Northoff G
Psychiatry Department, University of Frankfurt, Germany.
J Med Ethics. 1996 Jun;22(3):174-80. doi: 10.1136/jme.22.3.174.
Currently, brain tissue transplantations are being developed as a clinical-therapeutic tool in neurodegenerative diseases such as Parkinson's or Alzheimer's disease. From an ethical point of view, distinguishing between the preservation and an alteration of personal identity seems to be central to determining the scope for further application of brain tissue transplantation therapy. The purpose of this article is to review "standard" arguments which are used on the one hand by proponents to prove preservation of personal identity and by opponents on the other hand to prove that brain tissue transplantation results in an altered personal identity. Proponents and opponents are shown to use the same arguments, albeit with different presuppositions. These presuppositions concern the meaning of the term "identity", either numerical or qualitative, the definition of brain identity, either structurally or functionally, and the relationship between mental states, psychological functions and neurophysiological properties as criteria for personal identity. Furthermore the respective neurophysiological, clinical and philosophical evidence for the different presuppositions are discussed. It is concluded that evaluation of personal identity in brain tissue transplantation should not only rely on the "standard" arguments but, additionally, neurophysiological, clinical and philosophical implications should be discussed.
目前,脑组织移植正在被开发为一种针对帕金森氏症或阿尔茨海默氏症等神经退行性疾病的临床治疗工具。从伦理角度来看,区分个人身份的保存与改变似乎是确定脑组织移植疗法进一步应用范围的核心。本文的目的是回顾“标准”论点,一方面支持者用这些论点来证明个人身份的保存,另一方面反对者用这些论点来证明脑组织移植会导致个人身份的改变。结果表明,支持者和反对者使用的是相同的论点,尽管前提不同。这些前提涉及“身份”一词的含义,无论是数字上的还是质的,涉及脑身份的定义,无论是结构上的还是功能上的,还涉及心理状态、心理功能和神经生理特性之间的关系,将其作为个人身份的标准。此外,还讨论了不同前提各自的神经生理、临床和哲学证据。得出的结论是,对脑组织移植中个人身份的评估不应仅依赖于“标准”论点,此外,还应讨论神经生理、临床和哲学方面的影响。