9. The issue of "personhood" is not a scientific, but is rather a philosophical issue. Nurses might keep in mind that the key to understanding any philosophical theory is to identify its "anthropology"-- or definition of "a human being" or "person". Different anthropologies lead to different ethical theories - which lead to different medical ethics theories. Some anthropologies match reality; others don't. Reality check:
Bioethics tries to claim that its theory really has no "anthropology". Bioethics is "just" about "ethics". However, almost all bioethics arguments incorporate a "personhood" claim on issues at both the beginning and at the end of life.
Philosophically, such a claim is per se a claim about "anthropology", and historically a very weak and academically indefensible one at that. It requires, e.g., that the soul and the body are two separate and independently existing substances. But think about it. If there is a real split or gap between the "mind" (or "soul") entity, and the "body" (or "matter") entity -- which is required if there is any "delay" in "personhood" at the beginning of life -- then one simply cannot successfully explain any causal interaction whatsoever between these two separate entities, either before or even after "uniting". Nor is there any scientific data to verify such a "split", nor any such "delay".
A lengthy response is not practical here, but solid arguments to refute such "delays" have been advanced for many centuries. E.g., if, the "rational soul" always contains virtually the sensitive and vegetative powers of the soul; if there is no split among the several powers of the soul itself; if there is no split between the soul and the body; if the body and soul must exist together as one single substance; and if there is scientific evidence that the "vegetative" power of the human rational soul is present immediately at fertilization (which there is), then the whole rational soul must be immediately present at fertilization - when "the matter is appropriately organized".
Personhood must begin when the human being begins. There is no frog, or carrot or tomato produced at fertilization -- and we know that empirically! Nor can this "delay" be legitimately reversed at the end of life - first the "rational" soul leaves, then the "sensitive" -- leaving only a "human vegetable". Empirically there is no such thing as a "human vegetable" - they exist only in bioethics text books.
It is long past time for us to recognize, acknowledge, and deal with the concrete reality that all human beings, at all stages of life, are human persons -- simply by virtue of their inherent human NATURE - not because of the active exercising of adult functions (which, BTW, must be caused by that human nature that is already there).
To choose not to acknowledge or deal with this information has already led to the acceptance, now almost habitual, of a two-tiered caste of human beings -- some of whom are "persons" and some of whom are not. If nothing else, the Nazi "science", rationalizations, propaganda, and concrete experiments -- and the on-going scourge of slavery and genocide -- should have taught us something about the inevitable real life consequences of such a human "caste" system.
The unheralded words of the single dissenting National Commissioner Louisell ring ominously clear: "American society is itself at risk -- the risk of losing its dedication to the proposition that 'all men are created equal.' We may have to learn once again that when the bell tolls for the lost rights of any human being, even the politically weakest, it tolls for all."
Although bioethics is unquestionably predominantly a "utilitarian" ethical theory, there are in fact many different kinds of "utilitarianism". Probably the most common in bioethics today is "preference" utilitarianism, actually a deconstruction of the classical utilitarianism of Bentham and Mill. A small sampling of some of the most articulate in the field could serve to indicate, in general, some of the main dogmas they hold in common -- which dogmas nurses currently meet on a daily basis, face to face, as "ethics" - but never recognize their "faces".
In "preference" utilitarianism an action is ethically correct if it satisfies the "preferences" of those affected -- and has the best consequences for the greatest number of "people". Modern utilitarianism, Bernard Williams explains, is supposed to be a system that is neutral (!) among the preferences that "people" actually have -- a "preference" being a reflection of the state of mind of the agent, and not to be judged by some standard of reasonableness other than whether it accords with the best utilitarian theory. Therefore, all preferences go into the melting pot, with no preference to count for more than any other; there must be "equal consideration of interests", as Singer puts it. But of course ultimately, these individual "interests" will be weighed UNEQUALLY against the total "good" or consequences for society as a whole -- a point about any utilitarian theory that is often overlooked or underestimated.
Of interest is the definition of "people" or "person" used in preference utilitarianism. "Persons" are those who have preferences, interests, desires, etc. For these utilitarians, not all human beings are "persons", while some animals are "persons".
Preference utilitarians especially need to attack those who hold the "sanctity of life ethic" ((which states that only human beings are "persons")), as simply prejudiced and racist tenets of "speciecism". As Oderberg explains the origins of this attack: "The charge was made famous by Peter Singer and is leveled by virtually all the followers of Singerian bioethics". They prefer instead a "quality of life" ethic. One way that "preference utilitarianism" attacks the "sanctity of life ethic" is by literally deconstructing or redefining it -- usually by means of "soft", meandering, but very clever "thought experiments" and pseudo "logical dialogues" that supposedly "evaluate" the "pros" and "cons" of the "sanctity of life ethic" - all in order to support a "quality of life" position.
One of the major theoreticians of "preference utilitarianism" for many decades has been Oxford philosopher/bioethicist/eugenicist Jonathan Glover. In his 1977 book, Glover literally redefines the "sanctity of life ethic" by means of redefining its major premise. Once that major premise is corrupted, of course, then all conclusions which flow from it will be corrupted as well.
The "sanctity of life ethic" is generally correctly stated as: "It is always a morally evil act to intentionally and directly kill an innocent human being." From that major premise it follows, e.g., that since human embryos and fetuses are innocent human beings, and since human disabled and terminally ill adults are also innocent human beings, to intentionally and directly kill them would be morally evil actions per se -- regardless of any "personhood" status, circumstances or intentions.
But Glover doesn't hold those actions to be "morally evil per se"; besides, he says, that would impede the advancement of global "positive eugenics" and genetic engineering which he, and most preference utilitarians, strongly advocate. So he redefines the major premise of the "sanctity of life ethic" itself as follows: "It is always intrinsically wrong to destroy a life that is worth living." Such a life would not be "mere biological life", but rather, as Glover vaguely describes it, the quality of life of one who consciously possesses preferences, plans, projects, desires, feelings, memories, a sense of identity, etc. -- what later came to be grouped together in bioethics and labeled "rational attributes" and/or "sentience". Only a "person" possesses a life that is worth living. Since unborn, born, and young human children, as well as many ill or disabled adult human beings, do not have this "quality of life", they do not have a "life that is worth living". They are not "persons" -- and therefore the direct and intentional killing of these human non-persons would not necessarily be a morally evil act. Voila! The "sanctity of life ethic" now is the "quality of life ethic"!
Glover, in turn, was the academic mentor of Oxford philosopher/eugenicist R. M. Hare. For Hare, the early human embryo, fetus and even young child are not "persons". They are not "real people"; they are just "possible people" (that is, they don't exist yet) -- and thus have no serious "interests" or "preferences" to be respected. We do, however, have "some" duties" toward "them". So, applying a sort of mathematical trigonometry set theory to the problem, his international public pop policy proposals go like this: "The maximum duty that is imposed is to do the best impartially for all the 'possible people' there might be by having an optimal family planning or population policy, which means necessarily excluding some possible people." Indeed. Hare asserts that the best policy will be the one which produces that set of people, of all "possible sets" of people, which will have in sum the best life, i.e., the best possible set of future possible people." [[And I ask you, would you buy a used car from this man?!]] Hare's bioethics interests lie largely in translating the Gloverian theory of "preference" utilitarianism into British law and global pop policies via the UN. One of Hare's most prominent students at Oxford was Peter Singer.
Most bioethicists today -- to one degree or another -- agree that a "person" is to be defined in terms of such "rational attributes" or "sentience". What are really "morally relevant" are "quality of life" characteristics, "preferences", or "interests". So too argues
Peter Singer, currently Professor of Bioethics at Princeton University's Center for Human Values. Like Glover and Hare before him, Singer -- the founder and first President of the International Bioethics Institute at the U. N., as well as the founder of "animal rights" -- argues that the higher primates, e.g., dogs, pigs, apes, monkeys -- even prawns -- are persons, because they actively exercise "rational attributes" and/or "sentience". However, some human beings, even normal human infants, as well as disabled and ill human adults, are not persons.
American philosopher/bioethicist Richard Frey, pushing Singer's logic, actually published an article in a major international bioethics and health care textbook that, since many adult human beings are not persons (e.g., Parkinson's patients, the mentally ill and retarded, the frail elderly, etc.), and since many of the higher primates are persons, then these adult human non-persons should be substituted in purely experimental destructive research in place of the higher primates who are persons.
Interestingly enough, Singer - as a preference utilitarian - does not believe in "rights" or "absolute autonomy" - unless their exercise increases the "greatest happiness for the greatest number of people" in the world! For example, Singer "allows" for a couple to "autonomously choose" to kill their unborn or born human child. But if the parents refuse, and if such an autonomous refusal would not be in the interests of "the greatest number of people", then he calls for the government to step in, do its "duty", and legally require them to do so! The same reasoning applies, BTW, to "living wills" and euthanasia.
Recently, Singer applied his form of "preference utilitarianism" to bestiality. He concluded that bestiality can be an "ethically correct" action, as long as it is not cruel, if it satisfies the preferences (e.g., sexual pleasure) of those affected (i.e., the human person and the animal), and if it has the best consequences for the greatest number of people involved (i.e., the total amount of "pleasure" experienced in the world would be increased). And, of course, since Singer defines many animals as "people", then "the greatest number of people" for Singer would include some human beings and some animals. Therefore, bestiality can indeed be "ethical". This is surely "theory" run amok!
Or consider the words of bioethics Founder Tris Engelhart, "Personsin the strict sense are moral agents who are self-conscious, rational, and capable of free choice and of having interests. This includes not only normal adult humans, but possibly extraterrestrials with similar powers."
Or, those of Winston Duke in 1972 in an article on the new biology in Reason Magazine, "It is quite possible that the advances in human biology in the remainder of the twentieth century will be remembered as the most significant scientific achievement of the animal species known as Homo sapiens. But in order to become a part of medical history, parahuman reproduction and human genetic engineering must circumvent the recalcitrance of an antiquated culture. ... Fit the parts of the puzzle together: nucleus transplant, test tube growth to blastocyst and uterus implant -- the result is clonal man. ... An Eugenic Age is just around the corner. ... Under scientific management, the result can be human parts-farming: the methodical production of precious organs such as eyes, hands, livers, hearts, and lungs. ... The foremost philosophical problem presented by the new biology is semantical: What is a human being? ...Humanity per se is based on cognitive abilities. A philosophy of reason will define a human being as one which demonstrates self-awareness, volition and rationality. Thus it should be recognized that not all men are humans. The severely mentally retarded, victims of lobotomies, the fetus, blastocysts, androids, etc., are not human and therefore obtain no human rights. ... It would seem ... to be more "inhumane" to kill an adult chimpanzee than a newborn baby since the chimpanzee has greater mental awareness. Murder cannot logically apply to a life form with less mental power than a primate. ... It certainly follows that the practice of abortion is not immoral. And it is furthermore conclusive that experiments with fetal material and the engineering of non-thinking Homo sapiens tissues are not immoral. A clear definition of humanity in terms of mental acuity, rather than physical appearance, should be encouraged. And libertarians should continue to defend as absolute the prerogative of humans to conduct their own lives independent of societal norms, whether that conduct involves euthanasia, suicide, abortion, organ transplant, or ownership of genetic material. ... Likewise, the incentive for developing a rational philosophical framework including a psychology of self-esteem will be magnified. ... [I]t would be increasingly obvious that a philosophy of reason is needed to meet the test of present day living, and that it is the only orientation able to readily absorb the ever developing spectrum of scientific discovery."
Finally, hearDan Wikler, as representative of the World Health Organization, declared that "The state of a nation's gene pool should be subject to government policies rather than left to the whim of individuals, ... The completion of the human genome project would also make it possible to promote some genetic qualities such as intelligence and lower the incidence of others. ... It may be conceivably required by justice itself," - i.e., "justice" as defined for bioethics by John Rawls.
This is what "bioethics" means - or should mean - to prolife nurses. It is not "ethics per se", but rather "federal ethics". It is neither "neutral", nor just a "communal conversation". It is incapable of resolving conflicts among its very curiously defined, utilitarian "principles", and even its Founders agree that it just can't work. It is, instead, a "will to power", an evolution from eugenic-minded post-war savants of science, to eugenics we now hear echoed daily around the world as "global health care" by like-minded bioethicists. It advocates the violation of just about everything traditional medical ethics held dear, and for the deconstruction of our most genuine inherent human rights - including, and especially, the right to life of even the most vulnerable. Indeed, many have argued that "bioethics" per se is not "ethical"!
Yet this is the "ethics" that greets prolife nurses at the bedside - up-front and personal, on a daily basis --, the "ethics" that informs them which medical actions they take are right or wrong - or "compassionate" -- for their individual patients. It sanctions physician and even nurse killing of the terminally ill in the name of patient autonomy, the use of the mentally ill in high risk destructive medical research in the name of "beneficence", and pop control, involuntary sterilization and abortion in the name of "justice" - whichever principle works - and because none of these humans are "persons". And this is "compassion"???
No wonder you are confused and conflicted, "Jennifer" - but the problem is not you. It is the "ethics" that is being forced on you against your deepest intuitions.
Listen ..... to ..... them.
Thank you.
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