Persons, Humanity, and the Definition of Death

227 Pages·2005·2.45 MB·English

by  John P. Lizza

Persons, Humanity,
and the Definition of Death
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Persons, Humanity,
and the Definition of Death
j o h n p. l i z z a
Professor
Department of Philosophy
Kutztown University of Pennsylvania
Kutztown, Pennsylvania
The Johns Hopkins University Press
Baltimore
© 2006 The Johns Hopkins University Press
All rights reserved. Published 2006
Printed in the United States of America on acid-free paper
2 4 6 8 9 7 5 3 1
The Johns Hopkins University Press
2715 North Charles Street
Baltimore, Maryland 21218-4363
www.press.jhu.edu
Library of Congress Cataloging-in-Publication Data
Lizza, John P., 1957–
Persons, humanity, and the definition of death / John P. Lizza.
p. ; cm.
Includes bibliographical references and index.
ISBN 0-8018-8250-8 (hardcover : alk. paper)
1. Death—Proof and certification. 2. Brain death. 3. Humanity. 4. Persons.
5. Medical jurisprudence.
[DNLM: 1. Death. 2. Brain Death. 3. Jurisprudence.
4. Personhood. 5. Public Policy. W 820 L789p 2006] I. Title.
RA1063.L59 2006
614⬘.1—dc22
2005013360
A catalog record for this book is available from the British Library.
For Kristiina, Kiira, Sofia, and Elena
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Contents
Preface ix
Introduction: The Biological Paradigm of Death 1
1 Establishment of the Biological Paradigm 7
2 Defining Death: Beyond Biology 17
3 Concepts of Person 34
4 Persons as Substances 51
5 The Constitutive View of Persons 63
6 Persons as Human Organisms 94
7 Persons as Qualities or Phases of Human Organisms 111
8 Public Policy and the Definition of Death 151
Notes 181
References 193
Index 207
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Preface
This work challenges the “biological paradigm” of death that has provided the
theoretical grounding for acceptance of “brain death” as death. Whereas the para-
digm treats human or personal death as a strictly biological matter, I hope to show
that human or personal death is no less a metaphysical, ethical, and cultural matter
than a biological one and that such considerations are necessary to justify any par-
ticular definition and criteria for death.
In chapter 1, I examine how the biological paradigm of death came to be estab-
lished. Some of the initial work on whether to expand the criteria for determining
death to include neurological criteria did not endorse the paradigm. Instead, there
was recognition that defining death and choosing criteria for its determination were
not strictly biological matters. Certain beliefs in the paradigm of death were needed,
however, to justify acceptance of the “whole-brain” neurological criterion for deter-
mining death as opposed to retaining only the traditional circulatory and respiratory
criteria or moving to a higher-brain or consciousness-related criterion for death.
Three different biological definitions of death have been proposed by theorists
who work within the paradigm: Bernat, Culver, and Gert (1981); Becker (1975); and
Rosenberg (1983). In chapter 2, I show how these proposals fail because they need
to be supplemented by a more ontologically and ethically informed view of the na-
ture of what dies (i.e., the human being or person).
In chapter 3, I discuss how alternative concepts of personhood affect the defini-
tion of death. Simplifying the account somewhat, I distinguish three concepts of per-
sonhood: (1) a species concept that strictly identifies the person with the human or-
1
ganism or body; (2) a qualitative or functionalist concept that identifies the person
2
with certain abilities and qualities of awareness; and (3) a substantive concept that
treats the person not as some qualitative or functional specification of some more ba-
sic kind of thing (e.g., a human organism) but as a primitive substance that has psy-
3
chological and corporeal characteristics. Relying on these distinctions, I show how
parties in the debate over the definition of death have used different concepts of per