NewPhilosophersubjectivity.Lacking a name forthis
condition,Jennett and Plum coined
one:PersistentVegetativeState.
PVSisn’t‘braindeath’.Inaddition
to permanentlylosing consciousness,
a brain-dead patient has lost all in-
voluntarybodilyfunctionandsocan’t
breatheorpumpbloodontheirown.
Inmanyjurisdictions,thebrain-dead
areconsidereddead.ButPVSpatients
aredifferent.Theyneednutrition,but
theydon’tneedthemachines.
Thesetragiccasesraiseenormous
metaphysical, epistemological, and
ethicalproblems.If someonewelove
is inPVS,aretheyaliveordead?Can
it bethatthepersonis deadandgone
butthe bodyalive? What,then,are
we– ourminds,orourbodies?Can
these things die at different times?
How dowe know, given the uncer-
taintyofwhethera conditionis per-
manentandthatsomepatientsdoin
factrecover?Whatsortsofresources
should we devote to keeping those
with no prospect of recovery alive,
anddo we protect or demean their
dignitybydoingso?
These are not abstract, seminar-
room problems. They are brutal di-
lemmasfacedbyfamiliesanddoctors
everyday.Andtheypointtoa prob-
lem that can only get worse as our
ability tofightdeathgetsbetter:our
conceptsof ‘life’and‘death’maynotbe
the universal absolutes we’ve always
assumed.They mightnot,to borrow
Plato’s phrase, ‘carve nature at the
joints’.Instead,theconcepts wemap
onto messy biological reality might
becomelessandlessfitforpurpose.
Consider another key element of
death: irreversibility. We might say
things like, I died forfour minutes on
theoperatingtable!, butweunderstand
that this really just means breathing
andcirculationstopped;if thespeaker
hadactuallydiedtheywouldn’tbehere
totellus aboutit.Death,atleastas a
biologicalconcept,onlyallowsforone-
way trips. (If there’s an afterlife and
thedeadcanindeedreturn,thiswillbe
extra-biologicalinsomesense.)
Again,this wasn’t a problem for
most of our history. The dead very
quicklybecamevisiblyincapableof re -turning to life. The 18th century Scot-
tish philosopher David Hume even
took the idea of a long-dead person
coming back to life as an example of a
literally unbelievable occurrence:
“... suppose, that all the historians
who treat of England, should agree,
that, on the first of January 1600,
Queen Elizabeth died [...] and that,
after being interred a month, she again
appeared, resumed the throne, and gov-
erned England for three years: I must
confess that I should be surprized at the
concurrence of so many odd circumstances,
but should not have the least inclination
to believe so miraculous an event.”
Hume’s objection is that such res-
urrection is simply too great a violation
of natural law for anyone to believe it.
But the problem is not merely scien-
tific, but conceptual – and again, tech-
nology threatens to burst our concepts.
Consider patients in cryonic
suspension. These are people who
have arranged to have their body (or
sometimes just their brain) frozen at
−130°C as quickly as possible after
their vital processes stop, in the hopes“I’m getting ‘O’ with a hint of ‘AB negative’.”
Miracle Mike, the headless chicken