Distanced Perspectives: Aids,Anencephaly, and Ahp

US court decisions guaranteeing life-sustaining care to anencephalic infants have been viewed with disfavor, and sometimes disbelief, by some ethicists who do not believe in the necessity of life-sustaining support for those without cognitive abilities or an independently sustainable future. The distance between these two views – one legal and inclusive, the other medical and specific – seems unbridgeable. This paper reports on a program using multicriterion decision making to define and describe persons in a way which both acknowledges the differences perceived by many as well as those commonalities insisted on in U.S. court decisions. It does this through application of the Analytic Hierarchy Process to a hierarchy of humanness criteria, and secondarily through reference to that concept's subset, personhood.     

Anencephalic infants and special relationships

This paper investigates the scope and limits of parents' and physicians' obligations to anencephalic newborns. Special attention is paid to the permissibility of harvesting anencephalic organs for transplant. My starting point is to identify the general justification for treating patients in order to benefit third parties. This analysis reveals that the presence of a close relationship between patients and beneficiaries is often crucial to justifying treating in these cases. In particular, the proper interpretation of the Kantian injunction against treating persons as means only takes on a different light in the context of special relationships. The implications of this analysis for our responsibilities to anencephalic infants is clarified.     

Defining Death for Persons and Human Organisms

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 (Bernat, Culver, and Gert) or as identical to human organisms (Capron, Seifert, and Shewmon). 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 (Boethius, Strawson, and Wiggins) 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.