Bioethics must ‘break out’ of ivory tower and engage society, academic says

Bioethics must ‘break out’ of ivory tower and engage society, academic says

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Jason T. Eberl, Professor of Health Care Ethics and Director of the Albert Gnaegi Center for Health Care Ethics at Saint Louis University. He spoke to Crux.

[Editor’s Note: Jason T. Eberl, Ph.D. is Professor of Health Care Ethics and Director of the Albert Gnaegi Center for Health Care Ethics at Saint Louis University. His research interests include the philosophy of human nature and its application to issues at the margins of life; ethical issues related to end-of-life care, genetics, and healthcare allocation; and the philosophical thought of Thomas Aquinas. He is the author of Thomistic Principles and Bioethics (Routledge 2006), The Routledge Guidebook to Aquinas’ Summa Theologiae (Routledge 2016), and The Nature of Human Persons: Metaphysics and Bioethics (Univ. of Notre Dame Press 2020), as well as editor of Contemporary Controversies in Catholic Bioethics (Springer 2017). He spoke to Charles Camosy.]

Camosy: One the frustrations of some of us who do bioethics have had in recent years comes from the marginalization of metaphysical questions. Can you unpack that frustration for a lay audience? What is metaphysics and why should it matter for those who care about bioethics?

Metaphysics is a complicated field to define, but foundationally it is the study of being and includes questions such as: What does it mean for something to exist? What kinds of things exist? and How do things persist through various sorts of changes?

Jason T. Eberl, Professor of Health Care Ethics and Director of the Albert Gnaegi Center for Health Care Ethics at Saint Louis University. (Credit: Courtesy to Crux.)

These and other questions explored within metaphysics cannot be answered by the empirical sciences, which is the main reason many bioethicists shun metaphysical questions in favor of addressing more procedural issues in the realms of clinical care, biomedical research, and health policy. Consciously or not, many in the field have adopted the “positivist” school of thought (also known as “logical empiricism”), which stipulates that only questions that can be definitively answered by empirical observation or logical deduction are worth studying.

Yet, there are metaphysical presuppositions underlying many bioethical positions and arguments, particularly those concerning the beginning and end of human life. “Person,” for instance, is a metaphysical concept and defining the criteria for what types of beings count as persons is a matter of debate that cannot be settled empirically or deductively. Even if one believes that the concept “person” is merely a legal fiction, one is taking a metaphysical stance on the emptiness of this category of being.

One of the key debates in all of bioethics, of course, is who or what “counts as a person.” From abortion, to euthanasia, to how we think about research on non-human animals, this question comes up again and again. Happily, this is the key focus on your new book with the University of Notre Dame Press. Can you say a bit about how metaphysics is important specifically for the debate over personhood?

Yes, this is indeed one of the most central questions in bioethics and proposed definitions of personhood cover a wide spectrum. For instance, a group of bioethicists I collectively refer to as “performance theorists,” such as Peter Singer, require self-awareness as a criterion of personhood, meaning that not only are preborn human beings excluded but even newborns and individuals who fall into an irreversibly comatose or persistent vegetative state. Other bioethicists link the emergence of personhood with neurological development during the fetal stage. Most Catholic and some non-Catholic scholars contend that every living human being, regardless of developmental stage or degree of cognitive function, counts as a person—or at least, in the case of an embryo or fetus, the preborn human being has the inherent potential to develop into a person and thereby merits the same moral respect.

A recent complicating issue for this last position is the combining of human and non-human genetic material, resulting in the creation of a “chimera” or “hybrid” organism — a chimera is formed by grafting stem cells from one species into another species; a hybrid is formed by fusing the gametes from two different species. Should such an organism be considered a person simply because they have some human DNA, or does it matter what that DNA codes for and whether the organism in question will develop self-awareness, a capacity for rational thought, and other qualities considered to be definitive of persons?

You take a “hylomorphic” view of what a person is. Is it possible for you to summarize this view?

The hylomorphic view of personhood is derived from the Greek words for “matter” and “form.” According to Aristotle, every existing material object has a specific form that defines it as a particular kind of object. Form refers to not only an object’s physical shape, but also how it functions and what functionally relevant qualities it possesses – think of the particular shape and solidity of a chair that allows it to function as a chair in contrast to the form of a table.

Living organisms are also enformed material beings that can be categorized into three general kinds: Vegetative life, sentient animals, and rational animals. Human beings, as members of the last category, count as persons insofar as our specific form endows us with capacities for self-awareness, rational thought, and freedom of will.

Yet, it is important to emphasize that we are essentially embodied animals. In this respect, hylomorphism differs from the substance dualist view of human nature espoused by thinkers such as Plato and Descartes, who identify a person with her “soul” or “mind” alone, disregarding the body as an essential component of a human being’s existence. It also differs from reductive physicalist views of human nature that consider a human person to be nothing other than her living body with its functioning brain.

What does this view mean for a traditional religious belief in the existence of a soul or spirit without a body? Say, in the case of angels? Or in the state of being for human persons after death but before the resurrection of our bodies?

In laying out his hylomorphic view of human nature, Aristotle uses the Greek term ‘psuche’ for the form of living beings, which later becomes the Latin term ‘anima’ and the German ‘Seel’, from which English derives the term ‘soul’ – and there are different types of souls informing the bodies of vegetative organisms, sentient animals, and rational animals. A human being can thus be described as a composite unity of a rational soul informing a material body that is genetically of the species Homo sapiens.

This view does not preclude, however, the existence of persons who are not embodied — namely, purely intellectual substances that St. Thomas Aquinas, who adopts Aristotle’s hylomorphism, identifies with the Biblical angels and demons. This view also allows for the possible existence of other species of rationally ensouled animals—such as intelligent extra-terrestrial lifeforms.

Since human beings are essentially embodied animals, the hylomorphic view entails that a human person can only fully exist as embodied. Thus, while Aquinas holds that a human person’s soul can persist in a disembodied state after their body’s death, he nevertheless does not consider a person in this “interim state” to be complete. Bodily resurrection is thus necessary for a human person to exist again as a perfected (the Latin term ‘perfectio’ means “complete”) being. Again, this view differs significantly from either a substance dualist view, in which a disembodied soul is considered to have been freed from its bodily constraints, or a physical reductionist view, in which a person ceases to exist altogether upon their body’s death.

These are heavy metaphysical topics and your book, though accessible and very readable, dives deep into them. Do you have any advice for bringing such topics to the public sphere in ways that could have import for this kind of discourse?

This is a very important question! As a bioethicist, I am definitely in favor of breaking out of the so-called “ivory tower” to engage significant issues of socio-political discourse. As an opening foray, I would argue for the relevance of metaphysical questions, such as those addressed in my book among others, to current socio-political debates. The Nazi party, for example, gained ground in Germany in the early 1930s by scapegoating certain groups of people — most notably Jews, Gypsies, homosexuals, and persons with disabilities — and declaring them untermenschen (sub-human).

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While we know the Nazis were wrong to categorize other human beings in this way, to prevent history from repeating itself we must ask why they were wrong. We must either develop in a postmodern fashion or rediscover from classical wisdom an understanding of human nature and personhood that allows us not only to reinforce our intuitive moral judgment of past practices, such as slavery and genocide, but also current means of demeaning human dignity, from camps housing undocumented immigrants — where apparently non-consensual hysterectomies are being carried out — to racial disparities in health care access. Respect for the inherent dignity of human persons requires that we first establish the criteria for who counts as a “human person,” which calls for clear philosophical and theological analysis, and should not be subject to the shifting tides of socio-political discourse which has arguably erred in both left and right directions.

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