I wonder how this man with no memory could have been considered competent to consent to the preservation of his brain. That part seemed a little like a circus.
He's an adult with many normal reasoning capabilities. Clearly if you were to ask him with regards to other preferences about the disposition of his mortal remains, like "Would you prefer to be buried or cremated? At what cemetery? What type, if any, of funeral service would you prefer?", he'd be capable of giving answers and they'd necessarily be the right ones. If he's capable of answering all of those questions, he's capable of making the decision to donate his brain to science. (After all, there is no conceivable way in which this harms his medical interests. It's not like they're asking him to consent to e.g. limited palliative care options with an eye towards getting his organs in the most usable possible state.)
Those are all polite, reasonable things with a reasonable range of answers.
But what they did was, saw his brain out on TV, then slice it into grotesque slides that they preserved on permanent display. Lots of people would have a problem with that.
Its questionable if he could be considered an adult. Certainly not an adult like you and me. Not able to 'think about it for a while' for instance. Perhaps the only answers he could give were impulsive ones. It would be childs-play to get him into a frame of mind where he was anxious to be agreeable, then pop the question.
If he was the type of person to object to that sort of thing, he would say so. They can do that to my brain, I don't care, I don't need to 'think about it for a while'.
And it's easy to verify if he was tricked. Ask him again later. But someone trusted should have been doing the asking in the first place, making this a non-issue. Not that I agree with your patronizing assertion of how easy it would be.
You could get me to agree, in a joking situation or a moment of contented fugue. But later I can rethink it, become dissatisfied, plumb my feelings and come up with my true feelings. Not as plausible if I can't remember past 20 seconds.
> he'd be capable of giving answers and they'd necessarily be the right ones.
> (After all, there is no conceivable way in which this harms his medical interests. It's not like they're asking him to consent to e.g. limited palliative care options with an eye towards getting his organs in the most usable possible state.)
Your comment seems to assume that medical or hedonic interests are obviously more important than interests in dignity, aesthetics, or tradition. That's a popular view, but the proper way to handle these sorts of cases does not rest on it.
It's very reasonable to think that one could get a legitimate answer to the question "HM, are you in pain?" without being able to get a legitimate answer to the question "HM, do you want your body used for scientific study?" The "true" HM, which we generally approximate as the man before the accident, might very well consider his dignity (as personally conceived) to be more important than pain.
That's why the correct answer to this, as already pointed out by others, is to rely on his gaurdian as our best guess as to HM's true preferences.
I profoundly disagree that the current HM stops being the most authoritative possible version of HM available to just because he happens to have a major medical condition. In particular, this ends up having fairly squicky consequences like having the real, actual, living HM getting outvoted by a third party's mental model of an HM who never actually existed. (I now feel like I sort of have to add for posterity "If you're a doctor reading this please do not override my future self's opinions solely on the basis that they're incompatible with my present self's opinions. I would like to reserve the right to change my mind in the next 30 years on this and many other topics, irrespective of whether I maintain 100% of my present mental acuity or not.")
It's not "just because he has a major medical condition". It's "because he has a major medical condition that interferes with his ability to assess the relevant choice".
The man literally cannot form new memories. How could we say that he could change his mind about something in a meaningful way? All the life experiences, reasoned arguments, etc. that are supposed to lead to people rationally changing their minds do not work on H.M.
Look, people end up mentally crippled in all sorts of ways, and we are forced all the time to ask the question "Is he so crippled that we cannot trust this new version? Or is the impairment minor enough that this new version is better representation than a third party mental model?" This question is unavoidable because there are extremes that make it clearly "yes" in some circumstances and clearly "no" in others. We have the "real, actual, living patient" in front of us all the time, and often they are profoundly disabled.
That's a philosophical viewpoint, sure. I'm not sure how you can reconcile it with a child's competence, or a mentally deficient person's?
Because in this case it wasn't the whole story that he 'happens to have a major medical condition'. The condition speaks directly to his ability to think and decide. Similarly to a child, or a senile person, at least in some degree.
The UK has the Mental Capacity Act. It's important to recognise tjat lack of capacity is limited - a person may not have capacity to look after their own money but you should not assume that they lack capacity to decide where to live for example.
Informed consent is mostly not that informed. Clinicians don't understand risk, cannot communicate risk to patients, and patients can't understamd that communication.
The experience of the decades of life he could remember? I don't see how postmortem brain scanning is any worse than doing memory tests on him when he's alive.
And children can agree to things just fine through their guardians.
He was 20-something when he lost his memory. So barely an adult.
And memory tests are not quite the same as dissecting his brain on television, then putting it on permanent display in grotesque life-sized cross-sections.
Further, he was institutionalized. So the guardians were - who? the doctors doing the dissecting?
You say "grotesque" in several of your comments, but this is a value judgment that is not shared by all. After death, what could be more poetic than using the instrument of one's intellect, the brain, to uplift the intellects of others?
And you, as an educated 21st-century world citizen can make judgements like that for yourself. This guy arguably can't. That's the whole issue, ignoring semantic arguments about word choice.
He probably wasn't, so I would assume he had some sort of court-appointed guardian or something (not sure which term is most applicable, but under the circumstances "guardian" may not be that far off...). That would not have been the first decision the guardian would have had to make, after all.
What I see is that you assume something, that is his doctors where his guardians. Then you draw a conclusion from that very assumed thing. That's intellectually dishonest. I don't know if there was a conflict of interest, or there wasn't. I would like to know, but can't find anything with a few minutes of googling.
I agree with your conclusion, that if there were a conflict of interest, then it's an outrage. But please don't assume something then draw conclusions from it.
It seems that you have strong emotions about the issue. I guess you would not have consented to this treatment. That's okay. But strong emotions doesn't make circular reasoning right.
Please let me know if you find, or have found already, anything more about the court-appointed guardian.
There's really no solution to this problem. It's obvious you disagree with the outcome, but equally obviously many would agree... he certainly didn't have the agency to give a solid answer by most of our standards (apparently some here disagree). There's no good solution, nor would I even agree there's a "default answer" here per se that we can fall back to. In the end all you can possibly end up with is a power struggle over whose personal preferences are going to be followed.
I have to agree here. The default would be to dispose of his body in a traditional way. There could be arguments about burial or cremation or maybe some other tradition I don't know about, but no one thinks of thin-slicing the head as any kind of default in todays (or yesterdays) world. I find the question of how this got approved almost as interesting as the original story. I can only think of 3 ways to decide: 1) prior consent from a parent 2) just ask him even though his brain is not normal 3) politics. Debating the legitimacy of #2 is really just going with option #3.
