Saturday, September 5, 2009

The Curious Case of the Coma Patient

Descartes’ statement, "Cogito ergo sum" commonly translated as “I think therefore I am,” was originally instigated by doubting everything ever known to him. He doubted the existence of broad topics such as the universe as well as narrower topics such as his own existence. The mere fact that he doubts such aspects of human life supports the idea that he thinks and in turn exists. Similarly, his life is validated due to his doubts about his existence. The fact that he is able to rationalize these thoughts about his existence indicates that his presence in reality is true.

After we discussed this subject in class, I wondered how Descartes would interpret the case of a coma patient. A coma patient with severe brain damage is unable to respond to pain, light, or any external factors. If a coma patient is having irregular heartbeats or difficulty breathing, then he is put on a respirator so that blood and oxygen can reach the brain. The respirator is used to keep the involuntary functions of the brain working. As a result, the brain keeps operating to help the body stay “alive.” Without the respirator, the patient would not be living for much longer since his brain would not be functioning. A coma patient is unconscious to all of reality and cannot be awoken from this vegetated state. Unconsciousness hinders the ability to recognize the external and as a result the ability to doubt the external is affected; therefore unconsciousness affects the patient’s ability to think at a conscious level. For Descartes, a coma patient might be considered nonexistent on the basis that he is not able to consciously think on a level of consciousness; therefore, because he is not thinking, he cannot exist. However, according to the practice of medicine, a patient in a coma is alive as long as his brain is still helping his heart and lungs function. The respirator keeps the brain working hence medically the patient is still living. Both of these views contradict each other in the debate regarding whether or not the coma patient exists.

So I wonder, is this coma patient alive because his brain is in fact working though it is assisted by a respirator or , would he be considered nonexistent because he is unable to think therefore does not fulfill Descartes‘ definition of existence?

Lastly, is there any possible way to prove that the patient is thinking at a subconscious level and is in fact capable of thoughts and possibly doubting a new reality even while unconscious?


  1. I think Manali poses excellent, granted loaded, questions that really bring the fundamental questions of philosophy to everyday experience. In response to the last two questions, my first response was to say that of course the coma patient does not exist in the way Descartes means because s/he has lost that which makes them human, the special ability to think (or to doubt), which proves existence at the fundamental level for Descartes. However, I wonder if we take away the individuality of the person when we attempt to characterize another person's existence in this way. Sure, to my eyes Terry Schiavo (an infamous brain dead case) was surely non-exsitent if we define existence in terms of the her ability to reason. However, that characterization relies on something that I percieve, or that some peice of medical equiptment has "percieved." Are we not, then, subjectifying an objective reality? In other words, how can I, or anyone for that matter, decide another person's existence, when that existence is completely individual, and does not depend at all on my perception of that person as existing?

    Manali's last question hints at the possibilty that perhaps the workings of something as complicated as a person's ability to reason might be unpercievable by current technology, but I think we have to ask ourselves whether this special part of existence can be percieved by any physical machine or being. Musn't we be conciouss of the fact that reason and its ties to existence is so powerful that perhaps we cannot hope to understand it? Who, then, are we to pronounce wether or not someone exists?

  2. I think it's important to point out that Descartes does not stop after he proves "I think, therefore I am." At this stage in the meditation, he believes that when he stops thinking he could cease to exist. So, if Descartes fell into a coma at this point in the meditations I think he would agree that he might cease to exist if the only evidence he had for his existence was "I think, therefore I am."

    Like Eric said, it gets more complicated when determining another person's situation because it seems that one does not solely believe "I think therefore I am." It seems that one also has to believe one's senses: that there is a person lying down with their eyes closed, hooked up to a machine that reports that they have no brain function. Therefore, I think one answer to this puzzle could be that we do not solely believe that "I think, therefore I am."

    Another thing that I think is important to mention is that the person in the coma may have the potential to once more become a thinking thing, in the same way an infant has the potential to become a rational being. Therefore, Descartes might argue that the body should be treated and valued as a thinking thing because it might start thinking again someday.

  3. I really like that you brought this up Manali! The issue of techonology, kind of like what you were stating above, was going through my head during our discussion in class. Descartes was writing at a time when technology such as respirators did not exist which leads me to wonder if now Descartes ideas on existence should be "thought" over by someone else. We have things today that can separate us from the reality that we are now living and place us into another reality. In the end, everything can in fact be questioned with the tech we have today! Take for instance the person in the coma! What if, in fact, we are in a coma and believe to be living these lives and just happen to be imagining ourselves looking at someone else in a coma when we are in fact the ones in a coma. It's like those weird instances where there is a picture inside of a picture inside of a picture. Descartes narrowed down everything to his cogito ergo sum because the advancements that allow us now to know the workings of the brain etc had not themselves "existed." And kind of like a long shot....but the average human of course has five senses: sight, touch, taste, smell, hear. At no point in time can we pick up on what each of our senses is detecting...the person in the coma can not pick up on any of their senses. But sense we cannot fully use our to their climax are we, in a sense, only partially existent...(just a thought).

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  5. I really like the questions you raised and also the points about the dangers of subjectifying an objective reality. Thinking about stuff like this is kind of fun though, since it seems tricky to imagine getting beyond our subjective selves to determine whether or not anything objectively exists outside of us. There are some people, solipsists, who believe no one and nothing is real outside their own mind, that when they are gone there is absolutely nothing left. Going with the subjectifying an objective reality, I was wondering why/how Descartes proved that anyone else existed besides himself. I don't remember how he went up from the bottom, but it seems like doubting the existence of other people at all would be a hard doubt to disprove especially especially if the only thing Descartes thinks he knows for sure is he, and only he,thinks.

    I also think it is interesting that Descartes felt comfortable stopping at cogito ergo sum- it seems like he could find reason to wonder about who or what it was that was thinking in the first place, whether that thing could be called a soul, or his soul, and where the idea there was an "I" that was thinking came from in the first place.

  6. I agree that this scenario is interesting think about. In response to Brendan's comment Descartes proves the existence of objects other than the self and God by stating he can detect things with his senses and God created him such that he would detect things with his senses, therefore the objects he is detecting (including other people) must exist unless God is a deceiver, and God is not a deceiver. I however cannot remember how he proves God is not a deceiver.


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