Personhood and the Persistent Vegetative State
The question of whether artificially administered nutntlOn and hydration should always be provided for patients in a persistent vegetative state (PVS) has sparked an intense and often bitter controversy. An important underlying issue in the dispute and the focus of this work is the kind oflife that is being sustained by the tube feeding. One approach to the question drives a wedge between person and body arguing that the PVS patient has died, but the remaining body still remains alive .. This view attaches little moral value to the vegetative body apart from the respect due to it because it once belonged to the former person. The everperceptive Daniel Callahan describes this position as clearly as anyone. Callahan maintains that "the 'sanctity of life' has to be the sanctity of personhood, not merely the possession of a body." At the heart of one's quality oflife lie certain crucial potentialities for personhood. These "must at least encompass the capacity to reason, to have emotions, and to enter into relationships .... A person who has lost all of these capacities cannot, in any meaningful way, be called a 'person' any longer."2 In his discussion of tube feeding for the imminently dying, Callahan clearly states this dichotomy between personhood and body. The practice need not be continued because it does not provide "any genuine benefit to the patient; there is no meaningful life present. It is a mere body only, not an embodied person."3 What about those in a persistent vegetative state? Such patients have exhausted their potential for personhood because they have lost not only "neocortical brain functions" but also have lost "all capacities for personhood, though clinical death has not yet occurred".4 I have deep philosophical reservations about the dualism implied in the dichotomy between person and body. Consequently, this article will offer a philosophical perspective on the nature of PVS life. Such an inquiry must encompass the empirical as well as the philosophical. While the exact relationship of the human biological structure to personhood remains a mystery, bodily life is nevertheless highly relevant for establishing the