Yes. A person who loses reason, memory or language is still fully made in the image of God. The worry that they might not be depends on an assumption most people never notice they hold: that being human, in the sense that matters, means having certain abilities. Dr. Daniel Hill, who works in theological anthropology, argues that this assumption is wrong. On his account the image of God is a commission and a promise. God gives the commission and God keeps the promise, so neither one drains away as a person’s powers decline.
That answer only means something if the hidden assumption gets examined first. So start there.
What assumption makes the question feel so threatening?
Put the worry in its plainest form and it runs like this. Humans bear God’s image because of something about us that other creatures lack. That something is usually named as reason, or the ability to speak, choose and create. A person with advanced dementia has lost much of it. So that person bears the image less, or not at all.
Each step sounds reasonable on its own. The conclusion is one almost nobody can say out loud about someone they love. When a valid-looking argument lands somewhere we find monstrous, the honest move is to look for the bad premise rather than look away.
The weak link is the first step. It treats the image of God as a capacity, something a person has and can therefore lose. Hill names this as one of the three standard Christian answers. The substantial view, as he describes it, holds that there is some property you possess that sets you apart from every other creature, “whether it’s reason or righteousness or something like that.” The relational view says humans image God by existing in relationships, the way the Trinity is a communion of persons. The functional view says the image is a vocation: God sends humans out to serve as his priest-kings in creation.
The question about dementia pushes hardest on the first view, but it presses the other two as well. Someone with advanced dementia may no longer recognize the people around them. Someone with severe cognitive impairment may never carry out a vocation in any visible way. Once you ground the image in what a person can do, every one of the three accounts starts to leak.
Why does the capacity premise fail even on its own terms?
Hill offers a counterexample that sticks. He asks his students whether they would eat an orangutan if one were served to them, and why not. Then he points out that “an orangutan might be able to reason a little bit better than an infant.” Infants, he notes, do not have object permanence. They cannot yet grasp that a hidden toy still exists.
Follow that through. If the image of God rests on reasoning ability, an adult orangutan has a stronger claim to it than a newborn child. Nobody believes that, and the reason we don’t believe it tells us something. Our conviction that the infant is a full human being comes from somewhere other than a test of the infant’s mind.
The capacity premise has a second problem. Abilities come in degrees. One person reasons better than another, remembers more, speaks more fluently. If the image rests on these abilities, the image comes in degrees too, and human worth becomes a ranking.
There is also a plain fact the premise ignores. Hill says that everyone has a range of powers, from reasoning to walking around, and that “what we tend to forget is that they’re all going to wane.” Old age reduces reason and restricts movement. For some people, he adds, limited powers describe their whole existence, as with muscular dystrophy or severe cognitive impairment. He states the resulting question directly: “Are they still in the image of God if they’ve lost the power of reason?” A definition of humanity that most people will eventually fail is a strange definition to build on. And whoever controls the definition controls who still counts.
What does Hill put in place of capacity?
Hill proposes a hybrid he calls the mediatorial or instrumental account. It keeps the functional view’s idea of vocation and changes what the vocation rests on. In his words, “God has given a particular vocation, but it’s a promise of what he will do in and through us, as opposed to a task we carry out” on the basis of our abilities. He states the content of that promise this way: “God has promised to make his word, his presence and his rule known in and through human creatures.”
The logical shift is small to state and large in effect. On a task view, the subject of the key sentence is the human being: I carry out the work, so the work depends on my abilities. On Hill’s view, the subject is God: God makes himself known through me, so it depends on God’s faithfulness. A promise belongs to the one who makes it. Weakness in the person it is made to does not cancel it.
This is why Hill can answer the dementia question without hesitation. “When your powers are waning, you are still someone who has been commissioned by God, and God has made a promise to do something in and through your continued existence.” He then puts it as plainly as it can be put: “So just in virtue of you being present, God is at work in and through your life.”
Notice what carries the weight in that last sentence. The person’s presence matters, and nothing is required beyond it. The claim is about where God’s work happens. It makes no promise that the person will feel it, understand it, or display it.
Hill also places his view inside a larger claim he does not develop in this conversation. He says he could argue from Scripture for how humans are made in the image of God, “whereas Jesus Christ just is the image of God,” and he calls that a larger conversation. The New Testament does speak of Christ this way. Paul writes of the Son, “Who is the image of the invisible God, the firstborn of every creature” (Colossians 1:15). If Christ is the image in the full sense, then human beings bear the image by being related to him, and that relation is something God secures.
Does the text of Genesis support this reading?
The creation account is short on definitions. Genesis 1:27 says: “So God created man in his own image, in the image of God created he him; male and female created he them.” The verse before it joins the image to a charge to “have dominion” over the creatures (Genesis 1:26).
Two things are plain in the text. The image is something God does: “God created.” Dominion is given along with the image, not earned by some prior quality. What the text does not do is specify which human feature counts as the image. Christians have filled that gap differently, which is why the substantial, relational and functional views all exist. Hill’s account is one serious attempt to read the passage, and other faithful readers land elsewhere. What the passage does rule out is the idea that humans grant the image to themselves.
Hill’s strongest scriptural point comes from somewhere else. When he talks about disability, he turns to Exodus 4, where Moses protests that he is slow of speech. God answers: “Who hath made man’s mouth? or who maketh the dumb, or deaf, or the seeing, or the blind? have not I the LORD?” (Exodus 4:11). In the KJV, the word dumb means unable to speak. Hill summarizes the force of the reply: God is effectively telling Moses not to tell him what he can and cannot do in and through him.
Look at what follows in the narrative. God does not repair Moses’s speech before sending him. He promises to be with his mouth (Exodus 4:12). This is narrative, so it describes one call rather than issuing a rule for everyone. Still, it shows the pattern Hill’s account predicts. Faced with a man’s limitation, God answers with a promise of his own presence.
What is the strongest objection?
The best objection is not that Hill’s view is unkind. It is that his view may have only moved the problem.
Here is the objection at full strength. A commission is a call to do something. If a person with advanced dementia can do nothing in response, in what sense are they commissioned? Saying that God works through their presence may sound like a comforting phrase with no content. If nothing about the person changes when God’s promise is or isn’t at work, how could anyone tell the difference?
Hill’s account has a reply, though it requires taking his wording seriously. He separates the vocation from the person’s performance of it. The promise is that God will make his word, presence and rule known in and through human creatures. A promise like that can be kept in ways the person does not originate. The clearest evidence Hill gives is how other people are changed. He argues that people with disabilities do more than receive the church’s service. Of those who are blind or deaf he says, “I need them to show me things about God.” If that is true, the promise is visibly at work. It may just show up in the people around the person rather than in a task the person completes.
There is a second reply worth reconstructing, though Hill does not make it in this conversation. A defender of the substantial view could say that reason belongs to human nature even when a particular person cannot exercise it, the way sight belongs to human nature even in someone born blind. On that reply, the person with dementia keeps the image because they keep the nature. Hill’s counterexample shows that a capacity view tied to what someone can do right now fails. It does not, on its own, defeat a version that locates the capacity in the nature rather than the individual. Faithful Christians hold each of these positions, and this argument does not settle which is right. Notice, though, that neither reply makes a person’s standing depend on what they can still do on a given day.
Why does this matter beyond the hospital room?
If worth is a capacity, worth can be ranked, and Hill’s research on the abolition era shows what people do with rankings. He has been reading the abolitionists Theodore Wright, Maria Stewart and David Ruggles, who had to argue for their freedom on the ground that they bore God’s image. Hill observes a recurring pattern: people denigrate someone else’s humanity as a kind of license to do whatever they want to them.
He gives an example of the capacity premise doing exactly this work. Hill describes Immanuel Kant as claiming that people with darker skin could not learn civility, were governed by their passions, and could be disciplined but could not attain culture or create. That is a capacity argument for a hierarchy of humanity. Hill traces how this reasoning licensed horrendous treatment, and he adds, “we are creative in our wickedness.” Lisa Fields named the mechanism underneath it: people can treat someone badly without guilt only after they have first stripped that person of their humanity in their own minds. The ranking is not idle theory. It is what quiets the conscience.
This is where the historical injustice meets the question about dementia. A dying grandparent and an enslaved person are not in the same situation. But the reasoning that would demote either one has the same structure. First you name the ability that makes someone count. Then you notice who lacks it, or seems to. Refusing the first step protects everyone the second step would harm.
Hill draws a practical consequence. He says “we tend to think more about rights than about duties,” and he would rather begin with duties. As a person, he says, “I have responsibilities to seek the good of those around me, and to view my flourishing as tied to theirs.” That moves the question. The people around someone with dementia should stop asking how much of the person is left. They should start asking what they owe a fellow image bearer, and what that person’s continued presence may be teaching them.
What stays unsettled, and what does not?
Some things remain open. Christians still disagree about how best to define the image, and Hill’s mediatorial account is one proposal among them. He points to a Christ-centered argument he does not lay out here. And how, exactly, God makes his word, presence and rule known through someone who can no longer speak is not spelled out. Hill’s account says it happens. It does not offer a mechanism, and an honest reader should notice the gap.
What does not remain open is the conclusion the hidden premise threatened. Hill describes the error plainly. We assume that capacities indicate usefulness, and so “people without those capacities are less useful and therefore less valuable.” He calls that a failure in our thinking. It is “not a problem on God’s end.”
The person who no longer knows your name has lost a great deal, and the loss deserves to be grieved. What they have not lost is the thing that was never theirs to hold up in the first place. God gave it, and God is the one keeping it.
Quick answers
If worth isn’t a capacity, do my abilities matter at all?
They do. Hill says the first thing you are is a creature loved and upheld by God, and that this does not diminish the particular things about you, from your height to your hair texture. He treats those particulars as signs of God’s loving care, not as the basis of your worth.
Can someone who cannot speak have a relationship with God?
Hill names this as a question believers often ask and argues it reflects a mistake in our thinking, not a limit in God. His appeal to Exodus 4 is that God made the mouth and does not depend on its abilities to work through a person.
Could a robot or AI bear the image of God?
Hill says he has not done work on this. He observes that computers can carry out functions they are programmed for, such as beating the best human chess player, but cannot create something new on their own the way a person potentially could. He treats the wider question as one people will have to work through.
Where can I read more?
Hill recommends John Swinton’s Becoming Friends of Time on disability, Mark Cortez’s work on christological anthropology, Rowan Williams’s short book Being Human, and Frances Young’s writing on being human and disability.
