Derek Parfit's Concept Of Identity

Margo is a patient suffering from Alzheimer’s disease who has recently contracted pneumonia. While treatment will allow her to live another five years, the progression of the disease will lead to rapid death. Further complicating the situation, Margo has written a will five year prior stating that doctors withhold treatment once the severity of the Alzheimer’s disease intensifies. In his integrity view, the philosopher Ronald Dworkin argues that autonomy derives its value from its capacity to protect one’s values, interests, and beliefs view. He asserts that due to the Alzheimer’s disease, Margo has lost her “sense of self” (Campbell, 1994) and the value in her autonomy; however, through the application of Derek Parfit’s conception of changing
Derek Parfit’s conception of identity, however, provides a different perspective. Parfit draws a distinction between survival and identity. While Margo could have physically survived to today, her identity would have undergone significant changes. In fact, with five years being a long duration, small changes in her personality, beliefs, and views could have generated a new identity. Neuroanatomy reflects this as new connections constantly formed in the cortex through new experiences and thoughts. Thus, while it may appear that Margo has lost her identity, it could potentially be that the current Margo is simply a distinct identity from the Margo five years ago. While there are some shared interests, values, and personalities – some degree of “psychological connectedness” – such similarities could be minimal (Parfit, 1971). If this is indeed true, while Margo’s decisions may appear erratic, such observations could simply reflect changes in Margo’s identity not her loss of identity, and thus, there would be value in respecting the current Margo’s autonomy and the set of values it protects. In fact, similar changes are seen in borderline personality disorder patients who undergo rapid changes in mood, behavior, and thought (Kernberg & Michels, 2009) – elements that underlies one’s personality and identity. Yet, few would claim
The pneumonia treatment will allow Margo to live another five years. Because individual life is often held precious, such life-saving procedure might appear beneficial. In fact, considering Margo’s positive relationship with the staff at the nursing home, it could potentially appear that Margo would enjoy the remainder of her life. It is, however, important to remember that the Alzheimer’s disease would progressively worsen Margo’s condition over the next five years. Research indicates that up to 50% of Alzheimer’s disease patients suffer from depression (Lyketsos & Olin, 2002). Moreover, over time, Margo will face difficulty with simply tasks such as speaking and eating (Neugroschl & Wang, 2011). Under such condition, it is difficult to see how Margo would “enjoy” the remainder of her life. The five years could potentially be a burden full of suffering and pain while treating pneumonia with morphine could end her life peacefully. It could be argued that Margo should first be given the treatment, and if she later demands euthanasia, her wishes can then be granted. The problem, however, remains in that the treatment will not restore her autonomy. In the case of burnt victims who demand euthanasia, doctors will often save these individuals to allow them to ponder over their decision more thoroughly (Caplan, 2008). The pneumonia treatment,