Guest Post: A Relentless Focus on the Given – Reviewing O. Carter Snead’s What it Means to be Human: The Case for the Body in Public Bioethics

Guest Post by Charles Camosy

Professor Carter Snead, at least in my world, is about as important a contemporary voice in bioethics that we have today. A professor on Notre Dame’s law faculty, he is perhaps better known as director of the de Nicola Center for Ethics and Culture—one of the most significant positions in the United States for doing public bioethics. He was heavily involved in the topic before coming to Notre Dame, including when serving as general counsel to the President’s Council on Bioethics chaired by Leon Kass. He currently serves on the Pontifical Academy for Life and as an elected fellow of the Hastings Center.

When Professor Snead came out with a book on public bioethics from Harvard University Press this month, that became good reason for many of us to pay close attention—especially when Alasdair MacIntyre gave a back cover endorsement calling it “indispensable reading” whether “you agree or disagree with Snead’s perspective.” Indeed, Snead makes it clear that he’s not merely preaching to the choir in this book, but instead aiming at making his case to folks with  different perspectives in “the spirit of friendship” and “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.”

His fundamental critique is as follows: Most of public bioethics—perhaps for understandable reasons flowing from the dramatic failures of medical ethics during the 20th Century—has an “incomplete and false vision of human identity and flourishing. It is a vision that defines the human being fundamentally as an atomized and solitary will [original emphasis].” It equates human flourishing solely with the capacity to formulate and pursue future plans of one’s own invention. Our legal understanding of issues related to public bioethics now tragically “views the natural world and even the human body itself as merely inchoate matter to be harnessed and remade in the service of such projects of the will.”

The antidote to the problem, for Snead, is the adoption of a moral anthropology with a relentless focus on the given. For, “human beings do not live as mere atomized wills and there is more to life than self-invention and the unencumbered pursuit of destiny of our own devising. The truth is that persons are embodied [original emphasis] beings, with all the natural limits and great gifts this entails. We experience our world, ourselves, and one another as living (and dying) bodies. Because we are bodies, vulnerability, mutual dependence, and natural limits are inextricable features of our lived human reality.”

He cites the dominance of the frame of “expressive individualism,” especially as discussed by Robert Bellah and Charles Taylor, as refusing to acknowledge human givens and indeed giving us the false sense that we can transcend them as mere tools of our will. Such a frame, he argues, “privileges cognition” in ways that end up excluding fellow members of the human family who have diminished, damaged, or immature cognitive capacities. In a related story, it tends to marginalize those who are fundamentally dependent on others, without an ability to bend much of anything at all to their will. Readers of this review can probably guess the basic moves in  his applying this central argument in chapters on “Abortion,” “Assisted Reproduction,” and “Death and Dying.”

Happily for those who don’t want to wade into those waters, Professor Snead avoids in-depth deductive arguments about the immensely complex and perennial bioethics question: What is a Person? (For those who want to dive deeply into such arguments, however, I can’t recommend highly enough a book which also recently came out by Jason Eberl from Notre Dame University PressThe Nature of Human Persons: Metaphysics and Bioethics. It is an in-depth, deductive take-down of an anti-body dualism in favor of a pro-body hylomorphism. Snead’s and Eberl’s books could be profitably read together, especially in a high-level bioethics course committed to exposing students to genuinely diverse perspectives on matters of public bioethics.) Snead instead takes what he calls an “inductive” approach that understands and critiques “the regnant anthropology of American public bioethics by analyzing the law and policy (and the academic discourse that undergirds them) as they currently stand.”

My own moral anthropology is very similar to that of Snead’s, so I can hear the critiques of his position very clearly in my head already. Most often it is a charge like vitalism. Or, as Jeff McMahon put it during a panel discussion with Peter Singer a few years back, we hold something like the “animalist” position.

And speaking for myself, I do plead guilty to holding the view that what makes us who we are is the fact that we are living organisms of the species Homo sapiens and our fundamental equality comes from the fact that our bodies share a particular nature (not accidental traits) of human animals in common. I totally agree with Snead that we must take the givenness of our bodies seriously—not just as limits, but as important , and even essential moral and legal concepts. For, again, sharing this human nature in common serves as the foundation of any defensible claims to fundamental equality of all human beings apart from accidental traits.

Significantly, especially for Snead’s goal of trying to speak across difference in the spirit of friendship, this is precisely the kind of concern that disability rights groups have had for many decades now—and have been emphasizing even more strenuously during the rise of ableism during the pandemic. The emphasis of public bioethics on cognition, will, and independence is rightly called out by such activists and academics as destructive of the given goodness of “disabled bodies” and refusal to allow them to be turned into objects.

Jeff Bishop has pointed out how a public bioethics focused on negotiating the claims of competing individual wills has impoverished itself by slouching toward a hopelessly thin proceduralism. But he has also emphasized that the challenge from intersectional critical theory to proceduralist bioethics—especially as it has focused us back on metaphysical arguments related to identity—may lead us in a very different direction. It may not be surprising, especially in light of Snead’s arguments, that many such activists and scholars refer to “bodies” in ways that are designed for us to acknowledge their givenness and what such givenness demands, both morally and legally. Public bioethics may be pushed to come out of its proceduralist bubble and once again broadly engage the kinds of anthropological questions Snead, critical theorists, and disability rights activists are asking us to consider.

Some may argue that this is an unlikely shift. As the field has come to be dominated by pragmatic clinicians with little stomach for doing difficult metaphysics in general, and moral anthropology in particular, it is difficult to see how something like this could happen.

I certainly get this reaction. But as reason for hope I offer the example of arguably the most important voice in clinical bioethics over the last three decades: Joe Fins. Once thought of as a proceduralist focused on something he called “clinical pragmatism,” Fins during the last several years has dived deeply into the biological, moral, and legal status of people previously described as being in a persistent or permanent vegetative state. Indeed, in his book Rights Come to Mind he rocked the bioethics world by undercutting the moral anthropological assumptions present in the bioethical proceduralism surrounding this population—something he now laments and calls out as leading to “therapeutic nihilism.”

Fins is still focused on the possibility of therapies which could produce proof of a certain level of cognition for those with catastrophic brain injuries, so he’s not (yet) in the camp of confronting the givenness of living human bodies qua living human bodies. But his journey from hard core pragmatism to understanding the necessity of getting the complex questions surrounding moral anthropology right, I think, offers supporters of Snead’s project hope that those who hold power in public bioethics can be convinced to move from thin questions of proceduralism to thick questions of moral anthropology.

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