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.
> (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.
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 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.
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.
Lots of people don't.
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.
And children can agree to things just fine through their guardians.
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?
Informed consent is mostly not that informed. Clinicians don't understand risk, cannot communicate risk to patients, and patients can't understamd that communication.
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.