Life, Death and the Boundaries of the Person
DNA maps and genetic cleansing; embryo cloning and euthanasia; organ transplants and physician-assisted suicide–never before have the traditional boundaries of life and death become so blurred. Never before has science intruded so pervasively into the sanctuary of the person. Where once only angels would tread, the medical establishment now treats. Are we closer to the secret of life, or just farther from God and nearer to the dust? In this symposium NPQ takes an anxious look at the new frontiers of man’s fate.
Life is not Sacred
BREMEN, GERMANY — Physicians in the Hippocratic tradition were pledged to restore the balance — or “health” — of their patient’s constitution but forbidden to use their skills to deal with death. They had to accept nature’s power to dissolve the healing contract between the patient and his physician.
When the Hippocratic signs indicated to the physician that the patient had entered into agony, the “atrium between life and death,” he had to withdraw from what was now a deathbed. Both quickening — coming alive in the womb — and agony — the personal struggle to die — defined the extreme boundaries between which a subject of medical care could be conceived.
In our world, these boundaries have been obliterated. By the early 20th century, the physician came to be perceived as society’s appointed tutor of any person who, having been placed in a patient role, lost his own competence.
Physicians are taught today to consider themselves responsible for lives from the moment the egg is fertilized through the time of organ harvest. They have become the socially responsible professional manager not of a patient, but of a life from sperm to worm. Physicians have become the bureaucrats of the brave new biocracy that rules from womb to tomb.
In societies confused by the technological prowess that enables us to transgress all traditional boundaries of coming to life and dying, the new discipline of big-ethics has emerged to mediate between pop-science and law. It has sought to create the semblance of a moral discourse that roots personhood in the “scientific ability” of bioethicists to determine who is a person and who is not through qualitative evaluation of the fetish, “a life. ”
What I fear is that the abstract, secular notion of “a life” will be sacralized, thereby making it possible that this spectral entity will progressively replace the notion of a “person” in which the humanism of Western individualism is anchored. “A life” is amenable to management, to improvement and to evaluation in a way which is unthinkable when we speak of “a person.” The transmogrification of a person into “a life” is a lethal operation, as dangerous as reaching out for the tree of life in the time of Adam and Eve.
The churches — one of the most important agencies for defining moral issues in public life — bear a particular responsibility as a lost civilization turns to them for guidance on such issues as abortion, euthanasia, organ transplants, embryo cloning and eugenics.
“A life” is the most powerful idol the church has had to face in the course of its history. More than the ideology of empire or feudal order, more than nationalism or progress, more than gnosticism or Enlightenment, the acceptance of “life” as a God given reality lends itself to a new corruption of the Christian faith.
The Christian West has given birth to a radically other kind of human condition unlike anything before it. Only within the matrix which Jacques Ellul calls the “technological system” has this new type of human condition come to full fruition. A new role opens for mythmaking, moralizing, legitimating institutions, a role which cannot quite be understood in terms of old religions, but which some churches rush in to fill.
The new technological society is singularly incapable of generating myths to which people can form deep and rich attachments. Yet, for its rudimentary maintenance it needs agencies which create and legitimate fetishes to which epistemic sentimentality can attach itself.
We seem to need a Linus blanket, some prestigious fetish that we can drag around to feel like defenders of sacred values. “Life” has become this blanket: it has come to constitute an essential referent in current ecological, medical, legal, political and ethical discourse. Consistently, those who use it forget that the notion has a history. It is a Western notion, ultimately the result of a perversion of the Christian message.
When the Lord announced to Martha “I am Life,” he did not say “I am a Life.” He says “I am Life” tout court. This Life has its historical roots in the revelation that one human person, Jesus, is also God. This one Life is the substance of Martha’s faith. In the Christian tradition, we hope to receive this Life as a gift; and we hope to share it. We know that this Life was given to us on the Cross and we cannot seek it except on the via crucis.
This Life is gratuitous, beyond and above having been born and living. But, as Augustine and Luther constantly stress, it is a gift without which being alive would be dust.
Life in the Christian tradition is personal to the point of being one person, both revealed and promised in John 19. It is something profoundly other than the life which appears as substantive in all the headlines about abortion or euthanasia in American newspapers.
At first sight, the two have nothing in common. On the one side, the Bible says: Emmanuel, Godman, Incarnation. On the other, the term is used to impute substance to a process for which the physician assumes responsibility, which technologies prolong and atomic armaments protect; a substance which has standing in court, can be wrongfully given, and about whose destruction without due process or beyond the needs of national defense or industrial growth the so-called pro-life organizations are incensed.
However, at closer inspection, life as a property, as a value, a national resource, a right, is a Western notion which shares its Christian ancestry with other key verities defining secular society.
The notion of a human life as a distinct entity which can be professionally and legally protected has been torturously constructed through a legal-medical-religious-scientific discourse whose roots go far back into theology.
The emotional and conceptual connotations of life in Hindu, Buddhist or Islamic traditions are utterly distinct from those evident in the current debate on this subject in Western democracies.
In the United States, the politicized pro-life movements are sponsored mainly by Christian denominations.
It is for this reason that it is mainly up to the churches to de-mystify “life.” The Christian churches now face an ugly temptation: to cooperate in the social creation of a fetish which, in a theological perspective, is the perversion of revealed Life into an idol.
The History of a Life
Biblical scholars are well aware of the limited correspondence between the Hebrew word for blood, dam, for breath, ruah, and the Greek term we would render as soul, namely, psyche. Neither comes anywhere near the meaning of the substantive, life. The concept of life does not exist in Greco-Roman antiquity: bios means the course of a destiny and zoe something close to the brilliance of aliveness. In Hebrew, the concept is utterly theocentric, an implication of God’s breath.
Life as a substantive notion appears two thousand years later, along with the science that purports to study it. The term biology was coined early in the 19th century by Jean-Baptiste Lamarck. He was reacting to the baroque progress in botany and zoology which tended to reduce these two disciplines to the status of mere classification. By inventing a new term, he also named a new field of study, “the science of life.”
Lamarck’s genius confronted the tradition of distinct vegetable and animal ensoulment, along with the consequent division of nature into three kingdoms: mineral, vegetable and animal. He postulated the existence of life that distinguishes living beings from inorganic matter not by visible structure but by organization. Since Lamarck, biology searches for the “stimulating cause of organization” and its localization in tissue cells, protoplasm, the genetic code or morphogenetic fields.
“What is life?” is, therefore, not a perennial question, but the pop-science counterfoil to scientific research reports on a mixed bag of phenomena such as reproduction, physiology, heredity, organization, evolution and, more recently, feedback and morphogenesis.
Life appears during the Napoleonic wars as a postulate which is meant to lead the new biologists beyond the competing descriptive studies of mechanists, vitalists and materialists. Then, as morphological, physiological and genetic studies became more precise toward the middle of the 19th century, life and its evolution become the hazy and unintended by-products reflecting in ordinary discourse an increasingly abstract and formal kind of scientific terminology.
THE DEATH OF NATURE | A thread which runs back to Anaxagoras (500-428BC) links a number of otherwise profoundly distinct philosophical systems: the theme of nature’s aliveness. This idea of nature’s sensitive responsiveness found its constant expression well into the 16th century in animistic and idealistic, gnostic and hylomorphic versions. In these variations, nature is experienced as the matrix from which all things are born. In the long period between Augustine and Scotus this birthing power of nature was rooted in the world’s being contingent on the incessant creative will of God.
By the 13th century, and especially in the Franciscan school of theology, the world’s being is seen as contingent not merely on God’s creation, but also on the graceful sharing of his own being, his life. Whatever is brought from possibility (de potentia) into the necessity of its own existence thrives by its miraculous sharing of God’s own intimacy, for which there is no better word than — His life.
With the scientific revolution, contingency-rooted thought fades and a mechanistic model comes to dominate perception. Caroline Merchant argues that the resulting “death of nature” has been the most far-reaching event in changing men’s vision and perception of the universe. But it also raised the nagging question: How to explain the existence of living forms in a dead cosmos? The notion of substantive life thus appears not as a direct answer to this question, but as a kind of mindless shibboleth to fill a void.
LIFE AS PROPERTY | The ideology of possessive individualism progressively affected the way life could be talked about as a property. Since the 19th century, the legal construction of society increasingly reflects a new philosophical radicalism in the perception of the self. The result is a break with the ethics which had informed western history since Greek antiquity, clearly expressed by the shift of concern from the good to values. Society is now organized on the utilitarian assumption that man is born needy, and needed values are by definition scarce. It becomes axiomatic that the possession of life is then interpreted as the supreme value. Homo economicus becomes the referent for ethical reflection. Living is equated with a struggle for survival or, more radically, with a competition for life. For over a century now it has become customary to speak about the “conservation of life” as the ultimate motive of human action and social organization.
Today, some bioethicists go even further. While up to now the law implied that a person was alive, they demand that we recognize that . . . there is a deep difference between having a life and merely (sic!) being alive. The proven ability to exercise this act of possession or appropriation is turned into the criterion for personhood and for the existence of a legal subject.
During this same period, homo economicus was surreptitiously taken as the emblem and analogue for all living beings. A mechanistic anthropomorphism has gained currency. Bacteria are imagined to mimic “economic” behavior and to engage in internecine competition for the scarce oxygen available in their environment. A cosmic struggle among ever more complex forms of life has become the anthropic foundational myth of the scientific age.
LIFE AS ECOLOGY | Ecology can mean the study of correlations between living forms and their habitat. The term is also and increasingly used for a philosophical way of correlating all knowable phenomena. It then signifies thinking in terms of a cybernetic system which. in real time is both model and reality: A process which observes and defines, regulates and sustains itself. Within this style of thinking, life comes to be equated with the system: It is the abstract fetish that both overshadows and simultaneously constitutes it.
Epistemic sentimentality has its roots in this conceptual collapse of the borderline between cosmic process and substance, and the mythical embodiment of both in the fetish of life. Being conceived as a system, the cosmos is imagined in analogy to an entity which can be rationally analyzed and managed.
Simultaneously, this very same abstract mechanism is romantically identified with life and spoken about in hushed tones as something mysterious, polymorphic, weak, demanding tender protection.
In a new kind of reading, Genesis now tells how Adam and Eve were entrusted with life and the further improvement of its quality. This new Adam is potter and nurse of the Golem, his artificial creation.
In the sickening manufactured environment we have made for ourselves, health in the Hippocratic tradition has become an impossibility; balance has become hope-less.
The hope once symbolized in the mystery of the unborn has been corrupted; now there is only the legal entity of the fetus monitored on the sonogram. Agony, too, has been corrupted by the medicalization of death.
Dignity will not be found in the universal health care now demanded, but in hygienic autonomy and in a new found art of suffering and dying. In modern sickness I see the occasion for this discovery.
A History of Health
The concept of health in European modernity represents a break with the Galenic-Hippocratic tradition familiar to the historian. For Greek philosophers, “healthy” was a concept for harmonious mingling, balanced order. a rational interplay of the basic elements. He was healthy who integrated himself into the harmony of the totality of his world according to the time and place he had come into the world.
For Plato, health was a somatic virtue, and spiritual health, too, a virtue. In “healthy human understanding,” the German language — despite critiques by Kant, Hamann, Hegel and Nietzsche — preserved something of this cosmotropic qualification. But since the 17th century, the attempt to master nature displaced the ideal of the health of a people.
This inversion gives the a-cosmic health created in this way the appearance of being engineerable. Under this hypothesis of engineerability, “health as possession” has gained acceptance since the last quarter of the 18th century. In the course of the 19th century, it became common sense to speak of “my body” and “my health.”
In the American Declaration of Independence, the right to happiness is affirmed. The right to health materialized in a parallel way. In the same way as this happiness, modern-day health is the fruit of possessive individualism. There could have been no more brutal and, at the same time, more convincing way to legitimize a society based on self-serving greed. In a similarly parallel way, the concept of responsibility of the individual gained acceptance in formally democratic societies. Responsibility then took on the semblance of ethical power over ever more distant regions of society and ever more specialized forms of “happiness-bringing” service deliveries.
In the 19th and early 20th century, then, health and responsibility were still believable ideals. Today they are elements of a lost past to which there is no return. Health and responsibility are normative concepts which no longer give any direction. When I try to structure my life according to such irrecoverable ideals, they become harmful — I make myself sick.
HEALTH IS A PLASTIC WORD | Health and responsibility have been made largely impossible from a technical point of view. This was not clear to me when I wrote Medical Nemesis, and perhaps was not yet the case at that time. In hindsight, it was a mistake to understand health as the quality of “survival,” and as the “intensity of coping behavior.”
Adaptation to the misanthropic genetic, climatic, chemical and cultural consequences of growth is now described as health. Neither the Galenic-Hippocratic representations of balance, nor the Enlightenment utopia of a right to “health and happiness,” nor any Vedic or Chinese concepts of well-being, have anything to do with survival in a technical system.
“Health” as function, process, mode of communication; health as an orienting behavior which requires management — these belong with those post-industrial conjuring formulas which suggestively connote much, but denote nothing that can be grasped. And as soon as health is addressed, it has already turned into a sense-destroying pathogen, a member of a word family which Uwe Poerksen calls plastic words, word husks which one can wave around, making oneself important, but which can say or do nothing.
The situation is similar with responsibility, although to demonstrate this is much more difficult. In a world which worships an ontology of systems, ethical responsibility is reduced to a legitimizing formality. The poisoning of the world is not the result of an irresponsible decision, but rather of our individual presence, as when traveling by airplane …