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Bryce Daniel

Prof. Kelly

Philosophy 106

Contemporary Issues

18 April 2014

The Non-replaceability of Persons

Je McMahan, in his work The Metaphysics of Brain Death, proposes an account of

personal identity which separates the person from the human organism and discusses its

implications in terms of the morality of euthanasia. Peter Singer, in Taking Lives: Humans,

presents an idea of the replaceability of fetuses and infants, and relates it to euthanasia. In this

paper I will take both into account and discuss the replaceability of individuals in a persistent

vegetative state. I claim that while McMahans account of personal identity implies that an

individuals organism is replaceable, his claim does not imply that persons in a persistent

vegetative state are as well. The implications of this claim result in practical consequences that

should be accepted because it more clearly defines conditions for which an individual may

permissibly be euthanized, allowing us to euthanize individuals whose person no longer exists,

but who medical policy currently prohibits from euthanizing.

Before I can fully examine McMahans account of personal identity and its relation to

euthanasia, I will present his distinction between a person and their organism. I will use this

idea to explain the concept of personal identity and why cases of persistent vegetative state

explicitly do not allow for the replaceability of the person. In The Metaphysics of Brain Death,

McMahan draws a clear distinction between the personmeaning the mindand their

organism, their body. He claims that relation is not identity and while we are intimately

related to our organism, we are not identical to it (McMahan 97). The principle reason for this

duality rests within our origin as well as our death. Accepting the idea that we are identical to

our organism poses numerous issues, the first of which is conception. In the case of

monozygotic twinning, the organism splits within fourteen days of conception to form two

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qualitatively identical embryos (McMahan 98). Assuming we exist as a person at our

organisms beginning, it would be arbitrary to assign one of the subsequent embryos the

identity of the original person and not the other. This suggests that two new organisms form; if

we were identical to our organisms, then one of us ceases to exist when monozygotic

twinning occurs. Because ceasing to exist is generally a bad thing, it would follow that twins

are bad, but this is contrary to the general belief about twins. Additionally, were we identical to

our organism, we would cease existing it does, essentially surviving death in the continued

existence of a corpse. Similarly, if we were identical to our organism, death of the mind, would

be one and the same thing as death of the organism, but hospitals can keep organisms on

life support after the mind no longer exists (McMahan 94). It is also worth noting that we

cannot say that the mind is the brain for when the mind is no longer capable of existing

within the brain, the brain does not simply cease to exist (McMahan 103). In everyday

language, The phrase death of a person actually means death of the organism which was

the person. In order to avoid confusion, we must dierentiate between the two concepts of

death. The first concept is that of biological death of a living being in which the body ceases

functioning. The second is death of the conscious or potentially conscious being whose

existence is supported by the functioning of the organism. In the latter case, the body remains

functional, but the brain and the person is dead. When I die, I cease to exist regardless of the

biological state of my body.

Having identified the dierence, as claimed by McMahan, between a person and their

organism, I will now suggest the relevance of this distinction to euthanasia. According to

McMahan, euthanasia is an act of killing or letting die that is intended to benefit and actually

succeeds in benefiting the individual who is killed or allowed to die (McMahan 125).This

definition is important because it takes into strong consideration, the motive for euthanizing; an

act that benefits the individual due to happenstance cannot be considered euthanasia. With

this definition in mind, let us now examine the two types of persistent vegetative state. In the

first, the individual, defined as the person and their organism, survives in a permanently

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unconscious condition (McMahan 125). McMahan claims that their life is no longer worth

living. However, the individual cannot be aware of anything, so their current state has no

negative impact on them. They do not suer or feel pain. At this point, it seems beneficial for all

to terminate life-support. However, while pulling the plug would allocate medical resources to

others in need, this is not euthanasia (McMahan 126). Ending support would be justifiable in

that it increases overall utility, but it would be done without respect to the interests of the

individual whom is still a person, despite the lack of consciousness. A person in this state

cannot morally nor ethically be euthanized without their prior consent as they still maintain

basic human rights. The second type of persistent vegetative state is the result of the death of

the cerebral hemispheres (McMahan 126). This case is perhaps of more interest, as at this

point, the person has ceased to exist. In a more literal sense of the word, euthanasia is no

longer possible as you cannot kill that which is already dead. It is only the organism and not the

person that exists; therefore it is possible and permissible to kill it, as a mere organism cannot

be the subject of benefits or harms, (McMahan 126). McMahans notion of identity causes the

issue of euthanasia becomes a more complex discussion in which we must now consider the

parts of the brain required to support the mind, and at which point one can determine when a

person ceases to exist. These distinctions in vegetative state and their relation to euthanasia

will later be used alongside Singers idea of replaceability to illustrate why McMahans account

of personal identity does not imply that persons in a vegetative state are replaceable.

In this section of the paper, I will now discuss Peter Singers notion of replaceability as

described in chapter 7 of Practical Ethics. Singer claims infants are replaceable, but I will

conclude the same holds for organisms in a persistent vegetative state. I will then use this to

determine that McMahans account of personal identity does not imply that persons in a

persistent vegetative state are replaceable as they are similar to sentient, but not self-rational

infants. Singer subscribes to the view total utilitarianism, which claims we should maximize the

total amount of utility that will ever be experienced, including for those who do not yet, but

potentially will, exist. Under the total view, it is necessary to ask whether the death of an

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individual would lead to the creation of another being who would not have otherwise

existed (Singer 185). If child X is sick, the total utilitarian must consider whether it would

increase utility to kill child X and replace it with child Y, assuming child Y is healthy. Singer

claims that when the death of a disabled infant will lead to the birth of another infant with

better prospects utility will be greater if the disabled infant is killed (Singer 186).

Essentially, this is replaceability. In the case of prenatal diagnosis and a subsequent abortion,

replaceability is more ubiquitously accepted. As discussed earlier, self-consciousness, which

could provide a basis for holding that it is wrong to kill one being and replace it with another, is

not to be found in either the fetus or the newborn infant (Singer 188). It is this lack of

consciousness in individuals in a persistent vegetative state that allows some individuals to be

deemed replaceable. McMahans account of personal identity draws a distinction between a

person and their organism, allowing us to discuss the two cases of vegetative state separately.

In the case in which the individual is unconscious, they should not be treated as replaceable.

Singer claims that we cannot treat individual human persons as being interchangeable or

replaceable because they have hopes, dreams, and fears, and when you kill them, you thwart

their aspirations. Furthermore, persons have the ability to fear the loss of their dreams.

Regardless of their state of consciousness, they are still persons and should not be euthanized

or replaced without consent. This notion is key to the claim that persons in a vegetative state

are not replaceable in the same way that possible persons, fetuses, and infants are. In the

second case of persistent vegetative state, patients who are brain dead (i.e. both hemispheres

of the brain no longer function) are no longer persons. Because their organism cannot

experience harm in the same way a person can, there is no way to euthanize it. However, in

this case, the organismnot the personcan be considered replaceable.

I will now discuss the implications of the practical consequences and suggest that they

should be accepted into common practice. In terms of social policy, families of patients who

are brain dead should be able to pull the organismfor that is all that remainso of life

support. When the brain no longer contains a mind, and by extension the person, it is

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essentially just the organism that remains, and therefore is replaceable. The human body is

neither self-conscious nor autonomous and so it should be treated no dierently than a human

fetus or infant. If we are to accept the practical consequences of McMahans view, we are

allowed to euthanize specific individuals, depending on whether their person still exists. As

medical technology continues to develop, we will learn more about where in the brain the mind

exists and will be able to determine, with more accuracy, when the person ceases to exist.

McMahans insight into personal identity is important as it requires us to determine the point at

which a person is no longer a person and therefore considered replaceable. Families could

then to pull the plug on patients in a persistent vegetative state whose brain no longer

functions without moral or legal repercussions. Despite what some claim, accepting

McMahans view does not commit us to accepting persons as replaceable. Individuals who are

unconscious still meet the qualifications of human as dictated by Singer and therefore have the

right not to be replaced.

In this paper I have, using arguments from McMahan and Singer, claimed that

McMahans account of personal identity, in relation to individuals in a persistent vegetative

state, does not imply that some persons are replaceable. McMahans view suggests that

individuals consist of both the person and the human organism. Although persons and their

organisms are closely related, they are not identical. This allows him to claim that in the case of

permanent unconsciousness, euthanasia is not morally permissible, whereas in the case of

brain death, the person no longer exists and therefore killing the human organism is not

immoral. Singers rules for replaceability allow me to claim that in the case of persistent

vegetative state, where the individual is not brain dead, the person still exists and so they are

not replaceable. A person is never replaceable, just their human organism, which lacks the

capacity to be harmed in the same way a person can, and is aorded no more rights than a

fetus or nonself-conscious infant.

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!Works Cited

Mcmahan, Je. "The Metaphysics Of Brain Death." Bioethics 9.2 (1995): 91-126. Print.

Singer, Peter. Taking Lives: Humans, Practical Ethics Second Edition, (1993): 176-217. Print.