[Editor’s Note: O. Carter Snead, Professor of Law and Director of the de Nicola Center for Ethics and Culture at the University of Notre Dame is one of the world’s leading experts on public bioethics – the governance of science, medicine, and biotechnology in the name of ethical goods. His research explores issues relating to neuroethics, enhancement, human embryo research, assisted reproduction, abortion, and end-of-life decision-making. He is the author of What It Means to be Human: The Case for the Body in Public Bioethics (Harvard University Press, October 2020). In 2008, he was appointed by the director-general of UNESCO to a four-year term on the International Bioethics Committee. In 2016, he was appointed to the Pontifical Academy for Life, the principal bioethics advisory body to Pope Francis. He is also an elected fellow of The Hastings Center, the oldest independent bioethics research institute in the world. He spoke to Charles Camosy about his new book.]
Camosy: I’m not usually wowed by back cover blurbs, but your new book has endorsements that are simply extraordinary: from Alasdair MacIntyre to Leon Kass to Mary Ann Glendon. Congratulations, first of all, on writing the kind of book which has this kind of public praise from several of the most important luminaries of our day.
Snead: Thanks very much for the kind words. It is humbling, to say the least, to have the generous endorsements of people whose work and personal witness mean so much to me. The ideas and arguments in the book were profoundly shaped by every one of them. After reading the manuscript my wife joked that “it reads like Alasdair MacIntyre and Leon Kass had a baby.” Given their deep influence on me, I took that as a compliment!
On the one hand, it might seem strange to Crux readers that one would need to make a case for “the body” at all. Why do you think such a case needs to be made? Does it have something to do with your critique of expressive individualism?
As I argue in the book, all law and policy is made for the sake and protection of persons. As such, at the foundation of every law is an animating premise about human identity and flourishing — an “anthropology,” in the basic and original sense of the term. When I took a hard look at the vital conflicts of public bioethics, namely, the law of abortion, assisted reproduction, and end of life care, I found that the anthropology tracked what Robert Bellah first dubbed “expressive individualism.”
This vision takes the person to be a mere isolated and atomized individual will whose highest thriving consists in interrogating the interior of the self to find his own unique transgressive “truths” and to configure his destiny accordingly. Because this anthropology identifies the person with his will alone, it takes the mind to be the seat of personal identity and regards the body as a mere instrument to pursue the projects of the will. It understands human relationships as transactional, formed by agreements, promises, and consent for the mutual benefit of the parties involved. People thus encounter one another as collaborative or contending wills, pursuing their own individual goals. Claims of unchosen obligations and unearned privileges are unintelligible within this framework.
Because this regnant anthropology of American public bioethics is, to borrow the words of Alasdair MacIntyre, “forgetful of the body,” it is inadequate as a foundation for laws and policies responsive to the lived realities of vulnerability, mutual dependence, and finitude that comprise the human context of this domain. It is true, of course, that human beings exist as individuated, free, and particular selves. And there can be great value in the exploration of the vast interior of the self to discover and express the authentic and original meaning found there that serves as a guide to one’s future plans, and even as a transgressive witness against wrongheaded and repressive customs. But this is only a partial and incomplete picture of the fullness of lived human reality. The anthropology of expressive individualism alone cannot make sense of our fragility, neediness, and natural limits. Worse still, it cannot offer a coherent, internally consistent account of our obligations to vulnerable others, including children, the disabled, and the elderly.
So, I try to propose an anthropological “corrective” for these areas of the law — one that takes seriously our embodiment and gives a more coherent account of who we are and what we owe to one another. To that end, drawing on MacIntyre, I propose virtues and practices necessary to build up what he calls the networks of “uncalculated giving and graceful receiving” on which we all depend for our survival and flourishing. Put most succinctly, I argue that by virtue of our embodiment, we are made for love and friendship. And for public bioethics to be just and humane, it must be built upon this truth.
Your approach has a particular focus on the example of newborn children. Why did you highlight this population in particular?
Reflecting on the newborn child and our relationship to her demonstrates that expressive individualism is an insufficient anthropology to ground public bioethics (especially the law of abortion and assisted reproduction), and points towards a richer anthropology that takes embodiment and its meaning seriously. Newborns are a pristine example of the fragility, dependence, and finitude of embodied human life. They possess none of the characteristics privileged by expressive individualism, which defines people by their cognitive powers to interrogate the inner depths of the self to discover authentic truths and configure future plans accordingly. As such, expressive individualism cannot give a coherent account of what a newborn is, beyond an instrumental element of someone else’s life plan.
But I argue that the newborn has a claim on all of us – particularly her parents – to provide care and support, irrespective of what he or she can offer by way of recompense. You don’t care for your child because of a contract to do so or because you stand to gain something from it. It is an unchosen obligation by virtue of your relationship – the story of which you both are a part. The parent learns how to make the good of the child his own, and develops the virtues of uncalculated giving necessary for the flourishing of embodied persons – just generosity, hospitality, and misericordia (accompanying others in suffering). And the child learns the virtues of graceful receiving, including especially gratitude and humility. As he grows, the child moves from dependence upon this network of uncalculated giving and graceful receiving to becoming an active participant in and sustainer of it — one who understands how to make the goods of others his own.
One worry I’ve had in recent years, and especially during this pandemic, is that we are running out of cultural resources — especially in the post-Christian consumerist West — which can give an account of why human beings with advanced dementia count as the same as the rest of us. Do you share that concern? And if so, how might your approach address that issue?
I do share this concern. For such patients the law governing refusal or termination of life sustaining measures stubbornly clings to a vision of the patient as an atomized autonomous will as its animating premise, when the embodied reality is precisely the opposite. In the face of dependence on life-sustaining measures, the law offers incompetent patients the right “to be left alone” and the false promise of directing one’s own care by “remote control” after cognitive abilities necessary for competence have been irretrievably lost. In the face of terminal illness, the law of assisted suicide merely offers a right to self-annihilation. These are the consequences of embracing the anthropology of expressive individualism as a foundation for the law.
Viewed through the lens of the anthropology of embodiment, however, all living members of the human family are worthy of care and protection, regardless of age, disability, cognitive capacity, dependence, and most of all, regardless of the opinions of others. Everyone can participate in the network of giving and receiving, even if only as the passive recipient of unconditional love and concern. There are no pre- or post-personal human beings in the anthropology of embodiment.
As for the public bioethics of the end of life, the law must embrace the reality of embodiment in time. Accordingly, we should adopt measures designed to protect against abuse, abandonment, fraud, and mistake, while facilitating care for the patient in his current state, rather than as he was or as we might wish him to be. The law should encourage and offer care, not open a pathway to suicide by transforming the healing art of medicine into a handmaiden of death.
Do you think one can make your case for the body in a purely secular sense or using secular claims about the good? Or is the kind of case you’re making here fundamentally and necessarily a theological one?
Here’s what I say about that in the text: This book is a proposal of an alternative governing vision that resonates more truly with our lived experience, shared values, hopes, fears, and needs. Accordingly, the criteria for evaluating the proposal should be tailored to the standards of the public square, where the aim is political persuasion rather than apodictic philosophical proof.
There are no demonstrable first principles offered here — only axioms, postulates, and propositions, to be judged by reason and experience. But this is the way of law, politics, and public policy. In the end, this book is a proposal offered in the spirit of friendship, anchored in the firm belief that we can only govern ourselves wisely, humanly, and justly if we become the kind of people who can make each other’s goods our own.