Friday, March 18, 2005

The Self After Brain Damage

A very interesting discussion is taking place over at Hot Needle of Inquiry regarding the Terri Schiavo case. She wrote of a friend of hers who suffered major head trauma and was comatose for eight months. When he awoke, he was no longer the person she remembered.

And then one day he woke up. But he wasn't my friend anymore. He couldn't learn. He has had a terrible sad life for the last ten years. College being out of the question, he enrolled in the Army. Dishonorable discharge. Since then he's been a heroin addict, a "jesus freak" (sorry, I don't know what else to call it), a male nurse, in-and-out of jail, a janitor, and always, a drunk. He broke his parents' hearts a thousand times. There is nothing left of the bright boy so full of promise, that I once knew. My friend isn't in there. Someone else is the tenant. It is almost like demonic possession.

We agree that that which was Terri Schiavo before the heart stoppage, is gone. Even if she recovers, she will have to learn all over again, but never what she was before.

I left a comment stating the following:

As I was writing a comment, a thought hit me that erased what I was going to say before. I thought that I would not want to go on living if I ended up in Terri's position. But I would not be I if my brain became that damaged. I would be gone, and something similar yet diminished would remain. It happens every minute of our lives, the old "I" is replaced by something similar, yet hopefully enhanced. Do I have the right to say that the diminished other does not deserve a chance at improvement, especially after I am gone?

When is a person dead? The biological questions are murky as the Schiavo case itself points out. What I am wondering is when is identity lost? Spiritually, one can say that the soul leaves the body on death. Maybe that should be turned around to say that a person is dead when the soul leaves the body, whether the body stops functioning or not.

Materialistically, I think that what we are are the patterns of energy flows through our brains. The patterns change over time with new stimuli, yet the memory of previous states creates the sense of a continuing identity. Continuity is the key, so long as the present mind-state is reasonably continuous, we can say that the identity, and mind, is still alive.

Douglas Hofstadter wrote about this concept in his book Gödel, Escher, Bach: An Eternal Golden Braid. He uses a form of this idea in one the alternating allegorical chapters. The story describes conversations between Mr. Anteater and Aunt Hillary. Aunt Hillary is a colony of ants that Mr. Anteater converses with by reading the paths the ants make and the patterns of workers, soldiers and drones. The ants have no concept of Aunt Hillary, nor do the ants have any more identity to Aunt Hillary than neurons do in our brains. Mr. Anteater had another ant colony friend who had ceased to exist when a sudden rainstorm completely discombobulated his ant-patterns. When the ants created a new pattern, the old friend was gone, even though most of the ants survived, and Aunt Hillary remained, .

Now, I am an organ donor, based on the "I'm dead, and therefore not using them" argument. But if I suffer head trauma to the point where I might "survive" but have limited function pending a long shot at recovery, it would be difficult to say if "I" survived. The key, once again, is continuity. If the patterns that make me me are gone, then I am gone, despite what my vital signs might say. The newly forming person might recover some memories, but the way he would deal with them would be different. In a way, it would be like an actor stepping into my skin and trying to play me.

The issue is whether my wishes from before the accident would apply to this new person. Essentially, my body would still donate its organs, but someone else is getting the whole shebang. I am starting to think that he deserves his shot, and that my "no heroic measures" position might change.

1 comment:

jinnderella said...

and that my "no heroic measures" position might change.

ditto me.
just read this book:

More than Human-- it won't be long until we can fix almost everything. ;)