THE PERSONHOOD OF INDIVIDUALS WITH DISABILITIES

What does it mean to be a human person? Should all human beings be considered persons in a moral sense to whom ethical duties are owed? Or are some human beings (such as those with profound disabilities) non-persons who can be treated differently from real persons? Is personhood absolute, or are there degrees of personhood, and thus degrees of ethical obligations to them? Can personhood be lost while human existence remains? Are there reliable and valid criteria that one can use to determine whether a human being is a person or not?

Philosophical approaches have emphasized the unity of reason and spirit (Aristotle), or the capacity for rational thought (Kant), as the basis for personhood. This has been interpreted to mean the capacity for self-consciousness, the capacity to make free, autonomous choices, or the capacity to relate to others (Fletcher). Classical theological approaches to these questions emphasized the role of God in creating human reason (Augustine, Aquinas), or the capacity for a spiritual relationship to the divine as what makes us uniquely human: to be human is to be able to pray. More recently, anthropological approaches have questioned whether personhood is a viable concept at all (Fernandez-Armesto) in view of the necessarily indistinct boundaries of the concept. Some writers on disability have argued that the question of personhood in essence is the wrong question to ask (Hauerwas), and have emphasized the “disability of presence” instead of the “presence of disability” (Byrne, Nouwen).

If all human beings are persons with value and dignity, regardless of disability, are there nonetheless degrees of moral obligation to them? How can we utilize modern bioethical theories to understand the nature of these obligations? An analysis of ethical and legal principles in this regard suggests some preliminary guidelines for decision-making in the presence of disability.