Monday, July 23, 2012

Love, infants and personhood

Since the work of Mary Anne Warren, the following is accepted by many pro-choice philosophers:

  1. CogSkill: Personhood requires developed and complex cognitive skills, of a sort that fetuses lack, and that are had by no mammals other than humans or at most are had by humans, and some other primates and/or cetaceans.
The following view is also held by a number of people, some pro-choice and some pro-life:
  1. NonStage: When a person comes into existence, that person is a new entity that comes into existence.
NonStage is the denial of a view on which personhood is a stage property, like being an adolescent, a property that an entity comes to have at a particular stage of development. If NonStage is right, then I did not exist prior to being a person. Thus, if my existence began at conception, and NonStage is true, then I was a person from conception. On the other hand, if CogSkill is true, then NonStage implies that we who are persons did not exist as fetuses. CogSkill blocks the pro-life argument that fetuses are persons and hence ought not be killed. NonStage as combined with CogSkill blocks the pro-life argument that even if fetuses aren't persons, killing them deprives them of a future existence as a person, and hence is as bad as killing persons (I've defended this argument for a while; an expanded defense is here).

I will argue that the combination of CogSkill and NonStage is not a tenable view. Thus, if CogSkill is true, personhood is a stage property, and if NonStage is true, CogSkill is false.

So for a reductio ad absurdum assume CogSkill and NonStage, and consider Sally, a normal early human infant of three months of age, with a normal loving mother, Martha. Sally's cognitive skills are rather less developed than that of a normal adult dog. By CogSkill, since dogs don't have the cognitive skills needed for personhood, neither does Sally. (This is not at all a controversial conclusion among philosophers who accept CogSkill.)

Martha loves Sally, and does so quite appropriately, and indeed shold do so: it would be absurd to deny that mothers should love their babies.[note 1] But now observe an odd thing if NonStage is also true. When personhood shows up, a new entity comes into existence. And Martha, we may suppose, loves that entity, and does so appropriately, too. Call this entity "Sally2". There are now two possibilities. Either Sally ceases to exist when Sally2 comes into existence, or Sally continues to exist alongside Sally2, or more precisely in exactly the same place as Sally2 exists.

Suppose Sally ceases to exist when Sally2 comes into existence. This is absurd. Then Martha ought to mourn Sally's demise when personhood comes into existence, and mourn it to a degree proportional to her strength of love for Sally. But while some regret for the passing of infancy may be appropriate, a mourning proportionate to the love is not appropriate. Moreover, even worse, Martha's love for Sally would give her reason to administer to Sally a drug that would prevent Sally from developing the skills needed for personhood. For personhood means the end of Sally's life on the hypothesis in question, and so Martha would be saving Sally's life by giving her this drug. And that's a horrific conclusion. In any case, I think none of the philosophers who accept CogSkill and NonStage think that Sally ceases to exist.

The remaining option for the defender of CogSkill and NonStage is that Sally continues to exist alongside Sally2. Now, Martha should now have a maternal love for Sally2. But she should surely also continue too love Sally. After all, parental love should be unconditional. Besides, nothing happened to Sally to make her any less lovable. On the contrary, surely Sally is more lovable, given that she now supports the personal activity of Sally2.

So Martha will now need to love two living beings—Sally and Sally2—with a maternal love. And that is absurd. When complex intellectual skills are gained, parents don't come to love a new living being—they love the same child, but now have additional reasons for loving that child.

If there are two living beings to love after the attainment of personhood, and only one before, then it follows that, all other things being equal, the wellbeing of a baby after the attainment of personhood should count for at least twice as much as the wellbeing of a baby prior to the attainment of personhood. And that doesn't seem right at all.

So we have reason to reject the conjunction of CogSkills with NonStage.


Dan Johnson said...

Good argument. I had thought that there was some kind of tension between Warren-style criteria for persons and loving your infant/unborn child, but this articulates it far better than I could. Very helpful.

Dagmara Lizlovs said...

One thing we should tell these pro-choice folks is that at one time they were fetuses too. At one time they too didn't meet some cognitive criteria per Mary Ann Warren or fell under the even more bizzarre and radical view that the human fetus is a parasite in its mother's body. We should ask these pro-choicers where would they be now if their mothers had exercised their free choice and the "right to do with my body as I wish" with regards to them?

Alexander R Pruss said...


Well, those who accept CogSkills+NonStage will say that they were never fetuses: they will say that they came into existence about two years after conception.(!)

Dagmara Lizlovs said...


How lovely of them!!

"Moreover, even worse, Martha's love for Sally would give her reason to administer to Sally a drug that would prevent Sally from developing the skills needed for personhood... And that's a horrific conclusion." Already done as in the case of the "Pillow Angel" Ashley. I quote excerpts from an online Time Magazine article. It can be found at this URL -,8599,1574851,00.html

The Article:

Pillow Angel Ethics - by Nancy Gibbs.

What kind of doctors would agree to intentionally shorten and sterilize a disabled six-year-old girl to make it easier for her parents to take care of her?...
Dr. Daniel Gunther and Dr. Douglas Diekema, who first revealed the details of "The Ashley Case" in the Archives of Pediatric and Adolescent Medicine, think that many of their critics don't understand the nature of this case...
The case: Ashley is a brain-damaged girl whose parents feared that as she got bigger, it would be much harder to care for her; so they set out to keep her small. Through high-dose estrogen treatment over the past two years, her growth plates were closed and her prospective height reduced by about 13 inches, to 4'5". They stress that the treatment's goal was "to improve our daughter's quality of life and not to convenience her caregivers."
... But the treatment went further: doctors removed her uterus to prevent potential discomfort from menstrual cramps or pregnancy in the event of rape; and also her breast tissue, because of a family history of cancer and fibrocystic disease...
The parents say that the decision to proceed with "The Ashley Treatment" was not a hard one for them, but the same cannot be said for the doctors. "This was something people hadn't thought about being a possibility, much less being done," says Diekema, who chairs the bioethics committee of the American Academy of Pediatrics and was brought in to consult on this case. For the ethics committee of Seattle Children's Hospital, which reviewed the proposed treatment, "it took time to get past the initial response—'wow, this is bizarre'...
First they had to be sure there would be no medical harm...
The ethics committee essentially did a cost-benefit analysis and concluded that the rewards outweighed the risks..."If you're going to be against this," Gunther says, "you have to argue why the benefits are not worth pursuing."

They knew that the treatment would be controversial, though they did not quite foresee the media storm that would erupt when they decided to publish the case and invite their peers to weigh in. "I felt we were doing the right thing for this little girl—but that didn't keep me from feeling a bit of unease," admits Diekema...
Gunther also understands why the case has inspired such intense feelings—but notes that "visceral reactions are not an argument for or against." This was not a girl who was ever going to grow up, he says. She was only going to grow bigger. "Some disability advocates have suggested that this course of treatment is an abuse of Ashley's 'rights' and an affront to her 'dignity.' This is a mystery to me. Is there more dignity in having to hoist a full-grown body in harness and chains from bed to bath to wheelchair? Ashley will always have the mind of an infant, and now she will able to stay where she belongs—in the arms of the family that loves her."

To warnings of a slippery slope, Gunther tilts the logic the other way: "The argument that a beneficial treatment should not be used because it might be misused is itself a slippery slope," he says. "If we did not use therapies available because they could be misused, we'd be practicing very little medicine."

Dagmara Lizlovs said...

I would like to add that the "Pillow Angel" proceedures performed on Ashley in my previous comments were performed by the Seattle Children's Hospital and Regional Medical Center in violation of Washington State Law which requires a court order which in this case was not obtained.

Alexander R Pruss said...

This sad tale reminds me of the idea of non-optional virtues. Non-optional virtues ones you should have even if you're not going to have a chance to use them. E.g., even if you literally have no possessions, no time, nothing shareable, you ought to have generosity. Similar things can be said about organs like the uterus or the breast.

Dagmara Lizlovs said...


Here is another article that shows that short comings of CogSkills/NonStage business. It was written by a person suffering from similar dissabilities as the unfortunate Ashley. The full article can be found here:

From the Article:The other story from a 'Pillow Angel'

Been there. Done that. Preferred to grow.


Published 10:00 p.m., Saturday, June 16, 2007

"Like Ashley, I, too, have a static encephalopathy. Mine was caused by brain damage at the time of my breech birth. Like Ashley, I can't walk, talk, feed or care for myself. My motor skills are those of a 3-month-old. When I was 3, a doctor assessed me as severely retarded (that is, as having an IQ of less than 35) and I was admitted to a state institution called St. Nicholas Hospital in Melbourne, Australia. As the hospital didn't provide me with a wheelchair, I lay in bed or on the floor for most of the next 14 years. At the age of 12, I was relabeled as profoundly retarded (IQ less than 20) because I still hadn't learned to walk or talk."

"Like Ashley, I have experienced growth attenuation...Unlike Ashley, my growth was "attenuated" not by medical intervention but by medical neglect. My growth stopped because I was starved. St. Nicholas offered little food and little time to eat it -- each staff member had 10 children with severe disabilities to feed in an hour. That was the roster set by the state and accepted by the medical profession. Consequently my growth stopped shortly after admission. When I turned 18, I weighed only 35 pounds. I hadn't developed breasts or menstruated. I was 42 inches tall."

"My life changed when I was offered a means of communication. At the age of 16, I was taught to spell by pointing to letters on an alphabet board. Two years later, I used spelling to instruct the lawyers who fought the habeas corpus action that enabled me to leave the institution in which I'd lived for 14 years."

"In the ultimate Catch-22, the hospital doctors told the Supreme Court that my small stature was evidence of my profound mental retardation. I've learned the hard way that not everything doctors say should be taken at face value."

"After I left the institution, an X-ray showed that I had a bone age of about 6, a growth delay almost unheard of in an 18-year-old in the developed world... At the age of 19, I attended school for the first time, eventually graduating from university with majors in philosophy of science and fine arts. "Annie's Coming Out," the book about my experiences that I wrote with my teacher, was made into a movie (Best Film, Australian Film Institute Awards, 1984.)

Dagmara Lizlovs said...

I would like to some final comments on this sad story. Washington State law was violated in Ashley's case because the law requires a court order before a minor could be sterilzed (the hospital involved claims it was an 'internal miscommunication'. The Ashley Treatment was illegal, yet none of the participants has been brought up on charges. This girl has a right to the due process of the law and her day in court.

One of the doctors who performed the procedure, Daniel Gunther, committed suicide in 2007. The question around Dr. Gunther's suicide was whether or not it was brought on by the controversy around this case or by his history of depression.