me as permanently dead
     if I have been unconscious for a year.
     And if it is clear even before a year has passed
     that I will never regain consciousness,
     I should be declared dead even sooner.

          If I have become unconscious
     and I cannot be awakened to resume my purposes in life,
     then I should be considered dead as a person,
     whatever the condition of my other bodily functions.

          Or if I am constantly in a dream-like state,
     where I cannot tell the difference between
     my internally-created images and the facts of the real world,
     then also my status as a full person is seriously in doubt.
     Perhaps I have become a former person.

          When I am awake, I recognize myself and remember my purposes.
     I know how to get myself out of bed and get dressed.
     I know how to resume my daily activities.

          But toward the end of my life
     ---if I lose my mental capacities before death---
     I may drift in and out of consciousness.
     There may be times when I know who I am
     and other times when my self-consciousness is confused.
     If I can no longer understand the patterns of the familiar world,
     then I am losing my normal capacities of consciousness.
     While I am fully awake, others easily interact with me.
     We all appreciate the connections we have made as persons.
     But if my powers of consciousness begin to fail,
     others who have known me when I was a person
     may rightly say that I am "out of it".
     They will be able to say that I have become a former person
     when the activities we used to share are no longer possible.
     It might feel like a dream-state from which I cannot fully awaken.

D. Common-Sense Definitions of Consciousness.

          We all know what it means to be conscious or unconscious.
     When a patient does not wake up,
     doctors may be able to explain why the patient remains in a coma.
     But everyone will agree that the patient is unconscious.

          Thus I have assigned to my Medical Care Decision Committee
     the responsibility for deciding whether I am conscious.
     They will obviously seek the best medical advice and opinion
     about what might have caused my unconsciousness
     and about what might happen to me in the future.
     But it should be obvious to all that I am not awake.
     And if there seems little chance that I will recover consciousness,
     I should be declared dead
     and my remains should be used as I have instructed.

          Here are a few simple, practical tests that anyone can use:
     (1) Is the patient aware of pain?
     (2) Does the patient appear to hear and respond to sounds?
     (3) Does the patient turn away from strong, unpleasant smells?
     (4) Does the patient react to substances placed on the tongue?
     (5) Does the patient notice bright lights and respond to them?
     If these five senses are not working, then the patient is unconscious.

          On the interpersonal level, we can ask the following questions:
     (1) Does the patient know himself or herself?
     (2) Does the patient recognize other persons known for many years?
     (3) Is the patient pleased when others show care and concern?
     (4) Does the patient notice whether others are present or not?
     Doctors also know about all of these tests for consciousness.
     And they have many others which are more sophisticated
     ---some involving complex machinery
     that will determine if anything is happening in the patient's brain.
     Neurologists have several ways to measure and map blood-flow
     to various areas of the brain.
     If parts of the brain are deprived of blood, they quickly die.
     No further functions can be expected from those areas.
     Other instruments can measure and map the brain's electrical activity.
     An electroencephalograph will show where the brain is working
     and where it may have ceased working, perhaps because of a stroke.
     Different brain-waves can show the difference between
     a sleeping brain and a thinking brain.
     Such technical means can show whether or not a brain is conscious.
     If there is no blood-flow to the cerebellum, the patient is unconscious.
     And if the neurologist can determine that blood-flow will not return,
     then the patient will not regain consciousness.
     The electrical tests may also enable the neurologist
     to predict whether consciousness will ever return.

          If everyone agrees that the patient is unconsciousness,
     and if the doctors say there is little hope of consciousness returning,
     then that patient has become a former person
     because the other marks of personhood
     (memory, language, & autonomy) depend on consciousness.

QUESTIONS FOR PROXIES
ABOUT CONSCIOUSNESS AND SELF-CONSCIOUSNESS

          Beyond what a neurologist can determine
     by various tests of the functions of the brain,
     the people who have known the individual in question for a long time
     may recognize changes in personality or consciousness
     that indicate the loss of mental powers.

         The following questions should be asked by people
     who have known the individual for a number of years.
     These friends and family members will be in the best position
     to notice changes in levels of conscious functioning.
     If the individual was clearly a person during most of his or her life,
     some elements of that person's mental life may have disappeared.
     When such losses become extensive enough,
     we say that the individual in question has become a former person.
     Just where to draw the line will always be subjective.
     And the others who have known the individual in the fullness of life
     are best prepared to evaluate these losses.
     When reading the following questions for proxies,
     we might put our own names in the blanks and adjust the pronouns.
     We might imagine these questions being read and discussed
     by the members of our own Medical Care Decisions Committees (MCDCs).
     The questions should stimulate meaningful discussion,
     rather than be given simple yes/no answers.
     The bold face question introduce major sub-divisions.

     1.  Has _____'s thinking become rigid and inflexible?
     2.  Does _____ seem to be 'closing down' as a person?
     3.  Do we notice increased reluctance to experience new things?
     4.  Does _____ decline invitations
          he/she would have been accepted in an earlier phase of life?
     5.  Does _____ wish to turn off the TV or radio
          because new information is always upsetting?
     6.  Is novelty no longer welcome because it is traumatic?
     7.  Does _____ resist change in all forms?
     8.  Does _____ require routines to proceed in the same order?
     9.  Does _____ only welcome familiar thoughts and experiences?
     10. Is there a loss of a former richness of thought and experience?
     11. If _____ used to welcome new events and experiences,
           has this openness been replaced by closedness?
     12. Does _____ become upset
           by unexpected input and communications from other people?
     13. Does _____ cling to familiar and comfortable routines?
     14. Does _____ resist change even tho some suggested changes
           would clearly be in his/her best interest?
     15. Has _____'s mind become set into rigid patterns
           suggesting unwillingness ever to change again?
     16. If _____ was an avid reader, has this practice been given up
           because new ideas are no longer welcome in his/her mind?
     17. Have our conversations with _____ fallen into a repeating pattern,
           the same basic conversations takes place over and over again?
     18. Does _____ remember saying the same things before?

          These questions about openness to new experiences
     must be asked by others who have known the individual for some years
     because some people have been rigid all their lives.
     Even if they were closed-minded and dogmatic, they were still persons.
     If they have always resisted change,
     then many of the above questions would not indicate
     a deterioration of their mental lives.

          Only a change in a once open, flexible, and curious person
     into a closed-minded, inflexible, and non-curious individual
     might be a sign of the hardening of a formerly rich mental life.
     Such a change in myself, for instance, would definitely be a sign
     that my mind was beginning to deteriorate and shut down.
     That would indicate that I am moving toward becoming a former person.

     19. How well is _____ oriented in time?

     20. When _____ awakens,
           does he/she know what day of the week it is?
     21. What month of the year?
     22. What season of the year?
     23. What year?
     24. Does _____ know how old he/she is?
     25. Does _____ sometimes forget whether it is morning or afternoon?
     26. Does _____ have a reasonable sense of the passage of the day?
     27. Is _____'s personality continuous and consistent?
     28. Does _____ experience himself/herself
           as the same person who lived many years ago?
     29. Is there a continuity of memory or do some of the memories
           seem to be events that happened in a movie---to someone else?
     30. When moved to a different living arrangement, does _____
           seem to be the same person who existed in the former location?
     31. Does _____ have a continuing concept of himself/herself?
     32. Does _____'s sense of self today connect clearly with a self
           that existed at some time in the past in a different place?
     33. Is _____'s self independent of time and place?
     34. Or does _____ seem to be a new or different self over time
           or when moved to a new location?
     35. Has _____'s distinctive personality disappeared?
     36. Has _____'s personality flattened out?
     37. Has _____ lost some of the characteristics
           that used to make him/her different from other people?
     38. Has it become difficult for health-care workers
           to distinguish _____from the other patients?
     39. Has _____ faded into the "patient population"?
     40. Has _____ become anonymous---lost his/her name---
           and become better known by a room number?
     41. Is _____ aware of being different from other individuals?
     42. Does _____ know his/her difference from others from the inside,
           not merely different in external facts and appearance?
     43. Does _____ recognize himself/herself as different
           from every other individual who has ever lived?
     44. Or has _____ begun to identify himself/herself
           as part of a group rather than as an individual?
     45. Has _____ begun to forget who he/she was, remembering
           "the past" as events that might have happened to others?


III. MEMORY

          When is a person?
     We are persons when we possess the power of memory.

          Memory---being able to recall past experiences and learning---
     distinguishes persons from all other creatures.
     As our memories become fuller and more useful,
     we become more complete persons.
     And as our memories begin to fade,
     we lose the characteristics that made us interesting persons.

          Almost all of us can remember what we did in the last five minutes.
     You were probably reading this essay five minutes ago.
     And if you can't remember at least some ideas from the previous page,
     then you might as well give up reading now:
     The ideas are leaking out the bottom of your brain
     as fast as they are coming in at the top.

          And we probably all remember what we did in the last 24 hours.
     Human memory goes even farther back, of course:
     We remember last week, last month, last year,
     and probably several years back into the past.

          As we go farther back, memory dims.
     We may remember only important or traumatic events from childhood.
     And we may re-discover memories in dreams
     that we had forgotten in our waking moments.
     Our human memories differ from computer memories.
     A computer can remember even the most trivial information forever.
     But we human beings must have reasons for remembering things.

          Also, we remember in different ways from computers.
     The computer keeps all the raw data just as it was fed in.
     But we persons remember events as meanings.
     And we almost never retain the details of the raw data.
     If the experience was not interpreted and processed at the time,
     it is probably lost forever from our memories.
     But, of course, we now have many other ways besides memory
     for retaining important facts from the past.

          Another proof that human memory works by meanings
     is the impossibility of remembering something
     we heard in a foreign language.
     A tape recorder could record every syllable.
     But our human minds remember only the sound of foreign speech.
     And when we were first born, all languages were foreign to us.
     Until we acquired our first language, our minds retained nothing verbal.
     Likewise, when we first opened our eyes,
     we were assaulted with millions of rays of light
     ---all meaningless to us since we could not make sense of them.
     And without organizing patterns for understanding visual impressions,
     we forgot whatever came into our brains thru our eyes.
     When our memories began to work,
     we recognized repeats in what we saw and heard.
     These formed patterns in our brains so that we could recognize
     such sights and sounds when they came around again.

          And because this capacity for recognizing patterns
     must develop very early in life,
     babies born blind or deaf who gain these senses later in life
     sometimes never become as adept at remembering and understanding
     as those who started to form these patterns shortly after birth.

          Babies born blind but not deaf, of course,
     develop better-than-normal memories for voices and sounds,
     since that is the way their minds were first organized.

          Likewise, babies born deaf but not blind
     usually develop more acute visual discriminations,
     since that was the first way their minds were organized.

          Important memories are also found in animals,
     but, interestingly enough, their memories are often organized by smell.
     Even years later, they can remember a person or a place by its smell.
     For example, fish find the stream where they were spawned
     when their olfactory nerves tell them "this is home".

          However, the family dog will have no response
     to a picture of its long-dead master.
     But we humans are often flooded by memories
     when we see a picture from childhood.

          Our personal memories make us special persons.
     In large part, we are the sum of our memories
     ---the collection (in our brains) of everything
     we have learned and experienced since we were born.
     And if we lose these memories,
     we become either other persons or former persons.

A. Memory in the Life-Cycle:
             The Dawning and the Darkening of Memory.

          After birth, a baby's brain develops very quickly.
     Very soon the baby notices similarities between what it sees now
     and something that happened earlier in the day or some previous day.
     Recognizing the special people in its life
     may be one of the first signs of memory in a child.

          (If the previous paragraph made you remember something
     from your childhood or the first years of your children,
     this shows how words can evoke memories.)

          In the first few months of life, infants are easily distracted
     because they lack purposeful attention and memory.
     Before we became full persons, our memories were rather random.
     Odd bits of information stuck in our minds,
     but other events sliped thru our memories as quickly as they happened.
     Why do we remembered some events from childhood and not others?

          As children we were easily distracted from whatever we were doing.
     Something new always seemed more interesting than something old.
     Older children sometimes take advantage of younger children
     because they are so easily distracted from whatever they are doing.
     When the baby is offered a new toy,
     the old toy drops to the floor as if it did not exist.

          And young children have difficulty
     foreseeing the importance of putting toys away in their proper places
     so that they can be found when they are wanted again.
     When memory is poorly developed, the child lacks continuity thru time.
     Life comes to the baby as a series of moments
     ---perhaps the way life happens to animals even in their adult years.
     But as the baby gains the power of memory,
     its life becomes more organized and purposeful.

          Organized memory emerges slowly in infants.
     For instance, we do not expect infants
     to remember stories read from a book.
     An infant lacks the necessary system of concepts in its mind
     to make sense of what it hears and hence to remember it.
     The infant's sensory organs may be working perfectly,
     but the storage and retrieval system is still under development.

           Memory works only when sensory input makes sense to us
     ---when we have some reason for remembering something.
     Even as adults, most of what we perceive every day is forgotten.
     We have no reason to store everything that happens to us.
     But an infant remembers even less because it has
     no means of distinguishing the trivial from the important.

          Much of what a baby remembers is short-term memory,
     what it needs for its survival.
     As adults we may remember little from our childhood years.
     But while we were there, we clearly did remember what was important.

          But if there were a baby that did not remember any experiences,
     we would decide that it is extremely retarded.
     Animals are expected to remember only a few rudimentary things.
     But since we human beings remember so much,
     we naturally expect persons to have functioning memories.

          By the time we become adults,
     we have taken in and remembered uncountable bits of information,
     most of which is stored in our brains with instant access.
     When we are called upon to remember the value of pi,
     we remember instantly that it is 3.14,
     even if we have never used this value.
     That is an example of rote memory,
     perhaps not related to anything meaningful in our experience.

          And as we lose our abilities to call up information as needed,
     we remember that we used to remember the facts that are now lost.
     We may notice and mourn the loss of our quick memories when young.
     And if we lose a large part of our functioning memories,
     others may question whether we are still full persons.

          Victims of amnesia do not forget most of what they learned in life.
     They remember how to talk, how to understand their native language,
     most of the abstract things they learned in school, etc.
     But they have forgotten specific periods of their lives.
     They may forget who they are.
     This may have been caused by a psychological trauma,
     which made it painful to remember that period of their lives.
     Later they may regain access to the closed parts of their memories.

          If we suffer a stroke or some other brain injury,
     we may forget large parts of what we felt we knew forever.
     But because human memories are stored everywhere in the brain
     ---rather than filed chronologically or categorically,
     as in a computer or library---some pieces of memory always remain.

           But if an injury or disease causes us permanent memory loss,
     then we may be diminished as persons so severely
     that we no longer remember what was important to us earlier in life.

          For instance, if a stroke rendered me incapable
     of understanding and using English,
     then my life as a philosopher would be completely over.
     I would then have lost everything I learned thru the medium of language.
     And in a deep sense, I would be a different person---or former person.

          If we live long enough, all of us will experience some memory loss.
     We should notice it ourselves first, but if it becomes severe enough,
     those around us who know what we used to remember
     will be able to notice just how much we have forgotten.
     Sometimes such memory losses are temporary.
     Maybe there are certain times (such as later in the day or evening)
     when our memories dim.
     But when our full powers of memory return,
     we feel relieved that memories temporarily lost
     have now become accessible to us once again.

          Until recent years, it was usual for memories to last until death.
     For most of the years of the human species,
     physical death followed quickly after mental death.
     But now medical technology empowers us to keep a body 'alive'
     after the person has ceased to be.

          Most of us may hope that our bodies will not be kept 'alive'
     after our memories (and perhaps other mental powers) are gone.
     Instead of needlessly extending the process of dying,
     when the mind and its memories are gone,
     we should probably let go of the body.

          Each of us should leave instructions in an advance directive
     stating how we would want to be treated if we lose our memories, etc.

          And as a whole society we need to be more accepting of death,
     more ready for the natural termination that will come to us all.
     Others will be able to accept our deaths as well
     if we have set up procedures in advance
     that will enable others to manage our deaths.
     Usually, managing death means postponing it as long as possible.
     But perhaps that emphasis should shift toward accepting death,
     now that we have become so successful in extending life.

B. If I Lose My Memory, I Will Be a Former Person.

          Right now as I look back on more than half a century of life,
     I do not remember most of the things that happened to me.
     But I have no problems remembering the most important events.

          I spent some years in college, for instance,
     studying mathematics, chemistry, physics, etc.
     But since I have not used most this learning for more than 30 years,
     I have forgotten almost all of it.
     I have no idea how to solve a differential equation,
     even tho I studied how to do that for at least one quarter.
     I suspect that I could re-learn such subjects easily,
     but I have no inclination to pursue them.
     I leave such matters to those interested in science and mathematics.

          When I turned from science to philosophy,
     I no longer kept up with scientific developments,
     but I think that I am a better philosopher
     because of my solid grounding in the natural sciences.

          If and when I begin to forget matters important to me now,
     then I may be declining as a person.
     And others who observe this decline
     may be in better position to evaluate me because
     I may lose perspective on myself as I lose my mental powers.
     I may even enter a 'second childhood'.

          I will be like a child again
     if I lose my organizing memory and personality.
     The self that now writes these words may disappear before I die.
     Life may just roll over me as a series of disconnected experiences.
     My mind may shift from one subject to another
     like 'surfing the channels' on a television set.
     And if I forget what is important to me now,
     there will be no reason to remember one thing rather than another.

          If I enter 'second childhood', my memories will be mostly out of date.
     Even now, my dreams are usually set in my childhood home.
     If I become senile, is dreaming the way I will feel even when awake?
     Will I become lost on the street because the old landmarks are gone?
     Will I forget where I live, attempting to return to a childhood address?

          Children must be cared for by responsible adults
     because they cannot get their information in proper order.
     If I become like a child again, others will have to take care of me.
     I may not be able to find my own way in this world.
     Or I may have only a few moments of mental clarity each day.
     If I start to get the sequence of events mixed up in my mind,
     if I cannot remember who I am or what purposes I was pursuing,
     then my life as a full person may be drawing to a close.
     Certainly nothing more can be expected of me
     in the form of original, creative thinking.

          If I can no longer remember the person I was,
     if I am no longer interested in pursuing the purposes of James Park,
     I will have ceased to be that person.

          This could happen suddenly, as the result of a stroke,
     or I could gradually lose my memory and my purposes.
     Perhaps someday I will look at pictures of myself at an early age
     and not remember what the person in those pictures remembered.
     I may have access to information about the person I used to be.
     I might even be able to read the books I wrote during my best years.
     But if I have no personal memory of those thoughts,
     it will be as if someone else had written my books.

          (I have already experienced this odd sensation
     of distance from my own works,
     since I cannot remember what I wrote years ago.
     I am even having this experience right now
     as I re-write the draft of this essay,
     which is dated just 2-1/2 years ago.
     I do not remember writing these ideas.
     So it is lucky I wrote them down when I had them.
     I would not be able to recreate them as well today.
     And when I read passages of books that I wrote many years ago,
     I often enjoy coming across them as a reader does
     ---discovering them for the first time.)

          If I lose my personal memory of myself
     as the person I was during most of my life,
     I might be said to have become a new person.
     In a way this is happening all the time,
     as I revisit past phases of my life
     and see them in a different light now than I did then.

          Even physically, we are changing all the time.
     The old cells are dying off and being replaced.
     But there is usually enough continuity
     for us to be sure that we are the same persons
     who lived in these bodies so-and-so many years ago.

          But if my memory and the rest of my mind is so changed
     that I do not even seem to be the same person to myself,
     then I have probably become a new person in the old body
     ---if I still have enough of the capacities that make anyone a person.
     And if the new person who lives in my old body wants to live,
     then perhaps that wish ought to be honored and respected.
     That will have to be decided by the people around me at the time,
     whom I have chosen to make such decisions for me
     when my own mental capacities might be in doubt.
     And perhaps I will have deteriorated in other ways as well,
     so that I can hardly be expected to pursue any purposes at all.
     If my most important memories are gone,
     that might signal the disappearance of me as a person.

          I will remain a full person while I remember and recognize myself.
     Also, I must remember other persons who have been important in my life.
     One of the saddest notations found in nurses' notes
     is that the patient had a visitor but did not recognize who it was.

          If and when I fail to recognize myself and others close to me,
     that will be strong evidence that I have become a former person.
     If my own identity is slipping away with my failing memory,
     it will be hard to remember who I was.
     And it may be even harder to remember the other people in my life.

          If I can no longer interact with the people
     who used to be important to me,
     then I may still be worthy of respect as a former person,
     but it would be foolish and perhaps impossible
     for them to treat me as the same person I used to be,
     because I will lack my old responses.
     Those who respected me as the person I was during my best years
     may come to visit my body in a long-term care facility,
     but they will no longer be able to visit me as a person.
     It may be impossible for us to discuss subjects,
     such as the contents of this essay,
     even tho such issues would be very relevant to discuss at the time.

          If and when I begin to lose my memory, I hope those who know me
     will still respect me for the person I was during my best years.
     And I hope to be remembered and respected after my death.
     I will be dead for a much longer period than I was alive.
     And I hope some of the thoughts I have had as a living person
     will be helpful in the lives of other living persons.

           But I do not want my body kept alive without my person inside.
     My body will have already fulfilled its primary purpose:
     It has been a very good home for my person.
     But if my period of personhood comes to an end
     some time before my body would normally be laid to rest,
     instead of attempting to preserve my body as long as possible,
     it would be much better to use the same money
     to further the purposes I found most meaningful as a person.
     For example, it would be a greater honor to me as a person
     to spend the money making my books more widely available
     to people who can benefit from reading them.

          If I were in a position to enforce my opinion
     (the values I now hold as a fully-functioning person),
     then my decision would be to let my body go
     after my life as a person has been completed.
     (Perhaps my life as a person will never be completed;
     it might be just over.)
     Anyone who keeps my body 'alive' after my memory has departed
     does nothing for the person James Park.
     Perhaps they will attempt such efforts
     because of their memories of the person I was.
     But such efforts are contrary to my values.

          If you who survive me want to remember me as a person,
     you should apply yourselves to reading my books
     and sharing my ideas with others who can benefit from them.
     My person will be much better encapsulated in my books
     after I have lost my memory than in my body.
     The memory now contained in my brain resides in living cells,
     which are inherently impermanent and subject to decay.
     But even when my brain no longer can recognize my own words,
     the various persons I have been during the several phases of my life
     will be better preserved in my written words than anywhere else.

          I, for one, would not hesitate to declare myself a former person
     if the body I now own and operate is ever (before my biological death)
     inhabited by some form of human life
     that does not recognize the purposes for which James Park lived.
     If my skull contains no memory of James Park as a person,
     then as a person my life is over.
     And I request that those around me take appropriate measures
     to insure the wise re-use of my body (or any parts thereof),
     rather than keeping my body 'alive' as long as possible
     as a kind of 'living memorial' to the person James Park.
     In a very important sense, if I have no memory,
     James Park will have ceased to be.

          If I ever lose much of my memory,
     others must take over my decisions for me.
     And I hope they will respect the person I was.
     It may be difficult to relate with me
     after I have forgotten who I am and who the people around me are.
     If and when that happens, I should be regarded as a former person
     and treated with the respect and dignity due a former person.
     If I no longer understand what people say,
     if I have no thoughts to offer,
     or if I cannot remember what was said to me just a minute ago,
     then such loss of memory would qualify me as a former person.
     My own past life might become a mystery to me,
     unless I retained the ability to read my own books and journals.
     And I might be reading them as if they were written by a stranger.
     If my short-term memory is still working,
     I might be able to re-discover some interesting things about my life
     from reading and from listening to other people's memories of me.
     But if my earlier life is known to me only thru reading and listening,
     if I cannot recall any of it, then I have become another person
     than the one who lived those years---and remembered them for a while.
     It would be as if James Park had died already
     and I was a new person learning about him second hand.

          In order to put this philosophy of life and death into action,
     I have established my Medical Care Decisions Committee (MCDC),
     whose members have known me for many years.
     These people will decide when I have ceased to be a person.
     They will remember what I used to remember,
     what sort of a person I used to be.
     Thus, they will be in a better position to make decisions for me
     than any medical people taking care of me at the end of my life.
     Those doctors and nurses might not have met me
     until after I had deteriorated into being a former person.
     Only those who have known me for a long time
     will truly be able to gauge the degree of my loss of personhood.

          My Medical Care Decisions Committee will, of course,
     take advantage of all the information modern medicine can provide,
     but ultimately my medical decisions will rest with them.
     And because they will all have read this essay years in advance,
     they will be ready to apply my criteria of personhood to me.
     So even tho they may grieve the loss of the good times we shared,
     they will at least be intellectually ready to say
     that James Park has crossed the line into former personhood.
     They will not attempt to preserve their memories of me
     by preserving my body after my life as a person is over.

QUESTIONS FOR PROXIES ABOUT MEMORY

          The people who have known
     the person (or former person) in question for the longest time
     will be able to notice how much memory has been lost.
     Discussing the following common-sense questions
     can help them explore the degree of memory loss.

     1.  Does _____ remember himself/herself and other people?
     2.  Does _____ recognize and remember other people
           who have been important in his/her life?
     3.  Does _____ recognize himself/herself in a mirror?
     4.  Does _____ recognize himself/herself from recent pictures?
     5.  Can _____ recognize himself/herself from pictures
           from various periods of his/her past?
     6.  Do only the oldest pictures, perhaps from childhood, evoke memories?
     7.  Can _____ identify other people from old photographs?
     8.  Does _____ sometimes confuse periods of his/her history?
     9.  Does _____'s mind sometimes slip from the present
           into some past period of his/her history without notice?
     10. Does _____sometimes confuse relatives from different generations,
         such as confusing a mother with her daughter?
     11. Does _____wish to return to a home that no longer exists?
     12. Has _____ reverted to using the native language of childhood
         ---if this is different from a language learned as an adult?
     13. Has _____ forgotten some parts of his/her history?
         If others remember what _____ said and did
         better than _____ does, then clearly his/her memory is failing.
     14. Does _____ seem to be a different person
           because the past has disappeared from memory?
     15. Does _____ remember his/her past life reliably?
     16. Is _____'s memory of recent events less reliable than old memories?
     17. Does _____ sometimes lose track of a conversation
         because of lack of short-term memory?
     18. Does _____ sometimes have difficulty telling the difference
         between memories of real events and stories and dreams?
     19. Does _____'s memory seem to fade and
         depending on various other factors of health and circumstances?
     20. If you wanted to know something for certain about the past,
         would you trust _____'s memory?


IV. LANGUAGE AND COMMUNICATION

          When is a person?  Personhood is marked by
     flexible language and interpersonal communication.

          As we develop the capacity to understand and use language
     in the first 18 months of our lives, we are beginning to become persons.
     And if there is a time before the end of our lives
     when we lose this wonderful capacity
     to understand and communicate with other persons,
     then we are losing one of the most important marks of personhood
     ---a capacity that sets us sharply apart from animals and computers.

          A human being who could not recognize and use symbols
     might look like a normal human being in all outward respects,
     but it would not be a person.
     We know of a few very rare instances of children raised by animals.
     If they reached the age of 5 or 6 without human language,
     without every hearing or speaking a human word,
     without ever using a symbol system,
     then those human beings were not persons.

          And after the critical period for language imprinting has passed,
     it seems next to impossible for a human being to acquire a language.
     This fact also has serious implications for children
     raised in language-poor households,
     where language is confused or somehow missing.

          Without language, a human being remains like an animal.
     Animals can certainly interrelate with others in the household,
     but they cannot really understand what the others are doing.
     Human noises do not signify for the animals of the household
     what they mean for the persons who understand that language.

          Children raised without the benefit of language
     may look like normal children, but they are not.
     Persons can only interact with them as they do with household pets.
     Some forms of mental retardation and mental disabilities
     also result in children lacking language ability.
     They can learn to respond to sounds and signals,
     as a dog or cat might, but without language,
     there is no way to communicate with them.

          Luckily even children born deaf can learn sign language,
     so that their minds can be as fully symbolic
     as children who can hear and speak.
     Most human beings naturally become persons
     because they are so easily imprinted with their native language
     in the first few months of life.

A. Language Development in Children.

          As soon as we were born into this world,
     we were exposed to language---people talking every day, all day long.
     They talked to one another.  And they even talked to us,
     altho we could not understand a word they said at first.

          When we were born, all languages were foreign to us.
     But we quickly observed that people made noises to communicate.
     And we attempted to imitate human sounds before we knew their meanings.
     However, in contrast to a parrot, which can also make language-sounds,
     we began to understand what these sounds meant
     in the lives of the people around us.

          With language all around us, we soon began to pick up
     the connections between human sounds and the objects they signified.
     We noticed that certain vocalizations went with certain experiences.
     And because our minds were prepared by evolution
     to be very receptive to language in these early months,
     we quickly and easily acquired the language we heard.
     No formal instruction was needed.
     The language around us was just imprinted on our brains.
     We picked up thousands of abstract symbols (words)
     and the often complex grammatical rules for putting them together.
     Thru trial and error, we gained the ability to speak
     and to make ourselves understood by others.

          Also we soon discovered
     that language can refer to past and future events.
     The persons around us constantly talked about yesterday and tomorrow.
     So language was not mere pointing to what everyone could see.

          The persons around us used language to communicate with others
     concerning the things that were happening inside them,
     their private thoughts and feelings, many subtle issues and concerns
     that could never be shown by pointing.
     Animals never figure out this function of language.
     So most of what they hear is meaningless sounds.
     Try to teach even the most intelligent animal to read this page.

          After years of merely listening and talking,
     we discovered that words can be transformed into symbols on paper:
     We were introduced to reading and writing.
     After that, there was no limit to what we could learn.
     Language opened up worlds of information about things
     that we could never experience directly by ourselves in one life-time.
     We may have decided to learn new languages
     ---the ways of speaking and understanding that developed
     on different parts of the globe among our species, homo sapiens.
     With the help of these symbol systems,
     we could acquire an almost limitless amount of information.

          Our language capacity can continue to develop thru-out our lives.
     Every day we can learn new words.
     And perhaps we lose a few words that we used to know
     because we never have occasion to use them.
     If we study specialized knowledge, we will learn technical words
     that apply only to that form of behavior or concern.
     Words can be used to explain the meanings of new terms.
     So our knowledge becomes an interconnected web
     of hundreds of thousands of words, all defined by other words.

          Language is the most distinctive mark of a human person.
     Those who miss the critical period for language imprinting
     can never quite catch up with the rest of the human race.
     They never become full persons in the ways that all people
     who can read and understand this essay are persons.
     In extreme cases we might say
     that they remain members of the animal kingdom
     even if they are kept among us as members of the family.
     They must be guided thru all of the activities of their lives
     the way we guide the behavior of animals.
     Humans without language can be trained to respond to signals,
     but they will never understand why they are being so directed.

          When human animals first developed the capacity to speak,
     they burst out of the animal kingdom.
     About 100,000 years ago, our ancestors became persons.
     Since then, all human cultures have created abstract symbols,
     which the persons of those cultures use every day
     in the complex process of interacting with other persons.
     Thus, language is essentially an interpersonal phenomenon.
     If there were only one human being on the earth,
     it would probably not have developed language,
     and hence it would not have become a person.

          So the concept of "language" must be stretched to include
     other forms of human interaction.
     We relate with other persons thru the medium of language.
     And if we do not share a common language,
     we still try to connect with different symbol systems
     by pointing to things for which we know we all have words.
     But pointing and making noises does not work with animals,
     because they lack abstract symbols for the elements of their world.
     We have probably taken our language ability for granted
     because it developed so early in our lives.
     We have no recollection of acquiring our native language.
     We just grew up knowing our mother tongue.
     And most of us continue to use and understand language until we die.
     But some people lose their capacity for language before death.
     So if language and communication are essential to being a person,
     what do we make of human beings who have no language?

          Some human infants, however, do not develop language.
     They are treated in every way as if they will become persons.
     We speak to them and about them
     assuming they will eventually understand what we say.
     Most infants so treated do in fact develop language,
     without any further attention to the matter.
     But some defective infants never develop any ability
     to understand and use a human language.
     No matter how completely we treat them as persons,
     they never become persons.
     They look and feel like all other human infants,
     but without the communication capacity given thru language,
     they never become full persons.  They remain pre-persons.
     Talking to them does no more good than talking to our pets.
     Both creatures remain non-persons if they cannot understand language.

B. Animals Lack Full and True Languages.

          Even tho many pet-owners speak to their pets
     as if they could understand, treating them as if they were persons
     or could become persons with enough attention,
     at best such pets gain some awareness of human sounds,
     when they relate to a particular situation.
     "No" is a common sound that pets can understand.
     Some can understand the sounds we make
     when we say "walk", "sit", "come", etc.
     But we never expect our pets to talk back to us.