Over two recent Sundays I led the Adult Forum in a local parish. As I've done before, I began with the "Georgetown Mantra," and then worked with them to explore what other, perhaps more Christian, more Episcopal values we might want to bring to the discussion.
One of the issues brought home to me again is the question of what we mean when we use the word "person." Where, somewhere between the encounter of egg and sperm and independent breathing and squalling, do we say, "This now is a person?" At what point, somewhere between "this now is a person" and some legally-defined age, do we say, "This person is now an independent person with full legal rights, responsibilities, and protections?" At the other end of life, how much function, both physical and cognitive, must a person lose to lose the dignity and integrity and protections of being a person. And in between are there events, including individual choices and actions, that can result in loss of personhood?
In health care, of course, this has impact in many areas, even if we don't necessarily speak explicitly of "personhood." After all, the principle underlying the entire "Georgetown Mantra" is "Respect for persons." We're certainly conscious of it in the issue of abortion. At the same time, it is important in other areas. For example, discussions of when to allow natural death (if one can consider it "natural" after we've started treatment in the first place) have to do with personhood. Many folks who complete health care treatment directives set as one of their standards of "a quality of life acceptable to me" the capacity to make decisions, and/or to communicate. Without those capacities, have they lost "personhood" in a meaningful sense? What about severe brain injury, or brain disease, or brain death? Certainly, those raise issues of personhood, legally as well as morally; and we know this best when we say to families trying to make hard decisions in the midst of grief, "The person you know and love will not come back, no matter what we do from this point."
We even are looking at issues of personhood in matters of informed consent. When a person's capacity to consent is limited (legally by age, or functionally by limited cognitive capacity), we still assess whether the person can give assent. So, we will discuss issues of consent with a 16-year-old that we would not discuss with an 8-year-old; even though both have the same (lack of) capacity to consent.
The troubles that tear at churches these days are also about personhood. We're more conscious of it in liturgical churches, when we look at specific rites and who might be persons appropriate to participate; but all churches wrestle with it at some point. (So, I'm sure, do non-Christians; but I can't speak to that.) Again, are there events or actions that cause the rest of us to feel someone has lost or rejected moral or legal personhood? Some folks are arguing bitterly whether sexual acts have that result; and if so, which acts. Certainly, all parties begin acknowledging personhood; but sooner or later someone gets around to, "yes, those folks are persons, but...." At that point, we're not simply discussing social norms; we're discussing qualifying personhood.
In all of our moral reflections, we need to keep this concern in mind. It's all too easy to pursue principle over persons, or at least over the certain persons in the specific events. We want to discuss moral principles and ethical processes as if we all agreed on "personhood." But next time you're in that place, wrestling with moral conundra and difficult decisions, it will be worth it to step back and think again: who are the persons involved in this? And, just how do I understand and value personhood - theirs, and our own?