Even the human being with severe dementia remains fully a person: personhood is not identical with person-behavior (cf. Bexten 2017, pp. 195 ff., 293 ff.). Whoever ties personhood to actual capacities such as self-consciousness, reason, or cognition — as the empirical-functionalist concept of person (Locke, Singer, Parfit) does — must consistently assume that a human being with advanced dementia is no longer a person. The dissertation shows that this consequence reveals the untenability of the functionalist approach and constitutes a form of oblivion of the person.
The principle agere sequitur esse — acting follows being — states: the human being thinks because he is a person, not the other way around. When actual thinking ceases, personhood does not cease, but only one of its expressions.
The first dimension of personhood — fundamental spiritual existence — remains inalienable as long as the human being lives. The second dimension (actus humanus, intentionality) is impaired. The third dimension (self-transcendence, affirmation) may be hindered. Spaemann formulates it thus: “Someone who was a person has not ceased to be one.”
The dignity of the human being with dementia is grounded in his being, not in his capacities. The substance of the person is not annulled by the loss of accidents. The personalist norm holds without restriction: the human being with dementia, too, is to be loved for his own sake. Hengstenberg sees in this the touchstone of love.
Chapter assignment: Chapter 5: Oblivion of the Person, Chapter 4: What is human personhood?
Disability
Disability denotes a permanent impairment of bodily or spiritual functions. It concerns the deutera energeia (exercise of function), not the prote energeia (personhood). A disabled person is not a less worthy person — ontological dignity is independent of functional capacity. This distinction is fundamental to the Thomistic-personalist view: person-behavior (the actual exercise of capacities) may be impaired without personhood in the first dimension being touched. The principle agere sequitur esse states that acting follows being, not the other way around: it is not the capacity to act that makes the person, but the being of the person that grounds the capacity.
Ontological classification: Genus: State
Health
Health is the state of the unhindered bodily-spiritual unfolding of the person. It is not the mere absence of illness, but the bodily condition for the actualization of all three dimensions of personhood. As a personal good, health stands in close connection with bodily integrity: a healthy body enables the person to unfold her freedom, her reason, and her capacity for love. Illness and disability may impair the exercise of function, but they do not touch personhood in the first dimension and do not diminish the dignity of the person.
Ontological classification: Genus: State
Illness
Illness is the impairment of the bodily-spiritual constitution of the person. It may hinder or prevent the actualization of the dimensions of personhood, but it never annuls personhood or dignity. An ill person is not less a person — ontological dignity is independent of the state of health.
The distinction between illness and health concerns the body and the exercise of function (deutera energeia), not the first actuality of personhood (prote energeia). Illness points to the fundamental vulnerability and contingency of human existence. The fitting response to illness is medical care, which treats the patient as a person, not as a mere case.
Ontological assignment: Dementia concerns person-behavior (the second and third dimension), not personhood (the first dimension). Conflating personhood and person-behavior is (according to the ontology) the core of oblivion of the person.
See also: Beginning of Human Existence, Personhood, Dignity, Body, Medical Care, Suffering, Severe Dementia, Therapeutic Intervention, Contingency
Severe Dementia
Severe dementia denotes the irreversible loss of the capacity for clear and ordered thinking. In this condition, inner experience, feelings, and even moments of surprising clarity may persist to the very end. Severe dementia concerns the deutera energeia (exercise of cognitive function), not the prote energeia (first actuality of personhood). Personhood and ontological dignity remain wholly intact.
The human being with severe dementia is and remains a person — for personhood does not depend on the unfolding of capacities, but on being itself. The reduction of the person to her cognitive functions is a form of oblivion of the person. The personalist norm demands that the human being with severe dementia be affirmed and cared for as a person, not treated as a deficient being.
See also: Personhood, Dignity, Person, Oblivion of the Person, Irreversible Loss of Brain Function, Illness, First Dimension, Medical Care
See also
- Human Person
- Substance-Ontological Concept of Person
- Soul
- Body-Soul Unity
- Someone
- Embryo
- Interiority
- Nature
- Coma
- Substance Personalism
Sources: Generated by querying the Personhood ontology.
Further sources:
- Spaemann, Robert (2006): Persons. The Difference between ‘Someone’ and ‘Something’. Translated by Oliver O’Donovan. Oxford: Oxford University Press.
- Locke, John (1690): An Essay Concerning Human Understanding. Book II, Ch. 27 (advances the consciousness-based concept of person that the dissertation discusses critically).
- Singer, Peter (1979/1993): Practical Ethics. Cambridge: Cambridge University Press (advances the functionalist concept of person that denies personhood to those with dementia).
- Parfit, Derek (1984): Reasons and Persons. Oxford: Clarendon Press (the person as an epiphenomenon of psychological continuity).
- Hengstenberg, Hans Eduard (1957): Philosophische Anthropologie (German). Stuttgart: Kohlhammer (love as the touchstone of personhood).