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Personal Identity and Fractured Selves

Perspectives from Philosophy, Ethics, and Neuroscience

edited by Debra J. H. Mathews, Ph.D., M.A., Hilary Bok, Ph.D., and Peter V. Rabins, M.D., M.P.H.

Publication Year: 2009

This book brings together some of the best minds in neurology and philosophy to discuss the concept of personal identity and the moral dimensions of treating brain disease and injury. The contributors engage a crucial question: When an individual’s personality changes radically because of disease or injury, should this changed individual be treated as the same person? Rapid advances in brain science are expanding knowledge of human memory, emotion, and cognition and pointing the way toward new approaches for the prevention and treatment of devastating illnesses and disabilities. Through case studies of Alzheimer disease, frontotemporal dementia, deep brain stimulation, and steroid psychosis, the contributors highlight relevant ethical and social concerns that clinicians, researchers, and ethicists are likely to encounter. Personal Identity and Fractured Selves represents the first formal collaboration between the Brain Sciences Institute and the Berman Institute of Bioethics, both at the Johns Hopkins University. The book asks neuroscientists and philosophers to address important questions on the topic of personal identity in an effort to engage both fields in fruitful conversation. Contributors: Samuel Barondes, M.D., University of California, San Francisco; David M. Blass, M.D., Johns Hopkins University School of Medicine; Patrick Duggan, A.B., Johns Hopkins Berman Institute of Bioethics; Ruth R. Faden, Ph.D., M.P.H., Johns Hopkins Berman Institute of Bioethics; Michael S. Gazzaniga, Ph.D., University of California, Santa Barbara; Guy M. McKhann, M.D., Johns Hopkins University School of Medicine; John Perry, Ph.D., Stanford University; Carol Rovane, Ph.D., Columbia University; Alan Regenberg, M.Be., Johns Hopkins Berman Institute of Bioethics; Marya Schechtman, Ph.D., University of Illinois at Chicago; Maura Tumulty, Ph.D., Colgate University

Published by: The Johns Hopkins University Press

Contents

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pp. v-vi

List of Contributors

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pp. vii-viii

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Preface

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pp. ix-x

What makes me me, and not you? Am I still me, or the same me, no matter how many changes occur in my internal and external life? These arequestions that philosophers consider and have constructed theories of personal identity to resolve. These are also questions that clinical specialists inneurology, psychiatry, psychology, and neurosurgery regularly confront in thecare of patients with a variety of brain disorders and injuries and that...

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Introduction: A “Two Cultures” Phrasebook

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pp. 1-12

This volume is the product of a symposium convened by the Johns Hopkins Berman Institute of Bioethics Program in Ethics and Brain Sciences. The project brought together prominent philosophers and neuroscientists to address the following question: When an individual’s personality changes radically, as a consequence of either disease or intervention, should this change dindividual still be treated as the same person? Over the course of the...

PART I: FOUNDATIONS

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1 How Philosophers Think about Persons, Personal Identity, and the Self

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pp. 15-37

Most people develop a sense of self early in their lives and think of themselves as persistent. Whatever dramatic personal changes they may undergo over the course of their lives, they have a sense of living exactly one life from the inside.1 There are several philosophical questions to be asked aboutthis sense of self.2 One important question is whether anyone has a self corresponding to his or her sense of self. That is, we might want to make explicit...

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2 Toward a Neurobiology of Personal Identity

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pp. 38-49

Because mental experiences derive from the brain, it has long seemed likely that neuroscientists could make progress in understanding the neural basis of specific mental experiences. In this chapter, we review three approaches to advancing our knowledge of how and which brain structures and functions might contribute to the experience of individual or personalidentity. One approach, neuropsychiatry, is clinical and is derived from...

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3 Case Studies

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pp. 50-62

Peter Jones is a 75-year-old man with the diagnosis of Alzheimer disease(AD). There is no history of dementia in Mr. Jones’s family. He has no history of substance abuse. Before the onset of his illness, Mr. Jones had no history of psychiatric symptoms or treatment. He was a healthy child and a good student. He earned an M.B.A. from Harvard and went on to work for a Fortune 500 company, rising steadily through the ranks. He was never fired from...

PART II: PHILOSOPHERS HOLD FORTH

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4 Getting Our Stories Straight: Self-narrative and Personal Identity

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pp. 65-92

In everyday life we have relatively little trouble reidentifying people. Most questions of personal identity that we encounter can be settled by establishing relevant facts about human bodies. I may be uncertain that the personI am picking out of the police lineup is really the same person I witnessed running from the crime scene, but spying a distinctive tattoo may help settle the question for me. If I fear that the person claiming to be my long-lost brother...

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5 Personal Identity and Choice

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pp. 93-128

It was John Locke who formulated the problem of personal identity as it is understood by contemporary philosophers (Locke 1975). He asked whether personal identity is the same as human identity, and he answered no, on the basis of the following interrelated considerations. First, he offered a definition of the person as “a thinking, intelligent being that has reason and reflection and can think itself as itself in different times and places” (335). He went on...

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6 Diminished and Fractured Selves

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pp. 129-162

A large part of our daily life is based on knowing what to expect from human beings, and we are amazingly good at it, given how complicated humans are. After all, my brain and your brain are about as complicated as anything the world has to offer, and they control large systems, hundreds of pounds in my case, that to a casual observer might appear completely unpredictable. Consider all of the people attending this symposium. If we traced our...

PART III: NEUROSCIENTISTS PUSH BACK

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7 After Locke: Darwin, Freud, and Psychiatric Assessment

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pp. 165-173

The conveners of the symposium organized it around a single question: When an individual’s personality changes radically, as a consequence of either disease or intervention, should this individual still be treated as the same person? Along with this question came the four case studies that illustrate dramatic changes in personality due to major changes in brain structure...

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8 The Fictional Self

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pp. 174-185

What makes us human? This question has been debated for centuries—what is it that differentiates us from the rest of the animal kingdom? The philosophers have talked about “persons” as narrators of the self, as rational agents, and as social beings who can form theories about themselves...

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Conclusion: Common Threads

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pp. 187-193

This book and the symposium that initiated it were based on two premises: (1) that bringing together experts from two different fields—philosophy and neuroscience—whose work addresses the construct of personal identity would advance our understanding of the topic and be of value to individualsin both fields; and (2) that using examples of clinical cases in which individuals underwent a change in personal identity could ground the discussions...

References

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pp. 195-198

Index

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pp. 199-203


E-ISBN-13: 9780801895289
E-ISBN-10: 0801895286
Print-ISBN-13: 9780801893384
Print-ISBN-10: 0801893380

Page Count: 216
Publication Year: 2009