Monday, February 1, 2010

The Plasticity of Personhood

Qui in utero est, pro jam nato habetur, quoties de ejus commodo quaeritur- "he who is in the womb is considered as already born as far as his benefit is considered."

I remember asking my physiology teacher, Dr. Rhees, a question during class one day. "When does the spirit enter the body?" The gentle, ailing man raised his hands and slowly took a step or two back: "I don't know, I'm not qualified to say." I thought that was a cop-out. The answer to that question can prove the crux of bioethics issues such as abortion, stem cell research, and embryo screening (http://en.wikipedia.org/wiki/Preimplantation_genetic_diagnosis).

*disclaimer- much of what follows lacks organization and is speculative*

Up until now I have relied on a binary understanding that a given spirit is either A) God's offspring or B) God's creation. There's no gray here: nice, clean, black and white. I know that painfully few realities in this mortal sphere are this clear, but I thought that this issue really is that simple.

He formed every plant that grows and every animal that breathes, each after its own kind, spiritually and temporally—“that which is spiritual being in the likeness of that which is temporal, and that which is temporal in the likeness of that which is spiritual.” He made the tadpole and the ape, the lion and the elephant, but He did not make them in His own image, nor endow them with godlike reason and intelligence. First Presidency, “The Origin of Man,” Ensign, Feb 2002, 26

We are the literal spiritual offspring of our Heavenly Father. When we are born into mortality, we receive physical bodies created in His image (see Genesis 1:27). L. Tom Perry, “The Great Plan of Our God,” Liahona, Feb 2009, 10–14

True it is that the body of man enters upon its career as a tiny germ embryo, which becomes an infant, quickened at a certain stage by the spirit whose tabernacle it is, and the child, after being born, develops into a man. First Presidency, “The Origin of Man,” Ensign, Feb 2002, 26

So, back to that first "certain stage" question- when is it and what is it? First, what we know:
We know from the Edenic threat that Satan's hosts (spirit offspring of God) were capable of possessing the bodies God created for Adam and Eve. We know some bodies are possessed by evil human spirits, which seems to be the mutual habitation of one body by two spirit offspring of God (or perhaps displacement). We know human spirit bodies are capable of inhabiting animals (Mark 5:13, and possibly Edenic serpent) and influencing their actions. Speech can be given to animals (the serpent and Balaam's talking donkey).

Second, what we don't know but I wonder: perhaps the possessing of a body by a spirit offspring is a gradual process, and/or a reversible one (the spirit pops in and out). If it is a process that takes place after conception, it may not occur at a uniform stage, but perhaps in a range, say during week 3, give or take a few days. Perhaps we hop into the embryo or fetus and wait a while before "quickening" it. Perhaps each of us had a little window of choice within which we individually decided when to possess the embryo (presuming an irreversible, non-gradual entry). If we choose when to possess our embryonic tabernacle, is this process terribly different from the choice Adam made to possess his tabernacle, to "partake of the fruit" as it were? Might partaking of the fruit be equivalent to the decision of an unembodied spirit offspring of God to inhabit a mortal tabernacle?

Okay, so those two paragraphs weren't all that helpful. Once again, back to that first "certain stage" question- when is it and what is it? I had heard that on the abortion front, feticide is legal before the third trimester but not afterward. Also, though infanticide is a historically common event (in at least two cultures, an infant wasn't considered a person until age 1, making infanticide before that period culturally acceptable), in our culture infanticide is illegal. On the other end, as I recall that countless tens of thousands of fertilized oocytes fail to implant in wombs each year and are sloughed during menstruation (not to fact that no one balks when millions of sperm are killed or wasted). Thus, it would seem that somewhere between the separate gamete and newborn phases of human life, peoples' judgment swaps sides. Since I couldn't find a meaningful distinction between legalizing abortion before or after the second/third trimester boundary, I originally placed myself in the conceptionism camp- that life begins at syngamy (or perhaps the moment a unique genome is finalized). Now I'm not so certain. Could personhood be a spectrum? It seems unlikely. However:

Is Deus solus haeredem facere potest, non homo "God alone, not man, can make an heir" still true? Would the following be people-
(for a more exhaustive approach to this issue, see "Could a Zygote be a Human Being?" -John Burgess, Bioethics Volume 24 Number 2)

1) What if a bonobo egg and a modified (just enough to get the chromosome number the same and overcome any conception barriers) human sperm were united and produced a viable embryo that was subsequently born? Is that offspring (we'll call him BonoBob) a person? There's nothing magical or special about human DNA (you share about 99% with a chimpanzee, and about 79% with a mouse- in fact, I seem to recall that a human male shares a higher percent of his DNA with a male chimpanzee than he does with his own female sister), and the fertilizing and embryonic development processes, which are exhaustively documented, are independently powered by chemical and physical forces. The feasibility of this scenario is limited only by technology, not by nature.

2) What if the human sperm was half bonobo, half human (for a 3/4 bonobo DNA result)?

3) What if the human sperm was all bonobo, but the egg half human (for a 3/4 human DNA result)?

3) Etc. for organisms anywhere between 1% and 99% human DNA? Again, cellular replication mechanisms do not discriminate between human and non-human DNA, since both types are composed of identical macromolecules- namely A, T, C, and G, the simple quaternary DNA alphabet.

4) You can synthesize DNA or a virus from scratch in the lab, and only an obstacle or two remains to making a reproducing cell in the lab as well. At least the physical side of life we observe is independent of any "animating principle" outside of natural chemical and physical forces. If the creation of life is in the hands of mortals by natural (procreative) and "artificial" (in the lab) means, then isn't that life itself malleable? If German scientists start manufacturing humans in the lab, will the resulting organisms fully be people? What if 1 gene is taken out? What about 10? 1000 genes removed, but the organism is still viable and otherwise human?

5) What about a human embryo grown in a synthetic womb?

6) What about a human embryo born from a bonobo womb?

7) What about a bonobo with genetically engineered a) capacity for language, b) god module, and/or c) moral reasoning? (God Module: http://www.naturalnews.com/023055_the_brain_religion_consciousness.html, http://www.iol.ie/~afifi/BICNews/Health/health19.htm, http://cas.bellarmine.edu/tietjen/images/new_page_2.htm) *moral reasoning aside- Steven Peck, a current BYU professor, was infected by a rare bacterial disease he picked up in Vietnam. The cells traveled along his optic nerve, then bided their time in his brain. One night the ceiling fan grew grapes, which descended, then exploded over his bed. Paintings on the walls became a group of Satanic Wal-mart overlords who, it turned out, controlled the world. At the hospital, copies of his children with identical memories as their templates paced the halls and underwent intense assassination training. Basically, he went insane. Much like the protagonist in "A Beautiful Mind," he quite literally could not discern real from unreal. However, throughout this whole experience, his ethics remained undamaged. He talked with his wife about taking the assassination-training copies of his kids home since, in their minds, Steven was their father. He was worried because they might get in a fight and the assassination training might endanger the non-copies. Nevertheless, he analyzed whether he was ethically obligated to them as a father, and concluded he was.
On the other hand, you have the case of Phineas Gage, who lost part of his brain, and was sane and normal in pretty much every way with the exception of his ethics (according to some). He lost the ability to engage moral reasoning. These opposite cases suggest the biological underpinnings of moral reasoning. *aside complete.
So, if you gave some of the genes that most make us human, say for increased intelligence, moral reasoning, believing in God, language, etc. to a Bonobo zygote, would the resulting individual be a person?

8) A (post-conception, single-celled) monozygote? (since a zygote can split to give rise to identical twins, it cannot already be a human being since the zygote would not be identical with either human being. In other words, when person A split to form persons B and C, did A die? Or did mere cells split to form persons B and C? Plus, the zygote also gives rise to a placenta, and therefore cannot already at the zygote stage be simultaneously a placenta and a human being. Last, if some zygotes are not yet human beings, isn't it reasonable to categorically deduce that none can be? If that's the case, does merely the contemporary understanding of the passing of the possibilities of fission and fusion establish the earliest feasible individuation moment?)

9) A zygote a little further on- say after the development of the inner cell mass of the blastocyst, which becomes the embryo proper? But fission and fusion can still occur both before and after this development (a chimera is where two embryos fuse).

10) A morula?


12) An embryo at the moment of implantation? A few seconds before or after, or the middle of the duration? What if it briefly detaches part way through then reattaches? At gastrulation? A few minutes later?

13) A cloned kidney? A cloned arm? A cloned head? A cloned person?

14) A fused embryo? (non-identical twin embryos give rise to a single human being who carries two genetic codes, a phenomenon that can apparently occur at least up to the time of implantation- thus, 1 human being resulting from 2 full genetic codes. Does this mean we should seek to prevent fusion, as the process kills human beings A and B who necessarily perish when they fuse to form person C? Again, human biology is not immune from the oddities of biology elsewhere in the tree of life. Research "Multiple Occupancy View" and "Replacement View" if you're interested in a deeper dive here, or see John Burgess's "Could a Zygote be a Human Being?")

15) Foetus in fetu? (one monozygotic twin "incorporates" the other, which apparently continues to grow as a distinct individual. E.g. a five-month old seemed pregnant, and a well anatomically developed fetus was inside)

16) Conjoined twins? (comes from post-implantation fission. One human being or two or none?This is the converse of 14- 2 human beings resulting from 1 genetic code, and the degree of organ sharing and dominance varying between cases - http://www.youtube.com/watch?v=BkKWApOAG2g)

17) • Mentally handicapped• Those suffering extreme pain• Fetuses• Slaves• Brain dead• Those in a persistent vegetative state • Those that wish to die • Terrorists • Those who purposely harm themselves – Drug addicts – Destructively sexually active • Those incapable of paying for treatment • Children who will not grow up to be good soldiers • Animals – Higher (apes, rodents, etc.) capable of feeling pain – Lower (insects, etc.) • Criminals •Women • Non- ‐existing persons • Genetically malformed or maladapted

As you can see, this line of inquiry seems to follow the age-old "slippery slope" argument, which imputes the question of the validity of the "spectrum" counter (see http://bradcarmack.blogspot.com/2010/01/playing-god-slippery-slopes-and-fallacy.html), which would suggest that personhood is a spectrum rather than binary. This reasoning is the main cause for the title of this post, "plasticity of personhood." Perhaps personhood really is a plastic concept.

Three conceptions of personhood popular in recent philosophical literature:

First) neo-Lockean concept that a person is a self-conscious locus of responsibility. Implication? No one is a person until well after birth.
Second) neo-Cartesian pictures: a person is a thinking, sentient thing. Implication? If a wake state EEG is any measure, the earliest arrival of consciousness is around 28-32 weeks.
Third) Whether a person is a human being. (see "the argument from potential: a reappraisal by Reichlin).

Here's another personhood argument. Should a woman past her natural conception window - (say, age 59) be denied fertility treatments? Some argue that having children that late harms the child because you won't likely be around later on to be the grandparent, or is wrong because nature wouldn't approve, or is wrong because society will have to pick up the costs. (A 66 year old Briton is her country's oldest mother- she went to Ukraine to get fertility treatments. Also see http://www.dailymail.co.uk/news/article-1243839/Woman-60-oldest-person-given-IVF-treatment-British-clinic.html). Three contentions to these arguments. 1) on the "unnatural" front, please see http://bradcarmack.blogspot.com/2010/01/playing-god-slippery-slopes-and-fallacy.html. 2) To prohibit old-age parenting because of likelihood of death, one would need to first establish some reason why an above-average health, likely-longevity-due-to family history of longevity would be denied an exception to the rule and also second prohibit parents who are likely to die, from having children (say, parents living in a highly volatile, violent warzone, or parents in a demographic likely to die early from disease) on the same principle. Both necessities appear untenable. 3) the "harm to the child" argument fails unless there's a way to meaningfully declare that "non-existence" is superior to existence. That is to say, unless the child is created, there is no possibility of harming it, and since bringing into existence is at issue here, it is inappropriate to compare alternative 1 (no fertility treatments and therefore no child) to alternative 2 (yes treatments, the child is born with some measure of advantage/disadvantage). Most adults (Jimmy Stewart being a notable exception), even those who grow up with few privileges, would probably prefer their existence to non-existence (never having been born). This analysis would favor decisions likely to bring human beings into existence, whereas an opposite conclusion (assuming equating death with non-existence) would seem to favor suicide if a certain quality of life threshold is not exceeded- and in the old age debate, that threshold level seems quite low from those who argue against the granting of fertility treatment.

In connection with this debate, one might argue whether people generally are subject to an affirmative duty to create human lives by procreating (e.g. God's commandment for His children to multiply and replenish the earth remains in force. -Family Proclamation). In addition to arguing that adults have this positive duty (http://www.translegal.com/legal-english-dictionary/affirmative-duty) , it could be argued that not-yet-existent children (under the LDS doctrine of pre-mortal existence, "children" approximately equals mature human spirits awaiting a body) have a claim right (http://en.wikipedia.org/wiki/Claim_rights_and_liberty_rights) to be born. This argument can be made because of this statement "Children are entitled to birth within the bonds of matrimony, and to be reared by a father and a mother who honor marital vows with complete fidelity.: - Family Proclamation: Though we usually think that this sentence means that parents who intend to bear children should be married and honor their marital vows, try turning it around: Children are entitled to birth. Children are entitled to birth! If this is so, and normal reproduction is the only available means, then adults are obligated not only to marry and exercise fidelity, they are also obligated to intend to bear children. Two implications: 1) If true, then, are not adults who choose not to intend to bear children and/or marry and/or limit their reproduction in breach of an important duty? It would seem so at first glance. 2) Given the existence of all three duties, which, if any, is more important? A) to sire/give birth to children, B) to marry, or to C) exercise fidelity within marriage? C relies necessarily on B, which gives B more weight- but A can happen independent of B and/or C, and B can happen independent of A and/or C. If given the choice between either only A or only B, which is the more ethical choice (to marry but remain childless or to bear children out of wedlock)? This is no mere hypothetical- many individuals actually choose only A, and many individuals actually choose only B. In marrying but remaining childless one avoids the risk of exposing a human child to unwed or unfaithful parents, but fails in his/her obligation to bear children (remember, the right "children are entitled to birth" is meaningless if it fails to impose a duty on another- just like your right to free speech is meaningless unless it imposes a duty on others to refrain from infringing on said right). In bearing children out of wedlock, one fails in the duty to provide children faithful, married parents, but fulfills the obligation of giving birth to a/the child.

So that's the "old mother" question- here's another thought experiment/real-life scenario. A deaf couple (both parents deaf from birth) wants to have a deaf child. Is it ethical for them to Case 1) alter the genome of a zygote by removing the gene(s) for hearing, and/or Case 2) use PGD (e.g. fertilize four embryos, then test the genome of each and select the non-hearing embryo for implantation). Assume in Case 2 that PGD is not at-issue (only selecting for non-hearing is being ethically evaluated) and that of the four embryos, three have genes for hearing and one is deaf.

Tough questions, huh! At least, many people struggle a bit on these two cases. On the one hand, the parental virtue of respecting future agency seems breached, since the child will not be able to choose to hear later on. Plus, deafness is a disability, right? On the other hand, the parents live in a deaf community. They've been deaf their whole lives. They want to train their child to live and succeed in a deaf community. Deafness is not a disability to them or their community- it's a minority identity, like being Irish or Italian or Hutu or Jewish or Libertarian. Is it really appropriate to tell parents that they're harming a child because they want to raise a child to be like them in the only culture they know? Plus, there's the same "harming the child" contention as with the "old mother" scenario- assuming the zygote is not yet a person, it seems impossible to argue harm (picture an empty bench- how do you measure harm to the person who doesn't exist yet, aka the person on/not on the bench?) until a person exists- so if the person comes into existence after the genetic change, it seems the person was never harmed. If you would criticize case 1 or case 2, it might follow that you'd have to criticize deaf parents who didn't undergo PGD and select a hearing child, or you'd have to criticize parents with genetic predispositions for disease or disability for procreating at all, based on the same child harming criterion. To extend the analysis further, what if you changed the genes right before conception, by either manipulating or selecting from several candidate sperm and several candidate eggs? Does the ethical outcome in Case 1 or Case 2 change? To extend in a different direction, wouldn't the same analysis support allowing the parents to choose deafness even if the parents themselves aren't deaf? (many hearing parents have a child naturally but get a surprise in the form of a deaf child- so why not allow the same outcome through an intentional process, based on the reasoning above?) How about the ethics of choosing other traits for other reasons (say large size for a better chance at football, even though large size may be associated with diabetes risk and lower life expectancy; or gorgeous red hair to increase attractiveness; or non-acne-prone skin; or tallness to take advantage of a leadership heuristic [think Saul or "Based on the idea that height serves as a heuristic for judgments about status, dominance, and leadership potential, two hypotheses were tested: (1) Heights of U.S. presidential election winners are positively correlated with estimates of social, economic, and political threat in election years. (2) Height and victory margin are positively correlated regardless of the magnitude of estimates of social, economic, and political threat in election years. Both hypotheses were supported for the 43 elections from 1824 to 1992." http://www.ncbi.nlm.nih.gov/pubmed/11508013] , etc.? Parents do all they can to give their children unnatural advantages after birth, such as medical care, glasses, vaccines, surgery, elite education, and braces, just to name a few- if that behavior is ethical, why not allow parents to select genes that will negate the need for braces or glasses or, positively, bestow athleticism or height or intelligence or good looks?)? I assert that the ethical outcome necessarily relies on two positions of the evaluator: his/her concept of personhood and his/her concept of disability. Thus, as this example shows, it is insufficient for one to throw up one's hands in trying to determine personhood (as did one professor who I asked whether he thought ensoulment to be a discrete or continuous event, and when that event took place) if one would select either "yay" or "nay" when evaluating Case 1 and/or Case 2 above.

The utility of defining personhood is thereby brought into relief. It is important, I think, to engage and progress in these types of determinations, as they are essential to meaningful and, hopefully, increasingly correct ethical evaluations of novel bioethical issues that will continue to arise as a result of biotechnological advancements.

I wonder if status quo conceptions of personhood are overly self-centric. It's kind of a "if the individual/object in question is sufficiently like me, it's a person, otherwise, the unit is a non-person" definition.

The first presidency statement of the early 20th century says that Adam is the primal parent of our race, not our species, and implies other races. Some biological conceptions of species by apostles are demonstrably at odds with contemporary understanding of those terms - e.g. the "pattern of parentage" statements. Ironically, the pattern of parentage, and indeed, the contemporary consensus about human evolution both suggest a derivative for Adam's tabernacle, which is consistent with the idea man-like pre-Adamites and and other races of man-like populations. It also lends some support to a "plastic personhood" construct.

If the patterns we observe in this world generally apply to us, it would seem that human-like creatures, constituting every increment between us and our bodily ancestors .005, .05, .5, 5, and 50 million years ago were bodies likely inhabited by spirits- most likely spirit creations, rather than offspring of God. The primacy and import of the Adam and Eve story suggests that personhood is discrete rather than continuous: black and white rather than shades of gray. However, that discrete identity may be local to our spiritual heritage, rather than extending to the heritage of our temporal bodies.

"When we look to see the evidence of Creation all around us, from a grain of sand to the majestic planets, we begin to realize that we are the greatest of all God’s creations; we are created in His image. God created the earth in all its magnificent glory, not as an end in itself, but for us, His children. Indeed, we are His children, His offspring, and He is the Father of our spirits." M. Russell Ballard, “The Handiwork of God,” New Era, Mar 2006, 2–7



Exegesis: Implications from a few First Presidency statements (First Presidency, “The Origin of Man,” Ensign, Feb 2002, 26)

The LDS church does believe in evolution (at least in one sense): "the undeveloped offspring of celestial parentage is capable, by experience through ages and aeons, of evolving into a God."

It seems thinking and scientific inquiry will not suffice to help an individual know the beginning of human life: "Man, by searching, cannot find out God. Never, unaided, will he discover the truth about the beginning of human life." This makes practical sense, as God is the only readily accessible witness to the fact; however, it seems circumstantial evidence could at least help one approach a proper conclusion. Also, who is to say that natural means available to a searcher-scientist are not the aids God provides or would provide? Alternatively, if one asks and God answers by revelation rather than by a familiar normal mechanism, has not that seeker nonetheless "found out God" by searching, thus falsifying the statement?

On defining personhood. "There is nothing in this, however, to indicate that the original man, the first of our race, began life as anything less than a man, or less than the human germ or embryo that becomes a man." This seems to indicate that the human germ or embryo is not a man, else the phrase "human germ or embryo that becomes a man" would be meaningless (if an embryo is a person or "man" already, the phrase would read "man that becomes a man"). However, even as the infant son of an earthly father and mother is capable in due time of becoming a man necessarily implies that a born child is not a "man"/person. The only loophole is if the use of "man" refers to an adult or adult male rather than a person, (which could be- see also "the child, after being born, develops into a man") in which case it seems that "man" is equivalent to "mature human spirit" and has reference to neither the body portion of the soul nor the soul itself ("[Adam] took upon him an appropriate body, the body of a man, and so became a “living soul.”).

A statement from Elder Perry:
Perhaps we don't possess/receive our bodies until birth: When we are born into mortality, we receive physical bodies created in His image (see Genesis 1:27). This seems to indicate the timing of receiving a physical body (birth). If a spirit possessing a body is a necessary criterion of personhood, then personhood doesn't attach until birth. If this is true, one next should define parturition. Umbilical cut? Partway out of the womb? All the way out of the womb? Breathing? What about all degrees of pre-mature, from the sloughing off of fertilized and unfertilized embryos/oocytes all the way to stillborns, 23 week embryos that survive (viability is one of those tautological legal terms describing a fetus- if it lives it's viable, but whether it lives depends on technology- as predicted, the age at which a baby born premature can survive continues to decrease), or a day before 38 weeks that doesn't live? Some combination of the above?

If the "image of God" (having a face, two arms, a neck, etc.) is a dispositive criterion for personhood, then what about conjoined twins and disfigured babies that are born without these parts which in sum constitute God's image? What about chimpanzees, which have all those features? What about hypothetical beings who fill the gradations between the three categories of disfigured human, chimpanzee, and normal human?

The best, necessary, and sufficient criterion that I see for personhood is whether or not a particular physical body is possessed by a spirit offspring of God. Thus, I equate a "soul" with being a person, and anything short of a soul (including an unembodied or not-yet-embodied spirit offspring and a corpse) is not a person. This also allows the maintenance of a binary concept of personhood.

Candidate defining characteristics of a person, mix and match if you choose:
– Intelligence
– Language
– Make moral judgments
- Reasoning
– A soul
- Apperception
– A consciousness
– A self consciousness/awareness
- Physical image of God
- Physical potential for any or all of the elements of sentience listed above


What is quickening, and what are the mechanics of interface between the spirit offspring part of us and the body/brain part of us?

The mirror test of self-awareness (http://en.wikipedia.org/wiki/Mirror_test) is pretty cool. Animals that have passed the mirror test are all of the great apes (bonobos[5], chimpanzees[5][6], orangutans[citation needed], gorillas[citation needed]and humans), bottlenose dolphins[5][7][8], Orcas[citation needed], elephants[9], European Magpies[10], and pigs[11]
Humans don't usually pass the mirror test until about 18 months. This is close to the 12 months old marker that some cultures have used as the personhood threshold.

What's so special about birth that so few argue that personhood doesn't attach afterward?

Many people throw up their hands and say "I don't know" when questioned about personhood or the constellation of related issues. That's probably appropriate (in fact, it would make sense for people to say "I don't know" about issues more often than the current status quo prescribes), but that position also leaves you without a substantive basis for ethical condemnations where determinations such as personhood are dispositive (e.g. abortion or the deaf parents and old mother scenarios above). Thus, the default position is that whatever can be done is ethical until a grounded contention is articulated. The consequence of saying "I don't know" means that you lack a basis to either condone or condemn a particular behavior where the determination at issue is essential to all ethical evaluations (or at least any candidate evaluations that would be relied upon).

Is a mature human spirit inside a baby (or for that matter, an adult) constantly constrained by the inferior intellectual and emotional limits of the brain and body it resides in? If so, when is that human spirit liberated from its captivity?


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