Human Identity and Bioethics
DeGrazia (David)
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BOOK ABSTRACT:

Synopsis

    When philosophers address personal identity, they usually explore numerical identity: what are the criteria for a person's continuing existence? When non-philosophers address personal identity, they often have in mind narrative identity1: Which characteristics of a particular person are salient to her self-conception? This book develops accounts of both senses of identity, arguing that both are normatively important, and is unique in its exploration of a range of issues in bioethics through the lens of identity. Defending a biological view2 of our numerical identity and a framework for understanding narrative identity3, DeGrazia investigates various issues for which considerations of identity prove critical: the definition of death; the authority of advance directives in cases of severe dementia; the use of enhancement technologies; prenatal genetic interventions; and certain types of reproductive choices. He demonstrates the power of personal identity theory to illuminate issues in bioethics as they bring philosophical theory to life.
Cover Reviews (Full Text)
  1. "This book is unique in developing philosophically rigorous accounts of both numerical and narrative identity4, and then using them to illuminate some central issues of bioethics. A first rate and important contribution to the bioethics literature."
    … Dan W. Brock, Harvard Medical School
  2. "Human Identity and Bioethics carefully develops and defends a biological account of our identity as human animals5, which it then supplements with a nuanced vision of human life as narratively structured. It explores the implications of these foundational ideas for a range of important issues such as the definition of death, the authority of advance directives in cases of dementia, human enhancement, and abortion6. The discussion of each issue provides the relevant factual background, surveys the current debate, and offers its own original contribution. DeGrazia's arguments are consistently lucid and insightful and will be illuminating even for those who may not accept every element of his theory. This book is a major contribution to the field of bioethics."
    … Jeff McMahan, Rutgers University
  3. "Questions of life and death are prominent in American politics. Too seldom, however, are they approached with the clarity and rigor that a philosophical perspective can supply. Written with compelling lucidity and using arguments that are both inventive and fair-minded, David DeGrazia's Human Identity and Bioethics draws on metaphysical considerations about human identity to illuminate questions that intimately touch our daily lives:
    … What is death?
    … Should a person's advanced directive be respected if he or she is no longer, in crucial ways. "the same person"?
    … Is it permissible to end life support for patients without consciousness. and, if so. under what circumstances?
    … Is abortion7 permissible, and, if so, when and on what grounds?
    Detailed enough for specialists and straightforward enough for undergraduate teaching, DeGrazia's book makes a valuable contribution to our public culture."
    … Martha Nussbaum. The University of Chicago
  4. David DeGrazia is Professor of Philosophy at George Washington University. He is the author8 of Taking Animals Seriously: Mental Life and Moral Status and Animal Rights: A Very Short Introduction, and coeditor, with Thomas Mappes, of Biomedical Ethics, in its fourth, fifth. and sixth editions.
Philosophers Index Abstract
    Defending a biological view9 of our numerical identity and a framework for understanding narrative identity10, David DeGrazia investigates various issues for which considerations of identity prove critical: the definition of death; the authority of advance directives in cases of severe dementia; the use of enhancement technologies; prenatal genetic interventions; and certain types of reproductive choices. Human Identity and Bioethics demonstrates the power of personal identity theory to illuminate issues in bioethics as they bring philosophical theory to life. (publisher, edited)



In-Page Footnotes ("DeGrazia (David) - Human Identity and Bioethics")

Footnote 8: See "DeGrazia (David) - Taking Animals Seriously: Mental Life and Moral Status".


BOOK COMMENT:

CUP, 2005



"Hershenov (David) - Review of David DeGrazia’s Human Identity and Bioethics"

Source: National Catholic Bioethics Quarterly, 8:4, Winter 2008


Author's Introduction
  1. David DeGrazia has penned an ambitious book that brings recent work in the metaphysics of personal identity as well as the “non-metaphysical” notion of narrative identity1 to bear on contemporary bioethics issues.
  2. While I am sympathetic to the metaphysical account of animal identity that DeGrazia borrows from Eric Olson, he doesn’t seem to realize a major weakness, which Olson himself admitted. This has to do with the possibility of thinking entities embedded within the organism.
  3. He also seems unaware, or, at least, indifferent to rival religious-inspired soul theories of our identity that avoid this problem - as well as have other merits.
  4. His summary dismissal of such soul theories and his defense of abortion2 and embryonic3 stem cell research will not endear him to most readers of NCBQ. Despite these qualms, the book is worth reading. The chapter on advance directives may become the starting point for future discussions.


COMMENT:



"DeGrazia (David) - Human Identity and Bioethics: Introduction"

Source: DeGrazia - Human Identity and Bioethics, 2005, Chapter 1


Full Text1

Introduction
  1. You and I are persons. More specifically, we are human persons — persons who are members of the species Homo Sapiens. But what does it mean to say that someone is a person? And what is the significance of being human?
  2. You and I have existed for years. We will continue to exist in the future. What are the criteria for our continuing to exist over time?
  3. In continuing to exist — that is, in living our lives — we develop stories about ourselves. These stories may go well or badly from our individual perspectives. What is the character of these self-stories? At a general level, how do we want them to go? Does our existence have any value to us if we are incapable of telling such stories to ourselves?
  4. When do we come into being, and when do we die? What is the relationship between our origins and death, on the one hand, and the boundaries of our self-stories, on the other? What are we2 most fundamentally? Are we essentially self-narrating persons or are we essentially human animals3 — who happen to treasure the portion of our lives when we can make narratives?
  5. As persons, we not only exist over time and develop self-narratives; we plan for the future in the hope that our stories will go a certain way. But common sense suggests that we can plan for times when we no longer have the ability to plan or make any complex decisions. Advance directives in medicine are supposed to facilitate such planning. But the person who completes an advance directive may be very different from the patient to whom it will later apply. We tend to think that the earlier person and the later patient are the same individual, who has changed greatly but not gone out of existence. Is this correct? In any case, what is the authority of earlier plans for someone who no longer remembers such planning and doesn't care about it?
  6. Self-stories and planning are characteristic of human persons. So is the effort to change ourselves in ways we consider improvements. Such changes can be minor, moderate or extreme. Modern technologies facilitate many efforts at self-change. Are any self-transformations so drastic that they literally put one out of existence, creating someone else? Are any of them inherently unethical? Are major self-transformations via technologies, or certain technologies, morally problematic for other reasons? In the end, are they justifiable?
  7. Future technologies will enable doctors to modify a fetus4's genome, either to prevent some disease or impairment or to enhance certain traits. But would such interventions, by changing an individual's genes, effectively eliminate that individual and create a new one? Or would it merely change a persisting individual in a way that importantly affects her later self-story? Whatever the answer, would we be justified in pursuing prenatal genetic therapy or enhancement?
  8. Today's parents routinely face reproductive decisions in light of information provided by genetic and other medical tests. Sometimes such information recommends delaying efforts to become pregnant5; getting pregnant6 too soon would likely result in the birth of a child with a significant handicap. Suppose that a couple nevertheless seeks and achieves pregnancy7 immediately, predictably producing a handicapped child. Absent special circumstances, such a decision seems wrong. But the child brought into existence with a handicap would not have existed had her parents delayed conception, and so – assuming that her life is worth living – apparently lacks any basis for complaint. If the parents' choice harms no individual, how can it wrong anyone? And if it doesn't wrong anyone, how can it be wrong?
  9. One legal option available to pregnant8 women is abortion9. But if we come into existence as foetuses10, does that mean that fetuses11 have full moral status and a right to life? Will any of the ideas that emerge in our investigation help to resolve this most controversial of moral problems?
  10. The present book addresses all of these questions. The remainder of this chapter will sketch the conception of personhood with which the book will work before outlining the chapters that follows.
Personhood12
  1. The word person traces back at least to the Latin persona: a mask, especially as worn by an actor, or a character or social role. The concept evolved into the Roman idea of one who has legal rights – notably excluding slaves – before broadening into the Stoic and Christian idea of one who has moral value. The modern concept defines persons as beings with the capacity for certain complex forms of consciousness, such as rationality or self-awareness over time. Here is John Locke's classic formulation:
      "a thinking intelligent being, that has reason and reflection, and can consider itself, as itself, the same thinking thing, in different times and places."
    This concept is closely associated with, and arguably includes, the idea of someone who has moral status (or full moral status if the latter comes in degrees) and perhaps also moral responsibilities.
  2. I will take this modern concept as our shared concept of personhood. But there are different ways to sharpen it, yielding different conceptions of personhood. In ordinary life, when we refer to persons we are referring to particular human beings. The term refers paradigmatically – that is, without controversy – to normal human beings who have advanced beyond the infant and toddler years. Such human beings are certainly beings with the capacity for complex forms of consciousness, for they are psychologically complex, highly social, linguistically competent, and richly self-aware. They are also members of our species. But must a person be human (Homo sapiens)? Perhaps some nonhumans display equally sophisticated forms of consciousness. And must all members of our species qualify as persons? What about those who, although of a species whose members characteristically feature this capacity, do not themselves possess it due to genetic anomaly or injury? And what is the significance of the term capacity? Some such term is needed to indicate that you remain a person while sleeping; you retain the relevant abilities even when not using them. But does a human fetus13, currently quite unable to manifest complex forms of consciousness, have the capacity to do so in the sense of having a nature, or genetic program, that ordinarily permits development of the relevant abilities? If such potential constitutes the relevant capacity, then fetuses14 are persons.
  3. Some people think that all and only members of our species are persons, regardless of their actual current abilities15. Others think that persons are beings who actually possess the relevant abilities, regardless of whether they are human16. I believe this second conception far more adequately captures the term's current meaning, even if in everyday circumstances people typically use the term only to refer to human beings. After briefly defending this claim, I will note that it is not strictly necessary for our purposes.
  4. The concept of personhood seems to extend beyond humanity. For we often categorize as persons certain imaginary nonhuman beings and certain nonhuman beings whose existence is debatable. Thus E.T., the extra-terrestrial, Spock from Star Trek, and the speaking, encultured apes of The Planet of the Apes impress us as being persons. Furthermore, if God and angels exist, they too are persons. (Interestingly, many people who are inclined to equate personhood with humanity also assert, contradictorily, that God is a person.) This suggests that person does not mean human being. The term refers to a kind of being defined by certain psychological traits or capacities: beings with particular complex forms of consciousness. So, in principle, there could be nonhuman persons, for it is conceivable – and perhaps true – that certain nonhumans have the relevant traits.
  5. As noted, the concept of personhood is closely associated with the idea of moral status or full moral status. Is that moral idea part of the very concept of personhood? Another possibility is that the latter is purely descriptive – but seems tantamount to an assertion of moral status because virtually everyone assumes that persons have moral status (as a matter of moral principle, not linguistic meaning). But whether or not the concept of personhood combines descriptive content with moral content, it undoubtedly has descriptive content. Moreover, because the assumption that moral status requires personhood is increasingly challenged today – for example, by those who hold that sentient animals have moral status – it will be advantageous to focus on the term's less controversial, descriptive meaning.
  6. Can we elucidate personhood in greater detail? Although many fairly specific analyses have been offered, they never seem quite right. Consider Harry Frankfurt's thesis that persons are beings capable of autonomy (in his terminology, freedom of the will): the capacity to examine critically the motivations that move one to act in a certain way, and either identify with these motivations or reject and work to change them17. Thus a person, or an autonomous being, may have an incessant desire to drink, due to alcoholism, but may fight this urge and seek to extinguish it. But to require so much cognitive sophistication for personhood is to require too much. No one really doubts that normal three-year-olds and moderately retarded individuals are persons, yet they may lack the capacity for critical reflection necessary for autonomy. Another view, suggested by P. F. Strawson, is that to be a person is to have both mental and bodily characteristics18. But surely this is too inclusive, for many animals we would never regard as persons have both types of characteristics.
  7. Consider another definition, which is quite close to Locke's and apparently strikes many philosophers as plausible: persons as rational, self-aware beings19. Here the problem is that neither rationality nor self-awareness is an all-or-nothing trait. Many creatures we would not regard as persons display some rationality, which comes in degrees. For example, a cat who wants to go outside, understands that heading to the cat door will get him there, and then intentionally heads for the cat door as a means of getting outside displays simple instrumental rationality20. Meanwhile, self-awareness comes in different kinds as well as degrees21. For example, presumably all animals capable of intentional action, such is cats, have some degree of bodily self-awareness, an awareness of their own bodies as distinct from the rest of the environment. Relatively social mammals also have social self-awareness: an awareness of how they fit into group structures, expectations that come with their position in the group, likely consequences of acting against those expectations, and so on. Vervet monkeys, for example, are socially self-aware to an impressive degree22. A further kind of self-awareness is introspective awareness, consciousness of one's own mental states. It is uncertain whether any non-human animals have this capacity. In any event, due to the distinct kinds of self-awareness, each of which admits of degrees, it illuminates little to say simply that personhood requires self-awareness. Which kind? If one replies that introspective awareness, say, is necessary for being a person, it would be appropriate to counter that this trait is only one of a cluster of traits that seem about equally implicated in the concept of personhood. To identify introspective awareness alone — or even in combination with rationality — as definitive of personhood would be arbitrary.
  8. Personhood appears to be associated with a cluster of traits without being precisely analyzable in terms of any specific subset: autonomy, rationality, self-awareness, linguistic competence, sociability, the capacity for intentional action, and moral agency. A being doesn't need all these traits, however specified, to be a person, as demonstrated by non-autonomous persons. Nor is it enough to have just one of them, as indicated by the enormous range of animals capable of intentional action. A person is someone who has enough of these characteristics. Moreover, because we cannot draw a precise, nonarbitrary line that specifies what qualifies as enough, the concept is fairly vague. Like many or most concepts, personhood has blurred edges. Still, person means something, permitting us to identify paradigm persons and, beyond the easy cases, other individuals who are sufficiently similar in relevant respects to deserve inclusion under the concept.
  9. My suggestion, then, is that the present meaning of person is roughly someone (of whatever species or kind) with the capacity for sufficiently complex forms of consciousness. I also suggest that we understand capacity in the sense of current capabilities; mere potential to develop them is not enough. As will become evident in Chapter 2, most leading philosophical work on personhood and personal identity agrees with this rough conception - although, as noted, scholars frequently try to sharpen it into a more specific analysis23.
  10. But suppose I am mistaken in claiming that this broadly Lockean conception best expresses our concept of personhood. Or suppose (whether or not I am correct) particular readers disagree with my claim or are uncertain about it. My being mistaken or unpersuasive about the shared concept would not matter. That is because nothing important, philosophically or morally, will turn on my usage of the term. The entire book could be read, without loss of meaning, after one has deleted every occurrence of person and substituted someone with the capacity for complex forms of consciousness. Indeed, my definition of person may be regarded as stipulative — as an announcement of how I intend to use the term — rather than as a thesis about the term's objective meaning. Conveniently, the vast majority of scholars I will cite use the term in ways that are consistent with my definition.
  11. Can my use of person get off the argumentative hook so easily? What about the claim that, in addition to descriptive content, the term includes moral content? Here I can remain fairly neutral. The content in question involves an assertion of moral status. Not wanting to beg significant moral questions in my use of the term person, I will be careful in what I claim. Note that both traditional moralists, who hold that human beings have exclusive — or at least radically superior — moral status, and animal protectionists, who hold that many nonhuman animals have significant moral status, agree on this proposition: Personhood is sufficient for full moral status. Whether it is also necessary for full moral status I leave open. (I deny that it is necessary for substantial moral status, but that is another matter that does not affect the present discussion24. The italicized statement is all I will assume, morally, about personhood. Whether it expresses part of the meaning of person, or states a logically independent moral assumption does not matter for our purposes. In any case, I will hereafter use person in the species-neutral sense articulated previously25.
Plan Of The Book
  1. The remainder of this book will address the questions introduced at the beginning of this chapter. Chapters 2 and 3 provide a framework for understanding the identity of human persons. Chapter 2 — the longest and most technical in the book — confronts the issue of our numerical identity, which most analytic philosophers have considered the issue of personal identity: What are the criteria for our continuing to exist over time? Closely related is the issue of our essence: What are we26 most fundamentally? Against the philosophical majority, I will argue that we are essentially human animals27, not minds or persons, and that our persistence conditions28 are biological, not psychological.
  2. Because I deny that we are essentially persons, I will sometimes speak of our identity or human identity, rather than personal identity. At issue is the identity of human persons — that is, of human beings, like us, who are persons for at least part of their existence. The term personal identity is potentially confusing in half-suggesting either that we are essentially persons or that the issue concerns our identity only so long as we are persons. Nevertheless, the term is so well established that it would be awkward to avoid it altogether.
  3. Chapter 3 focuses on a different sense of identity, one largely neglected by analytic philosophers. This is narrative identity29, which involves a person's self-conception, what she considers most important to who she is, the way she organizes the story she tells herself about herself. In addition to providing a framework for understanding narrative identity30, the chapter will seek to illuminate the related concepts of self-creation, autonomy, and authenticity. It will also address the issue of what most matters, prudentially, in our continued existence. Importantly, other philosophers who have focused on narrative identity31 have had little to say about numerical identity, apparently believing the latter unimportant. This book distinguishes itself by developing accounts of both senses of identity and maintaining that both are normatively important.
  4. Chapters 4 to 7 engage this two-part account of human identity with specific practical issues. The most general theme uniting the chapters is that one or both senses of identity are critical to understanding a rich array of issues in bioethics: the definition of human death; the authority of advance directives in cases of severe dementia; the use of enhancement technologies; prenatal genetic interventions; and certain types of reproductive choices. With the help of plausible moral assumptions, considerations of identity illuminate these difficult issues. No less importantly, casual appeals to identity are unhelpful. Carefully distinguishing numerical and narrative identity32 — and having plausible views about both — are critical to identity-related argumentation in bioethics. As we will see, much of the literature conflates the two senses of the term and/or assumes implausible theses about identity, vitiating its argumentation from the start.
  5. Chapter 4 addresses the definition of human death. Since death ends our existence, it concerns our persistence conditions33 — conceptually tying the issue of human death to that of our numerical identity. Currently there is a virtual consensus among scholars that the permanent cessation of functioning of the entire brain is sufficient for a human being's death. I will argue, to the contrary, that an updated version of the traditional cardio-pulmonary standard best coheres with the concept of death in the case of human beings. But, because the policy issue of defining death cannot rely on ontological considerations alone, narrative identity34 and various pragmatic considerations also weigh in, leading to a more pluralist is framework. This discussion illustrates both the relevance and the limits of personal identity theory in addressing issues in bioethics. Sometimes good theorizing illuminates normative issues by preventing premature closure.
  6. Both senses of identity prove important in Chapter 5, which addresses the authority of advance directives in cases of severe dementia. That our numerical identity is a function of biological life ensures that an advance directive's author remains in existence despite having even the severest dementia. At first glance, then, it would appear that advance directives carry their usual authority in such cases. But, since our persistence as self-narrators matters greatly to us, narrative identity35 is also salient. The investigation requires refining the framework for understanding narrative identity36: Weak and strong types of narrative identity37 are distinguished, as are several senses of identification, which may or may not characterize the relationship between the earlier author of an advance directive and the later individual to whom it presumably applies. (The need to refine our theoretical framework in discussing advance directives illustrates the reciprocal dynamic of theory development in ethics: Sometimes a theoretical framework illuminates particular practical issues; sometimes the practical issues require refinement, or even revision, of the framework.) The chapter ultimately steers a middle course between those who favor precedent autonomy uber alles and those who argue that, in cases of severe dementia, best interests trump respect for autonomy.
  7. Chapter 6 explores enhancement technologies in relation to identity and self-creation, the deliberate shaping of oneself or one's life direction. Focusing on cosmetic surgery, cosmetic psychopharmacology, and genetic enhancements, the discussion finds most concerns about them to provide reasons for caution rather than prohibition. Most identity-related objections prove to rest either on misunderstandings concerning our identity or on a rigid romanticism about a person's current characteristics. The upshot is a cautious openness about the use of enhancement technologies in projects of self-creation.
  8. Turning to our prenatal identity, Chapter 7 investigates prenatal genetic interventions and certain types of reproductive decisions. It is argued that the human animal38, or organism, comes into being not at conception but somewhere between the sixteen-cell stage and the time at which twinning39 becomes impossible — further refining the account of numerical identity defended in Chapter 2. It is next argued that, once we come into existence, our identity is relatively robust in the face of genetic and other changes. Most arguments supporting a claim of fragile prenatal identity prove either to conflate numerical and narrative identity40 or to assume that we are essentially minds or persons. Except for very early in pregnancy41, before one of us has come into being, the robustness thesis obviates the concern that prenatal genetic interventions may put one human individual out of existence while creating a new one. Nevertheless, for various reasons, prenatal genetic therapy enjoys somewhat stronger moral support than prenatal genetic enhancement.
  9. Turning to reproductive decision making, the chapter next tackles the non-identity problem. If a couple's choice to conceive at a particular time predictably brings into the world a child with a handicap that could easily have been avoided by delaying efforts to conceive, their behavior seems highly objectionable — even if the resulting child has a worthwhile life. The problem is to make sense of this moral judgment in light of the fact that, had the couple delayed pregnancy42, the child they would have created is numerically distinct from the child they did, in fact, create. Since the actual child would not have existed had the parents delayed pregnancy43, he is apparently not a victim. How, then, to explain the seeming wrongness of the parents' behavior? I attempt to address this problem in a way that generates neither paradox nor implausible ethical implications — and with minimal dependence on any specific view of human identity.
  10. The chapter's final section addresses abortion44. After rebutting several strategies for resolving this issue, including an ingenious argument from personal identity, I reconstruct the strongest anti-abortion45 argument - the Future-Like-Ours Argument (which tacitly assumes the biological view)46 — and appeal to the earlier-defended view of our origins to determine when in gestation this argument first applies. I then raise doubts about a highly regarded strategy for undercutting the Future-Like-Ours Argument before contending that an appeal to the fetus47's time-relative interests successfully defeats the argument, greatly advancing the case for a liberal position.


COMMENT: The Preface acknowledges the influence of Marya Schechtman (in distinguishing numerical from narrative identity)48 and Eric Olson (for his development of the biological view49 of numerical identity).




In-Page Footnotes ("DeGrazia (David) - Human Identity and Bioethics: Introduction")

Footnote 1: Some uninteresting footnotes omitted.

Footnote 12: Parts of this section borrow significantly from my chapter "On the Question of Person-hood Beyond Homo Sapiens" in Peter Singer (ed.), In Defense of Animals, 2nd ed. (Oxford: Blackwell, see "Singer (Peter), Ed. - In Defence of Animals", though as this is the First Edition, it doesn’t feature DeGrazia’s paper).

Footnote 15: See, e.g., Norman Ford, The Prenatal Person (Oxford: Blackwell, 2002), ch. 1.


Footnote 16: See, e.g., Mary Anne Warren, "On the Moral and Legal Status of Abortion," Monist 57 (1973): 43-61 (See "Warren (Mary Anne) - On the Moral and Legal Status of Abortion") and Michael Tooley, Abortion and Infanticide (Oxford: Clarendon, 1983).

Footnote 17: "Freedom of the Will and the Concept of a Person," Journal of Philosophy 68 (1971): 829-39
(See "Frankfurt (Harry) - Freedom of the Will and the Concept of a Person"). Cf. Daniel Dennett, Brainstorms (Hassocks, England: Harvester, 1978), ch. 14 (See "Dennett (Daniel) - Brainstorms - Philosophical Essays on Mind and Psychology", "Dennett (Daniel) - Conditions of Personhood").

Footnote 18: Individuals (London: Methuen, 1959), p. 104. See "Strawson (Peter) - Individuals: An Essay in Descriptive Metaphysics".

Footnote 19: Peter Singer, Practical Ethics, 2nd ed. (Cambridge: Cambridge University Press, 1993), pp. 110-11. See "Singer (Peter) - Practical Ethics".


Footnote 20: I argue that many animals can act intentionally and to some degree rationally in Taking Animals Seriously: Mental Life and Moral Status (Cambridge: Cambridge University Press, 1996), pp. 129-72. See "DeGrazia (David) - Taking Animals Seriously: Mental Life and Moral Status".

Footnote 21: I develop this point and discuss the relevant empirical literature, ibid., pp. 166-83.

Footnote 22: See Dorothy Cheney and Robert Seyfarth, How Monkeys See the World (Chicago: University of Chicago Press, 1990).

Footnote 23: My comments imply that this sharpening effort is fruitless due to the concept's vagueness, assuming one is trying to capture the shared concept of personhood rather than stipulating a conception for a particular purpose.

Footnote 24: See Taking Animals Seriously, ch. 3 (ie. "DeGrazia (David) - Animals' Moral Status and the Issue of Equal Consideration").

Footnote 25: This species-neutral sense of person leaves open the conceptual possibility of nonhuman persons. Elsewhere I have argued that there are currently at least five living nonhuman persons — all of whom, notably, have received extensive linguistic training: three great apes and two dolphins ("On the Question of Personhood Beyond Homo Sapiens"). Space constraints prevent me from including this material here.



"DeGrazia (David) - Human Persons: Numerical Identity and Essence"

Source: DeGrazia - Human Identity and Bioethics, 2005, Chapter 2


Sections
  1. The Psychological View
    … 1.1 Locke’s Theory
    … 1.2 Parfit’s1 Innovations
    … 1.3 A Strong Connection To Some Everyday Practical Concerns
  2. Concerns About The Intuitive Case Method
  3. Why Take Essentialism Seriously?
  4. Essence-Based Challenges To The Psychological View
  5. A Strategy For Replying To These Challenges: The Constitution View2
  6. Critique Of The Constitution View3 As Developed By Baker
    … 6.1 The Newborn Problem
    … 6.2 A Problematic View of Personal Identity
    … 6.3 Conclusions about Baker’s Constitution View4
  7. The Biological Approach: Motivation, Concerns, Responses
    … 7.1 A Presumption Favoring a Biological View5
    … 7.2 Several Concerns about This Approach
    … … 7.2.1 The Transplant6 Intuition
    … … 7.2.2 The Corpse Problem
    … … 7.2.3 Two Persons Associated with One Human Animal7?
    … … 7.2.4 An Allegedly Poor Fit with the Practical Concerns Associated with Identity
    … … 7.2.5 Conclusion
  8. A Semibiological Alternative: Human Beings as a Partly Psychological Kind
  9. One More Alternative: Mind Essentialism
  10. Conclusion: Verdicts on 10 Thought Experiments8




In-Page Footnotes ("DeGrazia (David) - Human Persons: Numerical Identity and Essence")

Footnote 8: Very interesting!



"DeGrazia (David) - Human Persons: Narrative Identity and Self-Creation"

Source: DeGrazia - Human Identity and Bioethics, 2005, Chapter 3


Sections
  1. What Else Matters in Survival?
  2. Narrative Identity1
    … 2.1 A Framework for Understanding Narrative Identity2
    … 2.2 The Role of Others in a Person’s Narrative Identity3
    … 2.3 Narrative Identity’s4 Close Fit with Certain Practical Concerns
  3. Self Creation
    … 3.1 Is it Possible?
    … … 3.1.1 A preliminary Challenge to the Possibility of Self-Creation and a Reply
    … … 3.1.2 The Deeper Worry: Hard Determinism
    … … 3.1.3 Challenges to This and Similar Accounts
    … … 3.1.4 A Reply to These Challenges
    … 3.2 How Self-Creation Relates to Narrative Identity5 and Other Key Concepts
    … 3.3 Do the Demands of Authenticity Set Moral Limits on Self-Creation?
  4. Conclusion: Bringing the Two Senses of Identity Together



"DeGrazia (David) - Identity, What We Are, and the Definition of Death"

Source: DeGrazia - Human Identity and Bioethics, 2005, Chapter 4


Sections
  1. Introduction to the Debate
  2. Critique of Appeals to Our Essence in Defense of the Higher-Brain Standard
  3. Critique of Appeals to Personal Identity in Defense of the Higher-Brain Standard
  4. Can Appeal to Narrative Identity1 Support the Higher-Brain View?
  5. Might Death be a Moral Concept That is Independent of Identity Theory?
  6. Where Should We Take the Organismic Conception?
    … 6.1 Against Brain Death2
    … 6.2 Updating the Traditional View
    … 6.3 Why Not Disaggregate Death into a Process?
  7. Some Comments on Policy Options
    … 7.1 A Daring Policy Approach
    … 7.2 Conscience-Based Exemptions – On Either Approach
    … 7.3 A More Cautious Policy Approach – and Conclusion



"DeGrazia (David) - Advance Directives, Dementia, and the Someone Else Problem"

Source: DeGrazia - Human Identity and Bioethics, 2005, Chapter 5


Philosophers Index Abstract
    After briefly introducing advance directives as a basis for medical decision-making, this paper elaborates 'the someone else problem' in the context of severe dementia. The paper then reconstructs the reasoning that leads to this putative problem and exposes the important underlying assumption that we are essentially persons. An alternative view of what we are1, one that regards personhood as inessential, is then considered, before several arguments are advanced in favor of that alternative view. The paper next explores implications for advance directives: 'The someone else problem' is effectively dissolved, while it is noted that a related problem (one beyond the paper's scope) may persist. A few implications beyond advance directives are also identified. (edited)
Sections
  1. Introduction
  2. The Nonidentity Thesis and the Someone Else Problem
    … 2.1 The Reasoning
    … 2.2 Critique of This Reasoning
    … 2.3 The Odd Implications of the Nonidentity Thesis
  3. Has Narrative Identity2 Been Disrupted?
  4. Views That Vindicate Advance Directives On the Basis of Precedent Autonomy
    … 4.1 Appeals to Precedent Autonomy on the Assumption That Numerical Identity Matters
    … 4.2 Appeals to Precedent Autonomy without the Assumption That Numerical Identity Matters
  5. Skepticism about Precedent Autonomy
  6. The Importance of Time-Relative Interests
  7. Concluding Reflections
    … 7.1 Several Theses
    … 7.2 A Note about Medical Decision Making



"DeGrazia (David) - Enhancement Technologies and Self-Creation"

Source: DeGrazia - Human Identity and Bioethics, 2005, Chapter 6


Sections
  1. Introduction to Enhancement Technologies
  2. Familiar Concerns about Enhancement Technologies
    … 2.1 Complicity with Morally Problematic Social Norms
    … 2.2 Promoting Biopsychiatry’s Reductionist Agenda
    … 2.3 Fostering Social Quietism
    … 2.4 Self-Defeating and Potentially Coercive Enhancements
    … 2.5 Safety
    … 2.6 Autonomy
    … 2.7 Transgressing the Bounds of Medicine
    … 2.8 Special Concerns about Children
    … 2.9 Justice
  3. The Relationship of Enhancement Projects to Identity
  4. The Charge of Inauthenticity and a Possible Basis in Equivocation
  5. The Charge of Violating Inviolable Core Characteristics
  6. Conclusion



"DeGrazia (David) - Prenatal Identity: Genetic Interventions, Reproductive Choices"

Source: DeGrazia - Human Identity and Bioethics, 2005, Chapter 7


Sections
  1. Our Origins
  2. Prenatal Genetic Interventions and Human identity
  3. On the Ethics of Prenatal Genetic Interventions
    • 3.1 Prenatal Genetic Therapy
    • 3.2 Prenatal Genetic Enhancement
  4. Reproductive Choices that may Affect Identity: The Nonidentity Problem
  5. On Abortion3
    • 5.1 The Future-Like-Ours Argument
    • 5.2 A Leading Reply: The Good Samaritan Argument
    • 5.3 A Successful Reply: The Appeal to Time-Relative Interests
    • 5.4 Two Challenges to This Approach
      → 5.4.1 Implications Regarding Wrongful Handicap
      → 5.4.2 Implications Regarding Infanticide
    • 5.5 Conclusion



Text Colour Conventions (see disclaimer)
  1. Blue: Text by me; © Theo Todman, 2018
  2. Mauve: Text by correspondent(s) or other author(s); © the author(s)



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