Steven den Beste has a long essay on the nature of consciousness and identity (which I hadn’t noticed earlier because it starts out about anime, a subject in which my disinterest is astronomical). In it, among other things, he concurs with my comment a week ago about the late president (not to imply that he read it).
President Reagan’s heart stopped beating a few days ago, and low-level brain activity inside his skull also ceased. But he actually died long before that, from my point of view.
The problem is that we can’t really say when. It is usually a very long and gradual process. How much must you lose before you no longer exist at all? At what point is an Alzheimer’s patient really dead, if not when his heart stops beating?
Of course, that’s not a good criterion either, since hearts can be resuscitated. I’ve written before that, like identity, death itself is a legal state, not an objective scientific one.
He asks an ethical question as well:
Organ transplantation is one of the reasons why medical ethics now is forced to confront the question of when someone has actually died, even though their heart continues to beat. If we conclude they are nonetheless dead, it may be possible to save other lives.
In a case like that of Jon-Erik Hexum, or someone else who has suffered severe trauma to the brain in a car accident or via gunshot, that transition is sufficiently abrupt that it’s more straightforward. But should we consider the possibility of using Alzheimer’s patients as organ donors? And if so, how do we know that the disease has progressed far enough so that they, too, are effectively brain dead? I doubt that anyone will ever seriously consider using Alzheimer’s patients as organ donors precisely because it is such a sticky problem.
There’s a corollary to this question. Suppose we had a way of preserving brains, in some kind of suspension. We don’t know yet how to transplant them, or how to reverse the progress (if that’s the right word) of Alzheimers, but we could remove the brain and put it in stasis in the hopes that the future will both find a cure and the technology to replace it.
If the brain is the seat of the identity and the person, why wouldn’t it make sense to do such a preservation before the brain deteriorated, and the individual was lost forever to information death? Why would, or should, such a procedure be illegal (as it currently is)?
There was in fact a court case like this a few years ago. It wasn’t about Alzheimers–a man with a brain tumor petitioned a court to be allowed to be cryonically suspended if his condition took a turn for the worse, before it destroyed his brain. His assumption was that as poor as the prospects might have been for a cryonic suspension, it beat the odds of having a cancer destroy his mind, a condition that no future technology was likely to be able to repair. And in some sense, he was proposing an organ donation of his brain to his future self.
The court ruled against him, on the basis that he was asking permission to euthanize himself. The irony, of course, was that he was attempting to save himself, while the court was essentially sentencing him to a horrible death. Fortunately, his cancer went into remission, so the issue became moot for him, but the general principle remains. Unless and until we resolve the issues of identity, and where it resides, and what truly constitutes death (as opposed to the current and ever-changing function-based criteria) and differentiate the concept of information death from bodily functions, such issues will continue to be troubling, and in many cases, perverse.