In Defense of the Loss of Bodily Integrity as a Criterion for Death: A Response to the Radical Capacity Argument

The Thomist 73 (2009): 647-59 IN DEFENSE OF THE LOSS OF BODILY INTEGRITY AS A CRITERION FOR DEATH: A RESPONSE TO THE RADICAL CAPACITY ARGUMENT NICANOR PIER GIORGIO AUSTRIACO, 0.P. Providence College Providence, Rhode Island THE CONTEMPORARY DEBATE over the validity of the neurological criteria for death can be understood best as a disagreement over which of two distinct criteria for death--either the loss of bodily integrity or the loss of radical capacity-is compatible with an authentic anthropology that upholds the dignity of the human person.1 Traditionally, the presence or absence of bodily integration has been used to discern the presence or absence of human life. This is the criterion endorsed both by Pope John Paul II when he taught that the "death of the person is a single event, consisting in the total disintegration of that unitary and integrated whole that is the personal self"2 and by the President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research when it concluded that "death is that moment at which the body's physiological system ceases to constitute an integrated whole."3 Proponents have used this 1 For a more comprehensive account of my views on the validity of the neurological criteria, see my essay, "Is the Brain-Dead Patient Really Dead?" Studia Moralia 41 (2003): 277-308. 2 Pope John Paul II, "Address to the 18'h International Congress of the Transplantation Society, (August 29 2000)," National Catholic Bioethics Quarterly 1 (2001): 89-92, at 91. 3 President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research, Defining Death (Washington, D.C.: Government Printing Office, 1981), 33. 647 648 NICANOR AUSTRIACO, O.P. criterion to argue for the validity of the total-brain death definition for death: Since the brain is the integrating organ of the human body, loss of the brain inevitably leads to loss of bodily integrity and thus to death.4 In contrast, in recent times, the presence or absence of a radical capacity, more precisely the radical capacity for personhood, has been proposed as an alternative criterion for discerning the presence or absence of human life.5 Proponents have used this criterion to argue for the validity of the neocortical definition for death: Since the neocortex is the organ responsible for those distinctive higher-order functions-language, learning, memory, and complex thought-that constitute us as persons, loss of the neocortex leads both to loss of personhood and to death. In the new edition of his textbook, Catholic Bioethics and the Gift of Human Life, William May refers to a Thomistic argument-I will call it the radical capacity for sentience (RCS) argument-presented at a recent meeting6 that suggests that the presence or the absence of the radical capacity for sentience can be used to discern the presence or absence of human life.7 The RCS argument has been used to argue for the validity of the totalbrain death definition for death: Since the human brain is required for sentience, loss of the brain inevitably leads to loss of the radical capacity for sentience and thus to human death. Integral to this argument is the premise that animals are defined by their radical capacity for sentience: An animal is a sentient creature. Thus, according to this argument, loss of the whole brain, and therefore, the loss of the radical capacity for sentience, necessarily involves a substantial change that transforms a human being into something that is not even an animal. Convinced by the 4 This is the basic argument made by the President's Commission. Also see the analysis by James L. Bernat, "The Definition, Criterion, and Statute of Death," Semin. Neurol 4 (1984): 45-51. 5 As a representative example of this position, see Robert M. Veatch, "The Impending Collapse of the Whole-Brain Definition of Death," Hastings Center Report 23 (1993): 18-24. 6 Westchester Institute Scholars Forum on the Brain Dead Criteria, Washington, D.C., 1011 April 2008. 7 William E. May, Catholic Bioethics and the Gift of Human Life, 2d ed. (Huntington, Ind.: Our Sunday Visitor Press, 2008), 352-53. LOSS OF BODILY...