Inherent/transcendental Personhood
Inherent/transcendental Personhood
Inherent/transcendental Personhood
The way that people understand and relate to each other contributes towards
the acknowledgement or development and maintenance of personhood.
Nevertheless, being an actual person in the first place is important and
determining what or who is a person involves setting boundaries (Baldwin and
Capstick, 2007). Where someone falls in relation to those boundaries will
determine whether s/he is considered a person or a “non-person”. For some
theorists, particularly ethicists, this means possessing certain capacities.
Others would argue that personhood more or less equates with simply being a
human being, whereas the role of interaction with others has also been
highlighted, as has the importance of the physical body. The following
approaches to personhood will be considered in this section, and a few
examples provided of research into perceptions of personhood:
1. inherent/transcendental personhood
2. capacity-based approach to personhood
3. interpersonal theories of personhood
4. the body
5. empirical research into perceptions of personhood
1. Inherent/transcendental personhood
Being human has been equated with being a person in the sense that being-in-
itself is the only criteria. Kitwood (1997) claimed that personhood was sacred
and unique and that every person had an ethical status and should be treated
with deep respect. (He also later emphasised the relational aspect of
personhood but this is not necessarily contradictory.) In some religions and
according to certain spiritual beliefs, people have a kind of unique inner
essence which may even be believed to continue beyond human life (e.g.
through reincarnation or an after-life). The belief in a kind “non-material soul
that still exists intact underneath all the neurological losses of dementia”
(Post, 2006, p.231) may provide solace to carers and help ensure that
interaction with the person is maintained. However, a belief in the inherent
personhood of people (including those with dementia) does not necessarily
guarantee that they are treated humanely and with respect. Moreover, some
people believe that a person’s essence or soul may be lost or no longer possible
to reach, as reflected in statements made by carers in a recent small-scale
qualitative study:
“But you have to remember, that body is not who the person is. The person is
gone”
“There’s no sense is asking her…. She’s not there…” (Dunham and Cannon,
2008, p. 49)
Not everyone has religious or spiritual beliefs and even those who do, within
the same religion or philosophy of life, may differ greatly with regard to what
they believe and the strength of that belief. However, the main issue is not to
determine which religion has “got it right” or whether people really have an
innate, unique essence or soul but rather to understand how some people
define personhood and to recognise that this may be influenced by their
spiritual or religious beliefs. It could even contribute towards fear of dementia
in that their worst mental image of what dementia might resemble is applied
to a human being. Some people might find it more reassuring to believe that
the person is” no longer there”.
“who one is and who one can be are defined in the context of authentic
relationships” (Malloy and Hadjistavropoulos, 2004, p.152)
Buber (1970) identified two different ways that people relate to one another,
which may be of relevance to the maintenance of personhood in people with
dementia. These two ways are described through the word pairs “I-It” and “I-
Thou” (later translated to I-You”). The I-It mode of relating is one in which a
person relates to the other in a cool, distanced, non-involved way which fails
to fully acknowledge the individuality of the other as the other is objectified.
The I-Thou mode of relating, in contrast, involves meeting the other person in
a genuine human exchange. With reference to the I-Thou relationship, Barich
(1998) states, “You become a person (as opposed to an alienated and isolated
individual) when you enter into relation with people.” If people with dementia
are objectified through an I-It mode of relating, their link to the outside world
is threatened and perhaps damaged, especially when they themselves have lost
the capacity to install and actively encourage an I-Thou form of relating.
Buber’s concept was linked to religion in that it was intended to describe how
humans can enter into a relationship with God through their relationships
with others but this should not lessen its relevance to the debate about
personhood.
The concept of personhood has also been linked to the different selves that a
person may have. Sabat (2001) described three different selves: 1. the self of
personal identity (expressed through sentences using “I” such as “I feel, I
think etc,); 2. the self comprised of the attributes a person possesses and 3. the
self consisting of the social self or personae presented to others (e.g. through
social roles). People who have dementia gradually lose the ability to maintain
their social roles without necessarily having the opportunity or capacity to
take on alternative, valued social roles, particularly as doing so depends on
mutual recognition and cooperation, and more fundamentally, recognition of
their personhood. (note: insert something here about studies indicating that
people losing social roles does not necessarily imply loss of all notion of self)
Kitwood argued that there were two aspects to the person (i.e. the adapted self
and the experiential self). The adapted self and the experiential self represent
two different ways of being. The former is described as “highly and tightly
socialised, particularly in relation to the performing of given roles” (Kitwood,
1997, p. 15). The latter arises out of simply being with people within a context
of equality and mutual respect and attention. The experiential self may persist
throughout life until death provided that the right conditions are provided.
According to Kitwood, the I-Thou form of relating described by Buber,
provides the ideal framework for preserving and enhancing this aspect of
personhood.