What is the moral status of humans lacking the potential for consciousness? The concept of potentiality often tips the scales in life-and-death medical decisions. Some argue that all human embryos have the potential to develop characteristics—such as consciousness, intellect, and will—that we normally associate with personhood. Individuals with total brain failure or in a persistent vegetative state are thought to lack the potential for consciousness or any other mental function. Or do they? In Potentiality John Lizza gathers classic (...) articles alongside newly commissioned chapters from leading thinkers who analyze the nature of potentiality in bioethics, a concept central to a number of important debates. The contributors illustrate how considerations of potentiality and potential persons complicate the analysis of the moral consideration of persons at the beginning and end of life. A number of works explicitly uncover the Aristotelian background of the concept, while others explore philosophical issues about persons, dispositions, and possibility. The common assumption that potentiality is intrinsic to whatever has the potentiality is challenged by a relational view of persons, an extrinsic account of dispositions, and attention to how extrinsic factors affect realistic possibilities. Although potentiality has figured prominently in bioethical literature, it has not received a great deal of logical, semantic, and metaphysical analysis in contemporary philosophical literature. This collection will bring these thorny philosophical issues to the fore. Incorporating cutting-edge research on the topic of potentiality, this thought-provoking collection will interest bioethicists, philosophers, health care professionals, attorneys engaged in medical and health issues, and hospital and governmental committees who advise on policy and law concerning issues at the beginning and end of life. (shrink)

The debate over whether brain death is death has focused on whether individuals who have sustained total brain failure have satisfied the biological definition of death as “the irreversible loss of the integration of the organism as a whole.” In this paper, I argue that what it means for an organism to be integrated “as a whole” is undefined and vague in the views of those who attempt to define death as the irreversible loss of the integration of the organism (...) as a whole. I show how what it means for a living thing to be integrated as a whole depends on the sortal concept by which it is identified. Since interests, values, and ontological considerations besides strictly biological ones affect the concepts by which we individuate and identify living things, those non-biological considerations have a bearing on what it means for a particular kind of living thing to exist as a whole and thus what it means for one of us to die. Even if our bodies may remain organically integrated in some sense despite total brain failure, this fact should not lead us to reject brain death as death. Artificially sustained brain-dead human bodies are not human beings, but the remains of them. While such bodies may be alive in some sense, they are not human beings or human persons. They are not one of us. (shrink)

Critics of organ donation after circulatory death (DCD) argue that, even if donors are past the point of autoresuscitation, they have not satisfied the “irreversibility” requirement in the circulatory and respiratory criteria for determining death, since their circulation and respiration could be artificially restored. Thus, removing their vital organs violates the “dead-donor” rule. I defend DCD donation against this criticism. I argue that practical medical-ethical considerations, including respect for do-not-resuscitate orders, support interpreting “irreversibility” to mean permanent cessation of circulation and (...) respiration. Assuming a consciousness-related formulation of human death, I then argue that the loss of circulation and respiration is significant, because it leads to the permanent loss of consciousness and thus to the death of the human person. The DNR request by an organ donor should thus be interpreted to mean “do not restore to consciousness.” Finally, I respond to an objection that if “irreversibility” has a medical-ethical meaning, it would entail the absurd possibility that one of two individuals in the same physical state could be alive and the other dead—an implication that some think is inconsistent with understanding death as an objective biological state of the organism. I argue that advances in medical technology have created phenomena that challenge the assumption that human death can be understood in strictly biological terms. I argue that ethical and ontological considerations about our nature bear on the definition and determination of death and thus on the permissibility of DCD. (shrink)

There has been growing concern about whether individuals who satisfy neurological criteria for death or who become non-heart-beating organ donors are really dead. This concern has focused on the issue of the potential for recovery that these individuals may still have and whether their conditions are irreversible. In this article I examine the concepts of potentiality and irreversibility that have been invoked in the discussions of the definition of death and non-heart-beating organ donation. I initially focus on the recent challenge (...) by D. Alan Shewmon to accepting any neurological criterion of death. I argue that Shewmon relies on a problematic and unrealistic concept of potentiality, and that a better, more realistic concept of potentiality is consistent with accepting a neurological criterion for death. I then turn to an analysis of how the concept of irreversibility has been used in discussion of non-heart-beating organ donation. Similarly, I argue that some participants in this discussion have invoked a problematic and unrealistic concept of irreversibility. I then propose an alternative, more realistic account of irreversibility that explains how "irreversibility" should be understood in the definition and criteria of death. (shrink)

In this paper, I defend brain death as a criterion for determining death against objections raised by Don Marquis, Michael Nair-Collins, Doyen Nguyen, and Laura Specker Sullivan. I argue that any definition of death for beings like us relies on some sortal concept by which we are individuated and identified and that the choice of that concept in a practical context is not determined by strictly biological considerations but involves metaphysical, moral, social, and cultural considerations. This view supports acceptance of (...) a more pluralistic legal definition of death as well as acceptance of brain death as death. (shrink)

In their target article, Nielsen Busch and Mjaaland seek to shift focus away from controversy over whether donors in protocols of controlled donation after circulatory death (cDCD) are dead. Citing...

This paper challenges the recommendation of 1981 President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research that all jurisdictions in the United States should adopt the Uniform Determination of Death Act, which endorses a whole-brain, rather than a higher-brain, definition of death. I argue that the Commission was wrong to reject the "personhood argument" for the higher-brain definition on the grounds that there is no consensus among philosophers or the general population as to what (...) constitutes "personhood". I claim that philosophers agree that some potential for cognitive function is necessary for personhood and that, when this is absent in cases of anencephaly and persistent vegetative state (PVS), the individual should be considered dead. I further argue that the lack of consensus among the general population is due in large measure to misunderstandings about the medical reality of PVS and beliefs influenced by feelings for a specific individual in PVS. I also examine and reject two tutiorist arguments which have been used to support the Commission's position: that the higher-brain definition would threaten the severely senile and severely retarded, and that there are not currently adequate medical techniques for determining when all higher-brain activities have ceased. Keywords: death, personhood, persistent vegetative state, anencephaly CiteULike Connotea Del.icio.us What's this? (shrink)

This commentary challenges the conclusions reached by Franklin Miller and Robert Truog in their criticism of the President's Council's White Paper, "Controversies in the Determination of Death." I agree with much of Miller and Truog's criticism of the rationale offered by the President's Council for accepting neurological criteria for determining death but argue that they too quickly dismiss the alternative rationale of determining death by neurological criteria-i.e., the destruction of the psychophysical integrity of the human being that occurs when the (...) potential for consciousness and every other mental function is lost due to catastrophic injury to the brain. By focusing on the death of bodies instead of human beings, their view absurdly implies that decapitation would not necessarily result in one's death. Since total brain failure is a form of physiological decapitation, the neurological criterion coheres perfectly well with the ordinary understanding of decapitation as death. (shrink)

Name der Zeitschrift: Deutsche Zeitschrift für Philosophie Jahrgang: 64 Heft: 2 Seiten: 287-298.

It will engage bioethicists and philosophers as well as inform policy and law regarding issues at the beginning and end of life.

This paper discusses how alternative concepts of personhood affect the definition of death. I argue that parties in the debate over the definition of death have employed different concepts of personhood, and thus have been talking past each other by proposing definitions of death for different kinds of things. In particular, I show how critics of the consciousness-related, neurological formation of death have relied on concepts of personhood that would be rejected by proponents of that formulation. These critics rest on (...) treating persons as qualitative specifications of human organisms or as identical to human organisms. Since advocates of the consciousness-related, neurological formulation of death are not committed to either of these views of personhood, these critics commit the fallacy of attacking a straw man. I then clarify the substantive concept of personhood that may be invoked in the consciousness-related, neurological formulation of death, and argue that, on this view and contra Bernat, Culver, and Gert, persons have always been the kind of thing that can literally die. I conclude by suggesting that the discussion of defining death needs to focus on which approach to personhood makes the most sense metaphysically and morally. (shrink)

ABSTRACT Consideration of the potentiality of human embryos to develop characteristics of personhood, such as intellect and will, has figured prominently in arguments against abortion and the use of human embryos for research. In particular, such consideration was the basis for the call of the US President's Council on Bioethics for a moratorium on stem cell research on human embryos. In this paper, I critique the concept of potentiality invoked by the Council and offer an alternative account. In contrast to (...) the Council's view that an embryo's potentiality is determined by definition and is not affected by external conditions that may prevent certain possibilities from ever being realized, I propose an empirically grounded account of potentiality that involves an assessment of the physical and decisional conditions that may restrict an embryo's possibilities. In my view, some human embryos lack the potentiality to become a person that other human embryos have. Assuming for the sake of argument that the potential to become a person gives a being special moral status, it follows that some human embryos lack this status. This argument is then used to support Gene Outka's suggestion that it is morally permissible to experiment on ‘spare’ frozen embryos that are destined to be destroyed. (shrink)

The concept of potentiality is often invoked in debate over the moral status of human embryos. It has also been invoked, though less prominently, in debate over the moral status of anencephalic infants, individuals in permanent vegetative state, and the whole-brain dead. In this paper, I examine some of the theoretical assumptions underlying the concept of potentiality invoked in these debates. I show how parties in the debate over the ethical significance of potentiality have been talking past each other to (...) a large extent because they rely on different concepts of potentiality. The conceptual differences are traced to different assumptions about the nature of persons and whether external factors may affect determinations of possibility and therefore potentiality. Any assessment about the ethical significance of potentiality therefore requires an evaluation of alternative concepts personhood and the connection between possibility and potentiality. (shrink)

Human life and death should be defined biologically. It is important not to conflate the definition of death with the criteria for when it has occurred. What is distinctively "human" from a scientific or normative perspective has nothing to do with what makes humans alive or dead. We are biological organisms, despite the fact that what is meaningful about human life is not defined in biological terms. Consequently, as in the rest of the realm of living beings, human beings die (...) when they no longer function biologically as organisms. In contrast, a determination of exactly when death has occurred, required to serve various social purposes, combines social and normative considerations with biological facts. (shrink)

Each of the 13 articles in this collection wrestles with intricate metaphysical and moral aspects of the widespread belief that a thing’s potential—what it could, would, might, or will be, but isn’t yet—matters for how we should treat that thing. As John Lizza explains in his lucid introduction, the articles are grouped into three parts according to their aims and theoretical constraints. In this review, I briefly summarize and offer some critical discussion of each part.

John Lizza says that to define death well, we must go beyond biological considerations. Death is the absence of life in an entity that was once alive. Biology is the study of life. Therefore, the definition of death should not involve non-biological concerns.

John P. Lizza has long been a major figure in the scholarly literature on criteria for death. His searching and penetrating critiques of the dominant biological paradigm, and his defense of a theory of death of the person as a psychophysical entity, have both significantly advanced the literature. In this special issue, Lizza reinforces his critiques of a strictly biological approach. In my commentary, I take up Lizza’s challenge regarding a biological concept of death. He is (...) certainly right to point out that science is not value-free; however, this does not imply that there cannot be a characterization of biological death that can be shown to be superior to other concepts. After characterizing and justifying such a theory of biological death, I show that patients who meet the diagnostic criteria for brain death are unequivocally biologically alive. However, with respect to concepts of personhood and related ideas, I urge the acceptance of a pluralism of such concepts for matters of public policy. (shrink)

In his article, “Defining Death: Beyond Biology,” John Lizza argues in favor of a civil definition of death, according to which the potential for consciousness and social interaction marks us as the “kind of being that we are.” In this commentary, I critically discuss this approach to the bioethical debate on the definition of death. I question whether Lizza’s account is based on a full recognition of the “practical, moral, religious, philosophical, and cultural considerations” at play in (...) this debate. I further propose that a truly ethical debate on definitions of death ought to concentrate on how different definitions of death are used in diverse contexts – what definitions of death do – and focus less on who has the right definition of death for all situations. (shrink)

We are sceptical of concerns over the opacity of algorithmic decision tools. While transparency and explainability are certainly important desiderata in algorithmic governance, we worry that automated decision-making is being held to an unrealistically high standard, possibly owing to an unrealistically high estimate of the degree of transparency attainable from human decision-makers. In this paper, we review evidence demonstrating that much human decision-making is fraught with transparency problems, show in what respects AI fares little worse or better and argue that (...) at least some regulatory proposals for explainable AI could end up setting the bar higher than is necessary or indeed helpful. The demands of practical reason require the justification of action to be pitched at the level of practical reason. Decision tools that support or supplant practical reasoning should not be expected to aim higher than this. We cast this desideratum in terms of Daniel Dennett’s theory of the “intentional stance” and argue that since the justification of action for human purposes takes the form of intentional stance explanation, the justification of algorithmic decisions should take the same form. In practice, this means that the sorts of explanations for algorithmic decisions that are analogous to intentional stance explanations should be preferred over ones that aim at the architectural innards of a decision tool. (shrink)

This discussion note aims to address the two points which Lizza raises regarding my critique of his paper “Defining Death: Beyond Biology,” namely that I mistakenly attribute a Lockean view to his ‘higher brain death’ position and that, with respect to the ‘brain death’ controversy, both the notions of the organism as a whole and somatic integration are unclear and vague. First, it is known from the writings of constitutionalist scholars that the constitution view of human persons, a theory (...) which Lizza also holds, has its roots in John Locke’s thought. Second, contrary to Lizza’s claims, the notions of the organism as a whole and somatic integration are both more than adequately described in the biomedical and biophilosophical literature. (shrink)

The purpose of this book is to give a coherent account of the different perspectives on science and technology that are normally studied under various disciplinary heads such as philosophy of science, sociology of science and science policy. It is intended for students embarking on courses in these subjects and assumes no special knowledge of any science. It is written in a direct and simple style, and technical language is introduced very sparingly. As various perspectives are sketched out in this (...) book, the reader moves towards a consistent conception of contemporary science as a rapidly changing social institution that has already grown out of its traditional forms and plays a central role in society at large. It will appeal to students in a wide range of scientific disciplines and complement well Professor Ziman's earlier books. (shrink)

Kant’s philosophy of science takes on sharp contour in terms of his interaction with the practicing life scientists of his day, particularly Johann Blumenbach and the latter’s student, Christoph Girtanner, who in 1796 attempted to synthesize the ideas of Kant and Blumenbach. Indeed, Kant’s engagement with the life sciences played a far more substantial role in his transcendental philosophy than has been recognized hitherto. The theory of epigenesis, especially in light of Kant’s famous analogy in the first Critique, posed crucial (...) questions regarding the ‘looseness of fit’ between the constitutive and the regulative in Kant’s theory of empirical law. A detailed examination of Kant’s struggle with epigenesis between 1784 and 1790 demonstrates his grave reservations about its hylozoist implications, leading to his even stronger insistence on the discrimination of constitutive from regulative uses of reason. The continuing relevance of these issues for Kant’s philosophy of science is clear from the work of Buchdahl and its contemporary reception. (shrink)

The danger of human operators devolving responsibility to machines and failing to detect cases where they fail has been recognised for many years by industrial psychologists and engineers studying the human operators of complex machines. We call it “the control problem”, understood as the tendency of the human within a human–machine control loop to become complacent, over-reliant or unduly diffident when faced with the outputs of a reliable autonomous system. While the control problem has been investigated for some time, up (...) to this point its manifestation in machine learning contexts has not received serious attention. This paper aims to fill that gap. We argue that, except in certain special circumstances, algorithmic decision tools should not be used in high-stakes or safety-critical decisions unless the systems concerned are significantly “better than human” in the relevant domain or subdomain of decision-making. More concretely, we recommend three strategies to address the control problem, the most promising of which involves a complementary coupling between highly proficient algorithmic tools and human agents working alongside one another. We also identify six key principles which all such human–machine systems should reflect in their design. These can serve as a framework both for assessing the viability of any such human–machine system as well as guiding the design and implementation of such systems generally. (shrink)

John Martin Fischer is one of the leading proponents of semi-compatibilism, one of the ideas proposed in the debates on free will and determinism. According to him, even if it is not possible to make a free choice once determinism is accepted, persons can be held morally responsible for their actions. Thus, the ability to choose one of several alternatives, i.e. to act otherwise, is not necessary for moral responsibility. In his translated article Responsibility and Inevitability, Fischer sketches an (...) outline of a theory of moral responsibility that explains how persons are responsible for their actions, for the actions they do not perform (omissions), and for the consequences of their actions or omissions. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy after ChristJohn O'CallaghanConsider the words of Justin Martyr written in the middle of the second century after the birth of Christ and after Justin's conversion to Christianity:Philosophy is indeed one's greatest possession, and is most precious in the sight of God, to whom it alone leads us and to whom it unites us, and in truth they who have applied themselves to philosophy are holy men.1In addition to (...) the praise heaped upon the philosophers, among whom Justin had counted himself before his conversion,2 the text is one of the earliest pieces of evidence for the historical reality of Christian intellectual engagement with pagan or secular philosophy. Whether that engagement proved spiritually fruitful or sterile in any particular age or any particular tradition of philosophy, Christian intellectuals have often sought out engagement with philosophy as an inherent task of the intellectual life of the Church, in order to pursue and develop the understanding of Christian revelation and the mode of life informed by it. One lasting result of the impetus represented by Justin is to be found even now in the normative requirement in Catholic education that, at a certain stage of development, anyone who receives a [End Page 49] serious Catholic education must be introduced to serious philosophical reflection on where we came from, what we are, and where we are born to go.In addition, one of the general points John Henry Newman made in The Idea of a University is that the human mind looks for unity in the diversity of intellectual disciplines it pursues. In search of this unity, it seeks a kind of primary discipline that takes into account the truths discovered throughout the other disciplines as it seeks to understand what it can of the whole of reality, not just its parts. But Newman also pointed out that, in the absence of such a unifying discipline, practitioners of each particular discipline will often claim for their particular discipline the prize of being primary—of being the discipline by which all others must be understood and judged.3Take classical and modern physics. A familiar claim of some physicists, but even more so of non-physicist physicalists, is that physics is the fundamental intellectual discipline for understanding what is real. All reality, living reality, historical reality, moral reality, indeed perhaps even literary reality, must be reduced to reality as described by the physicists or rejected as unreal or epiphenomenal, or in a kinder, gentler vein, non-reductively emergent and supervenient. Whichever position is taken, whether reduction, non-reductive emergence, or epiphenomenalism, the thought is that the real work of the really real is done by reality as described by physics, either in its actual contemporary state or, more likely, in an idealized future state always on the horizon of where physics presently is. We are really atoms spinning ceaselessly in the void, mostly empty space, the warp and woof of a four-dimensional space-time manifold, or congeries of strings in an even more bizarre thirteen-dimensional manifold, or whatever was said most recently to surpass what was said before that by the leading physicists in California or Cambridge.However, anyone who has actually practiced physics knows that, even when uttered by a physicist, these are not claims of physics, but about physics. What prompts them is the sense that there is no intellectual discipline other than contemporary physics itself that can both understand the achievements of physics and integrate them into a larger intellectual comprehension of reality as a whole. These claims about physics nicely display Newman's point about the way in which a particular discipline, in the absence of a larger more comprehensive discipline, can take on an importance for its practitioners well beyond its disciplinary limits. [End Page 50]In the case of physics, if a more comprehensive unifying discipline is not to be found, this attitude is not entirely unjustified, for Newman's point is partly Aristotelian. Aristotle had pointed out that, if one cannot show that unchangeable, and thus non-physical beings, exist, then what Aristotle called "first philosophy" would just be physics as he understood it, the science of... (shrink)