Shewmon: Constructing the death elephant: a synthetic paradigm shift for the definition, criteria and tests for death

D. Alan Shewmon, “Constructing the Death Elephant: A Synthetic Paradigm Shift for the Definition, Criteria and Tests for Death." 2010 Journal of Medicine and Philosophy 35: 356-29 pubmed. Shewmon's article relates to the May 14, 2021, RCCE Zoom workshop with Shewmon about this article.

BLOG COMMENTS (85)

Stephen Kershnar         April 21, 2021 at 9:39 AM

AGAINST THE PASSING-AWAY CRITERION: METAPHYSICS, MORALITY, AND EFFICIENCY

Dear Romanell Colleagues and Friends:

Alan Shewmon’s excellent article has given us a lot to think about.

I do not see the argument for the Passing-Away criterion. Here is my argument against it.

(1) If (in this context) a criterion is worth accepting, then either metaphysics, morality, or efficiency justifies it.

(2) It is false that metaphysics, morality, or efficiency justifies the Passing-Away criterion.

METAPHYSICS
Metaphysics does not justify it because, as Shewmon points out, it is not the metaphysical end of an organism.

MORALITY
Morality does not justify it because one of two things is true.

(a) An individual has rights only if he has an interest or autonomy.

Yet an individual who irreversibly loses consciousness, but still has circulation of oxygenated blood, has neither an interest nor autonomy. Thus, morality allows us to do things to the individual even before he has passed away.

The same is true for value.

On some theories, albeit ones I think we should reject, the following is true.

(b) An individual has rights only if he will have, has, or had an interest or autonomy.

This is true for an individual who has passed away but has not de-animated. Again, the same is true for value.

EFFICIENCY
Shewmon has not provided an efficiency argument for passing away. Perhaps he thinks it passes a cost-benefit analysis. If so, he needs to be more explicit in setting out the costs and benefits. Other than organ retrieval, I am not sure what down side would be if we were we to rely on a rough approximation of the de-animation criterion.

In any case, efficiency is just a type of moral consideration. So, this category needs to be folded into the morality-argument.

On an unrelated side note, the efficiency argument for organ sales is plausible. It is an interesting question as to whether an efficiency argument for the passing-away criterion should be considered separately from the consideration of organ sales.

Best,
Steve K

Neil Feit           April 22, 2021 at 4:17 PM

Steve, I agree with your conclusion here but I'm not sure about how you present the metaphysical point. (I'll post another metaphysical complaint in a separate comment.)

Shewmon defines passing away as "the permanent cessation of the organism as a whole" (p. 278). You complain that this is not the metaphysical end of an organism. While there is something odd about passing away being, in some way, reversible, it does seem that permanent cessation is the metaphysical end (simply ceasing to exist).

Neil Feit           April 24, 2021 at 1:05 PM

Then again, I might be wrong. He does define it that way, but elsewhere suggests that it is (only) the annihilation of the individual "as a member of society" (p. 278). Also, if an organism ceases to exist upon passing away, it can't cease to exist (again) at de-animation.

Stephen Kershnar         April 25, 2021 at 12:44 PM

WHAT DO WE GAIN WHEN THE STATE RECOGNIZES THE THE PASSING-AWAY CONDITION?

Neil:

Do you think there is anything of value to Shewmon's two-part distinction.

That is, do you think there is something to be gained by treating passing away as death rather than merely the point at which organs can be harvested, people can begin grieving, religious services can be performed, etc.

If this is mislabeling, I wonder if there is something to be gained by mislabeling.

Best,
Steve K

Neil Feit           April 26, 2021 at 9:48 AM

Steve, I'm really not sure. I think there's a biological concept of death, the word "death" expresses this concept, and it's not passing away. So, I guess I think it's a kind of mislabeling but I'm not sure if something might be gained by it.

David H            May 6, 2021 at 4:39 PM

Response to Steve on interests of the permanently unconscious and the benefits of the permanence

I don’t see why you deny that the permanently unconscious lack interests. You write of the individual who “loses consciousness…has neither an interest nor autonomy.” Their brains may not be destroyed, just their capacity to become consciousness blocked, so the physical realization of that interest could be intact, even though they are never going to become conscious again. So, they could have an interest say in their organs being taken or not being taken, their body be respected in certain ways or not. Those could be interests that were formed autonomously and so while they will never again exercise autonomous decision making capacity, they may have Dworkin-like critical interests that are autonomously formed. So, they retain autonomy in the sense of autonomously formed interests still existing. They no more lose interests when permanently unconscious than do the sleeping who we could, let’s conjecture, keep permanently asleep with drugs. If you are assuming that permanent unconsciousness means the physical basis for their interests is destroyed, then I would agree to you. That is why I am skeptical of some advanced directives where the brain is damaged and the neurological basis of some high falutin Dworkin-like critical interests are destroyed. Then are gone just as some of one’s interests in philosophical rewiring thought experiments. I think one’s interests don’t survive the destruction so we have neither posthumous interests nor certain dignity interests when brain damaged that may have motivated advanced directives. By the way, you actually cheat or make a mistake when you describe the person in your post as “an individual who irreversibly loses consciousness” as their condition is permanent not irreversible in the modal sense that it was possible to revive the permanently unconscious.

What are the benefits of the permanence distinction besides organ retrieval? If AS is right and death is really ambiguous, then one benefit is to not treat an equivocal term as if it was univocal. Second, it is not implausible that people by the bedside of dying loved ones should mourn when they perceive the vital signs (heartbeat, pulse, breath) cease, rather than wait until some unknowable and invisible point of deamination is reached. It seems quite natural for most people in most environs throughout most of history to respond to the perceivable point of vital sign cessation as the moment of death. Their condition is only irreversible if they are in a high-tech ICU environment. Well, maybe not, if permanence depends upon low tech CPR

David H            May 6, 2021 at 4:43 PM

Reply to Neil
I don't think AS would claim that permanent cessation of the organism as a whole" is simply "ceasing to exist" and as a "metaphysical end." I think passing away is a case of a death cognate that is not to be understood terminator style as the going out of existence for the passed away body is still present and identical to the body that didn't pass. It is not yet remains of a body. I take it you don't mean it just ceases to have civil existence.

Stephen Kershnar         April 21, 2021 at 9:39 AM

DO PLANTS HAVE SOULS?

Dear Romanell Colleagues and Friends:

I do not understand why we should think that plants have souls.

Alan Shewmon says the following.

“From the perspective of hylomorphic dualism, deanimation corresponds to (and literally means) the separation of the soul from the body (or more accurately expressed: cessation of the soul “informing” the matter of the body as its substantial form and vital principle). This applies … to animals and plant “souls” (which is another term for their substantial form.” See page 282 paragraph 3.

I could see an argument for this based on concerns about restricted composition, mereological essentialism, or fission/fusion cases. Because I do not think this is plausible without a minimalist ontology – see, for example, Peter van Inwagen’s ontology – I wonder what the argument is for this.

The van Inwagen’s minimalist ontology carries with it a significant price in that we lose ordinary objects and simples disappear if the world is gunky.

Also, I wonder if the form (soul) of a particular plant – for example, my Venus flytrap named “DeMeo” – is a haecceity. If it is not, then one wonders how it individuates plants.

In short, why think animals have souls?

Best,
Steve K

Stephen Kershnar         April 21, 2021 at 9:40 AM

EMBODIED MIND THEORY IS INTUITIONALLY SUPERIOR TO SHEWMON’S HYLOMORPHIC DUALISM

Dear Romanell Colleagues and Friends:

We should reject de-animation theory.

On Alan Shewmon’s theory, an individual ceases to exist when, and only when, he undergoes an irreversible cessation of anti-entropic exchange of substances with the environment. See page 281 paragraph 5.

The problem is that our intuitions show us that an individual exists when, and only when, he has an embodied mind. The anti-entropic exchange is not the individual-maker. At most, it is a cause of it.

For now, I set aside the issue of whether the embodies mind must be conscious or merely have the capacity to support consciousness.

The standard arguments for the embodied mind theory are strong. Here are the intuitions.

(1) Location
A person is located where his brain is.

Consider, for example, when we switch the brains of two people – Prince William and his brother Harry – intuitively a person is located where his brain is (this is where the 10 billion neurons are located).

Please leave aside the technical issue of whether the individual is located where his brain is or where his neural system is located as it can extend beyond the brain.

(2) Individuation 1
If there is one animal with two heads there are two people.

Consider, for example, a cartoonish version of the Hensel twins.

(3) Individuation 2
If there are two animals who share one head, there is one person.

Consider, for example, Cephalothoracopagus Janicep.

In addition, the standard too-many-minds problem applies to animalism just as much as it applies to body- and brain-theories of a person.

(4) Too Many Minds
If an animal is not a body (only the former is essentially alive), then there are either two minds or two distinct individuals share a mind.

One can escape this if he were to say that a person is a brain or body that is contingently alive, but then the individual is not an animalist and, thus, has to drop the notion that an individual ceases to exist when he dies.

Best,
Steve K

Stephen Kershnar         April 21, 2021 at 9:43 AM

ATTEMPTED INTUTION-UNDERMINERS

Dear Romanell Colleagues and Friends:

Consider how an animalist – perhaps the incomparable David Hershenov – might respond.

(A) Waking and Sleeping Steve
Imagine sleeping Steve and waking Steve. Imagine they are cut off from each other, neither waking Steve recalls your dreams and dreaming Steve does not recall your waking self. We can even imagine damage to the brain so the two parts of the brain cannot communicate and thus the sleeping and waking thoughts are stored separately, causally unconnected. I suspect that if waking Steve is told that sleeping Steve undergoes terrible nightmares and tosses and turns and screams, you will and should care about the nightmares of sleeping Steve undergoes even though you cannot recall them, nor do they take an indirect toll on your health. They are as cut off from each other as the two heads.

I find this unconvincing. I think that this is just two heads that have withdrawn into a single skull like a turtle. If the Hensel twins are two people, so are the Hensel twins when they withdraw turtle-like inside a single head.

(B) Baby Without a Thinker
Consider advanced fetuses or babies without psychological continuity and just different parts of the brain feeling pain or pleasure but no self-consciousness uniting them. That is a baby with a scattered mind, not two babies who will soon fuse out of existence when the different mental states become unified. So, when the baby gets to the point that it can think I was in pain and I will be without pain soon, that is not a new baby who replaced the two babies with mental states that were not causally integrated and psychologically connected.

Consider the following dilemma: Do the thoughts have a single thinker?
(a) If yes, then the example does not get off the ground.
(b) If no, then this is a case of fusion.

The description of the fusion as occurring within a baby or fetus might mislead us, but it is no different than two hemispheres with distinct flows of consciousness completely inaccessible to the other fusing. Consider, for example, what we would think if the two hemispheres were to go to war over how to treat the wife of the original person.

(C) Psychological Continuity Lost
If you undergo a stroke that reduces you to with infant like brain that just feels pain and pleasure, you will have prudential concern despite no psychological continuity. Now imagine instead the injury puts you in a temporary coma, but the plasticity of your brain enables you to come out of the coma with an infant like brain and feel pain and pleasure with parts of the brain you did not before. I suspect that you would have prudential concern for that thinking being even though the thought is with part of the brain that was never used for thought before. If you accept that, then you should care about the other brain if you are a dicephalus and you should care about your animal after it receives a new brain.

The part of the brain matters if the brain so long as all the parts have the capacity – not potentiality – to contribute to the overall consciousness of the individual. Breaks in continuity – perhaps via amnesia, coma, freezing, or temporary disassembly – do not destroy the embodied mind.

Interests are a function of some combination of pleasure, desire-fulfillment, or objective-list goods. Psychological continuity is relevant only in so far as it causally contributes to one of them.

Best,
Steve K

David H            May 4, 2021 at 6:04 PM

Reply to Steve K. who is Committed to “Death” equivocation:

If you think you are part of your organism, the brain or brain parts that directly produce thought, then you will probably be committed (like McMahan) to a pair of senses of death. Since organs are not alive in the sense of organisms, then their death won’t be the loss of biological life processes but your brain rather than think with your brain, then you probably will join McMahan in claiming that the brain size person’s death consists of them going out of existence with the loss of the capacity for thought

David H            May 4, 2021 at 6:05 PM

Reply to Steve K – Motivation for Persons are Brains view ends up eliminating Brains:

McMahan and Parfit (2012) want to avoid spatially coincident thinkers (person and animal) so they conceive of persons as brain-size or cerebrum-size parts or cerebrum and some brain stem parts size. But I believe they have to end up denying that there are brains or brain parts and instead eliminate them for a material thinker. The reason is that organisms replace their parts over time. So the brain is not made up of the atoms it was before, even if not all the brain cells die and are replaced. The biological approach to personal identity (animalism) determines parts by their being caught up in life processes so it is no big deal that the brain replaces its parts. The advocates of psychological accounts of personal identity claim the person survives part replacement if there is no functional loss with the new parts. So they allow that the person can be supported by inorganic parts as well as organic. It is hard for the non-animalist to distinguish why a person couldn’t acquire inorganic parts if they could acquire new organic parts. See the reasoning behind Chalmers/Clark extended mind where Otto’s damaged cerebellum is functionally replaced by his notebook. But if the person can survive the replacement of his brain with an inorganic parts than he is not his brain. But the non-identity of the person and his brain means they were spatially coincident. So, there would be two thinkers. Thus, the theorist who thinks we are brain-size must eliminate brains and just have an ontology of material thinkers.

David H            May 4, 2021 at 6:05 PM

Reply to Steve K. Intuition mongering and Big Picture Metaphysics

I have intuitions that it would be good for an embryo to grow a brain, or a newborn with a terminally cancerous cerebrum to receive a cerebrum transplant, or for a stroke victim with a ravished cerebrum to have such brain plasticity that they can come to use a part of the brain they hadn’t before to realize thought. One can’t say that would be in their interest and someone has a prudential interest in switching animal bodies via a brain transplant. That is, one can’t prudentially care about one’s animal and one’s distinct person. So one sort of interest will have to be explained away as not-prudential and not tracking identity. We can go back and forth with intuition eliciting scenarios. I suggest it is better to do big picture metaphysics as I suggested in the Sulmasy brain death blog last month. One should ask whether the dependent brain can be a substance, is there a causal compositional principle that the Xs compose a Y iff … that can give us brains as the Y, whether the brain-size view of persons can avoid spatially coincident thinkers without the sparsest ontology as there are anatomical objects smaller and larger than the minimal thinker you are advocating that can be reduced to the size of your small thinking person or the thinker reduced to them (after the loss of one cerebral hemisphere). I would also point out that your view’s treatment of the dicephalus commits you to there being a two headed animal. It would be a thinker with a divided mind. Why can’t it think? We typically ascribe many properties to organisms in virtue of their parts doing things – you are injured because your arm is, you are diseased because your heart is, you are digesting because your stomach is, you are touching the floor because your foot is etc.. If you are already committed to such a human animal with a divided mind, why not allow that the person too can have a divided mind? Finally, you believe human thinkers would fuse out of existence if the different minimally sentient parts of the brain in the fetus (say one producing pains, the other pleasures) later produced integrated thought in a self-conscious being who can think “I am feeling pleasure now, I was earlier in pain” So, you are probably committed to the brain size person fissioning out of existence if hemispheres are cut. But you are probably also committed to the brain size person becoming smaller and maimed when one hemisphere is destroyed rather than disconnected from the other. That will involve a violation of the only x and y rule as x can become one hemisphere in one scenario but not the other when there is no physical or causal difference between X and Y. I have an argument for why the organism doesn’t suffer the only x and y rule and that is there will be a time lag where say the two halves of the divided worm undergo substantial change as they reorganize themselves from parts into whole organisms. So there is no survival of the original organism if half is destroyed rather than severed. Think of a plant cutting that has to reform itself before it becomes a living plant on its own rather than a part of the plant. So plant part is identical to a plant cutting that is itself a plant and thus no violation of the only x and y rule. But the halves of a divided brain can immediately think and thus there would be no functioning-based reason to deny that the brain size person can become one of them in the absence of the other. But that runs afoul of the rationale behind the only x and y rule that there shouldn’t be unexplained existences

David H            May 4, 2021 at 6:06 PM

Reply to Steve – Difficulties in determining the Minimal Thinker - Is the minimal thinker consist of the scattered tips of neurons?

When you push on the idea that the person is just those parts of the organism directly involved in the production of thought, absurdities soon followed. The assumption is we are parts of our brain as the toes and bone marrow aren’t involved in the production of thought. But which parts of the brain? The neurons that fire and receive information. But why the entire neuron? Parts of the neuron aren’t firing but play a role in maintaining stability in the cell, or removing waste products, energizing the cell etc. If you include those functions in the production of thought, how are you going to exclude the circulatory and respiratory systems? I doubt (with Olson) that a line can be drawing between directly involved in the production of thought and what is not directly involved in the production of thought. See my discussion of an analogue in what in the chef’s kitchen and garden is directly involved in the production of the meal and what is indirectly involved in my paper “Thinking Brains or Thinking Organisms” Acta Analytica

David H             May 4, 2021 at 6:06 PM

Reply to Steve – Growing Brains and Size changing Thinkers?

Imagine that a very young child’s brain is growing, adding neurons or what have. Has the person grown? Imagine there is no shared causal connections, no self consciousness, just different qualia emerging from the growing brain. Is there many different thinkers. Is there a scattered thinker? What unites the different parts of the brain other than they are caught up in the same life processes?

Stephen Kershnar         May 5, 2021 at 9:15 AM

VAGUENESS AND GAPPINESS: PROBLEMS FOR ANIMALISM?
(RESPONSE TO COMMENT 1)

David:

Great point. Here is what you say.

“If you think you are part of your organism, the brain or brain parts that directly produce thought, then you will probably be committed (like McMahan) to a pair of senses of death. Since organs are not alive in the sense of organisms, then their death won’t be the loss of biological life processes but your brain rather than think with your brain, then you probably will join McMahan in claiming that the brain size person’s death consists of them going out of existence with the loss of the capacity for thought.”

A embodied mind theorist (crudely brain theorist) can hold one of two position.
(1a) A person is a particular brain with the capacity for thought.
(1b) A person is a particular brain that is thinking.

Note the parallel to animalism. It can hold one of two positions.
(2a) A person is a particular thing with the capacity for life.
(2b) A person is a particular thing that is alive.

You are right that on both theories, when an individual loses the relevant essential property, he ceases to exist. On (1a) and (2a), the two theories seem to parallel each other.

Life-like processes are a continuum and, hence, (2a) and (2b) are committed to vague cases when an individual neither exists nor does not exist somewhere in the range of degradation. It is unclear if (1a) and (1b) have the same problem if minimum consciousness suffices for thought. Perhaps, though, they face the same vagueness problem, although I suspect animalism is in worse shape.

If an individual stops thinking or metabolizing and then starts again, we have gappy beings for (1b) and (2b). The problem is that (2b) faces the problem of explaining why it is the same individual – if it relies on something like van Inwagen restricted composition – in way (2b) does not, at least if (1b) is not committed to such an ontology.

This is because the new life-organizer is not identical with the earlier one because it is a different process.

Best,
Steve K

Stephen Kershnar         May 5, 2021 at 9:42 AM

INORGANIC-PART REPLACEMENT (RESPONSE TO COMMENT 2)

David:

Another great point. Here is what you say.

“[Organisms replace their parts over time. So the brain is not made up of the atoms it was before, even if not all the brain cells die and are replaced. The biological approach to personal identity (animalism) determines parts by their being caught up in life processes so it is no big deal that the brain replaces its parts. The advocates of psychological accounts of personal identity claim the person survives part replacement if there is no functional loss with the new parts. So they allow that the person can be supported by inorganic parts as well as organic. It is hard for the non-animalist to distinguish why a person couldn’t acquire inorganic parts if they could acquire new organic parts. … But if the person can survive the replacement of his brain with an inorganic parts than he is not his brain.”

Here is the animalist position.
(1) Necessarily, a person is an animal.
(2) Necessarily, an animal is a living organism.
(3) Necessarily, a living organism consists of carbon compounds functioning in a relevant way.
For now, ignore a capacity version of (1).

The following is true.

(4) Inorganic parts – not carbon - are not compounds functioning in a relevant way.

Hence, the animalist must accept that if a person persists with enough replacement of organic by inorganic parts, he ceases to exist.

The brain theorist must address whether the brain is essentially composed of organic parts. I suspect it is, but this is far less clear than for the animalist.

Inorganic Parts Comparison: Tie

Best,
Steve K

Stephen Kershnar         May 5, 2021 at 9:43 AM

TOO MANY MINDS OBJECTION (RESPONSE TO COMMENT 2)

David:

Interesting point. You also argue the following.

“[T]he non-identity of the person and his brain means they were spatially coincident. So, there would be two thinkers. Thus, the theorist who thinks we are brain-size must eliminate brains and just have an ontology of material thinkers.”

(a) Sparse Ontology. If one wants a very sparse ontology where only simples and organisms exist, then the too-many-thinkers objection is superfluous. This cannot be your objection.

(b) Non-Sparse Ontology 1. If a brain exists and thinks, then either we have too many thinkers or the animal derivatively thinks (thus, conceding to the brain theorist that the brain is the thinker).

In addition, the corpse problem rears its wretched head.

(c) Non-Sparse Ontology 2. If a brain exists but does not think, then we have the odd view that thinking does not occur via the neuron-web, but via something else. This is implausible on scientific grounds.

Too Many Minds Outcome: Advantage Brain Theory

Best,
Steve K

David H            May 5, 2021 at 10:12 AM

Reply to Steve on Vagueness, Gappy Existence and Sparse Composition Part I

My point was that your view means there are two senses of death or you have to claim that persons don't die because they are not alive. So you can't be criticizing Shewmon for two senses of death when you suffer the same problem. I think it is best, as Sulmasy argued in the article we blogged about last week, if death is "univocal".

I think a consciousness view doesn't suffer from indeterminacy in that consciousness is all or nothing. (So it is a nice counterexample to Parfit's claim that reductionist theories (non soul thories and haeceeist approaches) will be committed to there being no fact of the matter in spectrum puzzle cases.) So that is one benefit of a view that identifies people with mere sentient/conscious capacities or manifestations. still, there might be problems that it is unclear whether the same organ exists to realize consciousness when there has been too many part replacements. So even non-dualistic consciousness theories have might have to deal with indeterminacies. So the brain view doesn't avoid indeterminacy.

Biological life is far more vague than the consciousness. So you may think there is an advantage to a brain-view understood as that which supports consciousness which is essential to us. Shewmon pointed out that no one has done a very good job with a list of functions and dysfunctions that lets us know whether a body is still integrated or to what degree. That is why it is so attractive to bypass the issue as he did with his two scenarios - the one where the living mimicked brain death (extreme Guillaine-Barre and high cervical cord transection, the other having to do with the dying being less stable than brain dead). Despite his qualms, and he has forgotten more biology than I have learned, I think there is a precise moment that one dies if that is understood to be the same as the moment one goes out of existence. So if the termination thesis is true, I think it is and argued for it in the Sulmasy blog, then the logical argument I gave against vague existence due to the impossibility of vague identity will mean there has to be a precise moment that we go out of existence though we won't know when it is. (That is just what epistemicists have always said about all instances of vagueness - vague parthood, vague identity, vague existence.) So I deny your claim that my approach is committed to there being a period or state in which existence is de re indeterminate. It can be logically proven that there isn't such a state. It can also be helped by the impossibility of imagining indeterminately possessing mental states. Imagine it is, in reality, indeterminate when you go out of existence. Now imagine someone undergoing part replacement in the state of vague existence so the result is a determinately existing person. It will be indeterminate whether the original person is identical to the post-replacement person. If interpreted as de re vague identity, that means the original person will sort of have, indeterminately have the pains of the replacement person. We can't make any sense out of sort of having someone else's thoughts. So if vague existence is committed to vague identity (see my paper "Vague Existence Entails Vague Identity" in an Akiba edited anthology on vagueness), then the view commits you to the incomprehensive sort of, partially, indeterminately having someone else's pain. So vague existence and vague identity are logically impossible and psychologically incomprehensible

David H            May 5, 2021 at 10:17 AM

Reply to Steve on Vagueness, Gappy Existence and Sparse Composition Part II

I argued in the Sulmasy blog that there wasn't gappy existence in the frozen and dehydrated cases due to the preseence of capacities in the design environment. The real problem is for those who think it is gappy for then they have to explain why the frozen go out of existence when thawed as the original organism comes back into existence. That is a real mystery why actualizing that potential is fatal. I don't see what this has to do with van Inwagen's sparse ontology. Van inwagen, incorrect in my view, thinks the frozen are still alive because of subatomic movements that constitute life

I also argued in the Sulmasy blog that the brain view is committed to an even sparser ontology than van Inwagen. This is because there are entities bigger than the thinking part of the brain that could be reduced in size to the thinking part of the brain (cerebrum and some part of the brainstem?) and the cerebrum-sized person, if not the cerebrum, could be reduced in size to either cerebral hemisphere and support thought. so that will mean spatially coincident thinkers. the brain view has just pushed around the metaphysical lump in the carpet. These can be avoided only by denying there are any composites larger than the cerebrum or smaller. If this is going to be principled (see Clint Dowland's Phil Studies paper "Embodied Mind Sparsism" or my Acta Analytica paper "Thinking Animals or Thinking Brains?" So the brain view avoids spatially coincident thinkers - its original motivation in McMahan and Parfit - by having a sparse ontology that is sparse than van Inwagen's. The brain view denies the existence of all composites but the part of the brain producing thought, so there are no organisms. The van Inwagen view has both organisms and persons. You need to tell me how you will avoid multiple thinkers without a sparse ontology. Once we move to big picture metaphysics (issues of composition, vagueness, respecting the only x and y rule, providing a causal answer to the special composition question, identifying persons with substances that are independent and unified etc.) away from intuitions about thought experiments - the brain view is a disaster.

David H            May 6, 2021 at 5:26 PM

I don’t understand your reply. You write:

(c) Non-Sparse Ontology 2. If a brain exists but does not think, then we have the odd view that thinking does not occur via the neuron-web, but via something else. This is implausible on scientific grounds

I don’t deny that we think in virtue of contribution of neurons. In fact, the sparse van-Inwagen/Olson animalist allows cells into their ontology. My point is that the brain view (embodied mind theory of you, McMahan, later Parfit, Tim Campbell, Clint Dowland, Hud Hudson and maybe Nagel at one time) has to explain how it survives the ordinary metabolic replacement of parts if it is not an organism. The standard move of psychological theories of personal identity (see Baker or Unger) is to appeal to new matter being functionally equivalent to the old. So it must appeal to the preservation of cognitive functions, not life processes as the brain (or cerebrum) is an organ and not a living organism. Then you have a hard time explaining why the brain couldn’t be replaced with inorganic parts that were functionally similar. That is why Chalmers and Clark defend the extended mind theory that includes Otto’s notebook as part of the extended mind and extended self as it is functionally equivalent to the cerebrum which has since become damaged and doesn't store the memories now stored in Otto's notebook So once you allow non-organic parts that are functionally equivalent, as it seems you must to explain the metabolic turnover of parts of the brain, then you have the person and the organic brain being distinct. Otto’s notebook is not part of the brain nor is the cyborg’s inorganic parts. The cyborg is a combination of the organic and cybernetic. So once you allow brains to be replaced by inorganic parts but insist we survive the process if thought is sustained, then you must admit that we are not brains But then it looks like there are two thinkers where we are prior to the replacement of the brain and its organic parts - the brain and the person. They are distinct as they have different persistence conditions. So you must eliminate brains if you don't want spatially coincident thinkers. You can do that without denying that neurons contribute to the material person’s thought.

You actually have to eliminate more than brains to avoid too many thinkers and identify yourself with the thinker who can survive replacement of the organic brain with an inorganic parts. You have to eliminate anything bigger than the thinker that can be reduced to the size of the thinker and anything the thinker can be reduced to. So you won’t have cerebral hemispheres for if you were the cerebrum and it could survive the destruction of one cerebral hemisphere, then it would become spatially coincident with what had been a part of it. This is the old paradox of increase or paradox of decrease (aka paradox of amputation). The only principled non-gerrymandered sparse ontology will be one with just simples and thinkers. The brain will not be the thinker but will be eliminated. Or you need to find a way to claim that brain-size persons can’t become inorganic but organism part/whole considerations are not available to you. Or you have to claim that brains can have organic or inorganic phases. So our brains aren’t essentially organic.

David H            May 6, 2021 at 5:43 PM

Response to Steve about different Parts of the brain subserving thought:

I try to embarrass the brain view in having to admit that a fetus with a disunified mind due to different parts of the brain producing qualia without self-consciousness person taking ownership of the disparate states is really two thinkers. These two thinkers will fuse out of existence when the different experiences realized by different parts of the brain eventually are experience by a unified mind. You write:

“The part of the brain matters if the brain so long as all the parts have the capacity to contribute to the overall consciousness of the individual.” But given what you said earlier about two hemispheres with different flows of consciousness inaccessible to each other suggests to me that you have to treat my hypothetical fetus as more than one thinker. I take it that you accept McMahan’s judgement of there being two persons in the following thought experiment – borrowed from one of his students - of alternating the anesthetizing of a person’s two hemispheres throughout their existence so they never are both conscious or causally interacting. If that is two persons, why aren’t there two thinking individuals in the fetus who doesn’t yet have causal interactions between its qualia that are physically realized in different parts of the brain? Heck, your brain and mine might become fused and linked up in a sci fi thought experiment but that doesn’t make us now one thinker. So what right do you have to help yourself to the potential of different parts of the brain. Or to put it differently, what unites the different brain parts into one thinker when there is no causal interaction between its parts as in the hypothesized extreme split brain. My answer to what makes all the thoughts of the same individua is that there is one life event linking them and thus one living being thinking them. You are cheating by just helping yourself to the different brain parts as being part of the same brain. It won't work in the alternating anesthetizing split brain type of cases, so why does it work with the developing non-self conscious but sentient fetus

Neil Feit           April 22, 2021 at 4:46 PM

PHYSICAL DUPLICATES IN DIFFERENT VITAL STATES?

Shewmon realizes something metaphysically odd about his concept of passing away: "during the first few minutes or perhaps tens of minutes following the onset of asystole, two bodies could be in identical physical states, but one would have passed away and the other not, based on a *future* contingency" (pp. 279-280). That is, the cessation might be permanent in one case, so that this body passes away at the point of combined asystole and unconsciousness, but temporary in the other case (due to resuscitation after asystole and unconsciousness), so that this body has *not* passed away at this point.

This is implausible for anything that is supposed to be a DEATH concept or category. Two individuals who are physical, molecule-for-molecule, duplicates should have the same "life/death status" to use Shewmon's phrase. That is, they are either both alive, both dead (on any adequate way of understanding death), or both neither alive nor dead. (The last might be the case in certain kinds of suspended animation.) In a nutshell, if we call the two bodies above Body1 and Body2, and use "vital states" for Shewmon's "life/death status," the argument might look like this:

1. If passing-away is a genuine death-concept, then Body1 and Body2 are in different vital states [one having passed away but not the other].
2. Body1 and Body2 are not in different vital states.
So, 3. Passing-away is not a genuine death-concept.

Shewmon rejects 2 and thinks the implication in 1 is a virtue and not a defect, "insofar as it allows incorporation of disparate insights that seemed incompatible under the traditional notion of death" (p. 280). I guess I'm unclear on exactly which insights are at issue here and how they have been incorporated, but this does not strike me as a virtue.

Phil Reed          April 24, 2021 at 7:34 AM

Right. What are the disparate insight? Perhaps that we have two relevant concepts at the end of life, permanence and irreversibility. But these are concepts that trouble philosophers, not traditional ways of thinking about death. Thus, it would make more sense here to say that Shewmon is giving up the traditional way of thinking about death than to try to hold on to it and call his peculiarity a virtue.

Phil Reed          April 24, 2021 at 7:37 AM

Shewmon's view here reminds me of Elizabeth Harman's view that the moral status of the fetus depends on whether or not it ends up dying by abortion.

Neil Feit           April 24, 2021 at 12:53 PM

That's a good analogy -- the two views are very similar and so problematic in the same way.

 

David H            May 4, 2021 at 6:07 PM

Reply to Steve, Phil and Neil - Duplicates in Different States:

I am sympathetic to your view there shouldn’t be duplicates, one dead, one not. But won’t Shewmon agree that is just right for deamination and he is talking about another concept, one disambiguated from death as deamination? This alternative concept is much more tied to our attitudes and practices – when it is appropriate to grieve etc. As a general rule, two things can be physically indistinguishable and different kinds of things, or one healthy and the other not, or one existing and the other just remains. Think of two artifacts where intention plays a role in what kind of thing they are. One could be a damaged X while its duplicate is a non-damaged Y because of their different histories. Or the remains of X could be present rather than X, but there is no physical difference between the remains of X and the existence of artifact Y. Or to take biological examples, a blind mole millennia ago when moles lived about ground would be dysfunctional, and pathological, while a modern blind mole would not as its eyes are vestigial. One might even think the frozen creature is alive or neither alive nor dead (my view) because of its disposition to be thawed out and life processes restarted. But imagine the world is about to end in a Big crunch, there is no time for thawing out. Would you still say the organisms is alive or neither alive nor dead when it is physically impossible for it to be revived. Perhaps you will say it is because the relevant environment is the one it evolved to be in, not the big crunch one.

Neil Feit           May 6, 2021 at 4:47 PM

Reply to David H

I agree that there are cases where different kinds of things are physically indistinguishable, but I don't see how there could be a life/death difference. For the frozen creature (let's say sci-fi suspended animation) I share your view that it's neither dead nor alive. And I'd say this is the case even with the Big Crunch coming so that it's physically impossible to be revived. The impossibility would have to be due to internal changes in the creature, I think, for death to occur. Suppose someone goes into suspended animation so that there's a cessation of consciousness and circulation -- and, suppose that as a matter of fact, this turns out to be permanent because ten years later there is a problem in thawing him out. The Shewmon view is that he passed away ten years ago, but surely that wasn't the appropriate time to grieve, etc.

David H            May 6, 2021 at 6:24 PM

Reply to Neil Part I

I take it that AS believes we can be mistaken when it is appropriate to grieve - rogue vets that revive Soran and suspended animation that turns out to be permanent. If we knew more we shouldn't grieve when there is a rogue vet who will revive or a rogue family member that demands the original vet intervene and revive Soran and so we should grieve when it suspended animation is final. Incidentally, your suspended animation case probably needs to be tweaked and something else to introduce permanence like the machinery breaking down or being turned off. Being suspended is not going to get you to deamination without an intervention so that intervention produces permanence, just as AS says permanence comes in when a doctor takes away the non-heart beating patient's heart that prevents auto-resuscitation or the nurse is negligent and doesn't revive the patient under her care. (I actually don't like the nurse story as I think omissions aren't causal so I won't say she caused the permanence even if she is blameworthy for the death.) Anyway, so I think permanence begins later as the suspended aren't permanently so and don't on their own degenerate to deamination no one does anything to the non-breathing and non-heart beating as in the Soran like cases that AS has in mind. Maybe the later mourning then is more appropriate when the machine breaks down or is turned off and your case doesn't show mourning and permanence coming apart as it is the later suspended animation destroying intervention that makes the cessation of life processes permanent and is the appropriate time to mourn

I am not sure one should say someone has a disposition when it is physically impossible to actualize it. So if the suspended are alive in virtue of their disposition to realize life processes again, they don't have that disposition at the time of the big crunch. (Perhaps the relevant disposition is the environment they were in when they came into existence or their kind's design environment.) If you would agree that they lack the disposition and are dead then, then there is even a sense of physically impossible to revive someone when they are too far away from high tech hospitals. So while they could be revived in the hospital, it is physically impossible for them to be revived where they are given it is physically impossible to get to them at that time. I suppose this is sort of a Lizza-like point.

Anyway, what is decisive is whether there are two concepts in play, and we have been equivocating all along; if so, then it is fair not to extend the moral and emotional attitudes of deamination to passing away. You are treating AS as if he was wrong about death when he would say that he would only be wrong if he was saying Soran had undergone death1 (loss of anti-entropic abilities) but he is not wrong to say that Soran has undergone death 2 (passing away). I take it that your assumption if not your explicit point is that your point is that we don't have two concepts but two conceptions of one concept. I agree. So what I have said should be treated as conditional on there being two death concepts expressed by the same word. And I doubt it but I don't enough linguistics or philosophy of language to say when there is a disputed concept - two conceptions of the same concept vs. two conceptions of two different concepts.

David H            May 6, 2021 at 6:26 PM

Reply to Neil Part II

I think an interesting analogue to the AS-inspired meaning of death debate is transgender debates. I take it we shouldn't and couldn't solve the debate about transgender women by saying there are two concepts of women or even a cluster concept which seems to be a polite way of equivocating if the sufficient conditions need not overlap. That is a woman is someone with any two of the following four conditions. Rather, someone is wrong. about what a woman is. I think the same is true for death, one conception is wrong. but maybe I don't know enough about linguistics and the philosophy of language or socio-linguistics or whatever is the relevant body of knowledge. I suspect there is no linguistic solution on the meaning of death or the meaning of women. Neither side will be happy to claim there are two concepts and we have been talking past each other. So no paradigm shift via linguistics will resolve the conflict.

Phil Reed          April 24, 2021 at 7:38 AM

The Mirror-Image Analogy

I’m concerned about the mirror image analogy. For one thing, it does not seem easily compatible with a pro-life view. Shewmon says that conception is the beginning of an organism “in itself” whereas birth is the beginning of an organism in relation to the rest of the world. I would have thought that the standard pro-life view believes that the developing fetus is in a relationship with its mother and possibly others as well. The fetus can listen to Bach and recognize its father’s voice. We can perform fetal surgery on it. We grieve when it dies. It seems to be in a meaningful relationship with the rest of the world.

Shewmon might say: look, it’s just an analogy. But part of the argument here is to convince us we need a paradigm shift at the end of life. Shewmon tries to persuade us by saying that we already have two phenomena at the beginning of life. Since I’m pro-life, I don’t think birth is ethically and legally meaningful--I deny there are these two phenomena at the beginning. Thus, it’s harder for me to want to go along with the paradigm shift at the end of life.

In footnote 11, Shewmon says that birth as civil beginning does not preclude legal protections for the unborn. But he doesn’t explain why. Perhaps having two beginnings of life does not logically exclude legal protections for the unborn, but it does seem to make them less likely.

To put the worry more generally, I’m worried that despite Shewmon’s protests to the contrary, the period between the ontological and the civil will make it more difficult to protect a person’s dignity.

If we trade the dead donor rule for the deceased donor rule, and this paradigm shift really occurred culturally, then we can kiss goodbye all of the ethical fine points about spontaneous autoresuscitation that occur after a person is deceased.

Stephen Kershnar         April 25, 2021 at 1:17 PM

BAD NEWS FOR THE FETUS: IT IS NOT IN A MEANINGFUL RELATIONSHIP WITH THE WORLD

Phil:

Great points.

However, you say this about the fetus, “It seems to be in a meaningful relationship with the rest of the world.”

(A) Objective-List Goods. The fetus has none of the standard objective-list goods (for example, autonomy, knowledge, or virtue) other than family, and it has family merely in a recipient sense. If your view were correct, a newly created conceptus could be in a meaningful relationship and, intuitively, it cannot.

(B) Meaningful Life. The fetus also has none of the meaningful-life features. Here is John Martin Fischer’s theory of a meaningful (significant) life: A person has a meaningful life to the degree that the following are true.
a. He has free will.
b. He has contact with reality.
c. He loves what is worthy of love.
The fetus does not satisfy any of these. The third condition is not trivially satisfied by taking pleasure in food, quiet, etc.

(C) Bilateral Love or Friendship. The fetus is not in a bilateral love or friendship relationship with another.

Here then is an argument that the fetus is not in a meaningful relationship with the rest of the world.

(1) If an individual is not in an objective-list good, meaningful life, or is in a bilateral love or friendship with another, then he is not in a meaningful relationship with the world.

(2) The fetus is not in an objective-list good, meaningful life, or is in a bilateral love or friendship with another.

(3) Hence, the fetus in a meaningful relationship with the world. [(P1), (P2)]

Unless you say that someone in a coma is in a meaningful relationship with the world, which I do not think you would say, I have to disagree with your point.

Best,
Steve K

Stephen Kershnar         April 25, 2021 at 1:21 PM

RIGHTS WITHOUT INTEREST OR AUTONOMY? DUTIES WITHOUT CLAIMS? WHAT SAY YOU?

Phil:

Interesting point. Still, the civil condition need not track the fetus’ ontological status.

For example, we might decide due to the absence of rights or efficiency that a human being who has permanently lost the capacity for consciousness (for example, Terri Schiavo’s cerebrum has liquified) may be used to donate organs, sacrificed to save the fetus inside of her, or removed from prohibitively expensive machines.

This is consistent with Terri Schiavo still being present as an animal or hylomorphic being. I wonder, then, whether your defense of DDR in the case of the permanent loss of consciousness is due to slippery slope considerations or whether you have another defense of it.

Like you, I find calling the loss of the civil condition to be misleading. Still, I wonder what your objection is against redistributing a permanently unconscious (P-UCS) but breathing human being’s organs. Here is my argument to the contrary.

(1) If an individual has a right, then he has an interest, autonomy or the capacity for these (not potentiality).
(2) A P-UCS individual does not have these features.
(3) Hence, a P-UCS being does not have a moral right. [(P1), (P2)]

Perhaps you think the following is true.

(A) A P-UCS being does not have a right, but people still owe her a duty.

I wonder how one person can owe the second a duty without the second having a claim (read: moral right) against the first. This is false.

Perhaps, instead, you think the following.

(B) People do not owe the P-UCS a duty, but we should benefit from a free-floating duty (not owed to anyone) or an imperfect duty. Note they might be the same.

This will not work, though, because a person could satisfy the duty by giving to another charity rather than benefitting P-UCS, perhaps the individual who least merit aid aside from evildoers.

Best,
Steve K

Phil Reed          April 26, 2021 at 4:01 PM

SHOOTING THE MESSENGER: WHY STEVE'S BAD NEWS FOR THE FETUS IS MISTAKEN

Steve,

Since you are not pro-life, I wouldn't necessarily expect you to be persuaded that the fetus is in a meaningful relationship with its mother. The comment was directed more at someone who is pro-life and is tempted by Shewmon's two-death view.

Your (A) and (B) are red herrings. Whether someone has a meaningful life is not relevant to whether he is in a meaningful relationship.

Your premise (1) is ad hoc and devised to support the conclusion you already believe. I see no reason to accept it over (1*) An individual who has the capacity to be an object of love is in a meaningful relationship with the rest of the world.

I see no reason to think the relationship needs to be "bilateral," a condition that would block meaningful relationships with infants, for example.

Stephen Kershnar         May 1, 2021 at 12:03 PM

IN DEFENSE OF MEANINGFUL RELATIONSHIPS: IF SOMETHING LACKS THE CAPACITY FOR CONSCIOUSNESS, IT CANNOT BE IN A MEANINGFUL RELATIONSHIP

Phil:

You argue for the following.

(1*) An individual who has the capacity to be an object of love is in a meaningful relationship with the rest of the world.

Consider your use of the ‘capacity’.


THE BELOVED'S CAPACITY

Consider a neuron-less zygote or embryo that dies before it gets any neurons. Does it have the capacity to be in a meaningful relationship with the rest of the world?

If yes, then this capacity is independent of consciousness. This is implausible.

THE LOVER'S CAPACITY

Perhaps you mean that the individual has some property that make it capable of being loved by someone else. If this were true, this could also be true for inanimate things. Consider, for example, someone’s beloved 1970 Plymouth Barracuda. In addition, this focuses on the capacity of the lover and not the beloved. This is misleading.

If this is the sense in which you are referring to the capacity to be an object of love, then I fail to see why it has any metaphysical or moral significance. Why not instead focus on when it exists?


DILEMMA: IS THE RELEVANT CAPACITY HAD BY THE LOVER OR THE BELOVED?

Hence, you face a dilemma: Does the capacity to be an object of love focus on a capacity of the lover or the beloved?
(1) If the lover, then it applies to objects that will never be conscious and, thus, has no moral or metaphysical significance.
(2) If the beloved, then it is not true that earlier fetuses – zygotes and embryos – have this capacity.

Perhaps you mean ‘potentiality’ rather than ‘capacity’. If so, then I fail to see why potentiality is relevant to what we are discussing here.

Best,
Steve K

Phil Reed          April 24, 2021 at 7:40 AM

Passing Away

The death-concept of passing away is described at various places as an “event” and a “phenonemon”, which seem compatible with passing away being a duration (i.e. something that takes place over a period of time) rather than a moment. Shewmon says that permanence is something that has to be established (289), which sounds more like a duration. But Shewmon also repeatedly mentions it as a “moment.” In the definition of “passing away” Shewmon says it is a “cessation” which could be a moment or a duration. Confusingly, Shewmon also says that the passing away “occurs at the moment of onset of the cessation” (278). So cessation has an onset (that is, cessation is a duration), but passing away occurs at the beginning moment? Is passing away a duration or a moment?

If passing away were a duration, it would make more sense of Shewmon’s view of organ retrieval. We can’t retrieve a person’s organs immediately after asystole because the permanence hasn’t yet been established. Passing away is an event that begins at asystole and ends when autoresuscitation is impossible. The cessation is complete. That seems to make more sense of Shewmon’s view about when it’s appropriate to remove organs than talk of backward causation.

Phil Reed          April 24, 2021 at 7:41 AM

Backward and Logical Causation

Shewmon says that a person can pass away but how we treat the person after he passes away can cause him to pass away. This sounds like backward causality. Shewmon says this backward causality is only “apparent” because the relevant causality “is not physical but logical” (281). I do not know what a logical cause is. Perhaps some of the metaphysicians (or logicians?) in the group can help me out. In any case, despite Shewmon speaking of logical causes here, he reverts back to “retroactive” causes in his NHBOD discussion on pp. 288-9.

Shewmon gives an example of a patient who is full code and has a cardiac arrest. If the nurse “intentionally does nothing” then he is guilty of negligent homicide because he caused the cessation of blood circulation “to be permanent.” But if passing away occurs at a moment, then the nurse did not cause the passing away. He allowed it to happen by an omission. He could have intervened and did not. Yes, he is guilty of negligent homicide, but not because he caused the death (either logically or retroactively).

Shewmon’s view seems to be that what makes the nurse culpable is that he causes the death (the permanence). Consider a different patient who is terminally ill and with a DNR. The patient has a cardiac arrest and the nurse intentionally does nothing. By Shewmon’s analysis the nurse has caused this patient’s death (the permanence of the cessation of blood circulation) just as much as the nurse has caused the previous patient’s death. Yet we do not think this nurse has done anything wrong.

At the very least, I think these causality waters are tricky and deserve more clarification.

Neil Feit           April 24, 2021 at 3:36 PM

Phil, these are really interesting comments. I do think Shewmon wants the passing-away event to be a momentary event, or at least more or less momentary. So, yes, with respect to this event, talk of backward causality is misleading at best. Maybe this is a good way to think about the issue. Suppose you smoke a cigarette, and then I convince you to quit for good. Then, there was an event that we can describe as "your smoking your last cigarette." I did not cause this event. But I did bring it about that, or make it the case that, it can be described in this way. This relation between me and that smoking-event is the one that strikes us as backwards but it is not causal. I do cause you never to smoke again (or at least we can suppose this).

In the case of passing away, it seems false that the nurse causes the patient to pass away. But the nurse causes the patient never to return to life, and thereby brings it about (in a non-causal way) that the patient did in fact pass away. I guess this could be sufficient for moral and legal responsibility. (In your DNR case, the fact of the DNR seems to make all the difference.)

But I also think it brings up another problem with the claim that passing away is a kind of death. Events that happen after one's death shouldn't be able to bring it about that one died (even in a non-causal way). Maybe this is closely related to what I claimed was a problem in my earlier comment.

Stephen Kershnar         April 25, 2021 at 1:40 PM

CIGARETTE SMOKING AND BACKTRACKING

Neil:

Very interesting point.

You say the following.

“Maybe this is a good way to think about the issue. Suppose you smoke a cigarette, and then I convince you to quit for good. Then, there was an event that we can describe as "your smoking your last cigarette." I did not cause this event. But I did bring it about that, or make it the case that, it can be described in this way. This relation between me and that smoking-event is the one that strikes us as backwards but it is not causal. I do cause you never to smoke again (or at least we can suppose this).”

In your view, did Neil cause Phil to do the following?

(1) Not smoke at t1, t2, t3, t4, …
(2) Do something other than smoke at t1, t2, t3, t4, …
(3) Smoke his last cigarette

Proposition (3) intuitively seems to entail (1) or (2). If this is correct, then it appears that you caused many future events. It thus does not appear to backtrack to me.

The event smoke his last cigarette does not seem like a momentary event to me.

Like you and Phil, I am worried that Shewmon’s theory backtracks and not in a good way.

Best,
Steve K

Neil Feit           April 27, 2021 at 11:47 AM

Steve, I agree that the event of smoking his last cigarette is not momentary, but I was thinking that the event is over (past) when the cigarette is extinguished. So, I didn't cause (3) although I did cause (1) and (2).

Yes, I think we all object to Shewmon's account of passing away since it implies that the fact that one passed away is a "soft fact" that is infected by future contingencies.

Stephen Kershnar         May 1, 2021 at 12:10 PM

Neil:

Interesting point.

Still, if (3) is identical to (1) or (2) or, perhaps, both, then causing (1) and (2) causes (3). If so, I'm not sure this backtracks.

On the larger issue, I think you make a good point. Shewmon's account backtracks and this is a problem.

Best,
Steve K

David H            May 4, 2021 at 6:09 PM

Doubts about mirror images:

I agree with Phil's earlier comment. we pro-lifers don’t treat birth as significant but are already concerned, operating upon, praying about and trying to legally protect fetuses. So I don’t see birth as a civic beginning, the opposite pole of passing away. I see conception being paired with deamination. Perhaps AS doesn’t need to defend passing away with coming into civic existence.

Stephen Kershnar         May 5, 2021 at 8:46 AM

THE CLAIM ABOUT CIVIC EXISTENCE IS FALSE AND IRRELEVANT

Dear David and Phil:

Great points.

Here is Phil's comment from an earlier thread followed by your comment.

Phil
"I’m concerned about the mirror image analogy. For one thing, it does not seem easily compatible with a pro-life view. Shewmon says that conception is the beginning of an organism “in itself” whereas birth is the beginning of an organism in relation to the rest of the world. I would have thought that the standard pro-life view believes that the developing fetus is in a relationship with its mother and possibly others as well. The fetus can listen to Bach and recognize its father’s voice. We can perform fetal surgery on it. We grieve when it dies. It seems to be in a meaningful relationship with the rest of the world."

David
“I agree with Phil's earlier comment. we pro-lifers don’t treat birth as significant but are already concerned, operating upon, praying about and trying to legally protect fetuses. So, I don’t see birth as a civic beginning, the opposite pole of passing away. I see conception being paired with deamination. Perhaps AS doesn’t need to defend passing away with coming into civic existence.”

Does a civic beginning means other than
(a) when something gets moral rights or
(b) should get legal rights?

If it does not mean (a) or (b), then I do know neither what it means nor why we should care about it. If it means (a) or (b), then we need an argument as to why a conceptus satisfies them.

By analogy, if it were the case that Terri Sciavo’s cerebrum (and, perhaps, any other part of the brain that can support consciousness) had dissolved and so it was impossible for her to be conscious again, then why would she have moral rights? She has neither autonomy nor interests. If she has no moral rights, then it Is unclear why she should have legal rights.

Phil argues that a conceptus is in a meaningful relationship with the rest of the world, despite necessarily lacking consciousness. I think this is both false and, more importantly, irrelevant.

Perhaps you can explain why a conceptus has rights or why it matters whether the conceptus is in a meaningful relationship with the rest of the world.

Best,
Steve K

David H            May 5, 2021 at 10:32 AM

Steve
Very short story of a very old debate between us. It is the interest of the mindless fetus or the vegetative Schiavio (interest in the sense that broccoli is in a kid's interest, though he is not interested in it) to become minded. Schiavio has an interest in being healthy and the fetus has an interest in healthy development. Likewise, for the demented who are minimally conscious, they have an interest in self consciousness that they can't conceptualize and so if there is a miracle Alzheimer's drug we should give it to them even though they don't desire it. It is good for them to be healthy. They will flourish. And they will flourish at levels of well being that no other kind of creature approaches.

Medieval/Metaphysical Tangent. Good in the broadest sense (see Oderberg's Hourani lectures that led to his book The Metaphysics of Good and Evil) is perfecting or realizing the potentials of a thing's nature. Trees have a good. Goodness is broader than moral goodness. The good is in nature - a triangle drawn on a tree can be a good or bad one.

Creatures capable of great levels of well-being have great moral status. That is, they and their interests matter morally for their own sake. So someone with low well being, the brain damaged or brainless embryo, can have great moral status because they are the kind of entity that is capable of great well-being. Very valuable creatures have a right to life (and other rights)that protect that value. I fear the debate is too complicated for a quick blog exchange

Stephen Kershnar         May 5, 2021 at 2:16 PM

AGAINST CIVIC-BEGINNING AND MEANINGFUL-RELATIONSHIP ARGUMENTS

David:

Excellent response. Still, three points apply.

1. I am guessing that you agree with my claim that a fetus does not have a meaningful relationship with the rest of the world and, even if it did, this would be irrelevant.

2. Let us grant your position. I take it this is consistent with the notion that an individual's civic beginning is morally irrelevant and should be legally irrelevant.

3. Let us again grant what you say above, this does not show that the status-adjusted interest is significant enough to justify anything like a legal right or even a moral right worthy of serious consideration. A status of 10 (weight/interest) multiplied by a low interest number (0.001) generates a low weight. I submit that this is true for Schiavo. For conceptuses, the number might be different.

This shows we should be wary of these symmetry-type arguments.

Best,
Steve K

David H            May 5, 2021 at 2:30 PM

Regarding #3
Schiavio is a creature of great moral status because she is the type of creature that can obtain great levels of well-being. When it is unlikely to do so that she will obtain such levels, than triage factors may come into play but that doesn't mean she has less value, moral status or rights. Her right to life is no less than yours or mine. If there was a scarce sci fi pill that could restore her mind and the same pill could keep you or me from dying from Covid, it is a coin toss who gets the pill. That suggests her moral status and interests equal ours

John Lizza         April 25, 2021 at 11:44 AM

Reply to Neil's April 22 post: I don’t think that it is implausible for one of two individuals in the same physical state to be alive and the other dead, since whether a cessation of functions is realistically irreversible may depend on factors external to the individuals. (See my “Why DCD Donors are Dead” in JMP and discussed at a prior Romanell meeting.) I also think that we need to be careful about saying that they are either both alive or both dead on any adequate understanding of “death.” Shewmon’s claim is that “death” is not a univocal term, even though we have the one word “death.” Compare “bank” as meaning a financial institution and “bank” as meaning the side of a river. There are two adequate meanings of the same term. Although I do not think that death as “passing away”/“civil death” and death as “deanimation” are as separate in meaning as the different meanings of “bank,” I interpret Shewmon as suggesting that the former has a moral, social, cultural, and pragmatic meaning that the other term lacks. Both designate real but different events. I have tried to capture a similar distinction in meaning between the death of the human being/human person and the death of an organism

Stephen Kershnar         April 25, 2021 at 1:29 PM

DEATH AS AN INTRINSIC PROPERTY OR, AT LEAST, MINIMALLY EXTRINSIC

John:

Great point as always. Still, I think Neil is on the money. Here is my argument.

(1) Death is an intrinsic property of something.
(2) If (1), then two intrinsically identical things cannot differ in death.
(3) Hence, two intrinsically identical things cannot differ in death.

My argument for (1) rests on the following.
(a) Life is an intrinsic property of something.
(b) Life and death are similar in that they are both intrinsic or both extrinsic.

I gather you would reject (1). But I am curious as to whether you would reject (a) or (b).

I think of life as an intrinsic organizing principle, metabolism, or something along those lines. It might use extrinsic things (for example, Oxygen, food, or water), but it is distinct from them.

Even if these were extrinsic – in virtue of their relation to these extrinsic things – these are very different types of extrinsic things when compared to how people categorize individuals toward the end of their life.

Best,
Steve K

Pat D                April 26, 2021 at 4:30 PM

Alan Shewmon’s claim that “the somatic physiological equivalence between TBF and high spinal cord transection can be made exact for pur¬poses of the argument” [259] is misleading. Aren’t face, mouth, eyes, and ears somatic? SCI patients maintain visual, auditory, and orofacial functions, whereas TBF patients do not. Regarding the integral functioning of the whole organism, if TBF includes uncorrectable hypothalamic malfunction vis-à-vis temperature and blood pressure regulation, as Dan Sulmasy proposed (TMB 2019), then such integral functioning is absent and the organism is dead. This is not the case with the SCI patient, with or without a vagotomy (Shewmon 1999).

Pat D                April 26, 2021 at 4:32 PM

Life and death are contraries: life is a state of being alive; death is a state of no longer being alive. A thing can’t die if it hasn’t lived.

Living and dying are temporal events. The time of death, the end of a dying process, however long or short that process is, marks a transition from a state of being alive to a state of being dead. This transition entails a substantial change, in which what was formerly an organism is no longer an organism. (It differs from the substantial change that occurs with reproduction by fission in which what was one thing becomes two new things.) An organism is a living thing; that is, a thing that is self-organizing and self-regulating. A dead body (or loosely, a “dead organism”) is no longer self-organizing; it differs from other non-self-organizing things like a penny, for instance, in being composed of biochemical structures that were formerly organized and regulated by a living thing. Depending on the state of the physical disruption or decomposition of the body, these biochemical structures may be more or less recognizable.

A determination of death occurs in time. But life and death themselves are states of being and having ceased to be. Space and time are within being; being is not within space and time. Alan Shewmon’s dog, Soran, died on a particular day, at a particular hour, possibly a particular moment, or possibly time stood still. In any event, the fact of Soran’s death, of knowing that he died and is no longer alive, remains true independent of the time and place of its reaffirmation. (This atemporal feature of judgment relates to the immateriality of intellectual and volitional functioning to which Shewmon refers.)

David H            May 7, 2021 at 11:55 AM

Pat (First of two replies)

I disagree with your claim that death and life are contraries and that you can't die without first having lived. I do admit the latter claim is quite counterintuitive by I try to back it up below in some comments cut and pasted from some late additions to our Sulmasy blog last month on brain death

I believe we need a three-fold distinction not a binary life/death distinction amenable to contraries and death being just the negation of life. This is because of cryptobiotic organisms or sci-fi suspended animation (and DCD patients?): They are not dead because the capacity to metabolize in their design environment is there – just add heat or water. They are neither alive nor dead. They are not alive because they are not metabolizing, but not dead because they retain the capacity to metabolize which a corpse in a morgue or cremains in an urn do not. I think this account, let’s label it (a), is preferable to the alternatives to say that the cryptobiotic dehydrated or frozen or future astronauts in suspended animation are b) still alive c) indeterminately alive – i.e., sort of alive, sort of not alive d) dead but still existing and capable of life again upon heating or hydrating e) dead, non-existent but would live again if heated or hydrated, f) dead, not-existent, and be replaced by a duplicate if remains were thawed or heated.

Resisting (b): I appeal to the medical/philosophical authority of Dr. Frankenstein’s assistant, Igor, who exclaimed “It’s Alive!” only after the electric shot started up life processed not when the structures were there but not functioning. Seriously, do we really want to say someone is alive when there is no metabolism, homeostasis, activity? If you believe in a brain death criterion, then when the brains of the frozen are doing no integrating, they would be dead. But they aren’t dead, they are just not alive. We can capture that distinction by saying that death requires the loss of the capacity for life processes. It is too much of a stretch of “alive” to say the unactualized capacity for life processes is sufficient to ascribe life.

Resisting (c): I don’t think we want to say the cryptobiotic is indeterminate because we have determinate categories of i) life as involving life processes and ii) existing with the capacity for life processes in the absence of manifesting those capacities and iii) the lack of the capacity for life processes.

Resisting (d) I don’t think we should say the cryptobiotic creatures are dead if they have the disposition for life processes in their design environment that includes normal heat and hydration. Adding heat or water is not a case of miraculous resurrection. It is restoring life to the still existing who are neither dead nor alive, not resurrecting the dead..

Resisting (e): I certainly don’t think we should say the frozen or dehydrated are dead and non-existent for that means they are disposed to create a new distinct substance – when thawed or hydrated . A disposition for substantial change should involve collapse of the entity’s or dramatic reorganization and both are lacking in the case of the cryptobiotic. What we have retains a disposition for life processes. If the organisms didn’t exist cryptobiocally, then there wouldn’t be immanent causation when its life processes started up. (We would have a case of resurrection by reassembly and all of its problems.) That would then be a reason to say the result is a duplicate as the earlier states didn’t immanently cause the later states. But we don’t want to accept (f) that we have a new entity pop into existence when thawed.

Resisting (f) We don’t want to say the frozen or dehydrated can’t survive thawing or hydration for the same reasons we saw given just above that substantial change should involve collapse and decomposition or major reorganization of parts mentioned in previous passage.

David H            May 7, 2021 at 11:55 AM

Reply to Pat Part 2

A strange consequence of this third state between life and death (defended above) is that maybe could die without ever being alive If one could come into existence in suspended state, then lose the capacity for life, the individual could be dead without earlier being alive. So it is also not true for DS to say that one must have been alive to die. If death is the loss of the capacity for life processes, not the cessation of already actualized life processes like metabolism etc.,

Pat D                May 14, 2021 at 2:28 PM

David -

I disagree with defining life in terms of active metabolism. On my understanding, cryptobiotic organisms are alive - that is, self-organizing and self-regulating - albeit in a state of prolonged and profound inactivity. Sci-fi examples are abstract; organisms are not. I stand by my original position.

Pat

Pat D                April 26, 2021 at 6:23 PM

Permanent and irreversible loss of the (radical) capacity for integrated functioning differ as common sense and theoretical criteria for the determination of death. As Andrew Marvell might say, “Had we but world enough and time, this difference, doctor, were no crime.” Shewmon splits the difference by waiting a couple minutes after cessation of heartbeat before implementing the deceased donor rule.

This is not unreasonable. But I would parse it a different way. Permanence and irreversibility are not alternate definitions of death; they are different criteria for determining whether someone is dead. Judging that someone is dead is a judgment of fact. The fundamental criterion for making a judgment of fact is the insight that all relevant questions have been answered. Among the relevant questions for making such a judgment are those concerning what usually does happen or what remotely can happen to a person or an organism under the particular circumstances that have lead to the cessation of circulation or total brain failure (as defined above). The judgment may be correct or incorrect that this organism is dead, but that does not change the definition of death.

Neil Feit           May 2, 2021 at 6:43 PM

Pat D, I agree with your way of parsing the claims about permanence and irreversibility. I was wondering, though, about permanence as a criterion. Shewmon says the permanent absence of consciousness and circulation is a sufficient criterion for passing away (p. 278). I'm wondering how *permanence* can be tested, though, given that whether or not a condition is permanent can depend on future events (like a failure to resuscitate when resuscitation is possible). On the next page, Shewmon seems to say that (unlike irreversibility), the onset of permanence is "directly observable and precisely identifiable" (279 bottom). But given that molecule-for-molecule duplicates can differ with respect to whether the cessation is permanent, I guess I don't see how this works.

Maybe Shewmon is referring here to the criterion that he says is both necessary and sufficient? This is the absence of consciousness and circulation "at least up to the moment of deanimation" (p. 278). But this criterion makes essential reference to deanimation, so we'd need to use the criteria and test for that, in order to test for permanence.

Pat D                May 14, 2021 at 2:43 PM

Neil,

I agree that permanence is a questionable criterion for establishing that a particular organism/person is dead at a particular moment. I think that Shewmon's comment about the onset of permanence being "directly observable" only makes sense retrospectively. As far as a forward looking judgment, I think that the difficulty involves applying a probabilistic estimate (based on the different outcomes of similar patients in similar circumstances) to a particular case.

Pat

David H            May 4, 2021 at 5:45 PM

Is Hylomorphism Bad Biology even if it is not Bad Metaphysics like other hybrid views?

I think some hybrid accounts (Langford, Madden) that claim either thought or autonomic biological life processes are sufficient for persistence are bad metaphysics because they violate the only x and y rule when they posit someone survives as the headless body when the head is destroyed but are not that body when the head persists detached from the body. (I will actually point out in a later post that AS’s hylomorphism could run afoul of the rationale behind the only x and y rule but it need not.) He thinks that there isn’t a lesson to be learned from fission as it about personal identity in relation to two distinct pieces of matter but what matters is when there is just one piece of matter whether it is an organism and the original organism John p. 263. But these can’t be separated.) The identity of an entity X (body with head attached) with Y (decapitated body) shouldn’t depend upon whether or not there is a competitor Z (detached head) when X is related to a physically identical headless Y in both the scenario where there is a detached head and where the head has been destroyed. Not only is there no causal difference between X and Y when X is identical to Y and when it is not, but Y and Z owe their existence to each other without standing in any causal relationship to each other. Z would be X if not for Y, and Y would be X if not for Z. These are unexplained existences and should be avoided. (See my critique of the hybrid views that allow us to be become vegetative when our minds are destroyed but transplanted when our cerebra are moved - Madden, Langford - in Quaestiones Disputatae.) What I consider a biological mistake is when organisms pop into and out of existence when losing or gaining organs (cerebra or brain parts) that are not essential to biological life process.

David H            May 4, 2021 at 5:45 PM

Hylomorphism is Bad Biology Part I

Hylomorphism is bad biology because it tries to maintain that one can exist with either thought present but not the manifestation of life processes of the organism or can exist without thought as long as autonomic life processes are present in someone in a persistent vegetative state. My contention is that hybrid theorists can’t hold onto either thought or life being sufficient for persistence without bad biology. The problem is evident in to a cerebrum (or larger, minimal thought producing part of the brain) transplant causing one entity to pop into existence when a cerebrum is removed and another pops into existence when receiving the transplanted cerebrum. The typical transplant story involves the original human being becoming reduced to cerebrum-size and the rest of its matter becoming a new organism without any apparent cessation of life processes or beginning of new life processes. Then another human being that had been in PVS pops out of existence upon the receiving the cerebrum-size human being. Most advocates of Hylomorphism believe that the human being with the destroyed cerebrum still exists in a mindless sense, the soul that had the radical capacity for thought is present as evidenced by the life processes of the vegetative. So, if a person can exist paired down to some thought producing part of the brain or cerebrum, then that person when transplanted into the skull of the human being in the PVS will either co-locate with another human being which traditional hylomorphism thinks impossible (two souls in one body or two souls configuring the same matter and producing two spatially coincident bodies) or will have to destroy and replace the mindless human being or they both go out of existence in a case of fusion. And the mindless human whose cerebrum has just been removed and transplanted will be a new human being in a PVS. Organisms should not pop into and out of existence like that with the removal and reception of a cerebrum-sized organ. Cerebra are not biologically special. They should be treated like the removal and transplant of other organs.

David H            May 4, 2021 at 5:46 PM

Hylomorphism is bad Biology Part II:

I suspect hylomorphism is also bad biology in its insistence on our being essentially rational. Image the embryo that has genes necessary for the development of a rational brain that are removed before they are expressed. On one reading of hylomorphism, the embryo has lost the root capacity for rationality and so has undergone substantial change. But surely nothing has died. And the living can’t go out of existence without dying. So hylomorphism has to tell a story about the rational soul is still present even though the necessary genes aren’t. That makes mysterious the role of genes in rational development and our rational nature. It is harder for me to see the rationality as there but its manifestation is blocked when the genes are absent.

David H            May 4, 2021 at 5:47 PM

Shewmon’s Violation of the Only X and Y Rule unless Rescued by Mark Spencer:

On pp. 262-263, AS considers decapitation and the headless body and head are both preserved via whatever technology is needed. He considers two possibilities about the head, it is (1). conscious and the original person John or (2) The head is not John and but an automaton or zombie. There really should be a third option that it is conscious but not John. Actually, there should be a fourth option, and that is the four-dimensionalist account is that “John” doesn’t uniquely refer as there are two persons there all along, sharing earlier temporal parts before fission and diverging after fission (This is not the idea that each cerebral hemisphere belonged to a different person that AS does mention somewhere else in the paper.) I mention these pairs of additional options for comprehensiveness but they aren’t the possible problems I am concerned about. When discussing how to understand the headless body, AS considers (3B) the body is John, equivalent to John with TBF, or (3A) John is a scattered organism, (4) the headless body is a new non-personal organism or (5) his preference, the headless body is a new human person-organism, a younger twin of John but not John.

The mistake is to allow that a “better competitor” (“closet continuer” in the personal identity jargon) determines whether John is the detached head or the headless body. But the answer should always be the same as the causal relationship between John and his headless body is the same when there is a head in existence and when there is not. If a body with a destroyed head (TBF) is John, then that same body is John when the head still exists though functioning detached from the body. John can’t be identical to his body in one world and not another as that violates the transitivity of identity. There is no physical causal difference between the headless body in the two cases and John. So John’s identity should supervene on the intrinsic facts about his body and not extrinsic facts about what is going on elsewhere. And these facts are the same when he is the body with TBF that comes when one’s head it destroyed and when he is not due to the head being removed and functioning. This leaves us with unexplained existences (Hawley) as there is no causal explanation of why X is not Y, it is just the mere presence of Z that is decisive.

Now AS can borrow an idea from my old student, Mark Spencer, (MS told me he corresponded with AS about hylomorphism, and death) and claim the hylomorphic soul tries to realize its highest ability and so will go with the head when that is an option. Then there is a causal/factual difference between the headless bodies in the two cases, (Y has a part in one thought experiment that it lacks in the other – John’s soul) where there is head the soul has left the body, where there is no head, the soul withdraws into the remaining headless body. But for those of us who aren’t soul theorists, we can’t treat the two differently What we have to say is if the head is not necessary for integration, then we remain as the headless body when the head is removed and still functioning or destroyed. The removed head will be a new person. If whole brains are necessary for life, then we go with the whole brain in the transplant and go out of existence when the head is destroyed.

David H            May 4, 2021 at 5:48 PM

Avoiding Bad Biology:

The mistake is to make both thought processes and life processes essential. If only one is essential, then the human being doesn’t survive without the other manifesting and brain transplants don’t destroy recipients or create new being in their wake composed of the matter that used to compose their pre-transplant body from the neck down. So the bad biology can be avoided if either human beings can’t be reduced to the size of part of their brain as they are essentially living organisms or human beings can’t exist without a brain as brain death is the true criterion (central integrator) and human organisms can become pared down to their brain with a functioning brainstem. (Damasio, van Inwagen, Olson, Merricks, perhaps Bernat imagined brains as impaired, very maimed organisms.) My preferred way is to identify us with an organism that is essentially alive and only contingently a thinker. The healthy human organism will be a thinking person, mental development is a proper function, but not essential. (The mindless can be harmed because they have an interest in healthy development so I can capture all of Catholic bioethics.) None of us can be reduced to the size of a cerebrum or some slightly larger part of the brain if that is not an organism. But Shewmon insists that the brain dead and the decapitated and the high cervical transection and GB are functionally similar and so where the latter pair are alive, so are the brain dead and decapitated. Thus he is on record for the brain not being essential to life, a central integrator, but merely fine tunes an existing integrated organism. He also seems sympathetic to the idea that says the brain size person might not be an organism which suggest one can survive without the rest of the body. “If either the biological or the psychological dimension is lost but not both (e.g. conscious head or permanent vegetative state) we would say that there is a severely disabled person.” 264. And this occurs in a section entitled “Conscious Nonorganisms…”Elsewhere he mentions that it isn’t clear whether we should say the detached head is still an organism but doesn’t doubt there that the person couldn’t be reduced to that size and cease to be an organism “As far as I am aware, there has not been much development of a philosophy of organisms that would provide a reasonable nonarbitrary dividing line between mutilated organism and non-organism along the continuum of imaginable mutilations.” And he puts forth hylomorphism as the only view capturing both the upper brain and PC recognizing the importance of psychology and the bodily organism so I take it that, like other hybrid views (Langford, Madden), wants to capture the intuitions of the psychological and biological views of personal identity, one can be a mindless embryo and a mindless PVS patient, and one can survive if just one’s capacities for thought (maimed but still existing head size human being, person moving with the transplant, we could be preserved as brains in the vat). But it can’t be done without some very bad or strange biology. From a biological point of view, the cerebrum is like other organs, its removal doesn’t shrink you in size, nor cause most of your previous matter to be part of a new organisms, nor does the mindless human in a PVScease to exist upon receiving a cerebrum transplant.

David H            May 4, 2021 at 5:49 PM

AS’s Organ’s Organ Acquisition Proposal Violates the Spirit and the Letter of the DDR.

Modal considerations make this true regardless of whether death is understood as passed away/deceased or, as I think it should be, as deamination. AS thought that the DDR could be respected in spirit even if not in the letter of the law for taking organs would not kill the patient if they patient had agreed to withdrawal from a respirator and the heart and lungs had ceased to operate. They are no doing anything and so are no longer vital. He claims that removing them after the possibility of autoresuscitation has ended means that one has not caused the death. “even unpaired vital organs can be removed without causing or hastening death.” (288). I don’t know enough biology to be too confident but I suspect this is false if death is understood in terms of deamination as the time of the point of anti-entropic resistance has been hasted by the removal of organs. But even following AS’s reconceptualization of death in terms of passing away/deceased, it may still cause death when given his beliefs about omissions causing permanence or removing a heart causes permanence by preventing autoresuscitation. I think both moves are mistakes, he shouldn’t claim that the negligent nurse CAUSED the permanence, nor should he think of permanence as a replacement for death. So, if I was right, then the point of anti-entropic no return is later with the organs in the body than without as they can provide additional resistance to entropy. So their removal, pace AS, hastens death, as it changes the point of no return for one can resist entropy with hearts and lungs more successfully than without.

AS’s idea is that removing an organ doing nothing in the body doesn’t kill the patient. The patient is still alive in the sense of not having reached the anti-entropic point of no return because he could be resuscitated as only the point of auto-resuscitation has passed. My suspicion is that “the point of no return” is later with organs in the body than already removed. As AS writes (285) This point is reached when sustained anoxia-ischemia has caused a critical number of cells in a critical number of organs and tissues to begin the biological cascade inextricably leading to autolysis (i.e. the point beyond which the organism’s antientropic dynamism definitely fails and disintegration proceeds unabated.) The number and identity of organs and tissues dnd the percentage of cells within each organ or tissue required for such criticality is unknown…” I suspect that anti-entropic measures are more likely to be possible with organs in the body than not. If that is true, then removing organs has changed the time at which the loss of integration can be reversed, thus hastening death understood as deamination. Perhaps AS is misled by the decay of the body occurring at the same pace with the vital organs just sitting in the body but not pumping blood or oxygen, as when they are removed.

David H            May 4, 2021 at 5:49 PM

The Modal Objection to the DDR construed in terms of Passing Away

But AS thinks the DDR “as traditionally understood fallaciously focuses on the former (deamination) to the exclusion of the latter consideration (passing away)…” He also writes “ What is ethically important in the removal not cause the donor’s passing away.” But AS believes that one can cause someone to pass away by an omission, failing to do something. So, if a nurse doesn’t resuscitate then she has caused the condition to become permanent. Likewise, AS says if someone removes the heart, they have caused autoresuscitation to be impossible. Thus they caused the permanent loss of the operation of vital organs, thus killed rather than let die. (p. 289 “The same reasoning applies to the removal of vital organs during the initial period of potential for autoresuscitation following asystole, Such removal either eliminates the very basis of spontaneous reversibility (If what is removed is the heart)…” Likewise, I would argue, that if someone was going to engage in resuscitation after autoresuscitation had passed but doesn’t because the organs have been removed, then the removal made it permanent. If the omission to resuscitate can cause permanence, and if removing the heart and preventing the possibility of autoresuscitation can cause permanence, then why can’t removing the organs which causes someone to not resuscitate cause permanence? AS example of heart removal causing permanence doesn’t even required the guarantee that the person would have auto-resuscitated. It is just the removal of that possibility by the removal of the heart that causes permanent. Likewise, the person may never have been resuscitated even if the vital organs were not taken prior to the point of deamination but the possibility is forestalled by removing the vital organs as it changes the point of no return. So removing the vital organs causes the post-autoresuscitation patient’s condition to be permanent if removing the heart pre-autoresuscitation causes permanence. Thus viable organ removal - even of the idle heart and lungs – can hasten and cause death which violates the latter and the spirit of the DDR, pace AS’s claim “That under certain clearly defined conditions resembling NHBOD protocols, even unpaired vital organs can be removed without causing or hastening death.” (288)

David H            May 4, 2021 at 5:50 PM

AS’s strange essentialism:

I think AS is actually defining human beings in a disjunctive way rather than claiming rationality and animality are both essential. He writes “I join many others in the camp that regards a human person as essentially a biological-psychological hybrid being (George and Lee). If either the biological or the psychological dimension is lost, but not both (e.g. conscious head or permanent vegetative state) we would say that there is a severely disabled person.” That sounds more like saying they are each sufficient rather than essential. That is what hybrid theorists like Langford do. But the more charitable read is that the soul possesses the root or radical capacity for thought and life so the manifestation of either psychology or life processes is evidence that the other exists as a root capacity, though not actualized. So the essentiality condition is met as they are both present at least as radical capacities. The question then is why think the soul does both?

David H            May 4, 2021 at 5:52 PM

What the Thought Experiments Teach Us About Total Brain Failure

Shewmon writes “Similar thought experiments based on cases of dicephaly, Siamese twins, brain transplants, and so can be devised ad infinitum. What do they really prove about persons, organisms, and TBF? Nothing whatsoever. Why? Because they are all about questions of personal emuneration and person identity in relation to two or more distinct pieces of living matter. But in actual clinical practice TBF, there is only piece of living matter and only one person at issue.”

As I said earlier when discussing the only x and y rule, it is important to have a theory that doesn’t get in trouble with two competing candidates. If one runs afoul of the only x and y rule, that shows one is working with a bad theory of personal identity. It doesn’t help to point out that such cases don’t arise in the clinical setting.

But my main point here is that such thought experiments can tell us something about TBF if the interpretations that say the embodied mind view of McMahan, Parfit and our own Steve K put on them are correct. I don’t think they are so I ultimately agree with AS that they don’t tell us anything. But imagine that they were right. While the dicephalus doesn’t tell us much more than the cerebrum transplant, that psychological continuity or minimal unified sentience is crucial for identity, the former does tell us about the size of the person. Two headed persons resist the usual interpretation of the brain transplant as someone say six feet and two hundred pounds becoming pared down during the transplant to a few inches and pounds and then restored to a large size at its completion. But the dicephalus suggests persons were all along just brain size parts of organisms.

So if persons are only brain size, thus lack bodies that extend below the brainstem, then we know that TBF will be sufficient for their destruction. They never had living integrated bodies so it isn’t a possibility for such persons to survive TBF. It may be that TBF is just sufficient, not necessary for their death as such persons are just cerebrum-size and don’t survive in a PVS. Anyway, my point is that the thought experiments tell us something about our dimensions and persistence conditions and so they do have relevance to TBF. Of course, AS means that they won’t tell us if an organism survives TBF, but the thought experiments tell us, at least according to their advocates, that we lack not integrated bodies and so we couldn’t survive TBF

David H            May 4, 2021 at 5:52 PM

Radical Capacity and Regeneration:

AS goes to great lengths (271-273) to suggest that the capacity for thought is in the organism rather than the brain. I agree. But I don’t see why it has to hinge on the capacity to regenerate a brain in the future with a technological breakthrough akin to removal of cataracts. Why is it not enough that the human being has the capacity to assimilate a transplanted organ? I think the relevant potential is just what is healthy development. If a human being would be healthy with a transplant or regrown or repaired organ, and unhealthy without it, that is all that is needed to say some function such as thought is a capacity of the organism

David H            May 4, 2021 at 5:52 PM

Necessary and Sufficient conditions of Permanence:

I don’t why AS claims (278) that a sufficient but not necessary condition for passing away is the permanent absence of both consciousness and circulation of oxygenation of blood and that a necessary and sufficient condition is their absence to the moment of deamination. If permanence depends upon deamination – why isn’t any permanent loss not also necessary and thus a criterion for passing away.

David H            May 4, 2021 at 5:53 PM

Death should be defined in terms of life so “death” isn’t equivocal if life isn’t.

I would be more sympathetic to a pair of death terms if there were also a pair of life terms. But Shewmon doesn’t argue like McMahan and Baker that there are two senses of life – biological sense and a sense meaning “existence” – eternal life in a religious context need not be biological but mean never ceasing to exist, not never ceased to engage in biological integration. I think there is a nature to being alive and death will be the loss of the capacities for life – with some sort of appropriate irreversibility condition. So that is one reason why I am skeptical of the bifurcation of death into passed away and deamination. Perhaps the more charitable interpretation of AS approach is that he is defining death in terms of a univocal concept of life but defining one (the passing away account) in terms of the vital signs of life being permanently loss and the deamination as the irreversible loss of the capacity for life processes

David H            May 4, 2021 at 5:54 PM

The difficulty of giving up the search for a univocal sense of “death.”

I suspect that the prospects for replacing death with two new concepts will be as unsuccessful as solving the transgender debate by introducing two replacement words and concepts for “woman.” People are still going to insist that “women” excludes those who identify as women or insist that it does include them. Some may accept it is a cluster concept but to others, to quote or paraphrase Boorse on Wittgensteinian family resemblances and cluster concepts, that is the “last refuge of conceptual scoundrels”. Settling for a cluster concept (either W and X or Y and Z will due) is a polite way of saying the word is is equivocal.

AS’s strategy of bifurcating death also reminds me of Ben Bradley’s attempt to do away with “harm” because it is a Frankensteinian monster that includes too much – omissions, failing to benefit, moral setbacks to interests and so on.

Limits to Revision. I don’t know much about linguistics, but I have a hard time imagining people dropping the word “death” or accepting its’s ambiguity. They will try to explain away usage rather than admit to equivocating. Just try to treat killing without defining it in terms of a univocal death. There aren’t two senses of killing. Killing makes reference to death. We won’t say someone killed1 in terms of causing permanence of passed away and killed2 when causing deamination.

Is “passed away” being coopted for AS’s purposes? I don’t have any inclination to use “passed away” or “deceased” as differently from deamination. I wouldn’t use it if I knew the person could be revived by certain actions.

David H            May 4, 2021 at 5:54 PM

Grief, Passing, and Permanence:

As writes “I realized how preposterous it would have been to wait to begin grieving until some other theoretically hypothetical moment of death, such as…” (273) Why not just recognize different types of grieving are appropriate at different times without equivocating on death talk? We would all mourn if a loved one was rendered irreversibly mindless after being hit by a bus. Then we would mourn differently when our mindless relative later died. Why not treat AS’s family pet Soran the same way? I think the mourning isn’t even tied to permanence. Imagine someone is hit by the truck and vital life signs ceases. They can be revived though they will be mindless with a beating heart and air pumping lungs. So we would mourn even if their condition wasn’t permanent for they would be mindless after revived and vital life signs restored, so permanence is doing no work.

David H            May 4, 2021 at 5:55 PM

Split Family and Rogue Veterinarians:

what if the family was divided over resuscitation? Imagine someone with AS’s biological knowledge, who knows more biology than the rest of the involved parties, is aware that deamination hasn’t occurred and consciousness could be restored. Deciding to make death permanent leads to dilemmas when families are split. Or another vet comes in and resuscitates Soran and thus the family was in error as death wasn’t permanent. (On growing block theories of time, there isn’t even a fact of the matter whether it is permanent until deamination.)

David H            May 4, 2021 at 5:55 PM

Permanence Judgements are Prone to Errors:

Do we want permeance so prone to error. AS is right there will be errors about deamination but they are judgment errors about bodies and not judgment errors about the actions of others. AS claims determining the moment of permanence isn’t as problematic as determining the moment of deamination. But permanence depends upon deamination so it inherits the vagueness of the latter in that one doesn’t know when T1 is permanence until some vague period of deamination. Secondly, we can invent scenarios where there are split views about whether to resuscitate so we can’t tell when it is permanence until deamination occurs.

David H            May 4, 2021 at 5:56 PM

Bypassing Comparing Lists of Functions and Dysfunctions – Part I

A. How much loss of Function is death?

I think it ingenious of AS to bypass this issue with his appeal to the similarity of the transected or Guillain Barre (GB) patient and also the stability of the Brain death (BD) being greater than the stability of the dying. I have two minor concerns. One is couldn’t the dead be stabilized in the sense of no more decay or loss but they are still dead and static? Or does death mean continuous loss of stability in further decay? So, the dead could be stable at a lower degree of functioning than the dying. The dying are losing more functions more quickly than the preserved dead, but they have higher amount of functions. I fear that I am misunderstanding AS’s use of “stable”

B. Could the person have shrunk in size?

AS doesn’t consider that the high transection nor GB is not a case of shrinking the person so they become head size. (I think that is Jason Eberl and Melissa Moschella’s interpretations) If that was the case, one couldn’t extrapolate that the brain dead weren’t dead organisms because we don’t want to say that that the GB patient is a dead organism. It might be that both have bodes that are dead, at least both have bodies from the neck down that are dead. But the shrinking GB patient has a living head. So he is alive though his body is to be judged just as the body of the brain dead. Then when he is healed, his body returns to its normal size as the patient’s brain, the central integrator, restores life to the body below the neck. So the functional equivalence of the living transected or GB patient doesn’t help us determine whether brain death is death in the sense of the loss of integration of the body. Perhaps AS can appeal to hos other arguments that BD bodies show integration and emergent properties.

David H            May 4, 2021 at 6:11 PM

Bypassing Comparing Lists of Functions and Dysfunctions – Part II
C. Necessity of a sharp cut off of deamination.

Shewmon writes “And even if (hypothetically) degree of integration could be meaningfully measures, there would be no point along that continuum that could reasonably nonarbitrarily constituted the diving line between extremely sick, dying organisms, and just-dead (non-)organisms.” (259) See also his comment on page 273 “Any moment afterwards would have been anarbiraly and vaguely identified point along a continuum of physical changes, not an intantaneoous radical change.” Perhaps AS’s point is that there is no epistically reasonable point to say the cut off is here rather than an ontological claim. So then we are not really disagreeing. But there are logical grounds for claiming there is a precise but unknowable point at which too much function is loss for integration to remain. I will do it with part removal and replacement rather than specifying loss of particular functions. But functional loss and removal of parts responsible for those functions are equivalent. If too many of your parts are removed one is dead and replacement of those parts means a duplicate is found where you were. Too few parts removed and you become just smaller but still exist. Replacing those few parts restores you to your earlier size rather than replaced you with a duplicate. But there is somewhere in in between where is indeterminate whether you survive those loss of parts. This is the grey are that AS has in mind. But if those parts are replaced than there is a whole person there but it is indeterminate whether you are identical to that person. But indeterminate identity is impossible on logical grounds. The Evans/Salmon argument is roughly that X is determinately identical to X but if Y is indeterminately identical to X than Y has a feature that X does not and thus X and Y are determinately distinct. So if there can’t be indeterminate identity, then there must be a precise amount of matter that if replaced means I am replaced with a duplicate. One less atom, so to speak, and I survive. There should be no reason to believe that my replacement has a precise amount of matter (substitute function for matter) and there is not a precise amount of matter in the removal without replacement scenario where there is no fact of the matter whether I survive. There is a precise amount of matter (function) in both the removal and replacement of matter (and functions) and in the just removal of functions case.

John Lizza         May 9, 2021 at 12:57 PM

I don’t understand why Alan Shewmon (AS) unpacks the decapitation thought experiment in the way that he does. He gets my position right – that the decapitated head that is still conscious is John. However, I do not understand why there isn’t a sixth option that he would accept, i.e., that the headless human person-organism is John, not a new person Fred. Why not say that the headless body still has the same soul and thus retains the same radical potency for intellect and will that it had before being severed from the John’s head? Since DA believes that the brain is not necessary for a human person-organism to be integrated as a whole, the artificially sustained headless body could have the same degree of organic integration that an artificially sustained, brain-dead body has. So, if total brain failure does not entail John’s death, why should decapitation? This seems to be the logical conclusion that animalists, such as Don Marquis, draw. Why doesn’t AS draw this same conclusion?

One other point: AS writes “Even within the imaginary case of the thought experiment, no “thought-empirical” observation or test will help distinguish #1 from #2. #1 holds the “the head is John’s; when it communicates with us, John is communicating with us.” #2 holds that “The head is not John’s anymore. The behavior and communications of the head only resemble John’s former personality because of the retained neural circuitry, but they are coming from an automaton or ‘zombie’ rather than John.” I think that it is a reasonable empirical hypothesis to say that if the same neural circuitry continues to give rise to what appear to be the same thoughts, memories, and personality of someone as it gave rise to at an earlier time, then the continuation of that same circuitry, thoughts, memories and personality is indicative of the same person.

John Lizza         May 9, 2021 at 1:00 PM

AS cites Lee and George’s hylomorphic view in support of his position. However, subsequent to AS’s publication of this article, Lee and Grisez have used decapitation as an argument to support acceptance of total brain failure as death. They believe that both the artificially sustained brain dead body and the artificially sustained decapitated body have lost the radical potential for intellect and will, and therefore the human person-organism has died. Does AS accepts Lee and Grisez’s current view and, if not, why not?

John Lizza         May 9, 2021 at 1:03 PM

AS challenges the use of hypothetical cases to argue in support of one view about death over the other. I agree with David Hershenov that some thought experiments can be useful. However, I also think that some are not, because any intuitions about them require assumptions about background conditions that are too indeterminate to support one intuition over another. I think that some of Parfit’s thought experiments involving teletransportation and replication fall into this latter category. Indeed, I think that some thought experiments involving the psychological division or replication of persons tell us nothing about whether and where we would continue to exist, because they sunder the person from the social and cultural context in such a radical way that I just don’t have any good intuitions about what to say about them. AS’s sagittal bisection of a human being, along with Don Marquis’s thought experiment involving transplanting separate hemispheres into two different individuals that he uses to challenge to McMahan’s view, are such thought experiments. The reason why I do not have strong intuitions about such cases is that I have no idea how society would treat such individuals. I think that there would be two separate persons, but it is unclear how society would handle questions about their identity. I could imagine that for certain purposes, such as marital or parental relationships, we might resolve the identity questions by legal stipulations that best meet the social needs. For example, if polygamy were a concern, we might stipulate that for purposes of the continuation of a marriage, one of the two individuals would be identical to the original person before the split. This suggests that questions about our identity and continuation are as much moral and social matters as they are biological and metaphysical. Moreover, I think that this is exactly what AS is suggesting by semantically bifurcating death. Civil death involves moral and social considerations in a way that metaphysical death does not. I wish to draw a similar distinction between the death of the person (civil death) from the death of the organism, when these two events may not take place simultaneously.

Pat D                May 17, 2021 at 3:29 PM

PASSING AWAY & DEANIMATION

Rather than a purported paradigm shift in our understanding of death in binary as opposed to univocal terms, the distinction that AS makes between “passing away” and “deanimation” corresponds to the difference between a commonsense and a theoretical understanding of the very same phenomenon. In other words, there aren’t two elephants in the room.

A.S. Eddington opens his 1930 essay, The Nature of the Physical World, by saying (in abridged form): “I have settled down to the task of writing these lectures and have drawn up my chairs to my two tables. Two tables! One of them is a commonplace object of that environment which I call the world. It has extension; it is comparatively permanent; it is colored. If you are a plain commonsense man, not too much worried with scientific scruples, you will be confident that you understand the nature of an ordinary table. Table No. 2 is my scientific table, which is mostly emptiness. Sparsely scattered in that emptiness are numerous electric charges rushing about with great speed; but their combined bulk amounts to less than a billionth of the bulk of the table itself. Notwithstanding its strange construction it turns out to be an entirely efficient table. It supports my writing paper as satisfactorily as table No. 1. If I lean upon this scientific table, the chance of my scientific elbow going through is so excessively small that it can be neglected in practical life.” Table No. 1 and table No. 2 are the same table described from different perspectives.

Similarly, “passing away” and “deanimation” are two ways of understanding the very same phenomenon, death – that is, the going out of existence of an organism. “Passing away” is analogous to commonsense table No. 1 and deanimation to theoretical table No. 2. The criteria for determining (judging) whether or not a particular organism has “passed away” (i.e., is dead) relate the relevant phenomena – the cessation of circulation and consciousness – to us, the observers, in the ICU or operating room or home or on the street. The criteria for determining “deanimation” relate the phenomena to one another – the cessation of the anti-entropic exchange of substances with the environment to the departure of the soul – in terms that correlate the theoretical understanding of life in terms of anti-entropic processes and hylomorphic dualism.
Whether or not these theories are correct, the phenomenon to which they refer remains the same as that to which common sense refers.

Pat D                May 17, 2021 at 3:32 PM

TIME CONSIDERATIONS

The stipulated difference between “permanent” and “irreversible” cessation of vital signs also comes down to the difference between a commonsense and a theoretical perspective on the finality of death.

Determining the moment of death is not simply a matter of observation. Even in Soran’s case, it is a matter of understanding the nature of the vet’s actions, the expectation that Soran’s heart will stop beating as a result of the vet’s actions, plus the observation that it did stop beating. In most cases, like that of George Floyd, it is only in retrospect that one can surmise that the last pulse or breath observed was in fact the very last one. I daresay in commonsense terms that death is an event that has a duration – for instance, between the last systole and the heart’s failing to contract after it fills with blood again. For all that, the moment of death does not define death. Death marks the end of the life of an organism, but it is a matter of that organism ceasing to exist, regardless of the moment at which that event occurs.