Persons and personal identity

Simon Woods RGN, BA(hons), PhDLecturer in Bioethics, Institute of Medicine, Law and Bioethics, University of Manchester, Williamson Building, Oxford Road, M13 9PL, UK

Dialogue

Introduction

This discussion paper considers the relationshipbetween theories of personal identity and theories ofthe person with particular regard to the ethical impli-cations for terminal care. It is argued that some tra-ditional theories of the person and personal identityare seriously counter intuitive to the realities ofcaring for terminally ill and comatose people. Aviable alternative is explored.

Persons

What makes a thing a person,and what makes a personthe same person are two important and related philo-sophical questions. The first because nurses (amongstothers) have moral duties to persons and the secondbecause some of those duties apply to particular indi-viduals. The person who suffers a head injury and has complete amnesia may leave the hospital as thesame patient but are they also the same person? Theirreversibly unconscious patient may appear to lackpsychological characteristics, are they therefore aliving human being but no longer a person?

An important influence upon contemporaryaccounts of the concepts of person and personal iden-tity is John Locke’s definition:

. . . to find wherein personal identity consists, we must con-

sider what person stands for; which, I think, is a thinking

intelligent Being, that has reason and reflection, and can

consider it self as it self, the same thinking thing in different

times and places. (1977, p. 162)

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Locke’s definition of the person renders mosthuman beings prima facie examples of persons, thereare, in principle at least, two possible groups of excep-tions. First, the possibility of nonhuman persons,because Locke’s criteria are species nonspecific. Theas-yet-to-be proven existence of extra-terrestrials,may in the event, prove to be both alien creatures andalien persons. More likely perhaps is the possibility ofterrestrial nonhuman persons, such as certain speciesof primate and sea mammals (Harris, 1985; Singer,1995).

Furthermore, given Locke’s emphasis on psycho-logical characteristics it is possible in principle for aperson to be disembodied and therefore possible forcertain complex computer programmes to possess theright properties.1 I will not discuss the interesting pos-sibilities of such an extension of ‘person’ other thanto ask if such a programme existed and it developeda fault would we regard the engineers ‘caring’ for theprogramme as ‘nurses’ or health workers?

The second exception concerns human nonpersonssince, according to Locke’s criteria, being a human isneither necessary nor sufficient for being a person.Clearly a human corpse is still human but it is nolonger a person, the foetus is both human and alive butarguably not yet a person.There is a troubling class of

1 The extensive literature on cognitive science and artificial

intelligence includes both strong theoretical arguments and

some challenging empirical evidence in the form of computer

programmes to advance this view, the Turing test being an

interesting early example. See Hofstadter & Dennett, 1981;

Boden, 1987.

170 Simon Woods

individuals who are alive but on the Lockean view arejudged to be nonpersons, for example individuals whoare irreversibly unconscious or who lack the psycho-logical attributes for personhood. There are manychallenging cases within this class, for example onemay wish to distinguish the dying person from the liveindividual who has permanently lost their capacity forpersonhood. The Lockean position may support sucha distinction in the following way. Being a person is amatter of degree and therefore there is a threshold atwhich an individual becomes/ceases to be a person.This seems to endorse some of our intuitions regard-ing children, that infants become persons by degreesas they slowly develop the appropriate capacities.However, the threshold view is problematic in anumber of ways, not least because it leads to a soritestype paradox for persons. If personhood is a matter ofdegree then it is difficult to identify a clear demarca-tion line indicating the point at which a human infantbecomes a person and the point at which a personceases to be a person. Since there may be no evidencethat infants or dying individuals meet Locke’s criteriafor persons this seems to offend the intuition that bothinfants and the dying are also persons. John Harris’sanswer in the case of infants is to err on the side ofcaution, because an infant’s self-awareness is evidencethat they are developing the capacity for personhood(Harris, 1985). The case of the dying seems more problematic because as a person deteriorates theysometimes lose their capacities in something akin to a reverse of the process in which infants developtheirs. I suggest that a similar degree of caution, asapplied to infants, be extended to the case of the dying individual. The threshold view, however, is problematic from the point of view of identity.

Personal identity

Different kinds of thing have different criteria of iden-tity, which in turn makes possible the judgement thata thing is the same thing at different times. Numericalidentity offers the clearest account of the logical con-ditions of identity,2 but the conditions of identity for

persons fail to respect these properties. Personal iden-tity consists in those conditions that must pertain inorder to judge that an individual is the same individ-ual between time t and time tI (Wiggins, 1980; Parfit,1991). The philosophical theories of personal identityare complex but divide roughly into either physicalcontinuant theories or psychological continuant theories.3 There are some situations in life when intu-itions seem to endorse either of the philosophical theories. Some situations require a degree of, if notabsolute, certainty about the identity of a person,this seems particularly crucial in many moral and allpersonal relationships. In some moral contexts theidentity of the person seems rather less importantthan whether they are in fact a person or not.

Why is personal identity important? In life theidentity of individual people is important. Glover(1989) remarks that ordinarily ‘we are not naturallyimpartial between ourselves and colleagues’. The facta person has their own identity separate from that ofothers is important, it matters that an artist is givencredit for her work rather than that someone is givencredit. It is also important to discriminate betweenthe identity of different individuals; it matters thatwhen a woman leaves hospital, having given birth,she is given the child identical with the child she gave birth to and not a similar child born on the sameday. This seems to favour the physical rather than psychological continuant view since a new-born babydoes not exhibit psychological characteristics distin-guishable from those of other new-born babies.

When is a person not the same person?

If an individual falls below the threshold for person-hood then presumably they cease both to be a personand cease to be the same person, on Locke’s defini-

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3 The intuitions provoked by the conceptual considerations in

support of psychological continuant theories are frequently con-

tradicted by the intuitions provoked by empirical considerations.

See for example Parfit, 1991; Glover, 1989; Nagel, 1983;Williams,

1973. My view is that some combination of physical and psy-

chological continuation offers the best fit with the intuition of

what a person is.

2 For example Liebniz’s ‘identity of indiscernibles’ see Wiggins,

1980, chapter 1.

Persons and Personal Identity 171

tion: ‘the same thinking thing in different times andplaces’.

Parfit (1991) has argued that thinking of personalidentity in terms of survivorship is perhaps the mosteffective way of rendering the changes a person may undergo compatible with continued identity.However, these arguments are more sensitive to psychological changes than physical changes. Take the following example: assume that the technologyfor brain transplants has been perfected. Bill and Tim utilize this technology to undergo a brain swap.Unfortunately Tim’s body is irreversibly damaged by the anaesthetic and dies with Bill’s brain in situ.Bill survives but now has all of Tim’s psychologicalattributes, dispositions and memories. If the priorityof psychological characteristics holds true then itseems plausible to claim that Tim has survived, albeitin Bill’s body, rather than this being Bill with a different brain, because out of the two possibilities4

the evidence for continuity weighs in favour of Tim’s rather than Bill’s survival. By way of contrast,say the transplant was by computer technology rather than by scalpel and scissors, but a freak electrical fault damaged the equipment during theprocedure so that it was impossible to tell how much, if any of the transplant had occurred. Tim andBill both survive in a ‘locked-in’ state, unable to com-municate. Under these circumstances, for reasons ofphysical continuity, it would seem more plausible,even considering the uncertainty, to assume that Tim remained Tim and Bill remained Bill. Considerthe case of Don, a man whose terminal disease hasaltered both his physical appearance and psychologi-cal characteristics beyond recognition. Whilst theremay be no evidence to suggest that Don is capable ofa first person view, equally there is no evidence thathe is not.5 Don is not dead whilst there is a vital body

in evidence,6 although a Parfitian may argue thatwhoever is alive it is not Don or else what is alive isDon’s body but that Don is not alive in any mean-ingful way. However if we reject the bias towards thepsychological criterion then surely Don the patient isthe strongest, in fact the only, candidate survivor ofthe healthy Don?7

Resolving Don’s identity does nothing to resolvemany of the other difficulties this example raises.The concept of closest survivor seems to weaken thelink between past and future ‘selves’, weakening, asGlover suggests, the binding commitments made inpromises, and perhaps other moral obligations. InParfit’s account of similar situations he argues:

. . . a person can gradually cease to exist some time before

his heart stops beating. This will be so if the distinctive

features of a person’s mental life gradually disappear. This

often happens. We can plausibly claim that, if the person

has ceased to exist, we have no moral reason to help his

heart to go on beating, or to refrain from preventing this.

This claim distinguishes the person from the human being.

If we know that a human being is in a coma that is incur-

able – that this human being will never regain conscious-

ness – we shall believe that the person shall cease to exist.

Since there is a living human body, the human being exists.

But, at this end of lives, we should claim that only the killing

of persons is wrong. (Parfit, 1991, p. 323)

Parfit’s view seems to imply an incautious biastowards the psychological criterion for personal iden-tity, in particular in the form of evidence of a firstperson perspective. However my alternative suggeststhat where we are forced to be agnostic as regards

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4 Actually three possibilities as it could be argued this is a new

person!5 It might be that Don is capable of ‘I’ thoughts but not ‘Don’

thoughts, indeed there is evidence from survivors of brain injury

with respect to the survival of consciousness whilst seemingly

deeply unconscious cf. Jean-Dominique Bauby’s (1997) The

Diving Bell and the Butterfly.

6 The pronouncement of death is a legal task rather than a

medical or philosophical one, although both medicine and phi-

losophy has attempted to contribute to clarifying the concept

in the face of the increasing complexity arising from advances

in medical technology. See Veatch, 1989; Lamb, 1985, 1994; see

also Evans, 1994.7 David Wiggins’s ‘animal attribute’ theory argues that personal

identity is a case of animal identity and this rules out nonanimal

persons but does not exclude brain-damaged persons who have

lost the psychological capacities, e.g. the Lockean account. See

Wiggins, 1980, chapter 6.

172 Simon Woods

psychological survivorship, physical continuity pro-vides a basis for continued personal identity. As Donthe patient is the best, indeed the only, candidate survivor, it must be concluded that the patient Donshares identity with, is the same person as, the earlierhealthy Don. Against Parfit’s argument, that this is acase of human rather than personal identity, it is plau-sible, and perhaps morally preferable, to assume thatDon is the same person until he is dead. This wouldrequire us to accept the uncomfortable fact that weare sometimes justified in withdrawing aid from oreven directly killing a person.

References

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