Lizza J P
Liberal Studies Department, Parsons School of Design, New School for Social Research, New York, NY 10011.
J Med Philos. 1993 Aug;18(4):351-74. doi: 10.1093/jmp/18.4.351.
This paper challenges the recommendations 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 tutorist 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.
本文对1981年总统医学及生物医学和行为研究中的伦理问题研究委员会的建议提出了质疑。该委员会建议美国所有司法管辖区都应采用《统一死亡判定法》,该法支持全脑死亡定义,而非高级脑死亡定义。我认为,委员会以哲学家或普通民众对于“人格”的构成没有达成共识为由,拒绝接受支持高级脑死亡定义的“人格论证”是错误的。我主张,哲学家们一致认为,一定的认知功能潜力是人格存在的必要条件,而在无脑儿和持续性植物状态(PVS)的情况下,当这种潜力不存在时,个体应被视为死亡。我进一步认为,普通民众缺乏共识在很大程度上是由于对PVS医学现实的误解以及受对处于PVS状态的特定个体情感影响的信念。我还审视并驳斥了曾被用来支持委员会立场的两个托辞论证:一是高级脑死亡定义会威胁到严重老年痴呆症患者和严重智力迟钝者;二是目前尚无足够的医学技术来确定所有高级脑活动何时停止。