Ethical evaluation of deep brain stimulation as a treatment for Parkinson’s disease is complicated by results that can be described as involving changes in the patient’s identity. The risk of becoming another person following surgery is alarming for patients, caregivers and clinicians alike. It is one of the most urgent conceptual and ethical problems facing deep brain stimulation in Parkinson’s disease at this time. In our paper we take issue with this problem on two accounts. First, we elucidate what is (...) meant by “becoming another person” from a conceptual point of view. After critically discussing two broad approaches we concentrate on the notion of “individual identity” which centers on the idea of “core attitudes”. Subsequently we discuss several approaches to determine what distinguishes core attitudes from those that are more peripheral. We argue for a “foundational-function model” highlighting the importance of specific dependency relations between these attitudes. Our second aim is to comment on the possibility to empirically measure changes in individual identity and argue that many of the instruments now commonly used in selecting and monitoring DBS-patients are inappropriate for this purpose. Future research in this area is advised combining a conceptual and an empirical approach as a basis of sound ethical appraisal. (shrink)

I begin by comparing the question of what constitutes continuity of Personal Identity Online (PIO), to the traditional question of whether personal identity is constituted by psychological or physical continuity, bringing out the compelling but, I aim to show, ultimately misleading reasons for thinking only psychological continuity has application to PIO. After introducing and defending J.J. Valberg’s horizonal conception of consciousness, I show how it deepens our understanding of psychological and physical continuity accounts of personal identity, while revealing their shortcomings. (...) I then argue that PIO must also be understood against the backdrop of the horizonal conception, that this undermines sharp dichotomies between online and offline identity, and that although online psychological continuity might become necessary for the preservation of our personal identities, we cannot become our PIOs. Finally, I argue that if PIO is understood solely in terms of psychological continuity, any increasing identification with our PIOs assumes the form of a paradigmatic project of bad faith: a technological reduction of our self-consciousness, rather than the enhancement it should be. (shrink)

It is suggested that the best way to interpret animalism is as an identity thesis saying that each of us is identical to an animal. Since there are disagreements about the nature of animal persistence, this means that animalism itself not does not explicitly propose criteria of identity for persons. It implies the negative claim that features that have nothing to do with animal persistence have nothing to do with our persistence. Thinking of it as an identity thesis also makes (...) sense of the nature of the arguments surrounding the thesis. Central to such arguments are claims about the persistence of animals and persons in certain imagined scenarios. To adjudicate such arguments, we need a secure grip on some claims about animal persistence. Often these are generated by a theory of animal persistence. In the second part of the paper, it is argued that the attempt to build such theories on the assumption that life is essential for animal existence is implausible. In the way we speak, we seem not to recognise death as the ceasing to exist of an animal. No better way to think of animals is proposed in this paper. (shrink)

I defend a theory of the way in which death is a harm to the person who dies that fits into a larger, unified account of harm ; and includes an account of the time of death's harmfulness, one that avoids the implications that death is a timeless harm and that people have levels of welfare at times at which they do not exist.

Compatibilists disagree over whether there are historical conditions on moral responsibility. Historicists claim there are, whilst structuralists deny this. Historicists motivate their position by claiming to avoid the counter-intuitive implications of structuralism. I do two things in this paper. First, I argue that historicism has just as counter-intuitive implications as structuralism when faced with thought experiments inspired by those found in the personal identity literature. Hence, historicism is not automatically preferable to structuralism. Second, I argue that structuralism is much more (...) plausible once we accept that personal identity is irrelevant to moral responsibility. This paves the way for a new structuralist account that makes clear what it takes to be the diachronic ownership condition (which is normally taken to be personal identity) and the locus of moral responsibility (which is normally taken to be ‘whole’ person), and helps to alleviate the intuitive unease many have with respect to structuralism. (shrink)

In 2008 the Human Fertilisation and Embryology Act amendments made deliberately choosing to bring disability into the world, using assisted reproduction, a criminal offence. This paper considers whether the legal prohibition above, should influence other policy areas concerning the welfare of future children such as new possibilities presented by foetal surgery and in utero gene therapy. If we have legal duties to avoid disability in one context should this influence our avoidance of disability in this other context? This paper investigates (...) whether the State might have a stake in wider promotion of practices to reduce the degree of disability in foetuses that will come to exist. Not selecting for disability does not affect the welfare of any future individual, whereas treating in utero abnormalities can optimize the eventual child’s welfare; antenatal interventions stand to improve clinical outcomes and welfare should that specific child be born. I explore why the State may want to intervene in the antenatal setting and to what extent, if at all; the State should implement these technologies. I argue that if the State is justified in intervening to outlaw the choosing to create disabled lives using assisted reproductive techniques, it is also justified in putting pressure on prospective parents to accept therapies in utero to help their child be born less disabled. However, I qualify this with the argument that the State is not justified in using force or the criminal law in this situation during pregnancy. (shrink)

Hylomorphism claims that structure is a basic ontological and explanatory principle; it accounts for what things are and what they can do. My goal is to articulate a metaphysic of hylomorphic structure different from those currently on offer. It is based on a substance-attribute ontology that takes properties to be powers and tropes. Hylomorphic structures emerge, on this account, as powers to configure the materials that compose individuals.

This paper examines three proposals on the difference between the complex and the simple view about personal identity: Parfit’s original introduction of the distinction, Gasser and Stefan’s definition, and Noonan’s recent proposal. I argue that the first two classify the paradigm cases of simplicity as complex, while Noonan’s proposal makes simplicity and complexity turn on features whose relevance for the distinction is questionable. Given these difficulties, I examine why we should be interested in whether a position is complex or simple. (...) I describe two purposes of having a distinction, and show that extant accounts of the complex versus simple distinction fail to serve these. I argue that unless we find a satisfying account of the difference between complex and simple positions, we should not frame discourses on personal identity in these terms. (shrink)