Does a person with advanced dementia remain the same person?
Keeping a brain able to support consciousness is not enough for someone to stay the same person; they must also keep their deeper character, values and relationships.
Source
Withering Minds: towards a unified embodied mind theory of personal identity for understanding dementia
Study at a glance
- Design
- Other — Philosophical argument using conceptual distinctions, objections and a hypothetical case (the re-emergent patient) to revise a theory of personal identity
- N
- No participants or data; a theoretical argument
- Population
- Persons with progressive dementia and hypothetical future treatments that regenerate brain tissue
- Outcome
- Thesis: identity over time requires brain continuity sufficient for consciousness plus retention of higher-order personality, values and relationships
Structured fields used in claim comparison tables when every cited study has a complete layer.
What they did
The author reviews the distinction between numerical identity (being the same individual) and qualitative identity (what someone is like), and tests narrative, psychological continuity, brain identity and Embodied Mind theories against dementia. He raises objections to McMahan's Embodied Mind Account, including a thought experiment about a patient whose brain is regenerated after late-stage Alzheimer's but whose memories, values and relationships are gone.
What they found
Narrative views fail because a self-told story presupposes a numerically identical teller, and many dementia patients cannot tell a coherent story. Psychological continuity views imply identity may flicker day to day and that it does not matter, which fits poorly with caregivers' experience; brain identity views are too permissive, counting someone as surviving without any capacity for consciousness. McMahan's account faces the Identity-Concern Objection and implies the re-emerged patient is the same person. The author proposes a Revised Embodied Mind Account requiring both minimal brain continuity for consciousness and retention of higher-order personality, values and relationships.
The limits
What it doesn't show
The revised account is offered tentatively and leaves vague which traits count as higher-order and how much must be retained. It rests on intuitions about a science-fiction case, and the author admits empirical evidence on how people judge identity in dementia is inconclusive and varied. Including relationships in identity is acknowledged as controversial, since it seems to make identity depend partly on other people. The paper does not work out what the account implies for practical issues like advance directives.
Key terms
- Numerical vs qualitative identity
- Numerical identity is being one and the same individual; qualitative identity is having the same characteristics.
- Psychological Continuity Theory
- The view that a person persists if overlapping chains of psychological connections such as memories and values hold over time.
- Brain Identity Theory
- The view that we are our brains, so identity lasts as long as the relevant brain persists.
- Embodied Mind Account
- McMahan's view that we are embodied minds and persist given enough brain continuity to preserve the capacity for consciousness.
- Egoistic concern
- Caring about a future self in the special way one cares about oneself rather than about another person.
- Identity-Concern Objection
- The author's objection that McMahan's view oddly lets someone be the same person as a future self yet have little rational reason to care about that self.
Flashcards
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Research intelligence for this paper
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Quiz yourself
On McMahan's account, when does a person with Alzheimer's cease to exist?
Common questions
Why not just accept the narrative view of identity?
A self-told story needs a numerically identical self to tell it, and people with dementia often cannot tell a coherent story, so the view breaks down exactly where it is needed.
What does the Fenix case show?
On McMahan's view the regenerated patient would be the same person because consciousness never fully stopped, but intuitively he is not, suggesting brain continuity alone is insufficient.
How does the revised account differ from psychological continuity views?
It does not require memory retention; it requires higher-order traits, values and relationships plus brain continuity for consciousness.
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