WHAT IS A PERSON?

Understanding what it is to be an individual human being is vital if we are going to be able to make informed ethical decisions, particularly those that surround the start and end of life. Not surprisingly, it is an area strewn with controversy. By presenting a range of currently expressed views and ideas, this paper intends to stimulate informed debate.

Who am I? It is one of life's basic questions and it has troubled philosophers through the centuries. One aspect of the answer lies in working out what it is to be a person. This is not just of academic interest. Your conclusion will affect the way you think about key issues surrounding life, death and disability.

To start with we need to consider the ways that human beings are different from other animals. After all, genetics now tells us that we share ninety-eight per cent of our genes with chimpanzees and seventy-five per cent with round-worms (nematodes). So on a genetic level we are remarkably similar, but on a moral and ethical level most people believe that we are superior.

Forming an opinion about when a person's life starts and ends will also affect our views of technologies such as pre-implantation genetic diagnosis and antenatal screening. These look for imperfections in embryos and fetuses and give the option of terminating that organism's life. If you do not consider that an embryo has the status of a person, then this may not worry you, however if you do believe that embryos are small persons then you will see this act as murder.

At the other end of life, our ability to maintain bodily functions in intensive care facilities also makes us ask questions of the moment of death. Is a person who has no function in the cortical areas of his or her brain alive or dead? The question needs to be answered urgently if you are going to allow major organs to be removed and transferred to a waiting patient.

In addition, an assessment of what it is to be human will help us work out whether it is ever right to take actions that have the primary intention of shortening or ending a person's life.

Ethical declarations

Over the years the medical profession has made a series of declarations that contain comments about its view of the nature of human life and our need to treat it with respect.

Declaration of Sydney (1968)

This addressed issues about deciding when a person is dead. The difficulty is that modern techniques have produced some situations where it is difficult to know quite when a person has died. In these situations simple measures such as a non-beating heart, or lack of respiration are not sufficient. In these cases, this declaration states that the decision should be left with a qualified clinician.

Declaration of Oslo (1970)

This declaration paved the way for abortions to be carried out, in recognition that there will be occasions when the vital interests of the mother and developing child conflict. However it places this within a framework that recognises the Declaration of Geneva, under which a doctor states, 'I will maintain the utmost respect for human life from the time of conception.'

Declaration of Helsinki (revised, 1975)

This declaration addressed the issue of experimentation. It acknowledges the need to have high regard for the environment and for the welfare of animals in experiments. In particular it reminds the medical profession that, if human subjects are involved, it has a duty to put the health of the patient first.

Memorandum issued by the Honorary Secretary of the Conference of Medical Royal Colleges and the Faculties in the United Kingdom (1979)

This recognised that cessation of the heart was no longer accepted as equivalent to the moment of death. It says that 'Whatever the mode of its production, brain death represents the state at which a patient becomes truly dead, because by then all functions of the brain have permanently and irreversibly ceased. It is not difficult or illogical in any way to equate this with the concept in many religions of the departure of the spirit from the body.'

Biological development

The process of development that leads from an egg and a single sperm, to a newborn baby is remarkably complex and poorly understood.

But increased understanding of these biological processes has done little to reduce the animosity aroused in any debate that discusses the time when this developing unit of life becomes a person. The following is a review of some of the more commonly argued markers.

Fertilisation

From the moment that a sperm and egg unite and start to act as a single entity many Christians and people of other, or no, faiths, say that we have a new human being-a new person.

Taken at its most basic, fertilisation brings about the emergence of a new combination of genes and the start of a new unit of biology. Everything that happens after this point is merely a process of development. The very fact that this being is a member of the human species gives him or her the status of a person.

Those arguing against this view say that while the detailed genetics may be unique, you don't know whether it will spontaneously split into two and become identical twins. If the day-1 embryo is a person, then how do we view these twins?

They also point to the number of embryos that fail to implant, estimated at between 25% and 75%, saying that it is difficult to believe that all these are lost people. In addition they point out that fertilisation is a process that occurs over at least 24 hours, so there is no defining 'moment of fertilisation' to look back on.

Implantation

Implantation, where the embryo buries into the lining of the mother's womb, is another suggested marker. This is the time when a maternal-embryonic relationship begins to form. The embryo releases human chorionic gonadotrophin, which wards off a period and prevents itself being washed away. Thus without a successful implantation, which starts at about 5 to 6 days after fertilisation and is completed by about 14 days, its survival chances are nil.

Opponents of this time point out that implantation occurs before any nervous system is up and running. They argue that we accept that brain death is the time when a person's life ends, so there can be no person until the brain, or at very least some nerves, have started to function.

Up to 14 days the embryo has been a simple ball of cells. However, from this point a group of cells distinguishes itself within the ball and forms the primitive streak, the cell mass that will eventually become the full-grown baby. It was for this reason that the Warnock commission set 14 days as the point beyond which no-one is allowed to perform experiments on human embryos.

Neural plate

At around 17 days after egg and sperm meet the neural tube begins to form. If you see the nervous system as the key to being human, then this is your moment. However, the first nerves are a long way from forming the complex network that we accept as being a functioning brain.

In human form

After seven weeks of development all organs are basically in place and the embryo looks distinctly human. It is now called a fetus. Early thinkers such as Aristotle (383-322 BC) and the Catholic theologian and philosopher Thomas Aquinas (1225- 1274) decided that this physical maturity signalled the time when the embryo became 'ensouled'; became a person. According to Islamic scriptures the embryo is sacred from day-one and deserving of protection, but after about 6 weeks from fertilisation God breathes in the person's soul.

However, biologically this stage is just part of ongoing development and many of the organs, while present, will take weeks or months before they perform fully.

Quickening

Historically a lot of weight has been given to the first moment when a woman feels her baby move inside her womb-quickening. This occurs at about 16-18 weeks from fertilisation.

The problem with this marker is that ultrasound scans now show that the fetus has been moving for weeks before this moment. The movement hasn't been felt because previously the fetus was not heavy enough.

Viability

Neonatal intensive care units can now keep very premature babies alive. The youngest was born after only 22 weeks of development. If a baby can survive outside the womb, there can be no doubt that he or she must be a person, and by implication, this personhood must apply to all unborn fetuses of this age.

Opponents of this view point to the massed banks of equipment needed to maintain a very premature baby's life, saying that this is hardly independent survival.

But others say that the equipment makes no difference because if a person needed to be fully independent, then this would only occur once they had reached their teens, or beyond.

Birth

The moment when a baby leaves the confines of the womb and starts to breathe air is the legal point at which the status of a person is conferred. Many people point out that, while this is legally convenient, the timing of the birth itself is one of the least significant developmental stages in the child's life.

After all, a premature delivery could bring it earlier, or a delayed labour could hold it back it by days or weeks. This has little to do with the baby's personal development.

Self awareness

This is the point at which a human being becomes aware of itself and other persons as distinct entities.

A problem with using this marker is that clearly self awareness only occurs a few weeks or months after birth, and sometimes ends prior to death. It also leads to the situation where some higher non-human animals are placed in the same category as people.

A conclusion?

Sincere people of all faiths differ in their understanding of the time when a person's life starts. For a Christian it is important to understand the biology and then see how it fits in with biblical teaching and debate. It is also important to remember that, whatever the process, we are all created and loved by God.

Some biblical comments on the nature of human life

The Bible makes no explicit statement about the timing of the start of life or its conclusion. However there are some verses that people point to as giving guidance in the issue.

Genesis 1 and 2

Christians agree that the Bible teaches that God deliberately created the Universe, the world and all living creatures. Within that planned environment he formed a special relationship with human beings, saying that they are created in his 'image and likeness' (Genesis 1:26).

Genesis 9:5-6

God states that he considers human life to be of extreme value because it has been made in his image.

Psalm 139

The psalmist tells of his experience of a God whose love knows no bounds. There is nowhere you can hide from it, it has no beginning and no end. With this in mind he considers his own life and sees God's protection and care extending back to life in the womb. Many theologians say that it is right to assume that the author's intended meaning was that this extends to the first moment of life - the moment when sperm and egg combine.

Luke 1:41

In the New Testament two pregnant women meet. Mary is carrying Jesus, and Elizabeth is pregnant with John the Baptist. The gospel writer Luke records that, 'When Elizabeth heard Mary's greeting, the baby leaped in her womb, and Elizabeth was filled with the Holy Spirit.' Many take this fetal leap as an indication that the growing babies were people capable of responding to each other's presence.

Discussions of personhood

Many people have tried to break down the issue of what constitutes a person into a set of the attributes of a living being that endow person-hood. Others attack this approach, saying that it allows two separate descriptions of one person-it allows us to consider the body and the person as being two distinct elements. This gives permission to enquire whether we could ever have a living body that wasn't a person.

The Bible claims that people are separate from the rest of creation because we have been made in the 'Image of God'. The Bible, however, does not explicitly state what this means. Theologian Louis Janssens, addresses the issue by presenting a set of seven characteristics that describe aspects of what it is to be a person:

• a subject: A biblical under-standing of personhood starts with the acknowledgement that human beings exist as creatures who are under the rule of God their creator. They are subjects of his authority. Our personhood therefore resides principally in our relationship with God.
• an embodied subject: As subjects, human beings are also defined by having a human body. Historically philosophers have tried to separate the body from the mind and spirit, but there is now a consensus among contemporary Christian theologians that the elements are intrinsically united.
• part of the material world: The first chapters of Genesis place humankind firmly within the created world. God created the world, took a fragment of that world-the dust-and breathed life into it. This breath (Hebrew rwuah) is common to human beings and non-human animals (Gen 6:17). Similarly the Hebrew word translated as 'living soul' (nephes) is used for all living animals.
• inter-relational with other persons: In Genesis, God rec-ognises that Adam is insufficient on his own and creates a companion, Eve. The rest of the story of the Bible relates to the way that relationships between different people develop.
• an interdependent social being: Personhood expresses itself in the way that we relate as social beings. An interdependent society recognises the need to care for each other. Christian theologians believe that Jesus is the perfect human being and point out that, when on earth, he did the things that God the Father wanted, and was supported in his actions by the Holy Spirit. Therefore Jesus showed us an interdependent concept of relationship.
• historical: Individual people exist within a historical framework and are intrinsically interested in their forebears. Our personhood expresses itself within cultural historical contexts.
• equal but unique: Each person has equal rights, despite economic, educational or psychological differences-yet we are not all the same. Again theologians point to their understanding of God as a single being composed of three equal though different persons- Father, Son and Holy Spirit.
• called to know and worship God: One feature of a person is his or her ability to know and respond to God.

Conclusion

Answering questions of personhood demands that we consider physical, spiritual and relational issues. While many Christians conclude that a person's life starts at fertilisation, others adopt a gradualist position that places this later in development. However, the answer will pro-foundly affect the way we view each other and make medical decisions.

All Christians agree that every person is made in God's image, loved by him and so of extreme value. Adopting this attitude will foster a society that takes seriously the task of caring for everyone, especially the weakest and most vulnerable.

Further reading

• McFadyen AI (1990) The call to person-hood. Cambridge University Press.
• McCarthy B (1997) Fertility and faith -the ethics of human fertilization. IVP.
• Janssens L (1980) Louvain Studies
• Jeeves MA & Berry RJ (1998) Science, Life and Christian Belief - a survey and assessment. APOLLOS.
• Jones DG (1999) Valuing People - Human value in a world of medical technology. Paternoster Press.
• Wyatt J (1998) Matters of life and death - today's healthcare dilemmas in the light of Christian faith. IVP.