The Concept of the Person and the Value of Life

John Harris

Abstract:The concept of the person has come to be intimately connected with questions about
the value of life. It is applied to those sorts of beings who have some special value or moral
importance and where we need to prioritize the needs or claims of different sorts of individuals.
"Person" is a concept designating individuals like us in some important respects, but possibly
including individuals who are very unlike us in other respects. What are these respects and why
are they important? This paper sets out to answer these questions and to develop a coherent
and useful concept of the person.

We all know lots of people; we also all know lots of persons. Normally we use the term "person" as a
synonym for "human beings," people like us. However we are also familiar with the idea that there are
nonhuman persons, and humans who are not, or may not be persons or full persons. Nonhuman persons
may include gods, demigods, ghosts, extraterrestrials, angels, and devils. They may also include animals,
fictional and real, with special properties or characteristics. These will include Mickey Mouse and Donald
Duck, Winnie the Pooh, Tarka the Otter, Willy the whale, and, perhaps, educated nonfictional primates, like
Washoe and Sarah (see Allen and Gardner 1969; Linden 1975). Human nonpersons or humans who are not
fully fledged persons may include zygotes and embryos, or individuals who are "brain-dead," anencephalic
infants, or individuals in a persistent vegetative state. I shall explore these categories of persons and
possible persons more fully below. For the moment it is enough to remember our relative familiarity with the
idea of nonhuman persons and human nonpersons, whatever we feel about the existence of such individuals
or the respectability of the terminology. [End Page 293]
"Person" then is a concept designating individuals like us in some important respects, but possibly including
individuals who are very unlike us in other respects. What are these respects and why are they important?
The concept of the person has come to be intimately connected with questions about the value of life (see
Warren 1997 for a detailed discussion of the links between personhood and moral status). It is invoked in
circumstances in which we need a term of art, or as John Locke (1690), memorably put it "a forensic" term,
for those sorts of beings who have some special value or moral importance and where we need to prioritize
the needs or claims of different sorts of individuals. To identify individuals as persons is to bring them into the
same moral category as ourselves and to judge someone to be a pre-person or a nonperson is to distance
them in some sense from ourselves.
Many, if not most, of the problems of health care ethics presuppose that we have a view about what sorts of
beings have something that we might think of as ultimate moral value. Or, if this sounds too apocalyptic, then
we certainly need to identify those sorts of individuals who have "the highest" moral value or importance: a
moral value or importance comparable to that to which we believe ourselves entitled. I am not using the term
"moral value" here in any technical or even very precise sense. Talk about the lives of individuals having
moral value refers to the moral reasons we have for respecting claims to continued existence made by or on
behalf of such creatures. To evaluate these claims and compare them with other possibly competing claims,
seems to presuppose some view about just what it is that makes life important, that makes it wrong to end a
life prematurely, and of what it is that makes some lives, or the lives of some individuals, more important than
others. In short, what is it that makes it an obligation to try to save life or postpone death and what makes it
incumbent upon us to respond to an appeal or a claim for such life saving or death-postponing assistance?
It is scarcely conceivable that someone could have a view about the ethics of abortion or euthanasia or in
vitro fertilization or experiments on embryos, children, or adults or selective treatment of newborns, or
screening and genetic testing without a view about the moral importance of the lives concerned. All of these
require that we know both why, and the extent to which, we have a moral obligation to try to preserve the
lives of the individuals concerned. We also need such a view when it comes to more overarching decisions;
for example, when we consider how to prioritize scarce resources available for health care, or when we have
to [End Page 294] select between rival candidates for treatment, or when we are contemplating what public
health measures should be invoked and at what cost. Again we need to know why it is that we ought, morally
speaking, to prioritize public health, which applies almost exclusively to human beings, rather than, for
example, animal health.
In what follows I will attempt to provide the outline of an answer to the question: what is a person? 1
Consideration will be given to the questions of why it is that the lives of persons make specially urgent and
important moral claims upon us and to what those claims actually amount.
The problem at the heart of an interest in personhood is this: If the hospital is on fire what justifies our
decision to rescue the patients before the hospital cat and the animals in the laboratories? Before attempting
a positive answer to this question, however, it is important to clear away some misconceptions about
personhood and about what a plausible answer might be to the question: what is a person?

Problematic Answers

Life Begins at Conception

Many people have thought that the problem of when it is that life becomes morally important, in the ultimate
sense, is answered by knowing when life begins. Many of the most popular accounts of personhood
concentrate on attempting to answer the question of when life begins, treating life unproblematically in this
context as human life. I shall return in a moment to the wisdom of treating human life as the central issue. As
a separate matter, the question of when life begins is, I believe, profoundly unhelpful. Human sperm and
eggs are both alive prior to conception, and the egg undergoes a process of maturation without which
conception would be impossible. Both sperm and egg are alive and are human. 2 Of course, the event most
popularly taken to mark the starting point of human life, is conception. But conception is equally unhelpful as
a threshold of moral importance for a number of reasons. First, conception can result in a hydatidiform mole,
a cancerous multiplication of cells that will never become anything but a palpable threat to the life of the
mother. Second, even if human life does begin at conception, it is not necessarily the life of an individual,
twins may form at any point up to approximately 14 days following conception. [End Page 295]
Cloning also has raised problems for our understanding of when life begins. If one has a preimplantation
embryo in the early stages of development when all of the cells are totipotent, that is, where any of the cells
could become any part of the resulting individual, and one splits this early cell mass (anything up to the 64-
cell stage)into, say, four clumps of cells, each of the four clumps would constitute a new, viable embryo that
could be implanted with every hope of successful development into adulthood. Each clump is the clone or
identical twin of each of the others and comes into being not through conception but because of the division
of the early cell mass. Moreover, the four clumps can be recombined into one embryo. This creates a
situation where, without the destruction of a single human cell, one human life, if that is what it is, can be split
into four and can be recombined again into one. Did "life" in such a case begin as an individual, become four
individuals, and then turn into a singleton again? Whatever the answer to this question, all this occurred
without the creation of extra matter and without the destruction of a single cell. Those who think that
ensoulment 3 takes place at conception have an interesting problem to account for the splitting of one soul
into four, and for the destruction of three souls when the four embryos are recombined into one, and to
account for the destruction of three individuals without a single human cell being removed or killed. These
possibilities should give us pause in attributing a beginning of morally important life to a point like conception.
However, these problems are small compared to another major issue. The human embryo and fetus, in all
stages of its development from conception to birth is no more interesting or complex than the embryos of
other creatures and indeed no more interesting than the adult forms of other creatures like, for example, cats
and canaries. We need to know what makes human embryos more important than these other creatures, if
they are more important. So it can never be enough to know when life begins, we have to know why life of a
particular sort, whenever it begins, is important, and moreover why it is more important than other sorts of
lives to which, care, respect and resources might also be devoted.

Speciesism and Natural Kinds

Some people have attempted to overcome, or rather side-step, this problem by simply stipulating that it is
human beings that matter (see Warnock 1983). Although this move certainly avoids the problem, it does so
at some cost. It is difficult to imagine how one would defend a moral theory [End Page 296] that was
founded on the stipulation of an arbitrary (and totally unjustified) preference for one kind of creature over
another, particularly when this preference is asserted by self-interested individuals on behalf of their own
kind. We are all too familiar with the sordid and disreputable history of similar claims in which the moral
priority and superiority of "our own kind" has been asserted on behalf of Greeks at the expense of
barbarians, whites over blacks, Nazis over Jews, and men over women. Simply stipulating arbitrarily the
superiority of our own kind, whether defined by species membership, race, gender, nationality, religion, or
any other nonmoral characteristic is, and has always been, disreputable. Membership of a natural kind, or of
an ethnic, religious or other grouping, is not of itself a moral property.
 Potentiality
The problem is to distinguish in some morally significant respect, human embryos from the embryos and
indeed the adult members of any other species. Species membership is not enough because human
embryos seem not to differ, except in species membership and in one other feature that I will discuss in a
moment, from the embryos and indeed adult members of other species. Unlike adult members of many other
species they are not conscious, although they may become so at some stage during their development. The
one thing human embryos have that members of other species do not is their potential not simply to be born
and to be human, but to become the sort of complex, intelligent, self-conscious, multifaceted creatures
typical of the human species. There are, however, two fatal difficulties for the potentiality argument.

Two Problems with Potentiality

The logical difficulty. The logical difficulty is straightforward but telling. We are asked to accept that human
embryos or fetuses are persons, morally important beings whose interests trump those of other sorts of
beings, in virtue of their potential to become another sort of being. But it does not follow logically, even if we
accept that we are required to treat 'x' in certain ways, and even if 'a' will inevitably become 'x,' that we must
treat 'a' as if it had become 'x,' at a time or at a stage prior to its having become 'x'. This is a rather
cumbersome and inelegant way of making the point that acorns are not oak trees, nor eggs omelettes.
Anyone reading this essay shares with its author one very important, inescapable potential. [End Page 297]
We are both potentially dead, however, I hope neither of us is required to concede that it is therefore
appropriate for anyone to treat us now, as if we already were dead. Further, it should be noted that the
reader and I have this potential with far greater certainty than does the human embryo have the potential to
become a glorious, sophisticated adult member of the human species.
The scope of potential for personhood. The second difficulty with the potentiality argument involves the
scope of the potential for personhood. If the human zygote has the potential to become an adult human
being and is supposedly morally important in virtue of that potential, then what of the potential to become a
zygote? Something has the potential to become a zygote, and whatever has the potential to become the
zygote has whatever potential the zygote has. It follows that the unfertilized egg and the sperm, taken
together, but as yet un-united, also have the potential to become fully functioning adult humans. It is
sometimes objected that the individual sperm that will fertilize the egg is not identifiable in advance of
conception. I am not sure why this is an objection, and it is true that in normal reproduction the identity of the
sperm that will successfully fertilize the egg is unpredictable. But the identity of the sperm is not necessarily
opaque. The technique known as ICSI (Intra Cytoplasmic Sperm Injection) does identify the individual sperm
prior to fertilization.
In addition, it is theoretically possible to stimulate eggs, including human eggs, to divide and develop without
fertilization (parthenogenesis). As yet it has not been possible to continue the development process artificially
beyond early stages of embryogenesis, but if it becomes possible then unfertilized eggs themselves, without
need of sperm or cloning (see below), also would have the potential of the zygote.
Finally, cloning by nuclear transfer, which involves deleting the nucleus of an unfertilized egg, inserting the
nucleus taken from any adult cell, and electrically stimulating the resulting newly created egg to develop,
can, in theory, produce a new human. This means that any cell from a normal human body has the potential
to become a new "twin" of that individual. All that is needed is an appropriate environment and appropriate
stimulation. But this of course is true of normal reproduction. The zygote only has the potential to become an
adult member of the species if placed in the appropriate environment and treated thereafter in appropriate
and complex ways. The techniques of parthenogenesis and cloning by nuclear substitution mean that
conception is no longer the necessary precursor of human beings. [End Page 298]
Thus if the argument from potential is understood to afford protection and moral status to whatever has the
potential to grow into a normal adult human being, then potentially every human cell deserves protection. I
shall not be concerned to refute such an ethic here, but will simply note that it is a very exhausting ethic.

What is important about potential?

The account of potentiality given here and elsewhere has been criticized for its simplicity. John Finnis (1995,
p. 50), for example, has argued that: "[a]n organic capacity for developing eye-sight is not 'the bare fact that
something will become' sighted; it is an existing reality, a thoroughly unitary ensemble of dynamically inter-
related primordia of, bases and structures for, development." He concludes that "there is no sense whatever
in which the unfertilized ovum and that sperm constitute one organism, a dynamic unity, identity, whole."
On the other hand, the account of potential I have outlined treats potentiality as a rather more straightforward
idea. A has the potential for Z if, when a certain number of things do and do not happen to A (or to A plus N),
then A or A plus N will become Z. For even a "unitary ensemble of dynamically inter-related primordia of,
bases and structures for development" must have a certain number of things happen to it and a certain
number of things that do not happen to it if its potential is to be actualized. If this monstrous beast of Finnis's
is a zygote, it must implant, be nourished, and have a genetic constitution compatible with survival to term
and beyond. Why, the list of things that must happen in normal reproduction, should not also include
fertilization is unclear to me.
Moreover Finnis's insistence on a "unitary ensemble," on "one organism," seems vulnerable to cloning by
nuclear substitution. For any of Finnis's skin cells, if treated appropriately, might be cloned. As Julian
Savulescu (1999, p. 91) has recently reminded us, "What happens when a skin cell turns into a totipotent
stem cell is that a few of its genetic switches are turned on and others are turned off. To say it doesn't have
the potential to be a human being until its nucleus is placed in the egg cytoplasm is like saying my car does
not have the potential to get me from Melbourne to Sydney unless the key is turned in the ignition."
Most importantly, however, Finnis's objections, and those of a similar kind, miss the main point of the
argument from potential. The potentiality of something, or some things, has moral importance on the
assumption [End Page 299] that actualizing a particular potential is what matters. We would not worry about
what precisely it is that has the potential to be a person, or an adult human being, if persons or adult humans
did not matter. We are only interested in the potentiality argument because we are interested in the potential
to become a particular, and particularly valuable, sort of thing. If, as I suggested above, the zygote (Finnis's
unitary ensemble) is important because it has the potential for personhood, and that is what makes it a
matter of importance to protect and actualize its potential; then whatever has the potential to become a
zygote must also be morally significant for the same reason. Those with their "eyes on the prize," value
potentiality for personhood, not because the potential is contained within "one organism," but because it is
the potential to become something the actualisation of which has moral importance.

Gradualism
Another approach to the question of when human life becomes morally important is the gradualist approach
to moral status. It is suggested that since we know that a morally important person will almost certainly,
eventually emerge, it is appropriate to accord a gradually increasing moral status to the embryo or fetus. This
view is attractive and has about it the classic air of political compromise. However, if we know why, in virtue
of what, it is that normal human adults possess personhood, then we will in principle be able to gauge more
precisely when these features, whatever they are, might with some plausibility be said to be present in the
emerging individual. Furthermore, if, as I suggest later, personhood turns out to be a threshold concept, then
proximity to the threshold is unimportant compared with the importance of crossing it, and there is no
justification for taking a gradualist approach to personhood or moral status.

Brain Birth
Finally, Michael Lockwood (1988) has suggested an elegant solution to the problem of when morally
important life begins. Noting that "brain death" is an almost universally accepted criterion of death, and
hence of the termination of the moral status of the individual, he has proposed that "brain birth" might be a
sensible point at which to date the genesis of moral status. The problem is that "brain death," although
almost universally accepted as a criterion of death, seems less acceptable as a criterion of loss of moral
status. Discussion of why this is so is postponed, [End Page 300] however, until the consideration of a case
of persistent vegetative state in the penultimate section of this paper.

The Meaning of Life

Let us step aside for a moment from the previous concerns and consider the question "what is the meaning
of life?" rather than "what is it that gives moral status or ultimate value to life?"
Philosophers, of this century at least, have generally shied away from this sort of question, except, that is, for
the distinguished and much underrated Douglas Adams. In his seminal trilogy, "The Hitchhiker's Guide to the
Galaxy," Adams (1972, Ch. 27) conducted a famous thought experiment. He imagined a race of beings that
wished to solve the ultimate question, the question of the meaning of "life, the universe and everything," and
to this end constructed a hyper-intelligent computer to solve the problem. After seven and a half million
years, the computer came back with the answer "42." This answer is illuminating in an interesting way.
Clearly it seems unsatisfactory as an answer to the question: "What is the meaning of life, the universe and
everything?" However, the problem with criticizing the answer is that we have not the most rudimentary of
idea of what a more plausible (less outrageous) answer might look like. We seem to lack a perspective from
which to criticize any answer offered.
 Nonhuman Persons
If we turn now from this question of the meaning of life to questions of its value and ultimate status, things
are rather different. Here we do seem to have a perspective, not only from which to criticize possible
answers to the question, but from which to construct our own answer. Consider the question of whether there
are persons on other planets. Although we do not know the answer to this question, we do know what would
convince us that we had found an affirmative answer. We have, in the back of our minds at least, an idea of
what we are looking for when we look for people, or evidence of people, on other planets. Let us be clear,
however, about what we are not looking for.
First, we are not looking exclusively or primarily, for human beings. We do not expect persons on other
planets, if there are any, necessarily to be members of our own species. Second, we are not necessarily
even looking for organic life forms, it may be that we will become convinced that self-constructing machines
of sufficient intelligence would count as persons. Third, we are not looking for nonpersonal life forms,
although we [End Page 301] may also find these and be excited if we do. Neither are we looking for the sort
of machinery that would not count as a person (perhaps machinery left behind by persons long since
deceased).
These observations show us that we do not, in fact, regard species membership as hugely significant in
trying to understand what a person might be. Nor even do we require that persons be organic life forms.
What then are we looking for? What should convince us that we had discovered persons on other planets?
Suppose, that instead of us discovering persons on other planets, they discovered us. Demonstrating their
vastly superior technology by arriving on Earth having traversed unimaginable interstellar distances, the
extraterrestrials are hungry and tired after their long journey. What could we point to about ourselves that
ought to convince the extra-terrestrials that they had discovered persons, morally significant beings of
special importance, on another planet? What could we say of ourselves that should convince them of the
appropriateness of "having us for dinner" in one sense rather than another? What should convince them to
treat us as dinner guests rather than the dinner itself? What makes for a moral distinction between ourselves
and, say, lettuces or turnips?
Toward the end of the seventeenth century in his "Essay Concerning Human Understanding" the philosopher
John Locke attempted to answer this question in a way that has scarcely been surpassed. He wrote:
We must consider what person stands for; which I think is a thinking intelligent being, that has
reason and reflection, and can consider itself the same thinking thing, in different times and
places; which it does only by that consciousness which is inseparable from thinking and seems
to me essential to it; it being impossible for anyone to perceive without perceiving that he does
perceive. (Locke 1690, Ch. 27, Book II, p. 188)

It seems to me that it is beings possessing these capacities, or something closely akin to them, that we are
looking for when we ask the question "Are there persons on other planets?" And we must hope that if it is
others of vastly superior technology that are asking the question, that they recognize in us fellow creatures of
moral standing, fellow persons. It is a species-neutral description but it identifies those features, the potential
for which is so important to the failed potentiality argument and the presence of which in space creatures
should surely convince us that we had at last encountered persons elsewhere in the universe. [End Page
302]

Questions of Degree
Can one be more or less of a person? All of the elements in Locke's definition, intelligence, the ability to think
and reason, the capacity for reflection, self consciousness, memory and foresight, are capacities that admit
of degrees. Does this lead us into a hierarchy of persons and hence of moral importance or value? Let us try
another thought experiment. Suppose you were asked to write down in rank order of importance, the 100
things that made life valuable, worth living, for you. Of course there would be no clear rank order in
importance for many of the items, and many people would have died laughing long before the list had
reached a hundred items. Some lists would tend toward the prurient, others toward the exalted. The
philosophical interest in the exercise, contrasted with its human interest, lies not in the contents of the list,
but rather in the fact that for anyone reading this essay, or indeed meeting Locke's criteria, there are things
that make life valuable, worth living, or indeed valueless and hence not worth living. The importance of the
exercise is not what is on the list, nor some moral or objective evaluation of what is or might be on the list.
Rather the significance of the thought experiment is the fact that it identifies a particular sort of being, a
being that can value existence. My suggestion then is that if we ask "which lives are valuable in the ultimate
sense, which lives are the lives of persons?," the answer will be "the lives of any and every creature, whether
organic or not, who is capable of valuing his/her or its own existence."
The reasons why existence is valued, and the extent to which it is valued, are irrelevant to this question,
although they may be relevant to other questions. Thus the question as to which individuals have lives that
are valuable in this sense is a threshold one; anyone capable of valuing existence, whether they do or not, is
a person in this sense. The possession of this capacity, to whatever degree it is possessed, meets Locke's
criteria.

Consequences
This account of personhood identifies a range of capacities as the preconditions for personhood. These
capacities are species-, gender-, race-, and organic-life-form-neutral. Thus persons might, in principle, be
members of any species, or indeed machines, if they have the right sorts of capacities. The connection
between personhood and moral value arises in two principle ways. One of these ways involves the fact that
the capacity for self consciousness coupled with a minimum intelligence is not only necessary for moral
agency but is also of course the minimum condition [End Page 303] for almost any deliberative behavior.
More significant, however, is the fact that it is these capacities that allow individuals to value existence, to
take an interest in their own futures, and to take a view about how important it is for them to experience
whatever future existence may be available. This account therefore yields an explanation of the wrong done
to an individual when their existence is ended prematurely. On this account to kill, or to fail to sustain the life
of, a person is to deprive that individual of something that they value. On the other hand, to kill or to fail to
sustain the life of a nonperson, in that it cannot deprive that individual of anything that he, she, or it could
conceivably value, does that individual no harm. It takes from such individuals nothing that they would prefer
not to have taken from them. This does not, of course, exhaust the wrongs that might be done in ending or
failing to sustain the life of another sentient creature. Some of these wrongs will have to do with causing pain
or suffering or apprehension to a creature, others will have to do with wrongs that may be done to those
persons that take a benevolent interest in the individual concerned (see Harris 1998). But the account of
personhood I provide here explains why the lives of persons should be respected and sustained and the
wrong done when we fail to do so.
Another important consequence of this account is that it gives answers to the vexed questions discussed at
the outset, questions about the ethics of abortion, contraception, infanticide, and euthanasia. To this extent, it
does what a good theory of personhood should do. It explains many of the judgements that we intuitively
make about these issues, resolves some of the dilemmas that we have about the ethics of decision making,
and gives us ways to approach new and possibly unforeseen dilemmas. In uniting and explaining some of
our basic intuitions in biomedical ethics, it of course also violates some of these intuitions. In telling us how to
handle existing hard cases, it creates some new hard cases, but at least it enables us to think our way
through to their resolution.

Criteria for Personhood

An important question is whether the theory I have developed provides criteria for personhood. Of course,
the answer is that it does: Any self-conscious, minimally intelligent being will be a person. The problem is that
we not only want reliable criteria for personhood, but we want detectable evidence of personhood. Here
matters are not so simple, and we should err on the side of caution and assume, in the case of the sorts of
creatures that we know to be normally capable of developing self consciousness, [End Page 304] namely
human creatures, that they are persons at some safe time prior to the manifestation of the symptoms of
personhood. I do not have a set view as to when an appropriate point would be, but I do not think it plausible
to regard the emerging human individual, for example, as possessing the relevant capacities at any time
while in utero or during the neonatal period.

Personhood at the End of Life

Although there is always a period of pre-personal existence for developing humans, the same is not
necessarily true at the end of life. Some decisions about euthanasia are made easier if the individual
concerned is clearly seen to have lost personhood. The House of Lords in the United Kingdom were recently
required to determine such a case (Airedale NHS Trust v. Bland, (1993) 1 All England Rep. 821 H.L.), and I
believe that the only way of making sense of their judgment is to conclude that they determined that
individuals in persistent vegetative state have permanently lost personhood. It was this fact that justified their
eventual decision, in the landmark Bland case to authorize cessation of life-sustaining food and hydration.
Tony Bland suffered serious brain damage, leaving him in a persistent vegetative state (PVS). Bland's
parents accepted that their son had ceased to exist in any real, biographical, sense although his body
remained alive, and asked the English courts to declare that it would be lawful for medical staff to withdraw
feeding and other life sustaining measures so that their son would die. 4
Although the House of Lords were reluctant to change the definition of death, or even to address that issue, it
is clear from their decision that they thought Tony Bland's life did not in fact retain the sort of value that
required it to be sustained, and did not do so because he had lost all capacity for consciousness. In the
words of Lord Keith of Kinkel, "It is, however, perhaps permissible to say that to an individual with no
cognitive capacity whatever, and no prospect of ever recovering any such capacity in this world, it must be a
matter of complete indifference whether he lives or dies." Here Lord Keith seems to appeal to something like
the conception of personhood defended above. For what he identifies as mattering from a moral, and indeed
a legal, perspective is not life, nor yet human life, but a certain cognitive capacity.
There was no question in Bland's case of competing claims on the resources required to sustain him, so that
the decision to permit a course of [End Page 305] action designed to achieve the death his parents sought,
was a deliberate, conscious decision to end his life. A hotly debated question is whether such a decision
constitutes a form of euthanasia. Although the House of Lords strongly denied this is what they were doing,
their decision in the Bland case is thought by many (including myself) to legalize, for the first time in the
United Kingdom, a form (albeit very restricted) of euthanasia. This makes the United Kingdom the second
country in Europe 5 to have judicially recognized the necessity of bringing the lives of at least some
'innocent'-in the sense of having done nothing to merit death-individuals who have not requested death, to an
end.
It is important to emphasize the proviso "who have not requested death" for other instances of courts
defending the right to die have turned on precisely this issue. The landmark United States case concerning
PVS, that of Nancy Cruzan (Cruzan v. Director, Missouri Department of Health, 497, U.S. 261 (1990)), turned
crucially on whether Ms. Cruzan had expressed a wish to die prior to falling into PVS, indeed, it is often
described as a case establishing the right to die.
That the case of Tony Bland establishes a precedent for legally sanctioned euthanasia in the United Kingdom
is confirmed by the words of Lord Mustill in his judgment in that case, but his judgment also appears to
confirm the fact that it is not human life that is the determinant of moral significance:
The conclusion . . . depends crucially on a distinction drawn by the criminal Law between acts
and omissions, and carries with it inescapably a distinction between, on the one hand what is
often called "mercy killing," where active steps are taken in a medical context to terminate the
life of a suffering patient, and a situation such as the present where the proposed conduct has
the aim for equally humane reasons of terminating the life of Anthony Bland by withholding from
him the basic necessities of life. The acute unease which I feel about adopting this way through
the legal and ethical maze is I believe due in an important part to the sensation that however
much the terminologies may differ the ethical status of the two courses of action is for all
relevant purposes indistinguishable.

The key features of Lord Mustill's judgment are, first, the acknowledgment that the course of action
requested of, and approved by, the courts "has the aim . . . of terminating the life of Anthony Bland" and,
second, the fact that the supposed difference between acts and omissions relied on by the common law
tradition to make moral and legal distinctions, characterizes two courses of action that are ethically "for all
relevant purposes [End Page 306] indistinguishable." Terminating the life of Anthony Bland as a person
would not be permissible in English Law, neither would ending the life of someone who shared the same
moral status as Lord Mustill.

Conclusion
Personhood, as we have seen is intimately connected with questions about the ethics of killing and letting
die. Many people who have been interested in the distinctions between different sorts of creatures that
personhood highlights have followed John Locke in emphasizing a particular sort of mental life as
characterizing personhood (see, e.g., Tooley 1998). Although this is no doubt appropriate, characterizing
personhood as involved with the capacity to value existence makes clearer why personhood is connected
with a particular sort of moral value attaching to individuals and shows why it also answers questions about
the ethics of killing and letting die. Personhood provides a species neutral way of grouping creatures that
have lives that it would be wrong to end by killing or by letting die. These may include animals, machines,
extra-terrestrials, gods, angels and devils. All, if they were capable of valuing existence, would, whatever
else they were, be persons.
Defining "person" as a creature capable of valuing its own existence, makes plausible an explanation of the
nature of the wrong done to such a being when it is deprived of existence. Persons who want to live are
wronged by being killed because they are thereby deprived of something they value. Persons who do not
want to live are not on this account harmed by having their wish to die granted, through voluntary euthanasia
for example. Nonpersons or potential persons cannot be wronged in this way because death does not
deprive them of anything they can value. If they cannot wish to live, they cannot have that wish frustrated by
being killed. Creatures other than persons can, of course, be harmed in other ways, by being caused
gratuitous suffering for example, but not by being painlessly killed.
The life cycle of a given individual passes through a number of stages of different moral significance. The
individual can be said to have come into existence when the egg is first differentiated or the sperm that will
fertilize that egg is first formed (Harris 1992). This individual will gradually move from being a potential or a
pre-person into an actual person when she becomes capable of valuing her own existence. And if,
eventually, she permanently loses this capacity prior to death, she will have ceased to be a person.
John Harris, Ph.D., is Sir David Alliance Professor of Bioethics and Research Director, Centre for Social
Ethics and Policy, and a Director of the Institute of Medicine Law and Bioethics, University of Manchester,
England.

Notes
1. I first outlined an account of personhood in Violence & Responsibility (Harris 1980) and in The Value of
Life (Harris 1985, ch. 1). This paper develops ideas that first appeared in those books.
2. Although this does not of course mean that either of them individually constitutes "human life."
3. The point at which the divinely sent immortal soul is supposed to enter and animate the body.
4. It is not clear why there was any necessity to take the Bland case to the courts since it is already well
established that there is no obligation to sustain a baby by feeding (Re C (1989) 2 All ER 782; Re J (1990) 3
All ER 930).
5. The Netherlands legalized euthanasia under certain conditions in a High Court case decided in 1984 and
have since formally enshrined euthanasia in their legal system.

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