The insignificance of personal identity for bioethics

Bioethics

Volumn 24, Issue 9, 2010, Pages 481-489

  Shoemaker, David ^a  

^a BOWLING GREEN STATE UNIVERSITY   (United States)

Author keywords

Abortion; Advance directives; David DeGrazia; Death; Don Marquis; Jeff McMahan; Personal identity

Indexed keywords

ARTICLE; ATTITUDE TO DEATH; EGO; ETHICS; HUMAN; IDENTITY; INDUCED ABORTION; LIVING WILL; PSYCHOLOGICAL ASPECT;

ABORTION, INDUCED; ADVANCE DIRECTIVES; ATTITUDE TO DEATH; EGO; HUMANS; IDENTIFICATION (PSYCHOLOGY);

EID: 77955662582     PISSN: 02699702     EISSN: 14678519     Source Type: Journal    
DOI: 10.1111/j.1467-8519.2009.01719.x     Document Type: Article

References (40)

1. D. DeGrazia. dentity, Killing, and the Boundaries of Our Existence. Philos Public Aff, 442 2003; 31: 413-442.
2. For a very good example, see: Eric Olson. 1997. The Human Animal. Oxford: Oxford University Press. DeGrazia, op. cit. note 1, p. 414.
3. For sustained development and discussion of the notion of narrative identity, see: M. Schechtman. 1996. The Constitution of Selves. Ithaca, NY: Cornell University Press. For an application of narrative identity to bioethical concerns, see: D. DeGrazia. 2005. Human Identity and Bioethics. Cambridge: Cambridge University Press.
4. J. McMahan. 2002. The Ethics of Killing. Oxford: Oxford University Press: 68.
5. Thus McMahan calls his view a Two-Tiered Account of the morality of killing. See ibid: 245-265.
6. See ibid., pp. 425-426. For a more hedged view, see DeGrazia, op. cit. note 4, pp. 60-65. See also Olson, op. cit. note 2, pp. 70-72.
7. See my: Personal Identity and Practical Concerns. Mind 2007; 116: 317-357, especially p. 322.
8. Don Marquis. Why Abortion is Immoral. J Philos 1989; 86: 183-202.
9. DeGrazia, op. cit. note 1, e.g. p. 433; emphasis in the original.
10. Indeed, DeGrazia claims that personal identity theory is generally the investigation of three things: (a) the conditions for our persistence across time, (b) the conditions of our essence, and (c) what matters in survival. (See: DeGrazia, op. cit. note 1, pp. 414-415.) In what follows, I question the inclusion of (c) as a proper part of personal identity theory.
11. Derek Parfit. 1984. Reasons and Persons. Oxford: Oxford University Press: 253-266.
12. Ibid: x (note added in 1985); 208-209 and elsewhere.
13. Another way to think about this point: what matters in survival, in identity across time, may be very different from what matters in egoistic concern. So what matters in preserving what we ordinarily think of as survival might be some biological relation, whereas what matters for purposes of anticipation and self-concern might well be some psychological relation. One might, then, easily adopt the latter view independently of any investigation whatsoever into the nature of identity, and if so it would be clear that one was engaged squarely in ethical theorizing. My point here is that this is essentially what DeGrazia and McMahan are doing.
14. Metaphysics and the Morality of Abortion. Mind, 644 1999; 108: 619-646.
15. Don Marquis. Does Metaphysics Have Implications for the Morality of Abortion? Southwest Philosophy Review 2002; 18: 73-78.
16. I've argued for this point in 'Responsibility Without Identity,' unpublished manuscript.
17. See, e.g. Bennett Helm's excellent Plural Agents. Nous 2008; 42: 17-49.
18. Parfit, op. cit. note 23, discusses various fusion cases on pp. 298-299.
19. This would be metaphysical indeterminacy, not epistemological indeterminacy: it's not that we just wouldn't know (or would have no way of knowing) the identity of the fused person; rather, it's that there would just be no facts of the matter regarding whether or not this person would be me, you, or someone else.
20. My own thought is that there's no difference between the early fetus and the sperm/ovum case with respect to ownership of a valuable future, but instead of both having such a future, neither do. This is because, for one thing, I suspect a proper account of ownership would require owners to possess some basic sort of psychological capacities, which these entities altogether lack. But I'm not prepared to defend such a view here.
21. M.B. Green & D. Wikler. Brain Death and Personal Identity. Philos Public Aff 1980; 9: 105-133.
22. Ibid. See p. 118 for the 'of course' comment. Does this result mean, then, that Jones' organs are fair game? Not necessarily, for it's possible that Jones has 'turned into' Smith (through some radical psychological discontinuity), yet it wouldn't thus be permissible to harvest Smith's organs (insofar as he's still alive). But this is just to say that, while the motivation for investigation into the definition of death has been the concern over the timing of organ harvesting, it's not at all the case that a determination of the definition of death will settle the ethical issues at stake (nor do the advocates of this methodology believe it will).
23. DeGrazia, op. cit. note 4, p. 149; emphasis in original.
24. Jeff McMahan. An Alternative to Brain Death. J Law Med Ethics 2006 (Spring):44-48, 47.
25. Ibid. McMahan explicitly uses the phrases 'die' and 'cease to exist' interchangeably
26. Ibid: 47-48. See also McMahan, op. cit. note 5, pp. 423-426.
27. McMahan, op. cit. note 39, p. 48.
28. Strangely, McMahan admits as much (see op. cit. note 5, pp. 27 and 425), but he doesn't appreciate the force of the admission against his view.
29. Obviously, this argument draws on Parfit, op. cit. note 23, pp. 253-263.
30. Thanks to an anonymous referee for raising both the 'normative associations' worry as well as the amoeba reply.
31. One might think the response here, relying as it does on considerations of death to non-persons, leaves McMahan at least with a version of the 'normative associations' objection intact, for he wants to ground the definition of death for persons on personal identity theory. Nevertheless, insofar as the default view of death is surely that it is a unified concept (applying equally to all entities capable of dying), and insofar as a conceptual gap between ceasing to exist and dying is revealed when considering non-persons in fission cases, the burden of proof is squarely on McMahan to show why the 'normative associations' argument altogether prevents any conceptual gap in the person-based fission case as well.
32. An assumption David Hershenov deploys in The Death of a Person. J Med Phil 2006; 3: 107-120.
33. There are other possible objections I don't have the space to canvass here. One might be to draw from Lynn Rudder Baker's work to insist that uniqueness and essence cannot come apart in fission, that the pre-fission person's unique first-person perspective will survive into one of the fission products or into neither (but not into both). (See Persons and Bodies: A Constitution View (Cambridge: Cambridge University Press, 2000). There is much theoretical machinery involved in this view that would take a great deal of time to discuss and dissect, however, so I will set it aside here.
34. See, e.g. Rebecca Dresser. Life, Death, and Incompetent Patients: Conceptual Infirmities and Hidden Values in the Law. Arizona Law Review 1986; 28: 379-381; and Rebecca Dresser. 1989. Advance Directives, Self-Determination, and Personal Identity. In Advance Directives in Medicine. C. Hacker, R. Moseley & D. Vawter, eds. New York: Praeger.
35. See: D. DeGrazia. Advance Directives, Dementia, and 'the Someone Else Problem'. Bioethics 1999; 13: 373-391; DeGrazia, op. cit. note 1, pp. 440-441; and DeGrazia, op. cit. note 4, pp. 164-167.
36. See, e.g. Allen Buchanan. Advance Directives and the Personal Identity Problem. Philos Public Aff 1988; 17: 277-302.
37. McMahan, op. cit. note 5, pp. 496-503.
38. DeGrazia, op. cit. note 1, pp. 441-442; op cit. note 4, pp. 173-186.
39. Two points are relevant here. First, Steven Wall has suggested a possible account of advance directives in which YS binds herself via the directive, such that no matter what she might think or feel when demented, her earlier wishes are to be authoritative. On such an account, it seems as if numerical identity might do some real work: what renders the later self subject to the directive is precisely her numerical identity with the earlier, binding self. I don't want to rule out the possibility of such an account, but I haven't seen one like it developed before, so I'll remain agnostic until I can assess the details. (One initial worry is that we let ourselves off the hook sometimes in such self-binding arrangements, so it would be unclear whether or not (a) there would be legitimate instances of 'letting off the hook' in cases of advanced directives, or (b) a hypothetical later competent self might have done so where the actual later self was pleasantly demented.Second, Marya Schechtman has pointed out to me that it looks as if considerations of numerical identity actually do at least some minimal work for DeGrazia and McMahan (and perhaps others). After all, they're left with the problem of saying why YS's preferences should be given precedence over DP's only because they are the same person. So appeals to identity constitute at least some part of the argument. Fair enough. I don't necessarily want to insist here that identity plays no role whatsoever in these bioethical arguments; rather, I merely want to show that appeals to identity are far less significant to bioethics than have often been thought, and in particular they do little to none of the heavy lifting in these arguments, which is actually done by other relations. In the case of advance directives, what's doing the heavy lifting is the establishment of authoritativeness in preferences. Given that if YS and DP aren't numerically identical, YS's preferences for DP may still be authoritative, and given that if YS and DP are identical, YS's preferences may not be authoritative over DP's (as I point out in the next paragraph above), identity considerations play very little role in addressing the main issues.
40. See, e.g., Agnieszka Jaworska. Respecting the Margins of Agency: Alzheimer's Patients and the Capacity to Value. Philos Public Aff 1999; 28: 105-138.