Book Review

What it Means to be Human: The Case for the Body in Public Bioethics

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In this timely, provocative, and erudite work, O. Carter Snead, Professor of Law and Director of the de Nicola Center for Ethics and Culture at the University of Notre Dame, proposes that the way forward for American public bioethics (APB) is an investigation of the anthropology underlying it. His basic argument is that law relating to APB suffers from an anthropology that he calls “expressive individualism” (EI), and that it would do well to embrace an anthropology rooted in human embodiment instead. According to Snead, the purpose of the law in an EI framework is to “create the conditions of freedom to pursue one’s invented future, unmolested by others and perhaps even unimpeded by natural limits” (6). In contrast, Snead proposes a purpose of law rooted in embodiment: “to help create, support, and protect the networks of giving and receiving on which we all depend in our vulnerability as embodied beings in time” (274). This fundamental difference echoes throughout the book. After a brief introduction, chapter one provides a fascinating history of bioethical research, law, and practices, highlighting instances of extreme injustice and inhumane treatment of the vulnerable.

Chapter two presents Snead’s investigation into the dominant anthropology of APB via philosophical inquiry. He notes: “At the very deepest level, law and public policy exist for the protection and flourishing of persons. Thus, all law and policy are necessarily built upon presuppositions about what it means to be and thrive as persons” (65, italics in original). He makes special use of philosophers Robert Bellah, Charles Taylor, Alasdair MacIntyre, and Michael Sandel to discuss the definition of “person” and who ought to count as a “person” for legal purposes, and to engage their ideas related to EI. Snead suggests that the forms of individualism identified by these philosophers are well suited to describe the presuppositions underlying APB. He differentiates EI from individualism and argues that EI is a more extreme version of individualism in which ultimate moral authority lies in one’s inner world (known only by that person) and for which the telos of one’s life is self-discovery and self-expression.

Snead’s concern is that EI too narrowly focuses on the prime of life, ignoring the reality of the arch of embodied existence—the fact that all people are at times utterly dependent upon the care, strength, and wisdom of others. Thus, part of Snead’s main argument is that APB needs to remember the body and everything that embodiment entails. He also embraces MacIntyre’s suggestion that all people experience a “scale of disability” (89) and proposes that instead of EI, APB would be better grounded in an anthropology marked by caregiving, gratitude, and virtue. Snead bases his vision for an anthropology of embodiment on the paradigm of parenthood and implies that parental care of children is the ultimate example of “uncalculated giving and graceful receiving” (7). He proposes that “we need robust and expansive networks of uncalculated giving and graceful receiving populated by people who make the good of others their own good, without demand for or expectation of recompense” (269).

In chapters three, four, and five, Snead probes laws related to the three most prominent APB issues (abortion, assisted reproduction, and assisted suicide) in order to expose the ways in which EI is presupposed by them. His guiding question in these chapters is “what vision of human identity and flourishing anchors the relevant legal doctrines and principles of enforcement. . . . Is it a vision of personhood that takes embodiment seriously and is thus fit for grounding law meant to protect and promote the flourishing of beings who live, die, and encounter one another as bodies?” (108, italics in original). Concerning the current state of bioethical laws, Snead suggests that “they are limited weapons and tools of rational mastery fit for a lonely, disembodied self to defend and pursue its interests. They are not well-designed to address the complex needs and wants of a community of embodied, vulnerable, and interdependent human persons” (272). Each chapter explores crucial court cases and policies, and their implicit anthropology (which in each case Snead determines to be EI). Throughout the book, his opposition to abortion rights, the extermination of embryos produced via reproductive technologies, and assisted suicide become clear. Since current laws regarding each of these issues are rooted in EI, which does not adequately account for embodiment, they cannot, according to Snead, affectively promote human flourishing.

Whether or not Snead’s diagnosis is deemed accurate and his proposal accepted, anyone interested in APB, anthropology, moral ethics, or America’s ever-evolving social norms will likely find this to be a rewarding read. Additionally, individuals of all political persuasions will do well to carefully consider Snead’s insights, as they have potential to spark amenable bipartisan discussion. This is certainly a mark of the book’s success. Although this work is groundbreaking and incredibly influential, a few questions emerge as well.

First, one wonders if Snead’s analysis is truly inductive. It seems that he began with a theory (that APB is rooted in an anthropology of EI) and then set out to test that theory—an approach usually considered deductive. Perhaps the details of data collection, analysis, and how he originally arrived at his conclusion are omitted simply for the sake of space or presentation. Moreover, additional reflection on what law is and where it comes from might enrich his work. More attention could be paid to how laws reflect the values of the communities out of which they originate (they are not created in a vacuum). Moreover, laws are written and enforced by individuals (embodied people who are influenced by their own experiences, cultures, values, and interests). It is difficult to imagine how Snead’s proposed anthropological shifts might take place in America’s legal realm without first becoming normative in society at large. What might this look like in such a diverse society? Also, could Snead’s anthropological observations be equally applied by proponents of the laws he uses them to reject? Though Snead’s vision is beautiful, it is also optimistic, and it is unclear whether it can actually be implemented. To be fair, he intentionally (and understandably) leaves matters of application for future work—and this book skillfully sets the stage for such work.

Moreover, Snead’s use of familial relationships is both lovely and suspect. For instance, he argues that in most cases the experience of becoming a parent causes individuals to become less self-focused, more aware of the needs of others, and more willing to place the needs of others above their own (89–90). He also maintains that family members ought to be involved in end-of-life decisions and that these decisions should not be left to the individual’s past or present wishes (i.e., in a living will) alone because the individual’s care should not be bound to their previous preferences, and their current state of suffering prevents them from making optimal decisions (251). While, in theory, this sounds attractive, it is not clear that Snead has considered the embodied reality of many familial relationships. The devastating fact is that many parents do not treat their children with unconditional love (love is conditionally tied to certain behaviors, accomplishments, or to the child’s alignment with the parent’s own wishes for them). Furthermore, many kids experience abuse or neglect at the hands of family members, and many disabled children live in group homes where they are rarely visited by their families. It is also now well known in psychology that becoming a parent often triggers the parent’s own childhood wounds and may, without treatment, actually bring out the worst in them.

For many individuals, the only hope for flourishing is for them to heal from the harm inflicted by their family and to relearn basic principles for living well (emotionally, relationally, and physically). Unless society addresses cycles of generational trauma, it makes little sense to relegate important decisions to an individual’s family. Snead, following MacIntyre, admits that all people, at all times, are to some extent disabled. What, then, makes a person’s family more fit for decision making than the individual herself (or that individual’s prior preferences)? The matters raised by Snead seem less about America’s legal system and more about pervasive cycles of mental, emotional, and relational illness in society.

One promising way forward for Snead’s work might be interdisciplinary dialogue between fields poised for practical application (i.e., law, public policy, and government) and those working “behind the scenes” on topics like philosophy, theology, ethics, psychology, and sociology. Moreover, it would be interesting to hear responses from philosophers concerning Snead’s application of their discipline to bioethics. Further parsing of the relationship between appropriate forms of individualism (those that celebrate uniqueness and diversity) and the human need for community might help avoid a potentially dangerous false dichotomy. These features of the human experience are certainly not mutually exclusive. Additionally, this book offers the important reminder that the field of bioethics, and the technologies it seeks to regulate, are very recent in the scheme of human history. Thus, patience with the process, amiability toward those with different opinions, and open-minded curiosity are essential.

Finally, how might evangelicals engage Snead’s work? Snead rightly calls for an anthropology that takes account of human dependency and natural limits, loving communal systems, and the cultivation of virtue. One wonders if Snead’s list might be better balanced by considering humanity’s insidious corruption as well. In other words, theological response to Snead will need to hold in gentle tension the effects of sin, divine goodness, grace, and human responsibility. Moreover, while most American evangelicals are not able to directly affect society’s laws or the anthropological values motivating them, we can become people who cultivate the virtues Snead admonishes: just generosity, hospitality, misericordia, gratitude, humility, openness to the unbidden, tolerance of imperfection, solidarity, dignity, and honesty (note the resemblance to the “fruit of the Spirit”). The church can, with intention and the Spirit’s guidance, become a community of people who “make the good of others one’s own” (8). Finally, Snead rightfully calls for remembrance of the body (a notion consistent with the Christian rejection of Gnosticism). It seems, though, that even more fundamental is the need to remember our Creator (Eccl 12:1). After all, humanness is not merely marked by embodiment, but by createdness. Our createdness necessitates that we are not our own but that we belong to God, are part of the natural world, and participate in the one common humanity. For evangelicals, an anthropological framework for bioethics ought to therefore be a theological anthropology, and our theological anthropology ought to be rooted in a robust theology of creation.