Death/brain death Flashcards
1
Q
Ronald Dworkin and Rebecca Dresser - brain death
A
Brain death is a kind of a misnomer, brain death is not really death, they are still alive, there is a living homosapien, we have this fiction that biological death has occured because the person has stopped exiting, and the person ending is the moral ending of the person who had moral value, but the biological conditions of death have not occurred
2
Q
Dementia: alzheimers - Dworkin
A
Dworkin is concerned with the issue about advanced directives
You can set out some advanced directives for in case you get diagnosed with dementia
You can refuse life saving medical interventions
One thing you couldn’t do, until quite recently, you can request euthanasia in an advance directive
3
Q
Evidential theory
A
- You’re in the best position out of anyone to figure out what’s best for you
- Because we think the individual is better at deciding what id good for them, we know ourselves better than anyone else knows us
- If we want to have the best life possible, we should make our own decisions, as we have all the inside information on what we think will be good or bad for us
- Knowing what;s best for oneself, people are allowed to make their own decisions when the have their own money that they can decide to use
4
Q
Problem 1 of the evidential theory: weakness of the will
A
- eg. smoking, eating food you know is not good for you, and in general engaging in behaviours that you yourself recognise that are not in your best interests
- Regardless of how it’s possible, it is, people engage in decisions that they know are not good for them
- Nobody thinks that they are completely better off for smoking, rather than not smoking, but we still let people do it
- There may be warning labels on cigarettes, but it is still legally permitted
5
Q
Problem 2 of evidential theory: benevolence
A
- If you want to donate a kidney, you are allowed to
- Not because you recognise that giving a kidney is good for you
It’s good for the recipient, not the donor - The decision to donate a kidney is not evidence that donating a kidney is good for the donor
- But we still evaluate the donors autonomy
- You cannot take the kidney without someone consenting to do so
- A third party cannot make that decision
6
Q
The integrity view
A
- it’s good for you to be able to shape your own life
Taking away someone’s ability to make decisions for themselves does greater harm than making a bad decision like smoking - In the case of dementia, the implication is that, if you have the evidential view, then a patient’s decisions years in advance of developing dementia may not be evidence of what’s best for them in the future. This is not why we give patients autonomy - we do it because shaping our own life is a huge part of living a valuable life
7
Q
Counter example to the integrity view: weak-willed Jehova’s witness
A
- Jehova’s witness has a religious objection to life saving medical treatments, a jehovah’s witness may be low on blood, and all they need is a blood transfusion, but we allow them to decide to refuse a blood transfusion
- Eg. where a jehovah’s witness signs a document advance that they are not going to have a blood transfusion, don’t give me one, even if i’m begging you for it
- Low and behold, they want the blood transfusion
- Of Course you should withhold the blood transfusion, this is a counterexample to the integrity view
- It’s argued that it’s different than the dementia case, the jehovah witness are mentally able and freely exercise autonomy and change their decisions
- They can decide to change their mind and reject what they said earlier, as they maintain their competence to make decisions on their own half, they can make an informed decision
- If the jehovah witness becomes demented and can’t make a decision, they are so out of control with fear, they cannot make an informed decision and are able to later is able to gain back control, then you should stick to their decision
- Dworkin’s idea is that you are always allowed to change your mind, but it has to reflect a real autonomous decision
- Your earlier decisions are still binding unless you are freely and autonomously able to revoke them earlier on
8
Q
Rebecca Dresser’s criticisms
A
- She states: Dworkin assumes that Margo the dementia patient is the same person who issued the earlier request to die… but substantial memory loss and other psychological changes may produce a new person
- Dresser is not saying that margot forgot who she is, maybe she is just a new person
- Why does that matter? Because respecting your autonomy and plan out your life over time, assumes a single person exists throughout the entire period - your autonomy does not extend to other people
9
Q
Death
A
- irreversible cessation of integrated functioning by organism as a whole
- The biological functioning of the organism to stop is what death is
There may be some individual cellular activity that exists beyond the functioning of the organism, but that doesn’t mean the organism is alive - Dominant conception: brain death really is death
- Brain needed to integrate functions of whole organism
- When there is an irreversible coma, that means that the organism as a whole is dead
- The brain has this biological significance - responsible for integrating the functioning of the organism
- No functioning brain, no functioning organism
- Death of a brain = death of the whole organism
10
Q
McMahan thinks that brain dead people are not actually dead, only that the person (that you and i are) cease to exist, but the human organism is not dead in case of brain death
A
- Brain death is not necessary for the death of the human organism
- Eg. if you took someone’s brain out, sustain it’s life through artificial means, and hook it up to a matrix, even though your body is dead - the human organism is dead
- If all that is left of a human organism is the brain, then that’s not the human organism, it’s just an organism
- People tend to say a human organism survives, just because the person survives
- If the brain stops functioning, that’s when biological death occurs - the difference is that respitration and heart beat has to be artificially preserved
- McMahan thinks that this is kind of an arbitrary distinction - sometimes people who are alive need this intensive care, it prevents them from dying, they are not dead while that is going on - their body is still functioning, it is just that these two crucial things need some medical intervention
- This is the same thing with total brain death and persistent vegetative state
11
Q
Two concepts of death
A
- There is a distinction between a person who is defined in terms of pscyholgocal characteristics, and a homo sapien/human organism, which is defined in biological terms
- We can get away with thinking they are the same thing, because there are very few cases where there are human beings who are not people
- According to mary anne warrens view, they can come into existence at different times. The human body exists before consciousness exists
- Mcmahan thinks that they can and do stop existing at different times
- There’s a single notion of death that applies to different species and kingdoms of life, human beings can die in that sense too, where the organism goes from the state of being alive to being dead - and the person stops existing, besides persistent vegetative states and brain death, we normally as people stop existing when the organism dies
- But the person dying and the organism dying are two different defintions of death, they don’t automatically happen at the same time
12
Q
Are we organisms/bodies - McMahan is rejecting a view of Gretchen Weirob and Olson
A
- There’s the person and the organism, the moral notion of death is when the person stops existing, but the biological notion of death is not dying, it just goes from going from the state of functioning, to the state of being a corpse
- And the organism stops existing in cremation or the slow process of decomposition
- Olson claims that there is no such thing as a corpse
13
Q
McMahan’s theory of personal identity
A
McMahans proposal of personal identity
Identity of parts of brain necessary for human consciousness
14
Q
The statue and the bronze
A
- are they the same thing
- The statue and the bronze the statue is made of
- Have the bronze
- Make a statue out of it
- When did the statue come to existence
- When it was sculpted
- The bronze existed before it
- I destroy the statue, the bronze is still there
- Statue is made of the bronze, but they’re two different things - they do have a close relationship to each other
15
Q
Epicurus
A
- Founder of epicureanism
- He had an argument that - death is nothing to us; for that which is dissolved is withou sensation; and that which lacks sensation is nothing to us
- Death is not bad, it is nothing ot us - for that which is dissolved is without sensation
- Death is not consequentialist to us, it is nothing to us
Premise 1: after we are dead we are not going to have any conscious experiences or sensations, because we will be dissolved, so there can’t be a composite object
Premise 2: That which lacks sensation is nothing to us
