BY: FRANCIS CARDINAL GEORGE, OMI, PhD
Card. George is Archbishop of Chicago.
A Christian Bioethical Vision
Adapted from an address to the 7th Annual International Bioethics Conference on "Bioethics in the New Millennium," co-sponsored by The Center for Bioethics and Human Dignity, Christian Legal Society, Christian Medical and Dental Society, Nurses Christian Fellowship, Americans United for Life, and Trinity International University, July 21, 2000.
Adapted with permission from the Center for Bioethics and Human Dignity, Bannockburn, IL.
The announcement that the federally funded Human Genome Project had succeeded — ahead of schedule — in mapping the nucleotide sequences of all 23 pairs of chromosomes belonging to five human persons convinces me that we have arrived at the threshold of the Enlightenment project's final frontier. At the core of this modern project, a project not totally unrelated in its genesis to Christian values, is the notion of the intrinsic value of each human person and the subsequent desire to liberate all persons, to free them from the unfulfilling strictures of other persons and even from those limitations that physical nature imposes through the human body. According to the secular version of modernity, the means to this freedom and fulfillment for all are the free economy, the liberal democratic state, and above all, the scientific method of sensory observation and inductive logic that reveals the material and efficient causes operative in both physical and human affairs.
In economics and geopolitics, this combination of science and liberalism has recently generated a new global phenomenon and a corresponding new paradigm for describing the way in which the human family can and should relate: "globalization." However, the ability to transcend the constraints that time and space impose on the body — which is one of the conditions for the possibility of global interconnectedness — is not the final frontier of the modern project to maximize individual freedom. The final frontier is the body itself. In Pope John Paul II's words, "The human genome, in a way, is the last continent to be explored."1
Advancements in techniques and theories over the last 500 years have thankfully produced a revolutionary increase in our knowledge of the way the body works and how to prevent and treat its maladies. Francis Bacon's recommendation at the beginning of the Enlightenment that we "put nature to the test" to "relieve man of his estate" has been heeded with stunning results. One result of this enterprise to understand and control nature has been the discovery of the genetic basis for personal characteristics: physical, mental, and emotional. We are still far from completely knowing which nucleotide sequences correspond to these traits. We are even further from completely knowing how to manipulate chromosomal sites to promote human fulfillment. But we already know the genetic basis of many characteristics and are beginning to develop intervention techniques that allow us to alter the genetic code of both somatic and germ line cells.
This knowledge has the potential to contribute greatly to authentic human development. In his 1983 discussion Dangers of Genetic Manipulation, John Paul II lauded the advent of therapeutic genetic intervention on somatic cells — as long as these procedures are governed by ethical considerations similar to those of tissue or organ transplantation.2 These techniques must first be developed using animals; then their risks — including public health risks — and benefits must be weighed. In these cases, what is ambiguously called genetic engineering is actually genetic therapy that alleviates unnecessary suffering and restores normal bodily functioning. In the pope's words: "A strictly therapeutic intervention whose explicit objective is the healing of various maladies such as those stemming from deficiencies in chromosomes will, in principle, be considered desirable, provided it is directed to the true promotion of the personal well-being of man and does not infringe on his integrity or worsen his life. Such an intervention, indeed, would fall within the logic of the Christian moral tradition."3
Potential for Offenses against Human Dignity
On the other hand, as we have seen with all scientific and technological advances, our increasing knowledge and ability to transcend physical constraints also hold the potential for offenses against human dignity and flourishing. Of obvious concern are abuses against unborn human persons — scrupulously called "embryos" or "fetuses" in an attempt to mask their humanity — committed for a variety of purposes, including genetic research and the harvesting of tissue-producing stem cells. The ability to create a clone for one's personal use will constitute the height of self-centered narcissism and the instrumentalization of another. Also of concern are artificial methods of conception, especially in vitro fertilization and artificial insemination using both spousal and nonspousal gametes that, irrespective of whether the intended end is therapeutic or nontherapeutic, run the risk of destroying human life and promoting a utilitarian attitude toward one's spouse and children. Additionally, while improved prenatal genetic testing and therapies have the potential to enhance life, such tests will increasingly be occasions for both voluntary and coerced abortions based on a misguided biological reductionism and determinism and on an ever narrowing conception of what is "desirable." This passing century has seen what happens when the individual right to life is conditioned by whether or not one is wanted — by a party, a state, or one's parents.
For those of us lucky enough to be brought to term, these same factors — the capacity to diagnose predisposition to physical and even behavioral traits, biological reductionism and determinism, and an eclipsed sense of the value and rights of human beings in any condition — will threaten us with "genetic profiling" and the subsequent denial of rights to health care and jobs. In such a hostile cultural climate, the specters of assisted suicide and euthanasia haunt even those showing the first signs of genetic diseases that are otherwise temporary, treatable, or manageable. Finally, in such a climate, it is not inconceivable that even those who are sick or disabled by pathogens or accident will be seen as genetically responsible for their conditions and thus be considered as unnecessary burdens to be marginalized and eliminated. All the present schemes for extending universal health care by rationing coverage of some diseases threaten to leave large numbers of disabled persons more vulnerable than ever.
Gradually, however, the need to abort and euthanize such "genetically challenged" "undesirables" may diminish somewhat because of our increasing ability to create human beings not only free from disease, but also in possession of high degrees of characteristics that are indisputably good — beauty, intelligence, affability, longevity. Initially, the means to these ends will be gamete profiling and selection followed by artificial conception. Eventually, however, even these artificial means of conception may be bypassed through germ cell interventions aimed at "tailor-making" one's sperm and eggs.
Finally, the issue of nontherapeutic genetic manipulation now looms before us. What we are talking about here, of course, is positive eugenics accomplished not through coercion, but through free choices made possible through a free market — although one can also imagine the possibility of coerced therapeutic manipulations aimed at limiting the social costs of disease. Aside from unintended consequences — such as impairment or death or the intentional production of a useful "lower class" of human beings — what would be wrong with freely choosing to maximize a host of traits that are indisputably good? Why not develop now what Christians waiting for the resurrection in faith would recognize as a semblance of the risen body? The risen Christ is not constrained by the laws of physical nature; his body is incorruptible. He is completely free.
A Christian Bioethical Vision
Like us, Christ was truly a human being because he was born of a human mother, Mary. From Mary's womb he emerged fully human, like us in all things but sin, and with a clearly physical body. From the Garden tomb he also emerged a man, but no longer entirely like us in his body. For, having passed through a fully human life and the ultimate barrier, death itself, he emerged transformed, possessing what Paul calls a "spiritual body" — a body truly his, but transformed in ways that Scripture does not detail.
In the first letter to the Corinthians, chapter 15, Paul says that God provides all living things — plants, animals, humans, and even the heavenly bodies — with the kind of body appropriate to them. Even death does not prevent this: even the apparently dead seed in the ground rises in a new, leafy, and fruitful body. Paul applies this insight to the human body resurrected from the dead: "What is sown in the earth is subject to decay; what rises is incorruptible. What is sown is ignoble; what rises is glorious. What is sown is weak; what rises is strong. A natural body is put down and a spiritual body rises."
There is a technical distinction made clear by Paul's vocabulary describing natural and resurrected bodies. He describes the body both as sarx, which is the element of limitation and corruption in our bodies, the result of sin; and as soma, a more neutral term that indicates a body capable of being transformed into spirit while remaining a truly material body. The body's principle of life in our time and space is psyche, or soul. Its principle of life in its risen state is spirit. The risen Christ has become a life-giving spirit, Paul says, in whose likeness believers will be raised. Limitation and corruption cannot inherit the Kingdom of God and, at the Last Judgment, sarx is destroyed and soma becomes incorruptible and immortal. The nature of spiritual bodies, other than the certitude that they are human bodies transformed, is not revealed. In the light of both Scripture and the experience of visionaries whose holiness seems authentic, light is the metaphor that comes closest to grasping this transformation. Modern studies of light as energy give those who want to use science to pursue this question of faith an important opening, it seems to me, for responsible speculation.
If, according to Christian faith, Jesus is the first born of the dead, then the history of his body tells us the meaning and the nature and the destiny of ours. The body is integral to salvation history because Jesus our Savior has risen from the dead. An origin in time does not therefore demand that salvation means an escape into eternity. The bridge between psyche and spirit is that transformation that evangelists and doctrinal theologians call resurrection from the dead. Just as natural life is a gift, so is risen life pure gift. But between the one and the other comes the crucifixion of the body — Jesus' act of total self-sacrifice made possible, in part, by his material human body. In the light of faith, the gift of life must be surrendered, willingly sacrificed, so the gift of eternal life can be received.
It is in the face of the paradox involving the incontestable superiority of the resurrected and unconstrained body that the value of a distinctively Christian bioethical vision becomes apparent. In sketching the outlines of such a vision, however, a few words about the basic relationship between the faith and reason are in order, both being necessary for the development of ethical principles.
What is the relationship between Christian revelation and both philosophy and science? Pope John Paul II, himself a philosopher, has recently offered the church a long reflection on the relationship between faith and philosophy in Fides et Ratio. Throughout this document, the pope insists on the need for purely philosophical methods and conclusions — even contemporary ones, such as a phenomenological method — capable of both interpreting the data of revelation and making it more intelligible and thus more credible. Faith is pure gift. But according to Paul, faith has a double dimension. Faith means trust, and faith means truth. To see the truths of faith, to see the world with the eyes of faith is a gift from the God we believe in. But this same God also gives us the gift of reason. Reason can explore the vision of faith on its own terms in theology and, in philosophy and apologetics, reason can prepare a thinker to receive the gift of faith without ever explaining the mystery of faith itself. Theology and faith need philosophy and human reason and science. The pope is clearly opposed to a fideism understood as an irrational faith.
On the other hand, he insists that reason, philosophy, and science also need theology. He is equally opposed to a rationalism that limits reality to what human reason can know. Through the people of Israel, through Christ and his church, God has revealed truths that both purify reason and compensate for its limitations.4 Grace, in other words, "does not destroy nature but perfects it."5
The relationship between faith and modern science, a relationship with a rocky past, continues to be misunderstood. John Paul II's first major attempt as pope to deepen the dialogue between the church and science was his 1979 address commemorating the centenary of Albert Einstein's birth. He acknowledged "the greatness of Galileo," lamented his treatment "at the hands of churchmen and church institutions," and called for a more "fruitful concord between faith and science."6
Science, on the other hand, cannot operate completely independent from the kinds of normative considerations that come from faith rather than from science itself. Underlying the scientific method are concepts that transcend the empirical, such as the existence of a law-governed material world intelligible to human reason. In this context, the modern scientific project is properly seen as grounded in a number of beliefs. Also, and perhaps more importantly, science, as a purely descriptive enterprise, cannot provide an account of the human good and therefore cannot provide answers about which effects we should cause and which means to them are licit. Such normative considerations are the domain of both philosophy — specifically, a metaphysics of the person and ethics — and theology, which, as I indicated earlier, should guide philosophical reasoning.
Unfortunately, however, our culture, in granting epistemological hegemony to the scientific method, has not only contradicted science's theologically supported foundations, but has also rendered meaningless any universally valid normative claims about such issues as the value of persons and what constitutes authentic human fulfillment. The story goes something like this: Because known states of affairs — "facts" versus "values" — are those that we sense or measure, and because we sense in human affairs a plurality of conceptions of human value and flourishing, there are, logically, no universally valid normative concepts. According to such a secular humanism, the person is reducible to the material body, the condition of which is largely determined by his or her genes. Absent a philosophically or theologically derived anthropology that would guide human action, the goals of relationships, economics, politics, and science tend to become the maximization of the body's pleasure or the achievement of individual purpose. In practice, of course, this means maximizing one's own pleasure or purpose even at the expense of others, because "the other" has no indisputable intrinsic dignity, and because a life of self-giving is only one lifestyle among other options. Hobbes' assertion that there is no "highest good" does indeed translate into "a war of all against all." In this war, the weak — the unborn, the poor, the disabled, the genetically "inferior" — are the inevitable losers.
Ultimately, if guided only by empiricism and relativism, the modern project risks undermining its own stated goals. Even if we accept the Kantian notion of a "moral imperative" that imparts a value to the other (specifically, to "rational beings," who become "persons" as opposed to "things"), without an agreed upon conception of human flourishing, we are left without a criterion for determining what constitutes respect for others. Without a shared notion of human flourishing, which rights — the conditions necessary to flourishing that are to be protected against denial by others — are due?
A Christian Anthropological Vision
A Christian bioethical vision should thus be grounded in a Christian anthropological one, in the truths about the human person that revelation — especially the risen Christ — discloses and reinforces. First among these is the dignity or value of each human person at every stage and condition. Even without the aid of revelation, the uniqueness of each human being, the implications of natural law precepts, and the intentional affective response to persons commonly called "love" would all recommend this truth to us. But additionally, the revelation of our likeness to and relationship with God, especially as revealed through the Incarnation and Christ's self-sacrifice, incontestably attest to this truth. The God in whose image each of us is created knows and consecrates us in the womb. He sent his only begotten son, his eternal word, to "become flesh" and die for us on the cross. In this light, acts that manipulate, marginalize, or kill human persons in any phase or condition are grave offenses that should be proscribed by civil law in a civilized society.
Finally, the Christian anthropological vision sees not only the intrinsic value of persons but also their true fulfillment. Our being created in God's image reveals that we are most fulfilled by freely giving ourselves to others. Although our capacity to reason and choose is evidence of our being made in the image of God, this capacity ultimately exists in service of our social or transcendent nature — our common vocation to freely share our gifts for the good of others. The relationship between freedom and fulfillment is particularly important for understanding Christian anthropology. Free human acts not only reveal the nature of the self to oneself but also constitute the person who thus co-creates himself or herself in a limited but real sense and is therefore "autoteleological." Assisted by grace as a principle of action, we therefore become ourselves by freely giving ourselves to what is most valuable and capable of loving in return — other human persons and, ultimately, God. Conversely, we thwart our destiny when we refuse to enter into self-giving and self-sacrificing relationships oriented toward the good and the life of others. In contravening the dignity of others, we contravene our own human fulfillment. Human perfection, if it is not a gift from God, is self-destructive as an ideal.
According to this Christian anthropological vision, the human person who is created for communion with others is a unity of soul and body. In his catechetical reflections on human sexuality, the pope reminds us that Thomas Aquinas' reflection on the doctrine of the resurrection of the body led to his definitive move away from a Platonic characterization of the real person as the immaterial soul, with the body as but a problematic prison. As better described by Aristotle, the soul is the animating or unifying principle, or "form" of the body. The person is a unity comprised of a soul that expresses itself through and is conditioned by the body.
In a Christian vision of the person, the human body — including its sense faculties from which all knowledge of moral truths begins as well as its limitations — is essential to the development and salvation of the whole person. God-given and natural bodily functioning, including sexuality, are normatively significant because they promote the perfection of the whole person. In his "personalistic" reading of the natural law tradition, John Paul II has insisted that ethical principles derived by natural law from reflection on bodily finalities are not guilty of "physicalism," "naturalism," or "biologism." Natural bodily functioning "constitute[s] a reference point for moral decisions" and "rational indications with regard to the order of morality." Indeed, "natural inclinations take on moral relevance only insofar as they refer to the human person and his authentic fulfillment....The person, by the light of reason and the support of virtue, discovers in the body the anticipatory signs, the expression and promise of the gift of self, in conformity with the wise plan of the Creator."7
In other words, both Christian revelation and reason tell us that the normally functioning body that God provides is "good" because it promotes the perfection and the salvation of the whole person. The body, with its need for development and its limitations that temper our strength, intelligence, personality, and longevity, is integral to the development of virtues such as humility, which allow us to give ourselves to others. Following Paul's cue, we also "rejoice in our weakness," our "treasure in earthen vessels," because it puts us in need of God, thus drawing us closer to the ultimate source of our fulfillment.8
Additionally, the complementarity of these limitations constitute the "many gifts" that put us in need of, and draw us closer to, one another. What the pope says in Salvifici Doloris about the salvific meaning of suffering also pertains to our limitations: Both are "present in the world in order to release love, in order to give birth to works of love toward neighbor, in order to transform the whole of human civilization into a 'civilization of love.'"9
The qualities that nontherapeutic genetic enhancements would seek to obtain can be good, and the motives for pursuing them may also be good. But eventually one can imagine so-called superhumans who, less burdened by limitations, struggles, and the need for God and others, become self-centered and isolated and thus less than fully human. The best life is therefore not one freed from all physical constraints. One could imagine this self-centeredness being directed against those who, lacking access to gene-enhancing technology, might find themselves part of a grossly disadvantaged and permanently objectified underclass of persons. Even those not directly benefiting from such enhancements, but effecting them, would find themselves in danger of seeing persons as products to be created according to their desires and needs and of closing themselves off to the openness toward all that is the core of an authentic humanism.
A Christian vision of the future of bioethics must also emphasize the need for the evangelization of culture, including the culture of universities and the scientific communities. Because our nation does not include a common history, faith, race, or even language, law is often the most powerful carrier of culture in the United States. Major elements of our lives together are now regularly submitted for decision to the courts, and our culture's treatment of bioethical issues will inevitably be shaped by legal constraints and the decisions of judges and lawyers regarding embryo experimentation and storage, cloning, artificial conception procedures, prenatal diagnoses, abortion, genetic profiling, assisted suicide and euthanasia, and nontherapeutic genetic engineering. It is more important than ever to work together to achieve a Christian vision of bioethics and to consider carefully how to best translate that vision and principles derived from it into our system of law.
NOTES
- John Paul II, Address to the Pontifical Academy for Life, 1998.
- John Paul II, Address to Members of the World Medical Association: Dangers of Genetic Manipulation, 1983.
- Dangers of Genetic Manipulation.
- John Paul II, Fides et Ratio, 1998, para 75.
- Fides et Ratio, para 76.
- John Paul II, Address to Pontifical Academy of the Sciences Commemorating Albert Einstein, Apostolic Palace, 1979.
- John Paul II, Veritatis Splendor, 1993, para 46-50.
- 2 Cor 12:9 and 2 Cor 4:7.
- John Paul II, Salvifici Doloris, 1984, para 30.
Copyright © 2001 by the Catholic Health Association of the United States
For reprint permission, contact Betty Crosby or call (314) 253-3477.