“The human body is the best picture of the human soul.”Footnote 1
“I changed the subject by jerking my head once more toward the research building before we turned out of its sight. ‘We've got that to be grateful for, maybe even pious about. Then years ago our children wouldn't have stood a chance.’
‘So death by leukemia is now a local instead of an express. Same run, only a few more stops. But that's medicine, the art of prolonging disease.”Footnote 2
I am sure I am not the first person to have noted the irony (if not the political cynicism) of the timing of the passage of The Patient Protection and Affordable Care Act in the United States Senate on Christmas Eve, 2009. Doubtless this was an occasion for much unwarranted hysteria on the part of some reactionaries, which are in no short supply these days. But there is also just enough Machiavellian shrewdness in the act to make one wonder at the naked opportunism of a political machine deciding on such a monumental and controversial health care plan (notwithstanding the repeated and insistent opposition to portions of the plan by the nation's Catholic bishops) on one of the holiest nights of the Christian year. One suspects that the Senate counted on the fact that most people would be occupied by a different kind of wonder, over this night visitor or that. Maybe they banked on the possibility that many people would, on Christmas Eve, be in their cups or in their stocking caps, settling down for a long winter's nap. It was probably a safe bet. But I mention the timing of Christmas intentionally, since this is precisely where John Paul II's encyclical Evangelium Vitae begins, inasmuch as the Nativity of Christ “reveals the full meaning of every human birth, and the joy which accompanies the Birth of the Messiah is thus seen to be the foundation and fulfillment of joy at every child born into the world…It is precisely in this ‘life’”—in risen, eternal communion with the Father—“that all the aspects and stages of human life achieve their full significance.”Footnote 3 I shall return to this in due course.
But I must confess at the outset a congenital inability to make sense of or speak intelligently about the documents of officialdom, or to shed any kind of insightful light upon the gastrointestinal taxonomy of the Leviathan whose head makes its home inside the Beltway. I can speak no more authoritatively about the present constitution of modern medicine or the actuality of the experience of the physician or patient or about the science of modern biology—not, however, that this is enough to stop me from trying to do so anyway, but such is life in Yeswecanistan.Footnote 4
My interest here, though, is rather broader and more basic, that is: the latent and often (perhaps deliberately) occluded philosophical and theological assumptions about the status of the human person insofar as the latter constitutes the presumptive object of contemporary health care law. I want to suggest here that the understanding of human life and what constitutes it per se is altogether conceptually unavailable to the science of biology itself, and that biotechnological practices in particular presume an account of human nature which it cannot avoid articulating, even if at several degrees of remotion, by its very practice.Footnote 5 Finally, we cannot have an adequate account of human being—if at all—without theology.
As Michel Henry writes, “In the field opened by modern science, there is no person. It is not that the upheaval of knowledge that resulted from the emergence of the entirely new scholarship of modern science has similarly upset (or at least modified) our idea of a person, what makes his essential Being; rather, science quite simply suppresses it.” Thus François Jacob said that “Biologists today no longer study life”.Footnote 6 Commenting on this, Henry says, “To know that biology is no longer concerned with life, you have at least to know what life is, which is precisely what biology does not know.”Footnote 7 This is because biology adopts a kind of “methodological materialism” as its default position as well as its founding disposition towards the body.Footnote 8 So while biology, paradoxically, can disclose to us neither the nature of life nor the full meaning of the body, on the contrary, “the obsolete knowledge of Christianity, a knowledge that is two millennia old, furnishes us not with entirely limited and useless data about humans: today it alone can tell us, in the midst of the general mental confusion, what man is.”Footnote 9
What, then, is man?
Beginning in the 1970s, in the wake of the Roe v. Wade decision, the notion of “personhood” became a contested locus in theology and philosophy. Stanley Hauerwas registered the limits of this approach in a famous essay in 1975 entitled, “Must a Patient Be a Person to Be a Patient? Or, My Uncle Charlie Is Not Much of a Person, But He Is Still My Uncle Charlie.”Footnote 10 Implied in Hauerwas’ classic title is the suggestion that in some way the relations of natural—and especially ecclesial—kinship are ontologically prior to the philosophical concept of “person”. Notwithstanding Hauerwas’ criticism of the language of personhood the topic has been vigorously renewed in the direction of relation and reception in recent years among Catholic philosophers and theologians, conducted largely in the pages of the journal Communio by the likes of then-Cardinal Josef Ratzinger, Hans Urs von Balthasar, David L. Schindler, Steven A. Long, Kenneth L. Schmitz, W. Norris Clarke, and others. In brief, these figures have proffered an enriched conception of the person on much more explicitly theological grounds in the spirit of a nouvelle théologie-inflected Thomism. One of the contributors to this discussion, the German philosopher Robert Spaemann, has suggested, in his important book, Persons, that:
“Talk about ‘persons’ is common enough; talk about ‘souls’ has come to be discreditable. Materialism, in reductionist and non-reductionist versions, attempts to eliminate the soul without remainder and to account for its states and activities physiologically. Christian theology has more or less declined to put up a defence. Unwilling, for one thing, to accept ontological commitments at variance with those of its contemporaries—for theology more than ever today leans towards pastoral opportunism at the cost of intellectual and religious substance—neither does it want to obscure the biblical message of bodily resurrection with a philosophical doctrine of the soul's immortality. Yet how are we to think of our earthly and risen bodies as identical without a soul to provide for their continuity, is a question rather seldom asked.”Footnote 11
While theology, especially where the practice of medicine is concerned, may indeed privilege “pastoral opportunism” over “intellectual substance,” there are some theologians who have been willing to put up a defense against the methodological materialism, if not nihilism, at the basis of modern science. For example, as Sergei Bulgakov showed, every positivistic account of human life and death succumbs to “the ultimate ontological absurdity of a double annihilation: an appearance out of nothing and a return to nothing, a soap bubble that has burst, whose real content is emptiness. In order to avoid accepting the problematic of death, unbelieving thought takes refuge in this ontology of nihilism, in the ‘outer darkness’ of a double nonbeing: before death and after death.”Footnote 12 Death, then, is an “act of life”,Footnote 13 and can only be understood within the context of life, and not vice versa. Death then is intelligible only in virtue of that of which it is a privation: “God made not death, for he created all things that they might have their being.” (Wisdom of Solomon 1.13,14).Footnote 14
The classical language for this, which the Church has never really done without, is that of the soul as the “form of the body”. This indivisible unity of body and soul is what constitutes human being, not a composite of “rational” bits and “material” bits. As Aquinas puts it, the rational soul is “the substantial form of the body”. He even claimed that “The soul is more like God when united to the body than when separated from it, because its nature is then more perfect.”Footnote 15 “Although after death (in which the soul is separated from the body) not only does the animal not remain but no part of the animal remains, except equivocally, as is said in On the Soul II; yet flesh and bone would seem to remain more after death than-hand or arm, in which the operations of the soul are more evident.”Footnote 16 In 1312 the Council of Vienne solemnly enjoined all Christians to uphold and defend the doctrine of the rational soul as the essential form of the human body, and anathematized the contrary position as heresy.Footnote 17 The Church has maintained this position pretty consistently, despite centuries of nuance and refinement. This is reflected in John Paul II's thought, when he speaks of
…the Church's teachings on the unity of the human person, whose rational soul is per se et essentialiter the form of his body. The spiritual and immortal soul is the principle of unity of the human being, whereby it exists as a whole — corpore et anima unus — as a person. These definitions not only point out that the body, which has been promised the resurrection, will also share in glory. They also remind us that reason and free will are linked with all the bodily and sense faculties. The person, including the body, is completely entrusted to himself, and it is in the unity of body and soul that the person is the subject of his own moral acts. The person, by the light of reason and the support of virtue, discovers in the body the anticipatory signs, the expression and the promise of the gift of self, in conformity with the wise plan of the Creator.Footnote 18
“Life” then is characterized above all by receptivity—not only biologically but conceptually. Life eludes conceptual formulation; in this sense it is a transcendental—“Our life is hid with Christ in God.” In contrast to the late modern Baconian-Cartesian mastery of nature, nature is precisely not that which possess as an inalienable property but as a gratuitous gift. “Human beings ‘have’ their life, but they have it as recipients who were not asked whether they wanted it. They only exist as those who have received life.”Footnote 19 Hence St. Bonaventure says that “This is the death of men: they desire to possess and maintain.”Footnote 20
Bodies, after all, do not suffer pain and die; human beings do. Whatever is meant by the language of “the separation of the body and the soul” at death has—irrespective for the moment of whatever unsavory philosophical connotations it may possess—at least this to commend it: the human being is a substantial unity. Death, therefore, is a genuine loss, an indication of a disruption in the ontological order of reality itself, and never simply an exchange of one type of clothing for another. Man, Thomas Aquinas says, “is not soul alone”. He adds that this is in contradistinction to the view that the soul “makes use of the body” as an instrument, an idea which he attributes to Plato.Footnote 21 It belongs, he says, to human nature to have a real body.Footnote 22 Indeed, the “separated soul” is an intermediate state for Thomas, whose destiny is to rejoin the body, though in a mysterious new mode, since “it is contrary to the nature of the soul to be without the body.”Footnote 23 Thus he writes that “the soul united with the body is more like God than the soul separated from the body, because it possesses its nature more perfectly.” Again, bodies do not die; as Spaemann says, “Only persons die.”Footnote 24
Oblivio mortis
One reason why modern Christian funerals can be such garishly sentimental affairs is surely because of the shroud of Cartesianism that envelops our understanding of “the resurrection of the dead”. We cannot think of it in anything other than post-Cartesian (or worse, Gnostic) terms, that is to say: the body is the chamber of the soul, and at death we are burying or cremating something merely material, but, oddly enough, that which is entirely ‘immaterial’ to our true selves. The latter we sometimes identify with ‘soul’: that region of true human selfhood which is inscrutable to the human gaze, utterly inaccessible to human communication. Most of us, I think, tend to be more Cartesian or even Manichean than Christian when it comes to thinking death and resurrection. Many of us believe that, as Herbert McCabe once put it, “We consist of two bits: a body and a soul. The body has to do with the public world, with science and the realm of Ceasar which passes away; the soul has to do with privacy, with values and with the realm of God, which does not pass away.”Footnote 25 At a recent funeral I attended, the preacher said something along the lines of this, namely that here we were committing to the ground the “physical” part, but the “spiritual” part lives on.Footnote 26 This may all be a part of a very laudable and natural human desire for consolation in the face of the evidently absurd, but more often than not the notion of the resurrection remains, even in the face of death, little more than a pious fiction for most Christians insofar as it might offer us some consolation in a time of grief but we don't really imagine resurrection as the truth of our bodily existence. Rather we seem often to regard death as the reality and resurrection as—at best—an escape from the order of death. Resurrection, that is, is the exception and death is the norm. But this, it seems to me, has it rather backwards.
Take, for example, the recent novel by the Portuguese Nobel laureate José Saramago, Death with Interruptions.Footnote 27 In it, a small nation wakes up on New Year's Day to find that, in the previous twenty-four hours, not a single person has died. No death notices to report, no corpses to transfer to the morgue, no tears to be shed over the dead. In Saramago's variation on an old theme, Death has taken a holiday. But what would seem initially to be a source of great joy and celebration quickly descends into chaos: whole industries whose subsistence is premised on the reliable and faithful operations of death are now scrambling to find new rationales for their existence. The life insurance industry begins recalculating “death” so that their clients’ policies automatically expire at age eighty; funeral homes are likely to be run out of business; and a grisly cadre of border bandits emerges whose trade consists (with the secret collusion of the government) in transporting the dying over the frontier of a neighboring country that has not suffered the unfortunate violability of death. (There is a subtle analogy here with the medical industry, who are not unlike the band of mobsters who transport the dying across the mystical frontier separating life and death.) Most vocal in opposition to the State's handling of the crisis is the Catholic Church. Early in the novel, the anonymous Cardinal phones the prime minister in panic:
It is utterly deplorable that when you wrote the statement I have just listened to, you failed to remember what constitutes the foundation, the main beam, the cornerstone, the keystone of our holy religion, Forgive me, your eminence, but I can't quite see what you're driving at, Without death, Prime minister, without death there is no resurrection, and without resurrection there is no church…Footnote 28
Now Saramago is no big fan of the Catholic Church—and I suspect that in some quarters of the latter the feeling is mutual—but he expresses here what is I think the unstated, maybe even intuitive assumption of most Christians and indeed atheists like Saramago. But it seems to me that another novelist is closer to the truth (or at least my thesis, which I grant may not be the same thing). In a letter to a friend, Flannery O'Connor once wrote that “it is the virgin birth, the Incarnation, the resurrection which are the true laws of the flesh and the physical. Death, decay, destruction are the suspension of these laws. I am always astonished at the emphasis the Church puts on the body. It is not the soul she says that will rise but the body, glorified.”Footnote 29
The distinction between the “earthly” and the “glorified” body might be understood in some way to convey the irremediable sense of loss involved in any human death. Yes, we will be raised incorruptible, but there is something of this life, this body, that will not be restored, whatever that is. Because our resurrection is not simply the re-assembly of this mortal flesh and bones, our death is not identical with their dissolution, either. The body which is promised in resurrection maintains a kind of paradoxical relation to the “earthly”, one neither of strict identity nor sheer equivocal difference. Without resurrection we are, as Shakespeare says, “Creature[s] unprepared, unmeet for death”.Footnote 30 The extent of our unpreparedness, it seems, reaches down to the very level of ordinary language: a culture which, out of some deep insecurity about its own mortality, would rather call chicken battered and cooked in hot fat “crispy” as opposed to “fried” cannot realistically be expected to distinguish truthfully between “death” and “passing away”.Footnote 31
Therefore, “Christianity”, as Alexander Schmemann writes, “is not reconciliation with death. It is the revelation of death, and it reveals death because it is the revelation of Life. And only if Christ is Life is death what Christianity proclaims it to be, namely the enemy to be destroyed, and not a ‘mystery’ to be explained.”Footnote 32 As Pascal says, “Not only is it through Jesus Christ alone that we know God but it is only through Jesus Christ that we know ourselves. We know life and death only through Jesus Christ. Without Jesus Christ, we do not know what our life, nor our death, nor God, nor ourselves, really are.”Footnote 33 As Conor Cunningham suggests, “without this perspective, we can never speak of the horror of death, for it would be only a natural event, a moment in a process, and any resistance to it would be the result of an illusory sense of worth. Moreover, in being part of a natural process, the problem of actually picking it out, that is, noticing it when employing only natural terms, would be intractable. In short, death is horrific and abnormal, and such imitations of its unnaturalness point to it being overcome—not by positing some heaven in the sky, or through talk of a soul slipping away to some ephemeral realm, but by speaking of the hope of bodily resurrection, hope already present, however implicitly, in our noticing death and our sense of repulsion from it.”Footnote 34 Resurrection, then, grounds the possibility for naming death truthfully; otherwise “men will seek death, but will not find it; they will long to die, but death will elude them.”Footnote 35 We don't know what we're looking for.
The point of the foregoing is that a Christian anthropology must, it seems to me, begin with the resurrected body as in some sense the paradigmatic form of the human person. Death, therefore, does not ‘release’ the human soul; talk of the resurrection of the flesh would make little sense in such a context. But neither does resurrection entail a sentimentalization of death or a kind of stay against death's universal dominion. It does not imply that we can treat death without horror, or not regard it as a real loss. A proper Christological account of the person might prevent us from a kind of anthropological docetism: the body is not really “me”; moreover, my body is not really anything at all. The irony of this species of materialism causes the body itself to vanish. For as Josef Pieper points out, referring to Thomas Aquinas’ commentary on Aristotle's De generatione et corruptione, “it is not enough to say that [at death] the physical organism itself no longer remains. Even the limbs of the body must be spoken of in an entirely different sense of the words. To say ‘flesh and bones’ may still be meaningful; but in the strict sense it is no longer possible to speak of a ‘hand’. Only a living, animated hand is really a hand at all.”Footnote 36 But only if Christ's death is real, if it is the death of his truly human being, can our deaths be thought of as horrific and worth grieving.
Hannah Arendt once wrote that “The miracle that saves the world, the realm of human affairs, from its normal, “natural” ruin is ultimately the fact of natality, in which the faculty of action is ontologically rooted.”Footnote 37 To rephrase Arendt slightly, we might say that the miracle that saves the world—even death—is resurrection. She wrote that ‘this faith in and hope for the world…found perhaps its most glorious and most succinct expression in the few words with which the Gospels announced their “glad tidings’: ‘A child has been born to us.’Footnote 38 The nativity of Christ is already an anticipation of resurrection insofar as it instantiates or consummates an order of gratuity grounded in the act of creation itself. To Arendt's insight we might add that of von Balthasar, for whom it is first the mother's smile over her child that marks the nature of existence as such as both “miracle and play”, an experience of the sheer glory and gratuity of created existence, which is nothing other than that of love, of the “reality of being admitted” into a world of existence which you did not choose for yourself. This irreducibly generous act of generation is the first in the drama of divine glory as experienced by human beings and the ground for a properly Christian metaphysics of the body.Footnote 39
Outside the Church there is no Death: what I mean by this should now be somewhat clear: the human body is not a container for the soul but its form. In the light of the resurrected and glorified body of Christ, who still bears the wounds of the thorn and the lash, the cross and spear, we can genuinely mourn one's death as the loss of something irreplaceable; that is, because eternal life consists in the vision of God by our whole selves, and not just a separated soul, a proper Christian anthropology that began in some sense with the glorified body of Christ as the truth of the physical might suggest a very different biomedical practice than that with which we are familiar. The latter might presume the body as a given datum of medical experience, whose death it is the object of medcine to prevent or postpone. But the doctrine of resurrection does not permit us to treat the body as inert, premoral matter; rather it already bears the anticipatory signs of its eternal future. Thus we can say that the body was not made for death, but for resurrection.
As David Hart writes, “Only in the light of this impossible desire for the one who is lost, this insane expectation of a restoration of the gift, and this faith in what is revealed at Easter is it morally possible for Christian thought to regard the interval between oneself and the lost beloved as potentially an inflection of divine rejoicing, a distance of peace: not by way of some sublation of the beloved, nor according to the serene proportions of tragic wisdom, but by way of the Holy Spirit's ingenuity in resurrection, his ability to sustain the theme of God's love (the gift given) over the most dissonant passages, now under the form of hope.”Footnote 40 Contra the tragic pathos of modern dying, death is not ennobling but destructive: “For there is hope for a tree, if it be cut down, that it will sprout again…But man dies, and is laid low; man breathes his last, and where is he?”Footnote 41
Our life, as St. Paul says, “is hid with Christ in God”.Footnote 42 Neither biology nor physics can ask “Does God exist?” But importantly, neither does theology have much interest in this question; the latter doesn't begin by trying to prove an answer to it. But in light of the foregoing, the question at the intersection of theology, philosophy and medicine is not, “Does God exist”, but “Do human beings?”Footnote 43