Sulmasy: Whole-brain death and integration

Neil Feit           March 24, 2021 at 1:32 PM

EXISTING AND EXISTING-AS

When first discussing the ontological definition of death, Sulmasy says “death ought to mean the ceasing to be (going out of existence) of an organism” (p. 456). While he later puts similar claims in terms that do not imply simply ceasing to exist, he seems to have simply ceasing to exist in mind. This might be nothing new but I think there are two serious problems with it.

The first is that if a person dies on the operating table, the doctors seem to be looking at the same individual who existed moments before. If the individual simply ceased to exist, the docs are either looking at a brand-new thing, or at nothing but “simples arranged corpse-wise.” Now, that might be correct, but I don’t think the concept of death should entail it. On the other hand, if death is merely "ceasing to exist *as* a living human being" (for humans), then existence has nothing to do with the definition, which could be rendered more simply: death is an organism's ceasing to be alive (or perhaps ceasing to be a living human being).

Second, there are the old problems with "deathless exits" from life, discussed by Fred Feldman and others. A healthy amoeba that undergoes binary fission seems not to die, and yet it pretty clearly ceases to exist – it's not like budding, for example – and is replaced by two new daughter cells that begin to exist. On the proposed ontological definition, the amoeba dies upon ceasing to exist. While it is possible to argue that this is the nature of (healthy) amoeba death, it seems more plausible to me that the amoeba has ceased to exist without dying.

Replies

Stephen Kershnar         March 26, 2021 at 2:06 PM

A CONCEPTUAL DEFENSE OF DANIEL SUMALSY’S TERMINATOR ASSUMPTION

Neil and David:

Sulmasy’s claim is as follows.

(1) If someone dies, then an organism goes out of existence.

You raise two objections.
(1a) As far as the concept of death goes, it is possible that a person dies but does not go out of existence.
(1b) A person can cease to exist without dying.

Unlike you animalist-apologists (not the worst type of apologists), I think the following is true.

(2) Necessarily, if someone is an animal, then he is alive.

My claim is that an animal is essentially an organism and that an organism is essential alive. It is an interesting issue as to whether being alive involves integration, metabolism, or something else.

Underlying this is the following claim.

(3) A body is contingently alive.

That is, there is only one thing present, a body ,and it contingently has life. This is similar to have Lumpl contingently has the shape of Goliath.

If this is correct, then Sumalsy is only solid ground in assuming that, as a conceptual matter, an animal that dies goes out of existence. That is, (1a) is incorrect.

However, whether an individual is an animal is separate matter.

On (1b), I claim that the amoeba dies because its body is not doing any of the life-making functions (for example, integration or metabolism).

Best,
Steve K

Jim Delaney      March 27, 2021 at 9:22 AM

With respect to “deathless exists” such as fission cases; this may be a reason for not including “ceasing to exist” as part of the definition of death. I also have an intuition (though not a super strong one) that the amoeba ceases to exist without dying when it splits. But just to play devil’s advocate:

One possibility is that original amoeba does not actually go out of existence; so A does not split into B and C, but rather B branches off of A so you have the original and a new one. So there is no death but there is also no exit. Admittedly this would mean that there are some VERY old amoebas in the world and perhaps there are biological reasons for thinking both are new organisms.

The other possibility is that the original amoeba does die during the fission process. What is the main reason for rejecting this? Is it that there is no corpse? If a bomb explodes and a person is annihilated, there would also be no corpse. And if the matter that used to compose that person came to compose other people, this would be something like the amoeba case except that it would be more gradual, and would not be a case of healthy reproductive function. But the original person no doubt died. Or is the idea that there is no interruption in the biological processes in the amoeba case?

Stephen Kershnar         March 28, 2021 at 9:49 AM

AMOEBA, WE HARDLY KNEW YA

Jim and Neil:

Jim makes a good point. Let us call the original amoeba, "A." A fissions into B and C. Now consider the following claims.
(1) An individual is essentially an organism.
(2) An organism essentially integrates (or, perhaps, metabolism).
(3) A no longer integrates. This is because A ≠ B and A ≠ C, and B ≠ C (because integration is tied to an individual's identity), it.

As Jim points out, the lack of a corpse intuitively seems beside the point. It results from the lack of integration, but is not identical to it nor a necessary implication of it. For example, it is possible for the molecules of a body to disperse in all directions without leaving a corpse.

Hence, it seems that amoebas die.

Best,
Steve K

Neil Feit           March 29, 2021 at 2:11 PM

I agree that the lack of a corpse seems beside the point. The fact that there is no corpse is not a reason to think that the amoeba doesn't die. The real reason to say that it doesn't die, I would think, is that there is no dysfunction or disease. The amoeba is healthy and doing exactly what it's supposed to do.

Steve, I'd reject (2). A dead butterfly for example is still an organism -- a dead one. I don't have anything riding on this and I'm less confident about it than I used to be, but it strikes me as more plausible than the alternatives.

David H            April 1, 2021 at 3:51 PM

Reply to Neil on the amoeba not dying:

I take it to be a conceptual truth that death involves the loss of life processes or the loss of the capacity for life processes. So, any living being that has gone out of existence ceased to instantiate life processes and thus has died. The alternative is that they were alive and now don’t exist but are now neither alive nor dead. Imagine a woman in the first month of her pregnancy who asks her Ob/Gyn “Is my baby dead?” The doctor says “the good news is that your baby is not dead.” The women sighs and her face shows great relief. Then the doctor continues, “But the bad news is that your baby no longer exists.”

People are misled by the lack of corpse or a dying process. (I suspect there is a brief dying process in fissioning as the nucleus divides and ceases to control the organelles prior to the pinched cell dividing into two.) Many people point out that there is not a corpse. So that plays a role in thinking that people didn’t die in fission. Neil says that isn’t his reasoning as there isn’t disease preceding death. True, but why think a death can’t be programmed and dying a proper function? In fact, some organisms are diseased if they stay alive and fail to reproduce? They are supposed to die by fission, swimming upstream to lay eggs (salmon), or to become the first meal of their offspring who eat their way through their belly (gall midge?), or die during fornication (praying mantis, black widow) If it is a malfunction to stay alive, why can’t it be a proper function to die?

David H            April 1, 2021 at 3:56 PM

1. Should the meaning of “death” entail ceasing to exist? I think that it is true that one ceases to exist at death but I wonder whether this is not a substantial metaphysical issue and perhaps not best included in the definition of “death.” (But see my comment #5 below that suggests a defense of DS via Putnam-like semantic division of labor.) Whether the living human animal goes out of existence at death rather than becomes a dead animal or corpse should be the result of metaphysical/biological inquires. The so-called terminators (van Inwagen, Olson, Rosenberg, myself) maintain that at death animals cease to exist and present are just remains, not even a corpse if that is understood as a composite entity that is the size of the living human being. Animals are essentially alive and at death, despite macro-similarities, bio-chemical changes at the microscopic level indicate substantial change. (We are misled by appearances. Jason’s apt analogy of CPU destroyed with the external part of the computer intact may mislead us to think the computer still exists. But what we have with corpse is akin to only the façade of a house remaining and everything behind it destroyed. The anti-terminators (Feldman, Mackie, LaPorte, Thomson, Mackie) think the animal or body or person continues to exist as a dead body or animal. They appeal to the continued structure of the living and the dead body.

3. True by meaning or (Metaphysical) Fact? The existential claim of DS reminds me of McMahan’s criticism of attempts by Bernat and others to define death by building the concept “permanent” or “irreversible” into the definition of death in that makes resurrection false by meaning rather than by fact. Resurrection shouldn’t be deemed conceptual nonsense like married bachelors. There may be no God or resurrection may be metaphysically impossible if construed as the resurrection of same body whose parts are in the grave rather than a soul getting a new transfigured body etc. But maybe I am working with an outdated (pre-Quinean?) distinction between true by meaning and true by fact.

5. More Charitable Interpretation of DS’s definition of death as ceasing to exist. Perhaps I (and Neil Feit?) have misconstrued what a definition is like and the distinction between truths of meaning vs. truths of fact is problematic. Consider a Putnam-like division of semantic labor. You know the story – lay people don’t have a description/definition which distinguishes Elm trees from beach trees so they defer to the experts to determine the meaning of elm and beach trees. Likewise, what is meant by “life” and its absence, “death,” will be determined by those with expertise in the relevant biological/metaphysical inquiry. It will then turn out that when an animal dies, it goes out of existence. So, if people defer to the metaphysically/biologically informed experts and mean by death what the experts do, then the Terminator thesis, assuming it is not just a metaphysical account of what happens at death but to be included in the meaning of ‘death.’ Then DS will be correct in claiming death should be so defined.

David H            April 1, 2021 at 3:57 PM

5B. Quick defense of the Terminator Thesis that at death human animals cease to exist: 1) Death is a more principled point to demarcate non-existence than the Anti-Terminator’s appeal to loss of structure in the corpse. The latter have a sort of unprincipled vagueness – one doesn’t even know what anatomical parts will be relevant, even if their destruction is vague. Is it the loss of too much flesh and organs? Is the skeleton not identical to the body? Or must there be more bone than dust for the body to persist? To tie persistence to the “sufficient structure” seems to be a sort of “perceptual intuition mongering” and will vary from person to person, perhaps a coroner seeing sufficient structure where lay people don’t. Moreover, there is also little structurally in common between a one-week old embryo and an adult. Function is a much better, more principled basis for demarcating existence from non-existence. When an entity can no longer function (engage in life processes), it no longer exists. “Sufficient structure” must piggyback on function if it is to be principled. At the microscopic level, death involves dramatic chemical/biological changes. It provides a sharp boundary compared to an appeal to too much decay.

2) I think an even better reason to accept the Terminator Thesis is that otherwise there are disjunctive part/whole relationship – one for living bodies and one for dead bodies. We have a good idea of what it is to be a part of a living entity – caught up in life processes that assimilate and maintain matter. We can even say some dead skin or gangrene limb is no longer part of the body because it is not caught up in life processes – its parts maintained, replaced etc. by the life processes instantiated in the rest of the body. But what is it to be a part of a dead body? Is the blood pooling part of the dead body? Are the gases and bloating caused by decay part of the dead body? Are the products of cells like lactic that produce rigor mortis part of the body? Putrescine and cacaverine are both produced by the breakdown of amino acids in dead organisms and the two compounds are largely responsible for the foul odor of putrefying flesh. I assume that if the corpse smells it is in virtue of its changing chemistry as some new chemical compounds come to be parts of it and not due to some other compounds which are not parts of the corpse but constituents of something else that stinks. Something similar might be said about the adipocere (grave wax) which the corpse’s fats sometimes produce in a process called saponification which slows putrefaction. Are the products of the posthumous isolated cells still part of the body as they are still active, some cannibalizing the neighboring cells? Consider what to say about autopsies. If gases and blood exit and return during the autopsy are they part of the dead body. They are certainly not being assimilated or functioning as they would be in live bodies. If organs are removed and sewed back in by the coroner, are they parts of the dead body? If the lower half of the body is incinerated, does the body still exist reduced to the top half? Likewise, for destroying the left side, does the body remain reduced in size to the right half? If the body’s parts are spread out across the coroner’s table like the parts of a watch on a repairman’s table, does the body exist as a scattered object. If we say “yes” or don’t know what to say to any of these cases with the dead body then it has different part/whole relationship than found in a live body where we know they are not parts. I suspect many people don’t know what to say about the dead body, and the reason is that the dead body is an ontological mess which makes me conclude that there is nothing there, just remains. A really existing unified entity wouldn’t have disjunctive mereological conditions nor provide so many scenarios where we just don’t know what to say about whether something is a part of them.

Stephen Kershnar         April 13, 2021 at 9:00 AM

ANIMALS ARE ALWAYS ALIVE / UNLIKE SOME FREDONIA PHILOSOPHER'S CAREER

Neil and David:

Excellent points.

I maintain the following are true.

(1) An animal is essentially an organism.
(2) An organism is essentially alive.

I have two arguments for this position.
(A) Dictionary. This is the dictionary definition of both. Unless we treat these as terms of art, and there is no reason to think we do, significant weight should be attached to the dictionary.

(a) An animal is "a living organism ..."
(b) An organism is "a form of life composed of mutually interdependent parts that maintain various vital processes."

(B) Conceptual Argument
(a) Animalism is a different theory than body, brain (embodied mind theory), and constitution theory.
(b) The best explanation of the difference is the essential feature of life for an animal.
(c) If (a) and (b), then an animal is essentially alive.

Thus, on my account, the termination thesis is true, but not for the complex reasons David puts forth.

Unless one accepts Peter van Inwagen's theory of objects, or something like it, life (being an animal) is a contingent property of a person rather than an essential feature. It is similar to Goliath being a property of Lumpl.

Best,
Steve K

Neil Feit           March 24, 2021 at 1:35 PM

EXISTING, EXISTING-AS, AND THE CONCEPT OF DEATH

Later in the paper (p. 471 for example), Sulmasy characterizes the ontological conception of death as “the loss of the integrated functioning of a whole organism.” He suggests this is the best ontological standard. Sometimes he puts this idea of death in terms of having “ceased to exist as integrated whole organisms” (p. 476). This seems better, since it is at least conceptually possible to cease to exist as an integrated organism without simply ceasing to exist. While it might be true (though I doubt it) that when a human being dies, he ceases to be an organism and ceases to be a member of Homo sapiens, analyzing the concept in terms of existing or existing-as seems to muddy the waters: this conception of death can be put in terms of the permanent (or irreversible) cessation of the integrated functioning of an organism. (Perhaps this is just the cessation of life, where the concept of an organism’s life is the concept of integrated functioning of a certain kind.)

There might still be fission-problems for this as a general, biological concept, but maybe these aren’t problems or can be solved. Sulmasy’s main argument, I think, is that making clinical criteria for determining whole-brain death more demanding in certain ways is warranted, and at least in part because it enables a response to a challenge (“chronic brain death”) to the best ontological conception of death. I found this persuasive but thought it would be better framed in terms of determining when the organism has ceased to be alive, or has lost the relevant kind of integrated functioning, rather than ceased to exist or exist as an integrated whole.

Replies

Phil Reed          March 31, 2021 at 4:25 PM

I had a similar question, Neil. I think Sulmasy would say that "ceasing to exist" = ceasing to exist as the kind of thing that something is (in this case, a living human being) = for a human being, the permanent loss of integrated functioning.

Now, maybe the first equation is still suspect (or needlessly muddies the waters) and that is perhaps your point. But it would make his view about the concept of death consistent, I think.

David H            April 1, 2021 at 3:59 PM

4. Is Dan Sulmasy’s Account of Death as Ceasing to Exist Compatible with Christian views of the Afterlife?

Cartesian soul theories make claim the person exists after their death so death involve the destruction of the body but not the person. Or perhaps of greater concern to a Catholic like DS is a Thomistic-inspired hylomorphic so-called Survivalist account of posthumous existence prior to the resurrection. The survivalist believes people persist at death with the soul as their only part. (The Thomistic so called Corruptionist believes the person ceases to exist but their soul continues to exist.) So, they might be dead and in Hell, Heaven or Purgatory but still exist and aren’t alive again until in possession of resurrected body. DS’s account of death rules this out. Perhaps he will just say “too bad for the Thomistic Survivalist” (like our Jason Eberl), as the Corruptionist or some other account is true.

David H            April 1, 2021 at 4:00 PM

2. Is death as cessation of existence the mainstream view?

DS writes “The current mainstream view is that there is one ontological conception of death – the permanent loss of integrated functioning, by which an organism can be said to exist as the kid of thing that it is.” (page 467) Whatever the metaphysical truth, death understood as the human being going out of existence certainly shouldn’t be the standard view quote DS as most people think a corpse is a dead body that was earlier alive. They consider it one and the same body. Although some people do speak contradictorily about death – Grandma is in heaven and Grandma is in the grave – most of the secular would say that we are burying Grandma, the coroner is examining Uncle Jack, the Haddock of fish fry the one ate on Friday night was the same fish that was swimming in Chesapeake a few days earlier in the week. I agree with Neil that the major achievement of DS in amending the criteria and tests to avoid “chronic brain death” is obscured by a contentious metaphysic of death being the moment of ceasing to exist.

Stephen Kershnar         April 13, 2021 at 9:11 AM

EUTHANIZING THE TIGHTENED CLINICAL CRITERIA
Neil, Phil, and David:

There are two reasons to focus on permanent brain death.

(1) On the theory that a person is a functioning brain, the person goes out of existence when his brain ceases to function.
(2) on the person is a brain - functioning or not - even if a person did not go out of existence, he is no longer a person - but a dead brain - and the rights to that brain go to the brain owner (for example, the spouse).

Neither depend on whether a person's integration continues or not.

I realize you guys reject (1), but why reject (2)? That is, why think that an individual retains rights after he ceases to be a person?

Is this based on interest, autonomy, or dignity? The dignity reference is, of course, my attempt at poetry.

Thus, tightening the clinical criteria gets the morality of end of life issues wrong even if it were to the metaphysics of it right.

Best,
Steve K

John Lizza         March 24, 2021 at 6:25 PM

Hi Dan,

On page 460 you offer several arguments for rejecting a higher-brain formulation of death. The arguments are frequently repeated, but I think that they are not very strong. The first is that the higher-brain formulation raises a mind-body or person-body dualism and that you think that this seems to imply that persons accidentally inhabit bodies. This is incorrect. There is nothing dualistic about Jeff, McMahan’s view that persons are embodied minds or anything accidental about how a person goes with their brain. There are others who defend a higher-brain formulation on Thomistic, hylomorphic grounds, e.g., William Wallace and the early Shewmon. My own view of the person follows the kind of non-dualistic metaphysics of the human animal and human person found in Wiggins’ original Sameness and Substance. There are some Lockean inspired views, like Parfit and Green and Wilker, but again they are not dualistic, certainly not in a Platonic or Cartesian sense. I guess that there may be some Platonic or Cartesian dualists out there who argue for a higher-brain formulation of death, but I am not sure who they would be. They haven’t been very conspicuous in the current debate. So, it is a straw man argument and fails to engage with the metaphysical arguments that have been advanced in favor of a higher-brain formulation.
The second argument is that higher-brain death cannot be applied to other non-human organisms. Why not? Why can’t it be applied to all higher-order organisms capable of consciousness? Huang and Bernat have recently proposed that we need to identify the specific control centers for different species of organisms and they define species of organisms by their “most macroscopic unifying and integrating emergent functions.” So, although they think that certain concepts of death, such as irreversibility, apply to the death of any organism, they think that the critical functions for the integration of organisms differ across species. Also, Jack Wilson thinks that we should not expect to find a single account of death for all organic forms of life, e.g., humans, jellyfish, and fungi.
The third argument is similar to the “you wouldn’t bury a breathing body, would you?” argument made by the 1981 President’s Commission. (They made the first two and the last one as well.) Which higher brain theorist has suggested burying breathing bodies? Wouldn’t it be more respectful to the dead body to stop the breathing and then bury or dispose of the body according to some common custom? Ari Jofee, who opposes brain death, once made a similar argument against the whole-brain theorist. He said that he could put a small battery powered ventilator in a coffin along with the brain-dead bod. He then asked Bernie Gert whether it would be okay to bury the breathing body. After all, if the person is really dead, what would be wrong with putting the individual in the grave while their respiration is artificially sustained? Well, Bernie did not think it was a good idea for the same reasons that a higher-brain theorist would not want to bury a breathing body – the same reasons why we don’t throw grandma in the trash after she dies.

(See futher next post because of space limitation)

Replies

Stephen Kershnar         March 26, 2021 at 2:15 PM

FOR BURYING A BREATHING BODY

John:

In responding to Sumalsy, you cite the following argument.

“The third argument is similar to the “you wouldn’t bury a breathing body, would you?” argument made by the 1981 President’s Commission. (They made the first two and the last one as well.) Which higher brain theorist has suggested burying breathing bodies? Wouldn’t it be more respectful to the dead body to stop the breathing and then bury or dispose of the body according to some common custom?”

You then say, “Well, Bernie did not think it was a good idea for the same reasons that a higher-brain theorist would not want to bury a breathing body – the same reasons why we don’t throw grandma in the trash after she dies.”

If an individual is breathing but her cerebrum has liquified, so that she will never be conscious, I fail to see why she has a right. This rests on the following.

(1) A right is justified by interest or autonomy.
(2) A person who cannot become conscious does not have an interest or autonomy.
(3) Interest and autonomy setbacks cannot backtrack to when the individual was conscious.

For similar reasons it does not harm the individual.

If this is correct, then I cannot see the wrongness to the buried individual if we bury her while breathing. It might wrong her family members (or, perhaps, whoever else owns her body), but it does not wrong the individual.

In short, I think there is no legitimate concern for respect with regard to the buried individual, although there might be one with regard to the individual’s family.

Best,
Steve K

John Lizza         April 1, 2021 at 12:08 AM

Steve: I agree that since grandma is dead, she no longer has rights or conscious interests like we have rights and conscious interests. My point was just that we still do not just throw her in the trash. We treat dead bodies with respect, not the same respect that we have for living human beings but respect nonetheless. Burying a artificivally sustained brain-dead or permanently vegetative grandma would not be a violation of grandma's rights in the way it would be a violation of your or my rights if we were buried alive. Nonetheless, we have customs about treating the dead that would lead us to suppress remaining life-functions in grandma's remains before we buried her.

Stephen Kershnar         April 13, 2021 at 9:18 AM

CHARLIE DON'T SURF / GRANDMA'S INTERESTS DON'T BACKTRACK

John:

Great point, but I have to disagree. Here is my argument.

(1) A right is justified by interest or autonomy.
(2) A person who cannot become conscious does not have an interest or autonomy.
(3) Interest and autonomy setbacks cannot backtrack to when the individual was conscious.

I take it that you reject (3). I don't see why this is plausible. Do you claim that interests backtrack in general or just in the case of brain-dead bodies?

The lack of interest or autonomy is what distinguishes burying me when I am alive and conscious and burying a body when its cerebrum has liquified.

The reference to throwing grandma in the trash is unconvincing because the way we dispose of the body is due to duties we owe to the relatives or sensitive community members, not the never-be-conscious-again individual.

In short, do you think interests backtrack?

Best,
Steve K

John Lizza         April 14, 2021 at 10:51 AM

My point does not depend on accepting backtracking or posthumous interests. I can agree with you that the reasons why we do not throw grandma's remains in the trash after death have to do with the current interests of those who are still living. But that is exactly my point. There are other reasons that bear on how we treat grandma's remains. Regardless of whether we think grandma is dead under a non-brain, whole-brain, or higher-brain view, we still do not throw grandma's remains in the trash. Suppose one accepts only a non-brain formulation of death and Grandma irreversibly loses circulation and respiration. Grandma is now dead. So, is it okay to throw grandma’s remains in the trash? No. Suppose one accepts a higher-brain view and grandma irreversibly loses consciousness, but she can still breathe on her own. Grandma is now dead. So, is it okay to bury grandma’s remains while those remains are breathing? No, for the same reasons why we think it is wrong to throw her remains in the trash. We would develop respectful protocols that would involve suppressing grandma’s respiration, before we buried her, not because we thinks she has some interest or right to be treated in that way, but because of the current interests of those who are still alive.

John Lizza         March 24, 2021 at 6:25 PM

The fourth argument is that is offends common sense to think that an individual in permanent vegetative state with autonomous heartbeat and respiration is dead. Shewmon and other critics of whole-brain formulation make a similar argument against the whole-brain formulation: “Those bodies are warm to the touch. They process food. Just look at and smell the mess that they make. Can’t you feel how their hearts beat? Can’t you see how their wounds heal? How could a dead body gestate a fetus? You’re crazy to think that they are dead.” On the common sense side, I am not sure that the whole-brain theorist fares much better than the higher-brain theorist. But, common sense also goes against the non-brain formulation as well, since they are committed to thinking that an artificially sustained, decapitated body gets counted among the living “we.” That’s real offensive against common sense. Proponents of all three views have to propose some theory to address why the common sense intuition is wrong. I don’t see any way to do this besides talking about what kind of being we are that lives and dies, and that’s a philosophical question, not a biological one. Also, it is not surprising that technology would dish up problematic cases that our ordinary common sense has trouble with. Heck, I’m still miffed about Schrödinger’s cat.

Replies

Stephen Kershnar         March 28, 2021 at 9:58 AM

WHOLE-BRAIN SWITCHES UNDERMINE COMMON SENSE

I wonder about the following case. We transplant Prince William's whole brain into Harry's head and vice versa. The bodies are warm to the touch, process food, wounds heal, and yet, intuitively, William is in Harry's body and vice versa.

There are three options for the animalist and integrationists (they might be the same).
(1) Even though thinking occurs via the 10 billion neurons and they neurons switched location, William and Harry stay in their original bodies.
(2) The switch is impossible. Hence, it tells us nothing.
(3) Whole brains can transfer identity, but normally a life (organism or animal) is the bearer of identity.

Proposition (1) is implausible.
I do not know why we should accept (2). In theory, we could switch people's hearts. Why not their brains?
(3) is mistaken if in switch cases identity follows the brain, then intuitively a person is essentially his brain.

Common sense conflicts with the identity-maker. Intuitively, it seems that common sense should give way.

I think the same argument would apply to a cerebrum transfer, but that is a different discussion.

Best,
Steve K

David H            April 12, 2021 at 10:53 AM

Alternative Upper Brain Death Criterion Accounts that avoid DS’s Critique Part I:

I think DS’s critique of the problems of upper brain death are effective against those, like Veatch(?), who think the human being is not co-located or overlapping any other living, thinking entities. Then it is accurate to say “Above all, it just lacks common-sense realism and plausibility to declare individuals that are capable of breathing spontaneously, having sleep-wake cycles, and maintaining their own homeostasis, in terms of blood pressure, in terms of blood pressure, temperature, and hormonal balance, dead.” He then adds a few lines later “…it would be very hard to conclude that such an individua is dead.” (p. 460). I fully agree for the reasons he gives. But there are alternative, perhaps more metaphysically sophisticated theories like Baker, Shoemaker, and Romanell Center friend, John Lizza, that claim there are two overlapping entities, a person and an organism/animal/living body. On their view, the person no longer exists and thus is not present and engaged in the any of the life processes that DS describes in the quote above. They would, or should, claim there is someone else there, an animal (body), that meets those conditions. The person is not in a dead state and breathing, maintaining homeostasis etc. And their view would be that it is not morally problematic to end the life of the animal or body that is there. DS might contest that it is morally decent to treat the human animal that way, but his accusation of it being “rude, if not downright macabre” (460) fails to hit its target given the metaphysics of those who don’t identity persons and animals. (Now, I would agree with him that we shouldn’t distinguish persons from animals but that is another matter.)

David H            April 12, 2021 at 10:55 AM

Alternative Upper Brain Death Criterion that Avoids DS's Critique Part II:

Moreover, in my opinion, the above philosophers and others who defend an upper brain criterion don’t (though they do) even have to define death differently for persons than other animals. So, they can avoid DS’s (p. 460) accusation “Why should ‘dead’ mean something different in reference to parakeet than it does in reference to a human?” In the same TMB issue that DS’s paper is in, I argued that those materialists who think persons are not identical to animals should just argue for a different criterion of going out of existence, they need not introduce a new criterion for death or second meaning for “death.” Persons, on their view, go out of existence when capacities for thought are extinguished. But they don’t need to equivocate on the meaning of “death” or introduce a new criterion of death. Any living being who goes out of existence has died, i.e., lost irreversibly (appropriately qualified) the capacity to instantiate life processes. And those life processes could be defined in terms of integration as DS prefers, and could be governed by a brain-death or rival circulatory-respiratory criterion. One reason why it is not realized that the person has died a biological death is that there is still a breathing, living body on the hospital bed. But not recognizing that the person whose upper brain functions are essential has died is a mistake similar to not realizing that someone who is bruised in virtue of their thumb being bruised has ceased to be bruised when they have ceased to exist. That is true even if their bruised thumb continues to exist. Imagine all of the person but their thumb is destroyed. That is, every anatomical part but their thumb has been reduced to cremains. (They obviously haven’t become smaller as they would be if they only lost a finger and the rest of their anatomy had remained intact after the finger was amputated.) The person no longer has a thumb as the person no longer exists, ergo, the person no longer instantiates the property of being bruised. This is true despite the person’s bruised thumb still persisting. The person obviously hasn’t been reduced in size to the bruised thumb. So, likewise, in DS’s case, the person has died and ceased to instantiate life processes like breathing, homeostasis, temperature regulation and hormonal balance, though the animal that it overlapped still does so. Thus, I think a metaphysically sophisticated account of person/animal non-identity avoids DS’s critique quoted above.

What I said above is true for constitution theories like Baker, Shoemaker, and Lizza, might even be true if one believes the person is the brain, or the thinking part of the brain, as long as one believes organs can die. And DS seems to believe that organs can be alive and thus, it seems safe to assume, can die. DS writes (p. 457) “Third, the advent of cadaveric organ donation for transplantation showed that an organ (such as a kidney) was still apparently alive even when the donor had been declared dead.”

David H            April 12, 2021 at 11:28 AM

Reply to John: Person-Body Dualism and Mind-Body Dualism:

Like you, I don’t find DS's phrases “Person/Body dualism” or “mind/body dualism” helpful in critiquing those defenders of the upper brain criterion but I think there is a charitable reading that gets to the heart of the problem which is really an essential person/contingent person problem. It is a two-person problem, not a person/body problem, though the former problem arises from not identifying the person and the body.

If one means by “person/body dualism” that the person doesn’t have a body in the sense that none of the body’s parts and literally parts of the person, then most of the defender of the upper brain criterion are not dualists as they are materialists who believe persons like me are roughly six feet tall, approximately 200 pounds. Such persons are not just intimately causally connected to a body like the Cartesian imagines. But, as you know, your fellow constitution theorists believe the person has a body, the bodily parts are also part of the person. Baker will even say “the person is the body” in the way that the statues is a bronze lump. This is the “is” of constitution, not identity.

If one believes that the body is more like the trunk or from the neck down (that is, the body doesn’t get smaller when the person is decapitated or their brain transplanted) then perhaps if one agreed with McMahan and the later Parfit that we are cerebrum- size parts of animals then one might believe the body doesn’t include the brain and so they are materialist person/body dualists and materialist mind/body dualists

But the charitable read of DS’s use of the phrases is the one Jason expressed (below) in which the person is not identical to the body and bodily parts are not essential but contingent. But then the relationship between the person and the body needs to be explicated. If the body/animal has a brain, then it can think as it also a person, though contingently one. So now the defender of the upper brain criterion who doesn’t identify animals and persons will have to confront the infamous Too Many Thinkers Problem. Why can’t the animal use the brain to think if the person can? So why isn’t the animal not a Lockean person as it will have thoughts about thoughts? What is your response? Do you deny that animals think (Shoemaker)? Do you count persons by the constitution rather than identity relation and so deny there are two persons thinking (Baker), just one thinking person constituted by a non-identical animal/body?

John Lizza         April 13, 2021 at 4:30 PM

I agree with Baker that there is just one thinking person constituted by a non-identical animal/body. I thnk that Parfit has shown that animalism has its own too many thinkers problem. So, that may lead to a standoff on that problem between animalism and constitutionalism. However, we count persons for practical reasons. Is there any practical reason for counting two thinkers or persons if persons are constituted by animals/bodies? Also, a too many art works problem similar to the twoo many thinker problem may be generated for Michaelangelo's David. Is there any reason why we would count the statue and the marble that constitues it two works of art, even if they are not identical?

Jason T. Eberl   March 25, 2021 at 9:56 AM

Responding to Dan: (1) I’m curious what you think about Maureen Condic’s distinction between biological “coordination” and “integration” (see her 2016 JMP article). I’ve relied on this in my own defense of the integrative unity rationale for whole-brain death. (2) on p. 473 you state, “Digging deeper, one does find early evidence supporting the belief that the brain-dead body is physiologically unstable.” Shewmon has critiqued this premise in his “Spinal Shock” paper, in which he argues that physiological stability is regained in cases of long-term support for pts with total brain failure; we just don’t typically keep them alive long enough to witness such stabilization. (3) Finally, you can only do such much in one paper, but I’m curious what you think of Lee/Grisez’s “radical capacity for sentience” criterion; my main problem with their view is that they use it to defend the whole-brain criterion but it would also support (properly diagnosed) higher-brain death. Lee has responded to my critique by citing epistemic concerns of misdiagnosis (bolstered by Fins’s recent work) and other *practical* issues, but doesn’t rule out *in principle* that a (properly diagnosed) PVS (not MCS) patient is dead.

Responding to Neil: on p. 456 Dan says, “‘Death’ ought to refer to the event of an organism’s ceasing to be as the kind of thing that it is—an individual member of a biological natural kind”. If my computer completely crashes, the CPU becomes irreversibly non-functional, then I’d say that I no longer have a “computer” in front of me, even though it remains structurally intact and looks and feels like a computer; it no longer “functions” *as a computer*. A-T metaphysics puts this in terms of “substantial change” which allows for a change in a thing’s substantial kind, which entails something’s going out of existence, even if certain accidental properties persist as borne by whatever new substance (or sets of substances) persists in place of the previous substance.

Responding to John: The dualism to which Dan refers could be construed as Platonic/Cartesian dualism, which I agree is a straw man target. However, there is also the notion of “self/body” dualism in which a person/self is identified only with their mind/mental properties/brain and the rest of the body isn’t considered to be an essential part of the person. It’s this *accidental* (i.e., non-essential) relationship of one’s self to the rest of their body outside of the brain that I believe Dan (and I) finds problematic. Paul Root Wolpe made a similar charge of “cerebrocentrism” in this AJOB commentary on Ren/Canavero’s proposed head transplant procedure. While there are able defense of cerebrocentrism, there are also able critiques from Eric Olson and others. So there’s still a type of “dualism” worth engaging with as we debate a higher-brain concept of death.

Pat D    April 9, 2021 at 9:24 AM

David asked me to comment from a Lonergan perspective since Dan referenced Lonergan’s notion of a ‘thing’ and since I am working on a philosophy of health based on Lonergan’s philosophy.

First I want to say that I am persuaded by Dan’s argument (1) that death should be defined in biological terms as contrary to life, specifically as the irreversible loss of integrated functioning of the whole organism, (2) that the criteria for the determination of death in a clinical setting should include irreversible cessation of cardiopulmonary functioning or of ‘whole-brain’ functioning, (3) with the proviso that cessation of whole-brain functioning be understood to encompass dis-integration of autonomic and neuroendocrine (“cerebro-somatic”) functioning as well as brainstem and cortical functioning. I also agree with his assessment of the practical and policy implications of this definition of death.
However, I am not sure why Dan referred to Lonergan’s notion of thing (p. 470).
1. On the one hand, Dan’s emphasis on integration with respect to the unity of the organism and his appeal to both historical and clinical data in support of your argument are very compatible with Lonergan’s positions.
2. But Dan’s reference to a common sense understanding of biological kinds as ‘already-out-there-now-real’ is incompatible with Lonergan’s notion of thing. This formula pertains more to what Lonergan calls ‘bodies’ – sensibly perceived objects.
3. For Lonergan, the full act of knowing goes beyond experience to ask what it is that we perceive and then to ask further if our understanding is correct. Understanding correctly goes beyond the immediacy of the ‘already-out-there-now-real’ – as I believe Dan does in developing his overall argument.

Responding to Neil:
1. I agree that the definition of death does not entail an existence claim. However, the determination of death does involve the judgment that this person is dead – this person no longer exists as a (materially) living thing. It may exist as a body (corpse), but it is no longer alive or what it once was.
2. I agree that reproduction by fission involves substantial change that does not involve death. However, an amoeba can die if it is exposed to a toxic environment (like an anti-microbial) or hostile life-form.

Responding to John:
1. Per Lonergan, human development involves several levels of differentiation and integration – organic, psychic, and intellectual (or agential). On this account, death pertains to organic dis-integration. Delirium, dementia, PVS/MCS, coma entail dis-integration of higher level functioning that pose specific clinical, ethical, and ontological challenges, but these conditions are distinct from the death of the organism.
2. Speaking of death in relation to dis-integration of higher-level functioning is akin to speaking of sin as spiritual death. It may be meaningful, but the meaning falls back on a basic understanding of biological death.

Responding to Jason:
1. I can’t speak to Condic’s position, but I would distinguish different levels of organization/integration at the cellular, tissue, organ, and system levels, which are all subsidiary and subject to higher-level biological integration at the ‘level’ of the whole organism.

John Lizza         April 13, 2021 at 4:16 PM

Response to Pat: this probably does not do justice to your point but I think that the potential for consciousness is essential to human persons and that when that potential is lost the person has died. The remains of the person may be a living organism of some sort but it is no longer the body of a human person. Artificially sustained brain-dead bodies and artificially sustained decapitated bodies are the remains of human persons.

Stephen Kershnar         March 26, 2021 at 2:27 PM

OUR INTUITIONS TELL US THAT A PERSON IS A BRAIN

Guys:

The Sumalsy discussion and several of my outstanding Romanell Colleagues (for example, David Hershenov, Neil Feit, and – I think – John Keller) think that a person is an animal.

The standard arguments against this are convincing. Here they are.

(1) 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).

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

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

(3) If there is 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) If a 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

Replies

David H            April 1, 2021 at 4:25 PM

Response to Steve
First, I would think no one should claim it is intuitive to say the person is located where their brain is if you mean that the person is the brain or a part of the brain! The brain view is counterintuitive as it states we are a few inches and pounds and have never been seen or touched. Second, you need to be careful that you are not mixing up prudence-like concern and metaphysical indicators. It may be the former tells us nothing about what we are. Anyone sympathetic to Parfit’s claims that identity doesn’t matter because of their reactions to fissioning of the cerebrum and transplanting of the two hemispheres into different skulls, has no reason to believe that our concerns in transplant scenarios and lacking of concern towards one of the two headed conjoined twins indicates anything about who we are. If we can have concern for a being we are not identical to in the fission and transplant scenario, then such concern will not tell anything about who we are in the two headed scenarios. No metaphysical truths about identity are tracking our concern.

But I actually think we should care about the animal in prudential grounds for identity matters. Just as it was good for us as fetuses to grow a brain and become conscious, it is good for us to receive a transplant brain when we would otherwise be left brainless or unconscious. I also think that there is one person and animal in the two-headed case and that person should care about the mental states in part realized by the different brains despite their not being causally connected

David H            April 1, 2021 at 4:25 PM

Reply to Steve Part II:

I try to undermine the intuitions that they two headed shouldn’t care about each other by appeals to “Sleeping Steve” and “Waking Steve” who I believe are the same person. Let’s imagine the thoughts are cut off from each other, Waking Steve recalls none of the dreams of Sleeping Steve and Sleeping Steve’s dreams contain no content that makes no reference to the life of Waking Steve. We can even imagine damage to the brain so the two parts of the brain can’t communicate and thus the Sleeping and Waking thoughts are stored separately, causally unconnected. I suspect that if Waking Steve views a tape of his sleeping body undergoing terrible nightmares, screaming and tossing, Waking Steve would and should care about the nightmares of Sleeping Steve (really his sleeping self) and do something that could prevent those nightmares. He would do so with prudential concern not generic compassion and concern towards all. If Waking Steve cares about Sleeping Steve despite the lack of psychological continuity (there are no memories of the dreams or even indirect harms upon waking like fatigue and anxiety) then the thoughts of the two headed should have concern for thoughts supported by the other head. The same person is thinking all of the thoughts, even though some of her thoughts are not causally connected to the others. But she is the subject of all of those thoughts.

Secondly, you are perhaps already committed to a thinking being with a divided mind in the case of the two headed, even if you think you are just the brain. That is because there is an animal there with two heads who can think with both of them. If the human animal has a divided mind, why couldn’t the overlapping human person?

A third intuition pump is to think of late fetuses or neonates without psychological continuity and just different parts of the brain realizing the feeling of pain or pleasure but no self-consciousness uniting them. That is a baby with a disunified mind, not two babies who will soon fuse out of existence when the different mental states become unified. The same baby feels pain with one part of his brain and feels pleasure with a different part of his brain. The raw feels are both his because they are realized by parts caught up in the same life processes. That is what individuates subjects of thought, not having thoughts realized in the same gray matter. So when the baby develops to the point that it can think “I was in pain” or “I am in pain now but will be without pain”, that is not a new baby who replaced the two less developed babies with mental states that weren’t causally integrated and psychologically connected.

Fourth, if you undergo a stroke that reduces you to with infant-like brain that just feels pain and pleasure but is not capable any longer of any thoughts more sophisticated, you will probably 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 didn’t before but nothing conceptually more sophisticated. I suspect that you would have prudential concern for that thinking being even though the post-coma thought is with part of the brain that was never used for thought before. If you accept that, then the game is up and 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 via transplant. The reason the pains pre-coma and post-coma belong to the same subject is that the latter is individuated by life processes not gray matter that subserves both the earlier and later pains.

David H            April 1, 2021 at 4:30 PM

Reply to Steve Part III

Open access paper by Alexandra Boyle shows that apparent conjoined twins sharing just one head Cephalothoracopagus Janicep are just one organism on metabolic, immunological and homeostatic grounds. I was the referee in two different journals for her paper and told her that she had a great critique of McMahan there as JM (and myself earlier) thought this form of conjoined twins with one cerebrum but two brain stems was a problem for animalism if brainstems individuated organisms. They couldn't bit the bullet here as they could with the dicephalus and say there was just one organism with a divided mind. https://link.springer.com/article/10.1007/s11098-019-01316-x

David H            April 1, 2021 at 4:31 PM

Reply to Steve about Person-size brains Part IV:

We need a big picture metaphysics – considerations of parthood, vagueness, naturalism, puzzles of coincidence, sparse ontology, compatibility with scientific worldview, avoidance of too many thinkers, special compositional question, unity of thought consideration etc. - not just intuition pumps to brain transplants to determine what kind a being we are. Here are three such reasons to doubt the people are parts of animals metaphysic.

1. Special composition question – “The Xs compose a Y if an only if…” The usual answers are causal – contact, grasping, fusion, life processes. But producing thought is not a causal answer. What makes the parts of the brain part of the brain and keeps them there and sustains them and repairs them and replaces them has nothing to do with the production of thought. It is all the result of life processes. To say we are the entity composed of the particles that directly produce thought is like saying we are essentially kickers composed of the particles that can kick a football. What is needed is a causal answer to what makes something our parts. Life processes is the best answer.

2. Brains don’t think, organisms do. Life processes are constitutive of thought – your brain is crucially involved but it requires constant metabolic and homeostatic activity. These are not causally upstream processes. The very neurons are living cells are dependent upon the organism that built them, grew them, repairs them, maintains them, fuels their activity, them etc. there is no thought without life processes surging through the brain. And the life processes are not limited to the brain but extend throughout the body making the matter that instantiates the processes all part of the same animal and thinker. And if the brain truly was the thinker, why all of it? Why not just the tips of neurons that fire and receive electrical signals? If so, you are left with a thinker being the scattered tips of neurons. That should give you some pause. Why do other parts of the neurons contribute directly to thought when they maintain cell stability or excrete cellular wastes? They seem not more directly involves than circulation and respiration. Consider the cooking analogy – what is directly involved in producing the meal and what is not directly involved in producing the meal? Is there a principled line between food growing, food storage, food prep, seasoning the food, heating the grill or oven, stoking the fire, cutting and slicing, mixing, seasoning, arranging, etc? Likewise, there is no part of the body that is directly involved in the production of thought. Just more or less involved.

3. Brain view has embarrassing sparse ontology: McMahan, and later Parfit, want to avoid too many thinkers problem with brain view. But it just moves around the lump in the metaphysical carpet. Imagine, for the sake of argument, part of the brain D directly produces thought. Well, there will be anatomical structures slightly larger (the whole brain?) than D than can be reduced to the size of D and thus will be spatially coincident thinkers. Likewise, there will be structures slightly smaller than D - the respective left and right hemispheres - either of which D can be reduced to in size thus producing spatially coincident thinkers. To avoid this, one will need a sparse ontology where there are no such things smaller or larger than the thinking organ. So this will b a sparse ontology without cerebral hemispheres or whole brains or animals. That is the worst kind of sparse ontology. At least the animalist has a sparse ontology of animals and persons. The advocates of persons as part of the organism will only have persons, no organisms. This doesn’t fit the natural world of ontogenetic and phylogenetic development of mindless animals that preceded sentient species historically and in each thinkers’ embryonic life

David H            April 12, 2021 at 9:43 AM

4. Animals do better than cerebra in meeting Substance criteria:

Traditionally a substance is Metaphysicians have typically considered substances to be in some sense ontologically more fundamental than non-substances. Substances have historically been construed as capable, in some sense, of existing independently from the entities of the other ontological categories. For example, animals better meet an independence criterion than their smiles. The animal can exist without the smile, the smile can’t exist without the animal. However, it may be that neither human animals nor cerebrum-size thinkers ultimately meet the stringent independence criterion for being a substance. It is not easy to flesh out the independence criterion to produce the intuitive results that we are substances It may in the end be that we can only establish that the animal is more independent and more fundamental than the brain.

Considerations of unity distinguish animals and other organisms from the objects of unrestricted composition, heaps, aggregates, non-empty sets, committees, artifacts and even organs. The more united an object, the more the parts depend upon each other. This interaction can take the form of capacities being manifested by parts and the whole that would not be realized if not for the contributions of the parts. This teamwork can account for not just the realization of capacities but the very maintenance of the parts, their replacement, and sometimes their very creation. Organisms have more unity than the gerrymandered objects posited by the universalist which includes objects composed of the readers’ clothes and their neighbors’ computers. The animal’s parts contribute more to the properties of the whole (life, thought) than a heap of sand whose holistic or emergent properties like mass are just the unstructured sum of the masses of all the grains of sand. The organs and systems of an organism are in a state of mutual dependence in ways that the parts of artifacts are not. One plank of a table may be glued or nailed to the adjacent one but the planks at the far ends have little role in sustaining each other nor a vital role in sustaining the table. Maintenance of any artifact – repairs and replacements to maintain the unity of parts - must come from outside. Artifacts aren’t responsible for their unity in the way organisms are.

Alternatively, we can appeal to unity of parts to account for the greater independence of animals than rival candidates for being a substance like the brain. The unity of the animal is maintained by the animal, while the unity of a brain is not maintained by the brain. The animal takes in matter, metabolizes it, builds up itself, removes waste products, uses some parts of the body to defend and repair others and so on. The cerebrum or brain does little or none of this. The animal grows and maintains itself; though it does so with the aid of the environment, it could still briefly do so without that support. If cut off from the environment, i.e., deprive it of food, oxygen and water, the animal could maintain itself and function for a while. The cerebrum would not maintain itself, nor function cut off from the animal. Remove a cerebrum from an animal and thought would immediately cease and there would be no maintenance or operation as a whole. Only the individual cells of the cerebrum would appear to operate, thus providing further reason to prefer a sparse ontology of living beings. The cerebrum is utterly dependent upon the animal for its new parts, energy, removal of spent parts, repairs, and so forth. That suggests a cerebrum lacks the independence constitutive of a substance.

David H            April 12, 2021 at 11:39 AM

Correction. My title above "Reply to Steve about Person-size brains Part IV" Should have been typed in as "Reply to Steve about Brain-size persons Part IV," though I suppose it is true to write of "person-size brains" if one believes that persons are brain-size.

Stephen Kershnar         April 13, 2021 at 9:27 AM

REPLY TO DAVID PART I: DOES SEPARATING A BODY WITH TWO HEADS CREATE TWO NEW PEOPLE?

David:

Excellent point. However, your intuitions strike me as incorrect. Here is what you say.

"But I actually think we should care about the animal in prudential grounds for identity matters. Just as it was good for us as fetuses to grow a brain and become conscious, it is good for us to receive a transplant brain when we would otherwise be left brainless or unconscious. I also think that there is one person and animal in the two-headed case and that person should care about the mental states in part realized by the different brains despite their not being causally connected."

Imagine that the two heads have different religions, views, and like different guys. It strikes me a violently counterintuitive that there is one person there.

To see this consider if the two bodies were separated via surgery (they tried in Nip Tuck). They now live in different bedrooms, vote for different parties (neither though is a Never Trumper, they're thinking is clear), and date different people. Did the surgery create two new people?

Intuition? No

Conclusion: A person is a brain or a functioning brain.

Best,
Steve K

Stephen Kershnar         April 13, 2021 at 9:32 AM

REPLY TO DAVID II: YOU DON'T CEASE TO EXIST WHEN YOU SHARE A HOUSE WITH SOMEONE

David:

Great point. You write the following.

"Secondly, you are perhaps already committed to a thinking being with a divided mind in the case of the two headed, even if you think you are just the brain. That is because there is an animal there with two heads who can think with both of them. If the human animal has a divided mind, why couldn’t the overlapping human person?"

If the two hemispheres do not share the same thoughts, then there are two people in the head. By analogy, imagine the two heads on the single body can pull themselves into the same head (like turtles can pull themselves into their shell). It does not matter whether they are inside or outside a head.

Unless the animalist can reject the surgical separation case above - and he cannot - the two people can be in different heads or different hemispheres.

Best,
Steve K

David H            April 13, 2021 at 11:30 AM

Steve
I see no problem with the two heads having different views. It could happen intermittently with Sleeping Steve and Waking Steve. You may be a pious Jew in your sleep, sarcastic secular Jew when awake. Heck, you could be woke when you aren’t awake. Same person with a mind cut off from himself. It is just half of your thoughts are really stupid and annoying. (There is a joke here about your waking thoughts that I am resisting). And it certainly happen diachronically and you could later forget and be not causally connected to your earlier diametrically opposed views. You have not gone out of existence and been replaced by someone else with the lack of psychological continuity.

Anyway, cerebra can’t think. They need to be parts of bodies or parts of cerebra/vat complexes. So I don’t think cerebra were thinking before detachment and so detaching them doesn't move a thinker even if it provides a crucial component for a thinker.

You are just appealing to some transplant and continuity intuitions when I am sketching above an account of what makes thought possible, what makes something a substance that can think, how to avoid the most implausible of sparse ontologies, and what account can provide an answer to the special composition question. The cerebra-size person fails on the criteria of big picture metaphysics even if it has some intuitive appeal.

Stephen Kershnar         March 26, 2021 at 2:40 PM

METAPHYSICS IS NO SUBSTITUTE FOR MORAL REASONING

Dear Romanell Colleagues:

I am curious as to what you think about the continuum of disintegration.

If there is a continuum, then is there a point at which a person is dead?

This is especially true if, as I believe, there is no metaphysical vagueness, only epistemic vagueness.

If there is a continuum of disintegration without a threshold for death, and I believe this to be true, then I am not sure why we do not move to a value-based approach.

Daniel Sumalsy’s suggestion that whether we kill a human organism or let it die depends on metaphysics – Is it still alive? – rather than morality – Does it have a right to be kept alive or not killed? – is mistaken.

The issue is a moral one. Hence, the solution to it must be moral. Metaphysics is no substitute for moral reasoning.

This is true even if a person is essentially an organism and even if there were a sharp threshold for disintegration-based death. The fact that neither is true just weakens the case for substituting metaphysical for moral reasoning.

I think Sumalsy would have been better off keeping his metaphysical and moral reasoning separate. This is unlike chocolate and peanut butter.

Best,
Steve K

Replies

Phil Reed          March 31, 2021 at 4:37 PM

Steve,

You win the prize for best blog post headline for an earlier post above (Amoeba).

What are the arguments against metaphysical vagueness? If there is such vagueness, I don't see why there wouldn't be a point at which a person is dead. Presumably there is no moment at which dawn becomes dusk (I'm inclined to think this is not merely an epistemic point), but surely dawn does become dusk.

Metaphysics is no substitute for moral reasoning. But on some views, moral reasoning depends on metaphysics, e.g. your question "Does it have a right to be kept alive or not killed" depends on the kind of thing "it" is. I know you disagree, but my claim doesn't commit to me the view that metaphysics substitutes for moral reasoning.

Stephen Kershnar         April 2, 2021 at 11:10 AM

DEATH TO VAGUENESS

Phil:

Great points.

1. The notion that metaphysics does not allow for vagueness is the intuition that an object either instantiates a property or it does not. I guess I think this is a strong intuition.

On the dawn-dusk example, I don't think these are single properties, but rather a cluster of properties with a disjunction somewhere in them. If this is correct, then there should be a right answer as to whether a moment is dusk or dawn even if we don't know what it is. If a property tracks an attitude and the attitude can be had to an intermediate degree (for example, Fonzie-type coolness), then I think the vagueness is epistemic.

2. The sort of reasoning that Sumalsy needs is that an individual has a claim not to be killed or, perhaps, allowed to die. As you point out, the claim might depend on metaphysics, but he still needs to connect the metaphysics to rights (or, perhaps, desert, duties, or virtue). This is especially needed if life to death is a continuum with a vague range. If I remember correctly, and I might not, Sumalsy neither rules out the continuum nor explains the moral principle that would apply if there were one.

Best.
Steve K

Stephen Kershnar         April 13, 2021 at 9:38 AM

DESIRE-FULFILLMENT THEORY IS LIKE A LIQUIFIED CEREBRUM: THE OPPOSITE OF SEXY

Phil and David:

Great point, but glorifying brain dead animals is likely not going to work.

We can ask about an alive body with a liquified cerebrum this question: Does it have an interest (or autonomy)?

(1) Horn #1: Yes. This is implausible unless the satisfaction of its earlier desires (or intentions, motives, etc.) backtrack to when those attitudes occur.

This is implausible first because a desire has a property only when it exists (like any other object) and second because desire-fulfillment theory is a bad theory of self-interest.

(2) Horn #2: No. If no, then we may do what we want regarding the body so long as we satisfy the claims of the body-owner (for example, the spouse).

Arguing that a person is still present in the brain-dead animal is an interesting argument but irrelevant to what we may do to the body.

Lesson: Metaphysics is no substitute for morality.

Best,
Steve K

Stephen Kershnar         March 26, 2021 at 3:21 PM

ANIMALISM (AND INTEGRATIONIST NEIGHBORS) VS. CHRISTIANITY: ARE THEY CONSISTENT?

Dear Romanell Colleagues:

The common commitment to animalism or integration among Christians is strange (and not in the good sort of way).

Consider the following.

(1) At death, the materials that compose a person – for example, bone, fat, muscle, and neurons – rot away in the ground. That is, they stay in disintegrated form in the grave.

(2) If Christianity were to be true, then some people go to heaven immediately following their death.

(3) Life cannot jump from one collection of materials to an entirely different and spatially-discontiguous collection of materials.

Propositions (1) and (3) strike me as very plausible. After all, life is a feature of an object or, on a van-Inwagen-type account, it creates an object in material that is changing in an ancestral relation.

So Christian-animalists and their integrationists bedfellows must thus believe one of the following.

(a) God waits until much later to pull the material out of the grave and give it life again.

Hence, immediately following death, a person does not exist. That is, those in heaven have gappy existences. They are perhaps like tardigrades.

Perhaps, instead, they believe the following.

(b) God takes the material out of the grave right away and replaces it with duplicates.

That is, he gives us corpse-duplicates to bury. I find this so deceptive as to conflict with his omnibenevolence. Perhaps I am missing something?

David, Jason, Pat, and Phil – What say you?

Best,
Steve K

Replies

David H            April 1, 2021 at 4:22 PM

Regarding B – PVI’s resurrection sketch:

Unlike many other commentators, I am not morally troubled by van Inwagen’s solution, just skeptical of the metaphysics. Since deception has to be intentional, I don’t think God’s “body snatching” meets that standard. If van Inwagen is correct, then Grandma’s body can’t be reassembled and Grandma so restored to life, but she still exists later in Heaven or Hell. So Grandma can’t be in the grave, it is just a duplicate. It is our metaphysical ignorance, not God’s deception that prevents us from realizing that it can’t be Grandma or her corpse that we bury. In fact, it seems morally worse to whisk away Grandma’s fresh corpse without a replacement. We would never be sure that Grandma had died rather than is alive and missing. A faux corpse enables us to begin the grieving process.

My concern with van Inwagen’s solution is actually metaphysical rather than moral. If death involves the loss of the life processes that produce the biological integration constitutive of life, then even a fresh corpse may have to be reassembled (somewhat) for its parts to instantiate life. But reassembly involves a duplicate, not the original person. So, my worry is that the body snatching either occurs too early or too late. If life processes have stopped but can be restarted, the person God has taken away is not dead. But resurrection is of the dead according to the Nicene Creed. If the person is dead, then the bodily integration constitutive of life has been lost and resurrection would really be the creation of a living duplicate, not the restoration of life. (Maybe my three-fold distinction between alive, neither alive nor dead, and dead would allow resurrection to occur when someone is no longer alive and that is good enough.)

I also don’t see a problem with creatures existing intermittently (I wouldn’t take literally talk like Jesus saying to the good thief tonight you will be in Heaven) however, I wouldn’t say they are like tardigrades who I don’t think have gappy existences. See my other post that distinguishes life, being neither dead nor alive, and death.

Your list is not exhaustive of material options. See Zimmerman’s falling elevator model of resurrection. God causes the individual to fission at death and so there are remains in the grave and a living immanent caused body (better continuer theory) in Heaven or Hell. The latter is the better candidate on a closer continuer account.

Although not integrationist, it is materialist, there is also the haecceity model in which any matter with the non-qualitative property will be the original person.

Now I don’t like any of these. But keep in mind that hylomorphism is a kind of animalism, what Toner calls “Original Animalism” in contrast to the “Latter Day Animalism” of PvI and Olson. The hylomorphic animalist would say that any matter the soul configures will produce the same body that was earlier alive. So there is no need for the same matter. So while think the hylomorphic account has other problems with accounting for the afterlife, it doesn't seem to have the problems bothering you.

Stephen Kershnar         April 13, 2021 at 9:49 AM

GOD IS NOT A DECEIVER, BUT HE WOULD BE ON DAVID'S THEORY

David:

Great points.

I take it at the end of the day, your view is that a person dies. God snatches the body away and puts a replica body for people to grieve over.

In response to the deception argument (Essentially perfect beings do not deceive) you argue the following.

"Since deception has to be intentional, I don’t think God’s “body snatching” meets that standard. If van Inwagen is correct, then Grandma’s body can’t be reassembled and Grandma so restored to life, but she still exists later in Heaven or Hell. So Grandma can’t be in the grave, it is just a duplicate. It is our metaphysical ignorance, not God’s deception that prevents us from realizing that it can’t be Grandma or her corpse that we bury. In fact, it seems morally worse to whisk away Grandma’s fresh corpse without a replacement. We would never be sure that Grandma had died rather than is alive and missing. A faux corpse enables us to begin the grieving process."

Here is an analogy. Daughter A has a beautiful African convict fish in her fish bowl. It dies and her father replaces with an identical fish. He did not deceive her because he actually replaced it to keep the fishbowl biosphere healthy (there are plants, feeder fish that eat the plants, and the convict fish). Because his intention is not to deceive, he did not deceive.

Here is the disanalogy.
(1) The father has an independent reason to introduce a replica that is independent of what the daughter thinks.
(2) God does not have an independent reason to introduce a body-replica that is independent of what the grieving family members think.

In the above paragraph, you have not cited a reason that God introduced the replica-body independent of what the grieving friends and family think.

As a result, you are committed to the following.
(3) God acts in order to affect what people think and does so in order to get them to have a false belief.
(4) If (3), then God is a deceiver.
(5) Hence, God is a deceiver.

I for one and not going to stand around and listen to you badmouth God and your country.

Best,
Steve K

Stephen Kershnar         April 13, 2021 at 9:55 AM

CLOSEST CONTINUER THEORY AND LATER HERSHNOVIANISM

David:

You argue for a Closest Continuer model.

"Your list is not exhaustive of material options. See Zimmerman’s falling elevator model of resurrection. God causes the individual to fission at death and so there are remains in the grave and a living immanent caused body (better continuer theory) in Heaven or Hell. The latter is the better candidate on a closer continuer account."

Now being a scholar of the later David Hershenov's scholarship, I know he is not entitled to this theory because he rejects closest continuer theories on Parfit-like grounds. That is, whether A is identical to B cannot depend on facts about C. As you well know, closest continuer theory allows that identity is neither symmetrical nor transitive. This is enough to make Neil Feit start throwing haymakers on the topic. At least on Nozick's argument, the metaphysical weight to be attached to mental and physical continuity depends on the context without a meta-weighting principle. The later David Hershenov would have no choice but to give a snarky comment about such a theory.

Hence, this is not a theory available to followers of later Hershnevians. I do not know about the early Hershnovians (during the Giants fan period) because they left fewer archaeological evidence.

Best,
Steve K

David H            April 13, 2021 at 12:01 PM

Steve
I said that so-called "body snatching" was morally preferable to an empty grave as an an occupied grave with a replacement “corpse” allows people know their relative was dead. So in the terms of your nice analogy, God has an independent reason that is not deceptive. The interesting question is why he doesn’t share his reasons but that is just the old problem of evil or hiddenness of God. Nothing specific to the metaphysics of resurrection. I don’t know why God doesn’t share more of his metaphysics. It is too bad that the Bible doesn’t have an appendix for 21st century metaphysics students.

By the way, I do not defend the body-snatching view. I just think my version of it – God snatches you when you are no longer alive but not dead is metaphysically possible, unlike PvI’s view. I am assuming the language of the Bible and Nicaean Creed (the latter mentions "the resurrection of the dead") isn’t intended to be so metaphysically precise that it rules out resurrection of the non-living but not dead. Perhaps if I knew more about time and change, I could see how PvI’s account of death could occur without disintegration that requires the tiniest but still unprincipled bit of reassembly.

I presently don’t have a preferred view of resurrection as I have mostly abandoned my earlier reassembly view because of the time indexing problem – two people die at different times with the same bodily matters. I had just claimed the last to die is resurrected first but that seems metaphysically unprincipled. I don’t like haecceitism or related approaches that appeal to divinely bestowed non-qualitative identity facts. You are right that I am not a closest continuer thesis so wouldn’t help myself to Zimmerman’s approach for that and other reasons. What I am interested in now is just there being metaphysically possible, and not morally objectionable accounts. So called "body snatching," appropriately modified, fits the bill. And Jason’s hylomorphism may work but I am reluctant to give the soul so much immanent causal power.

I would like to have a more positive view of resurrection but it isn’t the type of issue that weakens my faith. It is just that I don’t know how God pulls it off. Hey, I am just a UB prof from UCSB, not a top 50 Leiter school prof. I will learn the answer posthumously. Or maybe not

Stephen Kershnar         April 15, 2021 at 9:42 AM

IF GOD WERE TO BODY SNATCH, THEN HE WOULD BE DECEPTIVE

Dear David and fellow God-fearing Christians:

Excellent responses.

I am missing the goal of the replacement-body that does not involve deception.

Here is what you say, "[B]ody snatching was morally preferable to an empty grave as an an occupied grave with a replacement “corpse” allows people know their relative was dead. So in the terms of your nice analogy, God has an independent reason that is not deceptive. The interesting question is why he doesn’t share his reasons but that is just the old problem of evil or hiddenness of God. Nothing specific to the metaphysics of resurrection. I don’t know why God doesn’t share more of his metaphysics. It is too bad that the bible doesn’t have an appendix for 21st century metaphysics students."

I think it fair to say that people could figure out that their relative was dead if God left a note, God left a rough approximation of the body, the decedent left a note, only part of their body was left, or in general when people disappear they were understood to be dead.

The fact that God chose to replace the body with an exact replica - one that even withstands genetic and dental testing - is most plausibly understood to fool people. Otherwise, why would it so often result in rigorous demands that the corpse be treated in very respectful and expensive ways.

Perhaps your position should be that, in the absence of a promise, deception is not wrong because it is not a right-infringement.

You note convincingly that haecceistic, hylomorphic, and non-qualitative identity approaches would solve the issue.

(1) Hylomorphism rules out animalism, at least in the latter's pure form, regardless of what some hylomorphists or animalists would claim. My guess is, and this is just a guess, this is one of the reasons that Jason is a hylomorphist.

(2) I think the same is true for haecceistic properties, at least one that would allow for a reincarnation-body.

(3) This leaves - John Keller-like - non-qualitative identity. I am not sure that animalism coheres with this view, but would have to think about it.

I find this view to be inconsistent with later Hershnovianism.

I would like to have a more positive view but it isn’t the type of issue that weakens my faith. It is just that I don’t know how God pulls it off. Hey, I am just a UB prof from UCSB, not a top 50 Leiter school prof. I will learn the answer posthumously. Or maybe not

David Hershenov, in his later intellectual period, held forth on the following issues: (1) the nature of a person, (2) God's existence and nature, (3) the afterlife, (4) the meaning of life, (5) the nature of morality, and (6) defining moral issues (for example, abortion, euthanasia, etc.). To then say that Hershnovianism takes no position on (7) how someone survives in the afterlife merely when (7) is less complex and momentous than several of the other listed issues sharply conflicts with the later David Hershenov's views.

Perhaps you are an early Hershnovian.

In short, the following are true.

(1) Animalism conflicts with the Christian afterlife.

(2) Body-replacement makes God a deceiver.

(3) Later Hershnovianism has the resources to address what happens to an individual in the afterlife.

(4) Without animalism, the Christian pro-life view gets murky.


Best,

Steve K

Jim Delaney      March 27, 2021 at 9:22 AM

Dan, thanks for a really interesting paper. I think I mostly agree, especially in the expansion of the criteria for assessing whole brain death.

This builds off a point SteveK makes. Perhaps others have commented on it as well so my apologies if I am repeating a point that’s already been made (I wrote these up yesterday but had trouble with the blog). But I wonder about disintegration. In your response to the counterargument, you say that there is a limit to how much external support may be required before one can say that the organism is no longer self-organizing and self-regulating (477). If a being needed all the support that a headless human being would, then such a being would be disintegrated. This raised a couple of questions for me:

If loss of integration is the ontological standard, and a being is either alive or dead, then I take it that there is a matter of fact about whether a being is no longer integrated. So if we are trying to identify the limit of external support that a being could receive and still be integrated, are these just epistemological issues? If so, I worry that it leaves the ontological standard pretty mysterious. If disintegration itself (ontologically) is on a continuum, then we would not have a sharp distinction between life and death.

The other question has to do with external support. Could integration depend on social facts about technology. Was the inability to breathe on one’s own disintegration in the past but is no longer when we invented ventilators? I know John Lizza has made some arguments about this with respect to moral status (not death), which is what made me think of this. I take it that you would say no, and that the amount of external support is a matter of biological fact?

Replies

Stephen Kershnar         March 28, 2021 at 9:39 AM

FEATURES OF INTEGRATION: (1) CONTINUUM, (2) BASIC FACT, (3) INORGANIC REPLACEMENT, AND (4) TEMPORAL GAPPINESS

I want to build on Jim's excellent point. If disintegration results in an individual no longer existing, then three things seem to be true.
(1) Continuum. There is a non-vague point on the disintegration continuum at which an individual ceases to exist.
(2) Basic Fact. This is a basic fact about a person's existence. It is neither explained nor justified by something else.
(3) Inorganic Replacement. Most of a person's parts cannot be replaced with inorganic replicas and the person still exists (because integration would be either minimal or not based on biological life).
(4) Gappy. A person's integrative activity could go to zero (for example, he is frozen to absolute zero) and be restarted, thus making his existence temporally gappy.

I am not sure this is a criticism of the view so much a setting out of the conditions of it. Unless one finds a van-Inwagen-type view of restricted composition plausible, I am not sure that this view is the most plausible one.

Best,
Steve K

David H            April 12, 2021 at 12:08 PM

Steve,
A Metaphysical nitpick about #3:

Most animalists (van Inwagen, Merricks, Olson, Damasio, Bernat, Shewmon at least at one time) who believe that we are organic animals and couldn't become partially inorganic cyborgs or fully inorganic robots would allow that most of our parts can be replaced as we could be pared down to the size of the brain. So while they couldn't get inorganic parts, most of their organic parts can be replaced. "Most" just entails something above 50% and perhaps most of our parts are not essential parts. so it is not accurate for you to write, "Most of a person's parts cannot be replaced with inorganic replicas." I supposed the more charitable read is you meant by "replaced" that most of our parts couldn't become inorganic parts. That is true, as living organic creatures don't have any inorganic parts - not even pacemakers or prosthetics.

Incidentally, on your preferred theory that a person is roughly upper brain-size, you should allow for inorganic parts as cerebrum-size thinkers are not essentially alive. If they can persist through normal metabolic exchange and their thoughts come to be realized by different carbon based molecules because they are functionally unchanged, then you should allow that the brain cells can be replaced by psychologically functionally equivalanet inorganic parts that

A Metaphysical Nitpick about #4.

Freezing an organism - to where there are no life processes being actualized - doesn't mean that when heat is added and the original organism returns to life that there was gappy or intermittent existence. Some would argue that the organism/person existed without being alive when frozen as it had retained the capacities for life. It is odd that actualizing capacities are fatal. The sleeping and unconscious have the potential for waking and that actualization is not fatal unlike the case of realizing a bomb's potential to explode. You believe the frozen is a new entity, not identical to the earlier living non-frozen organism. But then why should the frozen go out of existence when thawed? Is the creature really essentially frozen? If the frozen doesn't go out of existence when thawed, then it will be co-located with the earlier living organism that was frozen. So there will now be two co-located non-frozen living organisms/persons. If you doubt that the frozen can exist thawed, why think the earlier non-frozen person returns to existence when its remains are thawed?

Phil Reed          March 31, 2021 at 5:16 PM

CHRONIC BRAIN DEATH

It seems to me that Sulmasy is impressed by the phenomenon of Chronic Brain Death and he believes that it problematizes Whole Brain Death (WBD). He doesn't want to go to a higher brain account. But he also rejects reverting to an exclusive cardiopulmonary account. Why?

(1) Because some versions of WBD really do, by Sulmasy's lights, amount to a permanent loss of integration and so, are death.

(2) Because it will force us to give up lots of organ donation.

(1) seems to be the better reading of the paper. Sulmasy makes no mention of (2) directly. He does comment that his account reduces the supply of organs and he is willing to accept that consequence on the basis that we should not be utilitarians (p. 478). Good! However, his account is that the "majority" of individuals declared brain dead would be dead by his stricter criteria (see pp. 477-8). So the majority of organs would still be available. So he is not giving up much there.

Is (1) a sufficient response to the impressiveness of Chronic Brain Death? Here the epistemic conditions become important. Sulmasy seems to concede, as he should, that our degree of certainty for determining death should be very high (p. 465). Do his new criteria to test for integration meet this standard? Sulmasy says "I do not believe the exceptional cases of 'chronic brain death' reviewed by Shewmon would meet the more rigorous testing demands that I am suggesting" (477). That sounds tepid to me.

In short, if you want to have a high degree of certainty that the person is dead, and you are impressed by chronic brain death, then a Shewmon-like account seems the best route. Chronic brain death tells us that the death of the whole brain is the wrong place to look for establishing integration. Sulmasy, however, splits the difference.

If we had a technological (or some other) solution to the problem of organ supply, how much would that affect our discussion about the nature of death?

David H            April 1, 2021 at 4:01 PM

6. DS mischaracterizes anti-terminator phase sortal.

DS writes “One does not, however, refer to the ‘dead’ phase of grandma’s life when one says that grandma is dead. Death is not a phase, but end of all phases in the life of an organism.”
(462). No one talks about death as another phase of life, so that is a bit of a strawman. Instead many people instead speak of death as a new phase of the body – living bodies are identical to dead bodies. The same body is alive for a phase and dead for a phase of its existence. The standard account of phase and substance sortals is that the living body or living animal becomes a dead body or dead animal. So, the same animal/body was once alive and then ceased to be alive. “Living body” is a phase sortal. There is no substantial change, nothing went out of existence. No corpse popped into existence at death nor was there earlier as a living body co-existing with the animal that went out of existence at death.

Death can be an “existential assertion” and a change in phase sortals and kind (substantial) sortals on some metaphysics: DS writes on (462) “Death is not a sortal that distinguishes between kinds. Thus, the difference between life and death is neither a matter of phase sortal nor a matter of kind sortals. Rather, death is a matter of existential assertion.” Alternatively, one might claim that DS doesn’t see that death could involve both phase and substance sortals. If the living body is was just a stage of the body but its separate entity, overlapping it, then the living body or animal could go out of existence upon death but the body that was alive enters a new phase as a dead body. So there is an existential assertion about the animal correctly made at death and also a claim about a phase sortal as the body, that had been co-located with the animal, switches phases from a living body to a dead body. And if there is no such thing as a body that was once alive and is later dead, then there might be substantial change, a change in kind, as the animal goes out of existence and the corpse pops into existence. So if DS wants death to be just an existential assertion and to avoid it coinciding with either a phase change in a body that has just become a corpse or a change in kind with a corpse popping into existence, then a metaphysical account of the alleged corpse is needed. I think DS needs to borrow or provide a novel defense of the Terminator Thesis to maintain death doesn’t involve any phase transitions (live bodies becoming dead bodies) nor new substances emerging (corpses)

David H            April 1, 2021 at 4:03 PM

4. Death after Cardiac Donation (DCD) may involve killing on modal grounds.

I was surprised that DS didn’t consider Shewmon’s attempt to fines the Dead Donor Rule (DDR) when he mentioned the CR criterion will undermine organ procurement “…some have advocated for abandoning the notion of brain death and reverting to the classical cardio/pulmonary determinations that would of course eliminate the procurement of organs from warm, oxygenated bodies with intact circulatory function. This would be a blow to transplant surgeons…” (467-68). Shewmon 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. Removing an organ doing nothing in the body doesn’t kill the patient. The patient is still alive because he could be resuscitated as only the point of auto-resuscitation has passed. Maybe DS didn’t discuss this because he thinks Donation after Cardiac Death (DCD) was morally acceptable and Shewmon’s thesis just amounts to the same – perhaps a difference is that Shewmon, at least at the times when he assumed “death” was univocal, didn’t consider those non-heart beating patients to be dead. DS writes “Nonetheless, the advent of donation after circulatory death (DCD) provide an avenue for obtaining organs. For transplantation that offers another option for potential donors and individuals in need of transplants.” (478) I take DS to be endorsing DCD. I am assuming that neither he nor Shewmon think that in neither case does the removal of organs kill the patient as they weren’t doing anything at the time they were removed. But I am not an expert on what is going on when in DCD case.

I think neither Shewmon nor DS’s appeal to DCD can avoid endorsing multiple organ takings that will actually kill the patient. While it is not a mistake to think the patient is just being allowed to die when the respirator and other ICU equipment is turned off, it is a mistake to think the patient is not killed if his organs are then taken. This is because of death’s irreversibility condition. If death involves some sort of appropriately characterized irreversibility, “the point of no return” is later with organs in the body than already removed. Removing organs means that the body can’t be resuscitated and the irreversible condition constitutive of death has arrived sooner than he would be if the organs remained in the body. Thus, it is not a case of just letting the patient die. The removal of organs has changed the point of no return (irreversibility) So the spirit of the DDR is violated. Perhaps we should describe the body before the organs are removed and after auto-resuscitation is no longer possible – as being neither alive nor dead. It is not alive because it is not engaging in circulation and respiration, but it is not dead as it has the capacity for circulation and respiration if the appropriate interventions occur

David H            April 1, 2021 at 4:04 PM

5. Metaphysical Nitpick - Death is not absence of life.

DS writes that “Dead ought to be the antonym of being alive” (456) and “We call this ceasing to be alive ‘death.’” (457) I disagree and believe we need a three-fold distinction not a binary life/death distinction amenable to opposites (antonyms) 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 – frozen or dehydrated. 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            April 1, 2021 at 4:07 PM

Why it is possible to die without ever Being Alive:

A strange consequence of this third state between life and death (defended above) is that maybe could die without ever being alive - pace DS’s 463 comment “…there needs to be a fire in the first place for it to go out…just as there needs to have been a living person at the outset for one to say that he or she is dead.” 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.,

David H            April 1, 2021 at 4:08 PM

6. Sentient/Conscious distinction.

I didn’t understand DS’s distinction between sentience and consciousness. Some pains were sentient but not conscious because they were realized in the upper spinal cord? (p. 469) That sounds like unconscious pain which sounds like an oxymoron. Is consciousness just associated with conceptualized thought?

David H            April 1, 2021 at 4:12 PM

8. Brain death advocate need a story about transition from brainless embryos to brains as central integrators.

They need to show that the fetus's dependence upon the mother doesn’t undermine its status as an organism and then show that dependence of brain dead upon ICU is different. John Lizza and DS claim the decapitated tied to machines are not alive. Unfortunately, I am too ignorant about the biology so I want someone to tell me how they are different from fetus that is dependent upon its mother to survive? One doesn’t want to say potential to develop for we won’t think the fetus dead if it lost the potential (or didn't yet have it ready-to-hand) and wouldn’t be able to survive away from the mother at birth. Perhaps they can appeal to Maureen Condic’s claim that there is switch of central integration organs from placenta to brain at birth. A brain is only needed when the baby is born and has to deal with a much more complicated environment Condic claimed that earlier there was no need for the simple embryo in such a controlled assisted environment to have a central integrating organ. Then it develops and the placenta becomes a central integrating organ.

David H            April 1, 2021 at 4:18 PM

10. Liberal Account is even worse than DS thinks:

He mentions the death of pets determined by the owners. But consider animal deaths at a time in which there were no people. One can’t appeal to counterfactual of what people would say because the decision to favor one account of death is supposed to be idiosyncratic. To appeal to a CF is like appealing to substitute judgment for someone who has always been unconscious all their life or so congenitally cognitively impaired that they never developed any personality, values or idiosyncratic views that would enable someone to engage in substitute judgment rather than just make a generic appeal to a human being's best interests. Likewise, for favoring one view of death over the others. Perhaps the advocate of the liberal account will just say that in such cases there is no practical importance in having an account of death. Still, one can invent a farfetched scenario where some researcher has an interest in knowing when many animals have died in the past.

10b. There is still a need an account of default for death given that people may not have a view or be ambivalent or uncertain which is correct and there is no family members involved. Will the problems that the liberal account was trying to solve return with that default? Perhaps to some extent. But if one doesn’t have a view, then one might not care which determination is used. But that is still different from someone having a view that they never shared. So there could still be a fight over the default view and it is metaphysically and biologically problematic that the default is just a stipulation

Peter M Koch               April 10, 2021 at 2:50 PM

Following up on Jason’s earlier point, I would be curious to see how integration is understood here, as it is central to the ontological definition. Throughout the article integration seems to be closely related to, if not interchangeable with, “organization” and “regulation.” But there seems to be differences between these three notions. Further, there seems to be some fluctuation between integration and integrative functions throughout the article and in the discussion of the definitions. The use of integration (and in turn disintegration) in the onotological definition as opposed to function or functioning might have some implications worth exploring. For one, if the focus is on integration and not integrative function, then this leaves open cases in which a body remains integrated but the integration is not a result of integrative somatic functions, but rather results from some external or artificial machines. If, on the other hand, integrative functions (or capacities perhaps) are the central notion – something like “permanent loss of integrative functions” – then the clinical tests would be directed towards the loss of functions and their underlying capacities, which are presumably found in the brain, and not merely the absence of integration of the organism as a whole. Also, as a broader point, integration seems to be a relation between functions whereas a focus on functions seems to be about functions themselves. Anyways, just a few thoughts!

Replies

Pat D    April 12, 2021 at 11:31 AM

Peter, I’ll take a crack at responding to your questions.

First, a living organism is distinguished from an inanimate thing in virtue of its active self-organization, its self-organizing functioning, or what Varela and Maturana call ‘autopoiesis’. Even a single-celled organism organizes (1) its membrane-related functioning in maintaining a boundary between itself and its environs and (2) its intra-cellular metabolic functioning in meeting its own energetic and structural needs. When it is not able to integrate (self-regulate) these different ‘centers’ of functioning, it dies. Integration, then, has to do with unifying a differentiated set of functions – of regulating distinct types or centers of functioning – in a self-organizing way. Using a spatial metaphor, we can think of differentiated functioning as horizontal and integral functioning as vertical (terminating at the organism as a whole and not at any subsidiary system).

Second, although technology can replace deficient component functions – breathing, nutrition – it cannot replace the self-organizing activity (integration) of the whole organism.

I think that what I have said here is compatible with Dan’s position, although he might come at it a different way.

David H            April 12, 2021 at 12:38 PM

The Incoherence of the Social Standard of Death?

Crawford Elder pointed out that minds can’t be socially constructed as they are doing the social constructions. A mind can’t be both constructed (caused) by itself and do the constructing (the causing). So, there is at least one thing that can’t be constructed by the mind. Perhaps that should make us suspect that there might be other things that aren’t social constructions. Anyway, a materialist can probably run a similar argument with the brain. (I suspect even most social constructivists are materialists of some sort so the mind will be a material object.) So, the brain can’t socially construct itself as it is doing any social construction. Thus, the destruction of the brain, which would be brain death, couldn’t also be a social construct. Perhaps the social constructivists can still insist that while the existence of the thought producing brain can’t be a social construct, the line demarcating sufficient loss of bodily integration can be. Perhaps then only upper brain death can’t be a social construction. Anyway, the above point that if social construction can’t be pervasive, then we have some additional reason to suspect other things like integration are not social constructs.

David H            April 12, 2021 at 1:55 PM

A Liberal Compromise?

DS is quite unsympathetic to the liberal standard of death as “it is a formula for chaos. If anything should not be a choice, even in America, death should not be a choice. The liberal view obviously violated the desideratum of a single unified, ontological concept of death and strangely disaggregates the deaths of human animals from the deaths of other animals.” (p. 464). He also asks why stop with only brain death being a choice? And it is certainly awkward, to say the least, for hospital staff to act as if someone is alive because the family asserts it. Should they withhold their view so as not to contradict the family? Do they pretend that the family is correct? Or should they be taught not to make up their own minds or treat ‘death” as a cluster term or having a disjunctive definition? Do murder charges not get filed because of the family’s reluctance to declare the brain dead to be dead organisms?

While I am not advocating the following, it may be that some, but not all, of the problems with the liberal view go away. The usage of the word “body” often doesn’t distinguish between live and dead bodies. So instead of allowing people to determine whether or not someone is dead, we could allow them to determine whether to sustain the body. That is possible as “body” is ambiguous between live and dead body. One can sustain the living and one can sustain the death corpse (embalmment, freezing etc.) and prevent decay. So no one on the medical staff or the patient’s family would have go along with a falsehood or lie when doing so or agree the word “death” is ambiguous. I think the family rejecting brain death is most concerned with the loved one being sustained, not getting others to AGREE that their loved one is still not dead. Everyone can agree that the body is being sustained as the term applies to the both the living body and the dead body. Perhaps a terminator can even use “body” to refer to remains that don’t compose anything as they can be sustained

Of course, it is expensive to sustain the body but it is also expensive to bury the body. Perhaps insurance rates can reflect body sustaining interests. My compromise doesn’t help with inheritance and remarriage but I think the real fight is over sustaining the body or “unplugging” it. So we might in good faith be able to live (no pun intended) with allowing people to choose whether to sustain the loved one’s body. That language is not stipulative nor false nor involve bad faith. It doesn’t make any dubious semantics that “death” is a cluster term or ambiguous or varies across species. It might not even involve bad metaphysics if one is an anti-terminator