By Marshall Scott
This Lent I led a five-week adult class on ethics and moral theology. My point was to encourage those present (as I would encourage all of us) to approach moral questions as issues for theological reflection. I contrasted a theological reflection model with one that was not theological (or at least not explicitly so; but perhaps that’s a topic for another day); and because it was the one most familiar to me, I used the model most common in health care. We discussed “the Georgetown Mantra,” and its principles of Autonomy, Non-maleficence, Beneficence, and Justice, all under the umbrella principle of “Respect for Persons,” as well as the “technological imperative” (“Because we can do something, we must do it>”).
Eventually (I think perhaps in the last session), we found ourselves bouncing among a variety of issues, and I noted that they all had something in common. I said, “They all push us to the question of what it means to be human.” We went from abortion to embryonic stem cells to medical futility and health care at the end of life. We touched on the rights of the mentally or developmentally disabled, and possible future issues of simian rights (and I fully expect our children or grandchildren will be faced with them). They all had some connection, I said, “to what it means to be human:” what is human life, what makes human life meaningful, how much like me does another have to be to be meaningfully human. And when I got home and was discussing this with my wife, she said, “You know you put that wrong.”
And to an important extent she was correct. All of those issues are more often, and perhaps more productively, addressed not as what it means to be human but what it means to be a person. The two questions are related, but they aren’t identical. For example, we don’t argue whether a fetus is human, but we argue long and hard about whether the fetus is a person. We often describe the consequences of severe, unrecoverable brain injury by saying to a grieving family, “The heart still beats, but the person you love is gone.” (Interestingly enough, that’s what we say when the injury is the result of sudden traumatic insult. When it’s due to the gradual deterioration of Alzheimer’s, it’s what families say to us.)
We can see the questions aren’t identical when we ask what we mean by “human rights”: do we mean rights inherent in being human, or rights inherent in being a moral agent. Another way to put the question is to ask how a right applies if the holder of the right can’t freely exercise it. So, even when we disagree on whether a fetus is a person we do agree that a fetus can’t, on its own, exercise a right. And before we start jumping up and down, remember that we make calculations, gradations of moral agency, and so in some sense of personhood, all the time. A child has limited capacity to exercise rights, and how to exercise those rights becomes the responsibility of parents, who are considered the appropriate surrogates. Prisoners can’t exercise rights with the same freedom as the rest of us, and so (interestingly, like children) they become a “protected class” who can only be included in medical research with the greatest care to prevent coercion. In some senses, the state becomes their surrogate. Even after serving their time, most prisoners never regain such rights as the vote. Some prisoners have committed crimes so repugnant that the state claims they lose the right to life altogether.
Most of us would say that, in one way or another, some sense of personhood applies to all human life. At the same time, there are some who would say that full rights of personhood apply to all human life, and to any instance of human life. For them the important question is not whether the full rights apply, but who should be the appropriate surrogate to protect and exercise those rights. While it’s not the only issue in which this difference is highlighted (between those who apply some personhood, but not full personhood, and those who apply full personhood in all cases), the best known is the issue of abortion. More recently, and to no small extent related to abortion debates, is the issue of embryonic stem cell research.
It is the latter issue that is currently exercising our Anglican brothers and sisters in the United Kingdom. In the UK issues of the uses of embryos, whether for human fertility or for embryonic stem cell research, have been governed by the Human Fertilisation and Embryology Act 1990. A proposed revision has been passed in first reading in February, and according to a release by the National Health Service: “while no date has been set for its second reading or approval in principle it is viewed as a key piece of legislation on the government’s agenda.”
The proposed revision would allow for procedures far beyond what is currently permitted (and farther beyond what is currently permitted in the United States). In one matter of special concern, the revised law would permit the creation of “human admixed embryos,” also described as “cytoplasmic hybrids,” or “cybrids.” They would be created by removing nuclear DNA from an ovum from an animal and replacing it with nuclear DNA from a human being. The ovum would then be stimulated to divide, and the resulting embryo could then be studied. The goal would be to study specific genetic diseases (Parkinson’s and Alzheimer’s have been suggested) and how they develop in the earliest stages, in hope of suggesting new therapies.
As part of their own culture and context, our Anglican siblings are certainly involved in this. Archbishop Rowan Williams has commented. Bishop N. T. Wright, Bishop of Durham and Biblical scholar, worked it into his Easter sermon (blessedly, as illustration and not as central theme). Perhaps the best reflection is this blog post from Bishop Alan Wilson, Bishop of Buckingham, who has laid out important questions for reflection. All of them agree that central to this issue is the question of what it means to be human, and just how far we can go in seeing that which is human (whether person or not) as a means to an end, however good the end might appear.
While we have not spoken in General Convention to this specific issue (but 2009 is coming fast!), there are places where we might look to see how General Convention has considered this human/person distinction. We have repeatedly, and in relation to several different issues, affirmed that “all human life is sacred.” Life is, after all, God’s gift, raised especially when God chose to share human life with us in Christ. At the same time, Christ was a person, making and calling us to moral actions; and we have also made distinctions pertaining to persons as moral agents. For example, in resolution 1988-C047 (reaffirmed in resolution 1994-A054 with the language virtually unchanged) we affirmed, ” All human life is sacred from its inception until death,” and acknowledged that “We regard all abortion as having a tragic dimension….”
However, considering the difficult decision of abortion we “acknowledge that in this country it is the legal right of every woman to have a medically safe abortion….” We speak of “the person or persons seeking advice and counsel [on abortion],” and express “unequivocal opposition to any legislative, executive or judicial action… that abridges the right of a woman to reach an informed decision… or that would limit the access of a woman to safe means of acting on her decision.” Regarding research on the earliest human tissues, we have rejected “for the purpose of providing fetal tissues for therapeutic or medical research usages; and… the use of fetal tissues aborted for financial profit for use in therapy and medical research….” (1991-A096 ). On the other hand, we have agreed to:
(A) Support the choice of those who wish to donate their early embryos, remaining after in vitro fertilization (IVF) procedures have ended; and
(B) Urge that the United States Congress pass legislation that would authorize federal funding for derivation of and medical research on human embryonic stem cells that were generated for IVF and remain after fertilization procedures have been concluded, provided that:
1. these early embryos are no longer required for procreation by those donating them and would simply be discarded;
2. those donating early embryos have given their prior informed consent to their use in stem cell research;
3. the embryos were not deliberately created for research purposes;
4. the embryos were not obtained by sale or purchase….
In essence, we make a distinction between tissues conceived with the possibility that they might be born, and so become persons, and those tissues conceived with no possibility for personhood.
Here in the middle of America where I find my ministry, these issues are quite current. The topics of embryonic stem cell research, the therapies that might result, and the research dollars that might come to it, are matters of ongoing discussion. Abortion continues to be a matter of debate as much or more here as anywhere. With them both, we find ourselves wrestling again with both questions: what does it mean to be human; and do rights obtain to all instances of human life, or to persons. As our UK siblings are experiencing again, for us as Christians these need to be matters for theological reflection, and not simply of academic or clinical ethical discussion. As a Church, we have in the past sought to balance the sacredness of all human life with the importance of the rights of persons. However, as technological capacities change and cultural dynamics change, we must return to the question again: just what does it mean to be human, and how are we as Christians and specifically as Episcopalians to proclaim that in our time and place?
The Rev. Marshall Scott is a chaplain in the Saint Luke’s Health System, a ministry of the Diocese of West Missouri. A past president of the Assembly of Episcopal Healthcare Chaplains, and an associate of the Order of the Holy Cross, he keeps the blog Episcopal Chaplain at the Bedside.