Human Dignity and the Body in the Throwaway Culture

Over the last fifty years, it has become customary to frame moral questions surrounding medicine and the treatment of all forms of life under the rubric of "bioethics". The rapid development of modern technology opens new possibilities and, with them, a whole range of moral issues. At the same time,  many in today's increasingly secularized society question or reject traditional Christian teachings on the sanctity of human life. Indeed, Catholics find themselves defending the gospel of life in an often hostile environment. Frequently accused of attempting to impose their religious beliefs on the rest of society, they must also show that the Church's moral teaching on bioethical issues is a matter of right reason and not just Revelation.

In part one of this interview, Fr. Michael Baggot recommended five books on bioethics. In this second part, he covers some further recommendations.

Fr. Michael Baggot, PhD is currently Assistant Professor of Bioethics at the Pontifical Athenaeum Regina Apostolorum. He is also Research Scholar at the UNESCO Chair in Bioethics and Human Rights in Rome, Italy. He was Adjunct Professor of Theology at the Christendom College Rome program from 2018-2022. His writings have appeared in First Things, Studia Bioethica, The National Catholic Bioethics Quarterly, and Medicine, Health Care and Philosophy. He is editor of and contributor to the book Enhancement Fit for Humanity: Perspectives on Emerging Technologies (Routledge, 2022).

You can listen to the interview here.

1. Dignitas personae: Instruction on Certain Bioethical Questions
   by the Congregation for the Doctrine of the Faith
2. Resisting Throwaway Culture: How a Consistent Life Ethic Can Unite a Fractured People
   by Charles C. Camosy
3. What it Means to Be Human: The Case for the Body in Public Bioethics
   by O. Carter Snead

1.

You recommend three further books. The first book on your extended shortlist is the Congregation for the Doctrine of the Faith’s 2008 instruction Dignitas personae. It was eagerly anticipated because it was expected to come out in favour of the adoption of embryos. Contrary to expectations, the document did not do so but argued that embryo-adoption is morally problematic, without disqualifying it categorically. Why have you chosen this document over the same congregation’s 1987 instruction Donum vitae (The Gift of Life)? I have always felt that the earlier instruction was clearer and better argued.
I chose Dignitas personae because it is the most recent extended reflection on bioethical issues from what was then the Congregation for the Doctrine of the Faith (now, the Dicastery for the Doctrine of the Faith). It is the most extended reflection on these matters. At the same time, it is building upon Donum vitae, which is well worth reading. Written in 2008, Dignitas personae benefits from years of further reflection on new technological developments in procreation or other fields.

You mentioned the expectations and the controversy regarding embryo adoption. As you noted, the Congregation decided not to make a definitive judgement. It certainly did not give an unqualified endorsement to embryo adoption. So, with some exceptions, we do not see movements in the Church that are enthusiastically promoting this practice as part of the culture of life. At the same time, the Congregation did not offer a clear condemnation. It indicated that some of the moral concerns with in-vitro fertilisation and embryo transfer, which had already been addressed in Donum vitae, also arise in the moral evaluation of embryo adoption. In my opinion, it did not want to imply that these are morally equivalent. If they were, embryo adoption would be excluded in the same way as in-vitro fertilisation and embryo transplantation. There is still controversy over that theme. It is important to be aware of the parameters and principles that the Church has placed for reflection on these matters. Bioethicists are invited to contribute to this ongoing reflection. Perhaps, just as we had a sequel to Donum vitae, we will eventually have a sequel to Dignitas personae that offers a definitive judgement on this matter. There are good, faithful Catholic bioethicists who come down on different sides of this issue.

Dignitas personae is interesting for my own field of research: human enhancement biotechnology. To my knowledge, it is the first magisterial document that begins to explore these issues. It looks at genetic modification and other approaches that seek to radically alter human beings through biotechnology or pharmaceutical products. It introduces the standard distinction between therapy and enhancement: between that which contributes to healing, the repair, or the preservation of health versus enhancement, which goes beyond the goals of therapy. Some use the pithy statement: making us healthier than healthy or better than well.

Understandably, the document raises concerns about a new eugenics. Attempts to shape a superior human race would stigmatise those who do not have certain qualities and would favour those with others. It would exacerbate inequality in society: between those who have resources to pursue greater cognitive capacity, mood stability, delight, physical prowess,  beauty, or stamina. It raises pretty serious questions about society, justice, access. Dignitas personae just starts to address these concerns but there is a lot more work to be done.

I would move beyond the therapy-enhancement dichotomy. Some forms of enhancement could be morally acceptable. This may be the case with so-called therapeutic enhancements. These enhancements respect all the goals of a therapeutic procedure, but bring us to a state beyond the statistical norm of health, without inhibiting the person or distracting us from non-physical goods such as friendship, truth, social collaboration. These are big issues that the document introduces well but that need to be explored, especially now, a decade-and-a-half later. In bioethics, a decade-and-a-half is a long time.

2.

The title of your next pick, Charles C. Camosy’s Resisting Throwaway Culture, may take its cue from Pope Francis’ catchword for a disturbing contemporary trend. In line with Pope Francis’ concerns, the book articulates a consistent-life-ethic and suggests that care for human life should not be restricted to pro-life policy-making but also extend to caring for the vulnerable and needy that we meet in our everyday life. Have you picked this book because you agree with this these and believe we should take it on board?
In many ways, Camosy offers a very good explanation and application of what I was talking about earlier regarding Evangelium vitae. Evangelium vitae is clear and unequivocal regarding the evils of abortion, euthanasia, physician-assisted suicide, and other violations of human dignity. Camosy is likewise clear in this regard. Yet, he also wants to remind us of other themes: poverty, the treatment of pregnant women, the role of women in society. These are also mentioned in Evangelium vitae and are very much part of our tradition. He wants to make sure that we are truly creating this whole culture of life: one that welcomes people at all stages and takes the initiative to meet them in their needs, their vulnerability, their dependence on support. He does a good job of showing how these issues relate to each other. He helps us to purify the idea of a consistent life ethic, a term that has been very present in conversations about bioethics in the Catholic world.

Unfortunately, this term and approach has, in my opinion, done damage. Sometimes, it has relativized traditional themes of bioethics, like abortion. These issues start to lose their urgency and individuals no longer really take them so seriously. People say, “Well, we have so many other concerns: poverty, environmental issues, criminal justice reform. Efforts can become dispersed. The urgency of confronting clear violations of human dignity can be dampened.” That is not Camosy’s approach. Rather, he wants us to see that that there are concerns at all stages of life. He does not relativize traditional themes or treat all bioethical issues in exactly the same way.

A strength of his book is its capacity to treat these issues in a manner that is more comprehensible to a wider audience. Camosy is well known for his effort to enter into dialogue with Peter Singer, the major secular bioethicist, who is by no means on board with the Church’s teaching. Singer has famously said and written that he thinks the whole notion of universal human dignity is a Judeo-Christian doctrine that does not make much sense in a secular world and ought not to be embraced. He famously said that he supports not only abortion, but infanticide. He thinks that it is dishonest to support abortion without also accepting infanticide and that certain young animals might be more worthy of protection than infants with impaired autonomy or consciousness. Yet Camosy and Singer have engaged in many public debates and collaborated on different projects. Camosy presents strong, well-argued convictions to a wider audience, helps them to question their own positions and whether they are consistent with the goals of a just society.

"On some of these issues there can be a legitimate diversity of approaches."

Coming back to something you have mentioned a couple of times, both John Paul II in Evangelium vitae and Camosy stress how there are many different issues that belong to the culture of life or a consistent life ethic. It is not just about defending the unborn or opposing physician-assisted suicide. There are issues such as the death penalty and the treatment of immigrants. Here, I am not commenting on John Paul II’s analysis or Camosy’s presentation of these themes. However, we know that in contemporary debates, there can be a tendency to treat all these issues as if they were on an equal standing. There is a big difference between them. Abortion and physician-assisted suicide are moral absolutes. They are wrong under any circumstance. Debates on immigration, on the other hand, generally deal with affirmative rather than negative precepts of natural law. Affirmative precepts are always obligatory, but it is not always possible to fulfil that obligation in every circumstance or case that presents itself. There is much more room for discretion. So, whereas every unborn child has a natural right to life—the right to be immune from threats or actions which would violate or take away its life—not every immigrant has a natural right to enter the country of his or her choice. So there is a lot more room for discretion and debate on some of these issues, whereas there has to be a categorical opposition to abortion or euthanasia. Could you just expand upon these points?
Yes, that is very important. I am in in full agreement. John Paul II and Camosy as well. On some of these issues there can be a legitimate diversity of approaches, say, to promoting positively the good of respect for immigrants or assistance to those fleeing their country for financial motivations or due to political instability. Each country varies in its capacity and ability to embrace these immigrants, while also caring for the needs of its citizens. There can be a legitimate approach to immigration or any sorts of reforms that are necessary to come to the assistance of those who might be starting to flood a country.

We can appreciate the difficulties of pregnant women, but there is nothing that could morally justify the killing of her unborn child. We are quite categorical on that, but we should treat pregnant woman with respect, care, and recognise their unique vulnerability and needs. For some, that might translate into heavy state intervention that provide generous payments for maternity leave. Others who are concerned and committed to the good of these women may not support strong state intervention. They might think that other institutions—the extended family, civic organisation, local churches, synagogues—can supply for these needs. It is important in these issues, as you point out, to leave room for discretion and prudential judgments about the best means to achieve the goals of respecting human dignity.

There is a whole host of legitimate debates about the best economic system for any given country: one that alleviates the negative effects of poverty and ensures that citizens have access to work, a living wage, a dignified life for themselves and their family. It is important that, in these conversations, we do not demonise each other. We must not be quick to judge someone as insensitive to the plight of immigrants simply because he points out that his country might need a more stringent immigration policy and might not be in a position to welcome as many immigrants as it is or in the manner that it is. It is incorrect and unhelpful to demonise people in that regard. A proper distinction between these different issues is always necessary.

3.

Finally, you have proposed O. Carter Snead’s What it Means to Be Human: The Case for the Body in Public Bioethics. What does the author mean by a public bioethics and making a case for the body?
Snead works at the Notre Dame Law School. He is a lawyer and professor of law. Over the course of his career, he has become convinced of the analyses of expressive individualism in authors like Charles Taylor, that were developed by Carl Elliott. He believes that expressive individualism undergirds a lot of debates about bioethics in the public sphere and a pluralistic society. It is notion that each individual has an utterly unique identity that is discovered through a process of introspection—apart from any serious concern about unchosen commitments or responsibilities that could arise through family or work—and that this personally discovered identity ought to be respected.

More and more, the body becomes external raw material that can be manipulated and shaped according to the atomistic, radical autonomy of the individual.

This philosophy might not be well articulated in the minds of many. However, it seems to be accepted and it plays out in in different ways. It leads to this idea of radical personal autonomy. Think about gender identity. There is a strong sense that we, as a society, ought to do all we possibly can to respect this utterly unique, individual, introspective journey that has brought a person to decide that they are a man, a woman, or something else, regardless of that person's biological constitution.

That sense of inner self, of personal identity, is paramount and ought to be respected to the point that, as a society, we will use different pronouns, invest money in suppressing a fundamental process like puberty, or allow an individual to undergo what everyone in the not so distant past considered a bodily mutilation. All this so that the individual can express an utterly unique personal identity. This is one example in bioethics where there is this divide, this radical dualism, between the inner self and the body. More and more, the body becomes external raw material that can be manipulated and shaped according to the atomistic, radical autonomy of the individual.

Snead does not stop at this negative analysis or critique. He says that we also need to foster an appreciation for what it means to be a bodily being. We are not radically autonomous. All of us are born into, raised in, constantly sustained and shaped by a complex, intricate network of dependence and mutual support. He draws on Alasdair MacIntyre’s idea that all of us live somewhere in a spectrum of disability. At many stages of our life, we might be blessed with good health and be able to pursue our projects with a great deal of autonomy and self-determination. That is all well and good. But our dependence is still there. We have mentors, teachers, family, spouses who teach, encourage, and support us when we are discouraged or in need. That kind of dependence is all the more present at the earliest stages of our lives. We have great need for the nurture and care of our parents and for those around us. Then, as we advance in life, naturally there is a deterioration in our physical or even cognitive capacities. There is an even greater dependence on others. So, rather than run from or be ashamed of this finitude, vulnerability, or dependence that the body brings, we ought to acknowledge and embrace our mutual dependence. We ought to extend that care and concern to the weak, the frail, and the vulnerable, no matter what their state or capacity for exercising personal autonomy, just as we would hope that others extend to us, in our moments of greatest need and vulnerability, the same unearned care and concern.

Snead has an interesting take and profound philosophical and sociological reflections. Given his work as a lawyer and professor of law, he also does a very good job of bringing this to bear on the practical decisions that that we are making at a legal and political level.