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Persons, Humanity, and the Definition of Death

John P. Lizza

Publication Year: 2006

In this riveting and timely work, John P. Lizza presents the first comprehensive analysis of personhood and humanity in the context of defining death. Rejecting the common assumption that human or personal death is simply a biological phenomenon for biologists or physicians to define, Lizza argues that the definition of death is also a matter for metaphysical reflection, moral choice, and cultural acceptance. Lizza maintains that defining death remains problematic because basic ontological, ethical, and cultural issues have never been adequately addressed. Advances in life-sustaining technology and organ transplantation have led to revision of the legal definition of death. It is generally accepted that death occurs when all functions of the brain have ceased. However, legal and clinical cases involving postmortem pregnancy, individuals in permanent vegetative state, those with anencephaly, and those with severe dementia challenge the neurological criteria. Is "brain death" really death? Should the neurological criteria be expanded to include individuals in permanent vegetative state, with anencephaly, and those with severe dementia? What metaphysical, ethical, and cultural considerations are relevant to answering such questions? Although Lizza accepts a pluralistic approach to the legal definition of death, he proposes a nonreductive, substantive view in which persons are understood as "constituted by" human organisms. This view, he argues, provides the best account of human nature as biological, moral, and cultural and supports a consciousness-related formulation of death. Through an analysis of legal and clinical cases and a discussion of alternative concepts of personhood, Lizza casts greater light on the underlying themes of a complex debate.

Published by: The Johns Hopkins University Press

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Preface

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pp. ix-xii

This work challenges the “biological paradigm” of death that has provided the theoretical grounding for acceptance of “brain death” as death. Whereas the paradigm 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 particular definition and criteria for ...

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Introduction: The Biological Paradigm of Death

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pp. 1-6

Advances in medical technology have posed many ethical and social problems, but perhaps none more fundamental and challenging than the problem of defining death. The development of life-sustaining technology and organ transplantation has resulted in revision, worldwide, of the legal definitions of death. In addition to the traditional criteria for determining death...

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1. Establishment of the Biological Paradigm

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pp. 7-16

Before presenting my arguments for challenging the biological paradigm, I shall examine whether and to what extent the assumptions in the paradigm were made in the early work on defining death, when neurological criteria for death were first introduced. While it might be claimed that these assumptions were accepted long before the modern discussion of the definition ...

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2. Defining Death: Beyond Biology

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pp. 17-33

Proponents of a consciousness-related or “higher-brain” formulation of deathhold that the capacity for consciousness is essential to the life of a human being or person and that death occurs when a human being or person loses this capacity (Engelhardt 1975; Veatch 1975, 1988; Green and Wikler 1980; Gervais 1986; Lizza1993b; McMahan 1995, 2002). Advocates of this view understand consciousness and...

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3. Concepts of Person

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pp. 34-50

Gilbert Meilaender claims that two competing “visions” of a person—and of the relation of person to body—have been “at war with each other since the three decades or so that bioethics has been a burgeoning movement” (Meilaender 1993, 29). The first view divorces the person from our biological nature or the history of our ...

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4. Persons as Substances

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pp. 51-62

The current whole-brain neurological criterion for death specifies the cessation of all functions of the brain, including those of the brain stem. This criterion has come under attack from two sides: (1) by those who reject any brain-based criteria for death and argue for a return to the traditional circulatory and respiratory criteria and (2) by proponents of a consciousness-related formulation....

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5. The Constitutive View of Persons

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pp. 63-93

In an earlier work (Lizza 1991), I argued that the relation between the person and the human organism should be understood as one of constitution.¹ Following Tyler Burge’s discussion (1975) of how the notion of constitution captures the relation between ordinary objects, such as balls and tables, and the kind of stuff they are made of, such as gold or wood, I suggested ...

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6. Persons as Human Organisms

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pp. 94-110

Critics of a consciousness-related formulation of death who employ the “species meaning” of person, such as Capron, Olson, and Feldman, can (unlike Bernat, Culver, and Gert) consistently maintain that the person continues to exist in cases of permanent vegetative state (PermVS). Since these theorists identify the person with the human organism, they claim that, when we point to the ...

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7. Persons as Qualities or Phases of Human Organisms

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pp. 112-150

The constitutive interpretation of the relation between the person and the human being explains how there can be a divergence in the life histories of persons and human beings and how, at the same time, a person can be a substance without generating a case of relative identity. It may be claimed, however, that we should abandon the notion that persons are substances in favor of treating them as phases or functional specifications ...

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8. Public Policy and the Definition of Death

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pp. 152-180

In 1999, Stuart J. Youngner, Robert M. Arnold, and Renie Schapiro published a collection of essays entitled The Definition of Death: Contemporary Controversies. What is perhaps most interesting about the collection is that so many of the essays reject so many of the assumptions in the current biological paradigm of death. For example, Robert Burt ...

Notes

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pp. 181-192

References

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pp. 193-205

Index

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pp. 207-212


E-ISBN-13: 9780801888991
E-ISBN-10: 0801888999
Print-ISBN-13: 9780801882500
Print-ISBN-10: 0801882508

Page Count: 272
Publication Year: 2006