Wednesday, January 27, 2010

Wrestling with Angels

In a 2008 Panel Discussion Human Dignity and Bioethics: Essays Commissioned by the President's Council on Bioethics, Jean Bethke Elshtain , Ph.D. University of Chicago, and made a striking observation, from which I infer this:    When we discover ourselves stumbling over our inability to agree on the definition of a concept, we may too quickly dismiss the concept as unhelpful.  But instead, our very inability to define it, nail it down, or agree, may be an indicator of it's crucial importance as a transcendent, life changing concept.  Perhaps the more difficult it is to define, the more we should keep it before us.  After all, should it come as surprise that the ineffable is that upon which we should become contemplatives?


In the end, perhaps the most crucial concepts are those about which a reasoned philosophical or theological exposition must give way to stories, poems and art!


Do read Ehstain's remarks on the concept of human dignity.  (And don't miss his use of Anglican writer C. S. Lewis!):
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I was surprised to discover that a suggestion had been made, not by members of this Council—a suggestion they were responding to, or a number did, that human dignity is such a vague and porous notion we would do well to dispense with it altogether.

Now, many members of the Council, as well as authors commissioned to write essays for the volume, countered this suggestion, and I want to add my voice to this chorus by noting a simple fact:  we could not do away with the notion if we wanted to.  Only someone with his or her heads in the clouds of vaporous abstraction could argue that a potent evaluative notion that has been a central feature of discourse about human beings and human possibilities for centuries, ever more so in the last 60 years, might be removed by a person or commission or group that watches over our vocabularies.

A locution like "human dignity" troubles many because there is no knock-down definition to the term.  It generates debates; it doesn't settle them.  But that is true of what philosophers call essentially contested concepts, concepts that are powerfully descriptive and evaluative and that generate debates about how we are to understand and to apply them.  "Freedom" is such a word.  "Justice" is such a word.  The notion of human dignity is one of those contested concepts.  We cannot do without them, and it is pointless to make such an attempt.  This is also an argument that was advanced in the volume by Mr. Sulmasy.

Now, human dignity has entered our political and ethical vocabularies with increasing urgency over the past 60 years, and I think we know why that is:  two murderous wars in the twentieth century embroiling the West and beyond; gulags and death camps; the radical misuse of both genetics as eugenics and technology in the twentieth century totalitarian systems.

All of these horrific events remind us of what can happen when human dignity is negated or forsworn.  And I should tell you these events have been much on my mind the last few months because I'm teaching a graduate course this term at the University of Chicago called "Politics, Ethics, and Terror," in which we read the writings of three great Europeans,   Hannah Arendt, the anti-Nazi German theologian Dietrich Bonhoeffer, and Albert Camus, and their responses to twentieth century totalitarianism.  And each of them advances the notion of human dignity and talks about its violation in recalling those events or discussing or engaging those issues.

Now, let me offer a few other reminders of that era.  The great theologian, Paul Tillich , made 100 broadcasts into Nazi Germany during World War II over Radio Free Europe.  The theme of human dignity surfaced repeatedly in these messages.  These were essentially sermons to those who claimed to be German Christians.

In a radio broadcast from May 11, 1942 , Tillich proclaimed:  "Whoever has been deprived of rights has become a thing with which one can do what one desires.  He has lost his dignity.  He has become an instrument for strange ends, a slave of tyrants, a tool of arbitrariness, an object of violation.  Your rights are the acknowledgement that you are a person, that you have a dignity that is inviolable, that you are a uniquely irreplaceable self."

Then came the moment a year after the war ended when a young French writer, then 33 years of age, addressed a packed audience of college students at Columbia University .  Albert Camus , himself an unbeliever, told the American young people that he wanted to convey to them the horror and shame his generation of Europeans had just passed through.  He wanted to characterize as precisely and as accurately as he could the crisis of world dimensions then at hand.

In order to do this, he offered four brief vignettes.  Now, there's no time, obviously, to read all four, but let me repeat just one in Camus ' words:  "In Greece , after an action by underground forces, a German officer is preparing to shoot three brothers he has taken as hostages.  The old mother of the three begs for mercy, and he consents to spare one of her sons but on the condition that she herself designate which one.  When she is unable to decide, the soldiers get ready to fire.  At last she chooses the eldest because he has a family dependent on him, but by the same token she condemns her other two sons, as the German officer intended."

Now, what matters now, Camus concludes, is not, it seems, whether one spares a mother suffering or upholds human dignity, but whether one helps an ideology to triumph.  Now, one of the symptoms of the crisis that Camus goes on to describe in light of these vignettes is, in his terms, the perversion of values that judges a person or a historical force "not in terms"—these are his words—"of human dignity but in terms of efficiency and success."

And then he continues, "If nothing is true or false, good or bad, if the only value is that of efficiency, that is to say, the strongest, the world is then no longer divided into just and unjust but into masters and slaves, and he is right is he who dominates."  And in such a world the term, he continues, "human dignity" no longer figures.  It has been cast out.

Now, in his brilliant philosophical essay The Rebel , Camus plies this theme further.  His essay, he tells us, is the story of European, we might say, Western pride, and it is pride, superbia, that invites nihilism and the will to power.

Human dignity, by contrast, is all about limits—the articulation of limits to what one does or should do even if one can do it.  Can we articulate such limits, Camus asked, in a world—this was his haunting dilemma—in a world stripped of God or any transcendent reference point.

If we can't, he says, we're really doomed.  He believes that that belief in God is fading and, indeed, that the possibility of people agreeing that there is some transcendent point of value is also diminishing, so we've got to find another basis, argues Camus.  That was his challenge.  And he says if we cannot respect and articulate "a dignity common to all men," we are, indeed, on the downward slope.

Now, with these searing reminders of the twentieth century in mind, let me throw down the gauntlet, so to speak, cast in the form of a query.  Has anything good ever come from denying or constricting human dignity?  I can think of one horror after another in recent history— you'll forgive me for bringing up one more example from this era.  As I said, it's much on my mind—including the National Socialist euthanasia program that murdered children and adults with disabilities, mental and physical, by the tens of thousands, that flowed directly from constricting human dignity, from reading whole categories of persons out of the moral community.

Now, the definitive study of this program raises questions about how and why such a thing could come about, and the author, historian Michael Burleigh , attributes it to a post- and anti-Christian and illiberal ideology that entered into and dominated the thoughts of a sufficient number of people that the National Socialists thought they could move forward.

And they were, as many of you know, aided and abetted in this effort, given the prior publication of an essay by two doctors, Karl Binding and Alfred Hoche , on life unworthy of life.  And the argument in that essay was that some lives have a negative value.  The argument relied on a positivistic theory of law, that is, one does away altogether with any notion of a higher law or a natural law that might check human ambition, if you will, and embraces law as the will of a particular community, the Volksgemeinschaft in this case, or, more properly, in this regime, the inner will of the Fuhrer that was itself the expression of the will of the German people.

Those who could not be striving, sovereign selves, which was the ideal, are a threat to those sovereign selves for a number of reasons:  they allegedly weaken the gene pool, and they create a burden on the strong.  And if and when the weak burden the strong, the weak in this ideology must die.

So we see here a fusion of crude materialistic arguments, both economistic and Darwinian, with Darwin 's theory turned into a social ideology.  And then utilitarianism is thrown in for good measure—the greatest good for the greatest number.  And that contributed to this Weltanschauung that led to the deaths through planned starvation, which was mostly used against the infants and children, and lethal injection of minimally 200,000 upwards, maybe 400,000 persons with disabilities.

Now, everyone recognizes in these sorts of things that we hope are safely ensconced in the past a massive crude violation of something, and that something we tend to call human dignity.  Is it possible that attacks on human dignity can also creep up on cats' paws in the name of eliminating suffering?  Although that was one of the arguments, interestingly enough, that was made in Nationalist Socialist propaganda, too:  "We're kind people.  We're eliminating suffering."

Fast-forward to March 2005.   The New England Journal of Medicine published an essay on euthanasia for newborns, printing up the Groningen —I'm not saying it quite the way the doctors say it, but a city in—it's impossible to pronounce it the way they pronounce it—Groningen Protocol for such procedures.  The New York Times Magazine , July 10, 2005 , reprinted those protocols under the heading, "Euthanasia for Babies:  Is this humane or barbaric?"

Now, I suspect that all of us know that the average reader of The New York Times prefers the humane alternative, and the humane course, it perhaps will not surprise you, favors infanticide if the correct procedures are followed.  Euthanasia of newborns, under such circumstances, we are told, is the way of reason.  And those who say we shouldn't cross that line advance the way of "sentiment," a.k.a. unreason.

Now, the essayist Jim Holt asks his readers to imagine a heated dining room table argument about this issue.  The way of reason requires unflinching honesty.  By contrast, moral sentiments are inertial, resisting the force of moral reasons.  And the essay concludes in this way:  "Just quote Verhagen"—Verhagen is the Dutch doctor who worked up the protocols.  Just quote his "description of the medically induced deaths"—and you'll notice the sort of euphemistic way of putting it—"over which he has presided."  And these are the words of Dr. Verhagen :  "It's beautiful, in a way.  It is after they die that you see them relaxed for the first time."

Now, Holt claims that at this point even the most spirited dining room table conversation about moral progress will fall silent.  He imagines the hushed atmosphere as one in which the diners are overwhelmed by the vision of peace at last for deformed or handicapped infants.  But I suspect that many would fall silent from the claim—the shocking claim—that we must give these perturbed spirits some peace at least by killing them.
 
Now, Holt insists that brutal candor—"I'm killing them, and it's the right thing to do"—is the ethically preferred route rather than the much more complex approach that might say, "Permit multipli-handicapped infants to die rather than using sustained heroic measures to keep them alive if that's what's required."  This latter course is presented as "casuistic confusion."  So any course that reflects moral uneasiness is confused and dishonest, and any course that makes it easier for medical personnel to kill is honest and reasoned.

Now, what does all this have to do with the Council and its work and the volume that we were given to read?  Very interesting volume, too.   If I haven't said that already, I should say that now.  So let me go over some possibilities with the assistance of C.S. Lewis ' prescient essay, "The Abolition of Man."  I bring it forward in part because a number of the essayists refer to it.

Now, from the human dignity volume I read from the essay by Daniel C. Dennett the following:  "The psychologist Philip Tetlock identifies values as sacred when they are so important to those who hold them that the very act of considering them is offensive."  Now, you'll notice there's nothing about—no consideration of the truth claims of such a statement.  It's a statement about the emotional state of the speaker.

Now, this is sheer emotivism.  What is emotivism?  It's the insistence that all statements of value, all normative claims, reduce to subjective feelings.  That is, there's no truth warrant, no cognitive basis for these arguments.  It's the sentiments as opposed to reason of which The New York Times article speaks.  And Lewis sums up emotivism in this way:  First—firstly, in his language, that all sentences containing a predicate of values are statements about the emotional state of the speaker and secondly, that all such statements are unimportant.

Now, for Lewis , when powerful ordinary human feelings and responses are set up as contrary to reason, we are on dangerous ground, indeed.  For a botched treatment, he tells us, of some basic fundamental human emotion is not only bad literature, which is one of his major concerns, but is moral treachery to boot.

And he goes on to argue that one must not traffic in a false distinction between reason and emotion, rationality and sentiment.  That's the sort of positivistic emotivist approach to these things.  And in the regnant positivism and emotivism—in that epistemology, "the world of facts without one trace of value and the world of feelings without one trace of truth or falsehood, justice or injustice, confront one another and no rapprochement is possible.  It is all a ghastly simplicity."  That's the end of the quote.
And in such a universe, unsurprisingly, everything has a price rather than an intrinsic value or dignity, and those who promulgate such views, Lewis tells us, who debunk what they consider these traditional or sentimental values "often have in the background values of their own which they believe to be immune from the debunking process."

So with that in mind I would ask us to consider the claim in the volume by Ms. Churchland with Lewis ' argument in mind.  And at one point in her essay she says the following:  "I predict that those who today are morally opposed to embryonic stem cell research will fall silent once the clear medical benefits begin to emerge."

Now, this is a surprising statement for many reasons.  It suggests first that principled moral opposition can be erased by cumulative instrumental benefits, now entirely hypothetical, and, second, that good itself is located in a future state of affairs and that this hypothetical future state of affairs trumps any harms in the present.

Now, this is the stance, interestingly enough, that Albert Camus condemned in The Rebel :  those who believe anything goes in the present because of some alleged future state or benefit that will eventuate if only certain pesky groups are removed or certain voices of opposition are silenced.  And Ms. Churchland clearly finds voices of opposition an unpleasant vexation, even to the point of accusing moral opponents of, in one example she brings forward, favoring misery and death over the salutary benefits of—her example is mass vaccinations against human papilloma virus, which she equates to the smallpox virus.

Now, her example—I'm not an expert on the human papilloma virus and inoculations against it, but the example implicates her in a set of background values, obviously, that she doesn't bring to the surface for a debate, a set of assumptions about human beings and human behavior, the behavior of young women, including adolescent girls.  The assumption is they're going to have multiple sexual partners—I do mean multiple—before marriage and possibly after.

To the best of my knowledge—she compares it to the smallpox vaccination—there were no behavior correlates to smallpox as there are to the spread of the human papilloma virus.  But the assumption is we can do nothing about human behavior.  In fact, we simply have to assume certain things about it, but that's not brought forward for examination.

So what's interesting here is that often those that decry the moral certitude of their opponents who are strong moral evaluators, in the philosopher Charles Taylor 's terms, themselves are guilty of unyielding certitude that manifests itself often in not taking seriously the arguments of those they oppose or in diminishing the views of those they oppose.  Those folks favor misery or death, for example.  Another example I found in the volume of this was from Prof. Nussbaum 's essay where she claims that embryonic stem cell research involves nothing more than an indiscriminate "clump of cells."  And this has nothing to do with human dignity and its violation.  Now, I think I'm right that no serious fetologist or scientist would describe an embryo as just an indiscriminate clump of cells.  That would be a misdescription of what's going on there, but if you describe it in that way, again, it's easier to diminish any possible counterargument.

Now, as I move to the concluding section, let me turn to how we articulate limits to violations of human dignity and bring forward three essays in the volume.  Leon Kass , whom I respect enormously and with whom I'm usually in agreement or often in agreement, makes a move in his essay in the volume that I cannot take with him.  Namely, he distinguishes between the basic dignity of all human beings and the full dignity of being actively human or human flourishing.  Now, why do I find this a potentially troubling move?  Because it doesn't take much imagination, those of us who are familiar with the history of the twentieth century, to conjure up scenarios in which those possessing full dignity pass judgment on those of basic dignity as having a lesser dignity and go on to act accordingly. 
Now, Dr. Kass resists this strenuously, of course.  In medicine he says the ethical focus has to be on equal worth and dignity.  No life is worthier than any other, and under no circumstances should we look upon a fellow human being as if he had a life unworthy of life.  So all human beings should be treated as if they had full and equal dignity, and the burden is on those who think otherwise, which leads me to wonder why—create a situation rhetorically, if you will, where such possibilities might more likely emerge.

What is one to do if one has been declared unequal?  According to Kass, I must then assert my human dignity.  And this he calls rhetorically effective but not metaphysically based.  And I wondered if this was altogether reassuring.  It's certainly not reassuring to those who cannot rhetorically assert their dignity, and I was thinking as I read this also of Hannah Arendt's discussion in On Totalitarianism about what happens to those are first stripped of their civic standing and identity and then the fact that they can assert their basic human rights until they're blue in the face and it means very, very little unless there is a political regime or government that will acknowledge that and enforce it.

Where else to turn?  Very briefly, to the essays by Father Neuhaus and Prof. Meilaender .   Neuhaus argues in a very augustinian vein that our focus on human dignity should be on those most subject to having their dignity violated, that our focus should be there under the "do no harm" norm.  Too often nowadays, he avers, bioethics is an industry for "the production of rationalized permission slips" as scientific and technological imperatives are joined to wealth.

As an alternative, Neuhaus lifts up politics, amazingly enough, people debating how we are to order our life together.  And, inescapably, the question of limit as to what we are permitted to do is a political question, and we cannot remove fraught moral matters, as Ms. Churchland seems to want to do, from political debate.  That is, a small group of experts alone can't make these decisions.  The dignity of the human person is not primarily, Neuhaus concludes, about asserting the rights of the autonomous will but as an obligation to protect those whose autonomy is very limited.

And Professor Meilaender, who's here and can certainly speak for himself, seems to me correct in arguing that once you introduce distinctions of merit and excellence as affording the full measure of human dignity, you begin to sort of subtly undermine the egalitarian ideal of human dignity, and it is, of course, this idea that has underwritten and been absorbed into universal claims of human rights in the post-World War II era.  All you have to do is go to the UDHR, the Universal Declaration of Human Rights, and you'll see that immediately.

So this raises a very serious question, it seems to me, as to whether those who do not share this account can sustain a robust regime of human rights, most critically of the negative variety—you can't do these kinds of things to people.  This is what you're not permitted to do.

Now, I want to conclude with a claim from Prof. Nussbaum's essay—and I hesitated about bringing this forward, but what Dr. Hurlbut had to say in the last session helped me to screw my courage to the sticking point, so I'm going to do it—about a child with disabilities.  So I want to bring this forward because I think it's illustrative.  It's a personal story, but it's illustrative of a more general set of concerns.

It's a claim from Prof. Nussbaum 's essay.  It's not argued; it's just stated, that we should not accord "equal dignity to a person in a persistent vegetative state or to an anencephalic child, since it would appear there is no striving there, no reaching out for functioning."

Now, I confess I really don't know what "reaching out for functioning" means, exactly, but I do know the following, and this is the story:  In 2003 the 18-year-old son of one of my cousins died.  This young man was supposed to have died much before that.  He was born anencephalic.  He could never speak, couldn't feed himself, couldn't crawl, couldn't walk, couldn't do any of the things that normal human beings generally do or learn to do.  So I suppose there was no striving there, in a sense.  Prof. Nussbaum says we should not accord him dignity, full human status.  And for Peter Singer , certainly, Aaron would have been—for that was his name—would have been a prime candidate for euthanizing.
But to anyone who met him, Aaron was a beautiful child with the biggest blue eyes and the most striking dark eyelashes imaginable.  He stared out at the world, making no apparent distinctions, until his mother, my cousin, came into view.  And then—and I don't know any other way to describe this—something would happen.  His face would beam.  It would light up.  I don't know how else to put it.  Something was going on there, some type of recognition.  I would defy anyone to claim otherwise.  And certainly her love and care and devotion kept him going for 18 years.  And when he died, an entire family, his parents, sibling, grandparents, aunts, uncles, cousins, an entire community mourned their loss.

Now, the story of Aaron and Paula Jean is a story of human endurance, and I think it's also a story within my frame of reference of the receipt of the gift of grace.  But I would ask you to contrast it to the vision of peace promulgated by the euthanasia doctor who extols how beautiful are handicapped newborns who have been killed intentionally.

And I think this helps to set out in bold relief some contrasting possibilities, contrasting visions of our human future, because it's one in which human beings are certainly going to write some decisive chapters in whether we will abolish man in the sense of obliterating that dignity which is truly human and intrinsically ours or, by contrast, remember how to respect and to cherish our humanity, however weak and broken the forms in which it may appear among us.

"Respect the Dignity of Every Human Being"

Early this morning I was reading Monday's paper (yes, today is Wednesday... which tells you something about my life!), and came across an essay by Eboo Patel in which he wrote:
That bias is hateful to God is an ancient religious teaching. Take the Qur'anic idea that all human beings have the breath of God, or the Judeo-Christian teaching that we are all made in God's image.
Every religion holds up the ideal of the equal dignity of human beings. And every generation finds a way to violate that ideal by directing hatred at other communities. But prejudice is like cancer - it spreads.
If we can't find a way to follow the ancient teachings of our religions, perhaps we will be more likely to heed the lessons of a more contemporary tool - the poll. The single highest predictor of prejudice against Muslims is prejudice against Jews. (More here)
The Lord be with you,