In response to my last blog post, "Let's Stop Calling People Vegetables", Dr. Dianne Irving responded to explain the origins and motive for calling comatose people vegetables or being in a vegetative state. Below is her illuminating response.
The term "vegetative state" became popular at the "birth" of bioethics (1978
Belmont Report). It is traced to the "delayed personhood" arguments
used at the beginning of life issues: first the vegetative soul is present,
then later the sensitive soul is added, and finally (about 3-4 months) the
rational soul is added. Then and only then is there a human being with a
rational soul to be respected. St. Thomas (following Aristotle), as well as
many religions today still follow that odd and scientifically/philosophically
What bioethics did was also reverse this dictum to end of life
issues -- and this was taught in a major seminar at a Georgetown bioethics conference early on
(about 1990). Those of us in the seminar on "euthanasia" were taught that
-- just as there is a series of souls at the beginning of life -- at the end of
life the reverse happens (supposedly adapted from St. Thomas): in the dying
patient, first the rational soul leaves the body, then the sensitive soul leaves
the body, and finally the only thing left there in the patient is the vegetative
soul -- and thus there is no "person" really present! Of course, that would
also mean that with euthanasia, physician assisted suicide (PAS), and organ transplantation, the use of such
"vegetables" in human research, etc., would be "ethical". This concept of the
"vegetative state" was immediately picked up by one of the first new bioethics
international centers in France -- INSERM. They were the ones who really
popularized the phrase.
Of course, St. Thomas (and Aristotle) were systematically required as
classical realist philosophers to start their philosophizing with empirical
facts, and those that they "started" with in their "delayed hominization"
arguments were empirically false; they both still believed that there
were only 4 material elements in the natural world: air, earth, fire and
water! Needless to say, whatever philosophical personhood concepts they arrived
at from that false empirical starting place would be erroneous. But if you look
at both St. Thomas' and Aristotle's systematic dogmas on the "soul",
both taught that there was only ONE SOUL with THREE POWERS -- the
rational soul -- that INCLUDES VIRTUALLY BOTH THE SENSITIVE AND THE VEGETATIVE
Therefore, there cannot be three human souls, and there can be
no "splits" among the three powers of that one single human soul; nor can there
be any "split" between the whole rational soul and the human material body. The
human soul and human body come into existence simultaneously. So for both of
them, their systematic philosophical principles would contradict their own
attempts to argue for "delayed personhood". Therefore, they would never
have agreed that at the end of life there is only a "vegetative" soul present
(and thus no "person").
As an Aristotelean Thomist myself, I wrote an article
on this last year, with extensive direct quotations from both Aristotle and St.
Thomas, using the wonderful encyclical of Pope Leo XVIII as a backdrop: “’Revival’
of St. Thomas’ Philosophy – Yes, But Not His Erroneous ‘Delayed Personhood’
Argument; Concerns for Beginning and End
of Life Issues”
(April 4, 2011), at: http://www.lifeissues.net/writers/irv/irv_185revival.st.thomas1.html.
So, the current efforts to call these poor vulnerable patients "vegetables"
cannot be sustained academically or philosophically any more than can "delayed
personhood" at the beginning of life. The only reason these terms continue to
be used is purely political.
Dianne Irving, Ph.D.
Words matter. I have felt uneasy about referring to people as "vegetables" for a long time. People do not become vegetables. Ever. Tomatoes and carrots do not become human beings.
It is dangerous that this terminology has crept into the health care system. The word should be excised immediately from all medical writings and discussions.
Potatoes do not have dignity. Human beings do. With an aging population, it will seem easier to do away with the inconvenient, expensive, non-contributing ones if they are only "vegetables" anyway.
Well said. I completely agree. People NEVER become vegetables. "Vegetative state" is also a dangerous phrase --there is no such thing. Words do have power.
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