- Email: [email protected]
Introduction: Personhood: Intimity and otherness
Ethics, Medicine and Public Health (2016) 2, 479—480
Available online at
ScienceDirect www.sciencedirect.com
DOSSIER ‘‘PERSONHOOD: INTIMITY AND OTHERNESS’’ /Editorial
Introduction: Personhood: Intimity and otherness La personne : son intimité et le lien avec les autres
The concept of personhood is an ingredient of all metaphysically constructed systems, and is similarly central to bioethics. The idea of what constitutes a person most probably reached its height as a forefront topic during the enlightenment when the concentration on individual autonomy entered with full force into dialogues about ethics. However, even prior to the enlightenment, there has long been a difficult and often obscure discussion of the question of personhood. There are ample examples of philosophers who comment that personhood is unclear as a concept. Once definitions are at stake, there is a tendency to differentiate cognitive capacities from moral worthiness [1]. Others have emphasized that we can best approach the subject by concentrating on the vulnerability of humans and the nature of their suffering [2,3]. From the point of view of evolutionary biology, particularly in consideration of recent advances in genetics, one is compelled to contemplate the distinction between apes and humans. There are also many technical issues in the philosophy of mind that have yielded divergent points of view among thinkers regarding the sufficient or necessary conditions for achieving personhood. The resolution of the aforementioned debates bears heavily on how we constitute our contemporary bioethics. With respect to a theory of moral behavior, our concept of personhood will make particular difference in respect to how we care for those who have been deprived of mental or physical faculties. It has been the approach of some authors to contend that the real importance and consequence of attending one explanation as opposed another can only produce significant outcomes once tested against the mirror of hard cases where decisions and levels of care are the relevant tests of personhood. It is interesting to note that Ruth Macklin [4], a prominent figure in the search for universal principles to guide a global bioethics, has noted the circularity of efforts to define personhood resulting from the tendency of individuals to shape definitions according to their own moral goals. Where one sits on the map of controversial challenges can predict how the meanings will play out for them, both in theory and practice. Cautious observers of the philosophy of law such as Ronald Dworkin [5] have added to the view that personhood remains an ambiguous term. Edmund L. Erde has argued persuasively that an ordinary language approach influenced by the Philosophical Investigations of Wittgenstein has the best prospect by giving specific meanings to cases as they occur as opposed to any overarching definitional attempt [6,7]. The essays that are included in this volume each delve into aspects of personhood without arriving at a posited characterization. They do however convey stories on how to approach the ever-present concept of personhood upon which an approach to bioethics
http://dx.doi.org/10.1016/j.jemep.2016.10.008 2352-5525/© 2016 Published by Elsevier Masson SAS.
480 must be placed. The problems of consciousness and evolution are fundamental. Thus, the articles on animalism and advanced directives bear down on how humans feel, behave, and think differently than other living organisms. As a complementary article, the issue of language and selfreferencing is treated as a major philosophical problem that needs resolution in order to construct a responsible and respectful bioethics. The philosophical debates are supplemented by articles on how autonomy can be featured into discussions about personhood. The grand debate currently underway with respect to assisted suicide is dealt with in how we as a society can and should show respect for rational decision making, which is a pressing social concern especially in an aging population. One of the articles contained in this volume concentrates on how capacity should be sensitively interpreted because the current instruments, which are overwhelmingly cognitively oriented, can give misleading interpretations of the desire and will expressed in healthcare. Other articles concern how narratives should be viewed critically, suggesting inroads in how to avoid reductionistic results within the therapeutic encounter. Finally, there is a philosophical treatment addressing human enhancement and the associated dilemmas in the philosophy of mind, which are well placed within the current literature on the subject.
Disclosure of interest The author declares that he has no competing interest.
Dossier ‘‘Personhood: intimity and otherness’’
References [1] Beauchamp TL. The failure of theories of personhood. Kennedy Inst Ethics J 1999;9(4):309—24. [2] Loewy EH. Suffering and the beneficent community: beyond libertarianism. New York: SUNY Press; 1991. [3] Thomasma DC. The vulnerability of the sick. Bioethics Forum 2000;16(2):5—12. [4] Macklin R. Personhood in the bioethics literature. Milbank Mem Fund Q Health Soc 1983;61(1):35—57. [5] Dworkin R. Life’s dominion: an argument about abortion, euthanasia, and individual freedom. New York: Alfred A. Knopf; 1993. [6] Erde EL. Personhood: the vain and pointless quest for a definition. In: Thomasma DC, Weisstub DN, Hervé C, editors. Personhood and health care. New York: Kluwer Academic Publishers; 2001. p. 71—89 [International Library of Ethics, Law and the Medicine; vol. 7]. [7] Erde EL. Paradigms and personhood: a deepening of the dilemmas in ethics and medical ethics. Theor Med Bioeth 1999;20(2):141—60.
Titulaire de la Chaire de psychiatrie légale et d’éthique biomédicale Philippe-Pinel, Honorary Life President of the International Academy of Law, Mental Health (IALMH) D.N. Weisstub Faculté de médecine, université de Montréal, International Academy of Law and Mental Health, CP 6128, Succursale Centre-Ville, H3C3J7 Québec, Canada E-mail address: [email protected] Available online 21 November 2016
Available online at
ScienceDirect www.sciencedirect.com
DOSSIER ‘‘PERSONHOOD: INTIMITY AND OTHERNESS’’ /Editorial
Introduction: Personhood: Intimity and otherness La personne : son intimité et le lien avec les autres
The concept of personhood is an ingredient of all metaphysically constructed systems, and is similarly central to bioethics. The idea of what constitutes a person most probably reached its height as a forefront topic during the enlightenment when the concentration on individual autonomy entered with full force into dialogues about ethics. However, even prior to the enlightenment, there has long been a difficult and often obscure discussion of the question of personhood. There are ample examples of philosophers who comment that personhood is unclear as a concept. Once definitions are at stake, there is a tendency to differentiate cognitive capacities from moral worthiness [1]. Others have emphasized that we can best approach the subject by concentrating on the vulnerability of humans and the nature of their suffering [2,3]. From the point of view of evolutionary biology, particularly in consideration of recent advances in genetics, one is compelled to contemplate the distinction between apes and humans. There are also many technical issues in the philosophy of mind that have yielded divergent points of view among thinkers regarding the sufficient or necessary conditions for achieving personhood. The resolution of the aforementioned debates bears heavily on how we constitute our contemporary bioethics. With respect to a theory of moral behavior, our concept of personhood will make particular difference in respect to how we care for those who have been deprived of mental or physical faculties. It has been the approach of some authors to contend that the real importance and consequence of attending one explanation as opposed another can only produce significant outcomes once tested against the mirror of hard cases where decisions and levels of care are the relevant tests of personhood. It is interesting to note that Ruth Macklin [4], a prominent figure in the search for universal principles to guide a global bioethics, has noted the circularity of efforts to define personhood resulting from the tendency of individuals to shape definitions according to their own moral goals. Where one sits on the map of controversial challenges can predict how the meanings will play out for them, both in theory and practice. Cautious observers of the philosophy of law such as Ronald Dworkin [5] have added to the view that personhood remains an ambiguous term. Edmund L. Erde has argued persuasively that an ordinary language approach influenced by the Philosophical Investigations of Wittgenstein has the best prospect by giving specific meanings to cases as they occur as opposed to any overarching definitional attempt [6,7]. The essays that are included in this volume each delve into aspects of personhood without arriving at a posited characterization. They do however convey stories on how to approach the ever-present concept of personhood upon which an approach to bioethics
http://dx.doi.org/10.1016/j.jemep.2016.10.008 2352-5525/© 2016 Published by Elsevier Masson SAS.
480 must be placed. The problems of consciousness and evolution are fundamental. Thus, the articles on animalism and advanced directives bear down on how humans feel, behave, and think differently than other living organisms. As a complementary article, the issue of language and selfreferencing is treated as a major philosophical problem that needs resolution in order to construct a responsible and respectful bioethics. The philosophical debates are supplemented by articles on how autonomy can be featured into discussions about personhood. The grand debate currently underway with respect to assisted suicide is dealt with in how we as a society can and should show respect for rational decision making, which is a pressing social concern especially in an aging population. One of the articles contained in this volume concentrates on how capacity should be sensitively interpreted because the current instruments, which are overwhelmingly cognitively oriented, can give misleading interpretations of the desire and will expressed in healthcare. Other articles concern how narratives should be viewed critically, suggesting inroads in how to avoid reductionistic results within the therapeutic encounter. Finally, there is a philosophical treatment addressing human enhancement and the associated dilemmas in the philosophy of mind, which are well placed within the current literature on the subject.
Disclosure of interest The author declares that he has no competing interest.
Dossier ‘‘Personhood: intimity and otherness’’
References [1] Beauchamp TL. The failure of theories of personhood. Kennedy Inst Ethics J 1999;9(4):309—24. [2] Loewy EH. Suffering and the beneficent community: beyond libertarianism. New York: SUNY Press; 1991. [3] Thomasma DC. The vulnerability of the sick. Bioethics Forum 2000;16(2):5—12. [4] Macklin R. Personhood in the bioethics literature. Milbank Mem Fund Q Health Soc 1983;61(1):35—57. [5] Dworkin R. Life’s dominion: an argument about abortion, euthanasia, and individual freedom. New York: Alfred A. Knopf; 1993. [6] Erde EL. Personhood: the vain and pointless quest for a definition. In: Thomasma DC, Weisstub DN, Hervé C, editors. Personhood and health care. New York: Kluwer Academic Publishers; 2001. p. 71—89 [International Library of Ethics, Law and the Medicine; vol. 7]. [7] Erde EL. Paradigms and personhood: a deepening of the dilemmas in ethics and medical ethics. Theor Med Bioeth 1999;20(2):141—60.
Titulaire de la Chaire de psychiatrie légale et d’éthique biomédicale Philippe-Pinel, Honorary Life President of the International Academy of Law, Mental Health (IALMH) D.N. Weisstub Faculté de médecine, université de Montréal, International Academy of Law and Mental Health, CP 6128, Succursale Centre-Ville, H3C3J7 Québec, Canada E-mail address: [email protected] Available online 21 November 2016