Defending freedom Defending the body
A philosophical commentary on the invasion of the human being
Version auf Deutsch
The turn of the millennium is marked by a new conception of the human being. Science and industry in conjunction with the most powerful world rulers broke the news of the decoding of the human genome hailing it as the greatest step for mankind since the discovery of the wheel. Australian researchers reported the successful selective culture of tissues from embryonic material in animal experiments. The manipulation of pluripotent stem cells from clones proceeds at full speed in order to test their development potential for transplantable organs. In 1997 the cloning of Dolly-the-sheep had provoked shock and led to warnings worldwide about the cloning of human beings. The year 2000 saw a flood of scientific breakthroughs and fundamental ethical shifts which culminated in the resolution passed by the British parliament shortly before the beginning of 2001. The National Institute of Health in the USA had already released new regulations according to which research into embryonic stem cells was given the go ahead supported by public funds.
Meanwhile in Germany, the embryo protection law is coming under increasing pressure. It is true that the law has so far forbidden the use of embryos and stem cells, yet it is common knowledge that they are imported frozen from the USA. Many researchers see no reason why this fig leaf is still kept in place. Anyway, in routine laboratory practice the hitherto protected beginnings of human life have become just neutral collections of cells.
The step towards therapeutic cloning, which to a large extent has already been taken, is serious because it means that the principle of the inviolability of human life has been breached for the first time in full consciousness. It is no use appealing to the already accepted broken taboos in our society because here, in contrast to in vitro fertilisation, it is not a matter of violating the natural course of reproduction in order to bring a child into the world. It does not even involve using biological material resulting from abortion, for instance in experimental therapy with foetal tissue for the treatment of Alzheimers. No, in contrast to abortion, where a life is ended because it is unwanted, therapeutic cloning means consciously and deliberately creating a life so that it can be ended. The embryo that is produced from the mixing of donor cells with their own hereditary material, i.e. the human being whose development is set in motion, is brought into life solely for the purpose of using it to treat another human being.
The human being as object
It is only slowly beginning to dawn on people that with such steps we are leaving an ethical and legal realm that has grown up over centuries and we are only slowly beginning to realise what the consequences might be. Here the fundamental ethical decision has already taken place, namely, against all modern legal principles, wanting to make the human being an entity which is not only biological but also one which has a mind, character and social context into an object of peoples intentions. It is not just extremists like for instance the American Richard Seed who somewhat optimistically wants to clone himself and who is seen as a dreamer even in professional circles, but also eminent biologists like Professor Lee Silver of Princeton or the icon of genetics James Watson who openly issue calls for medical eugenics, for genetic improvement, for the right to reproductive freedom and the duty to produce an optimal baby.
Along with promises of eternal life and health, the creation of a humanity without suffering, which Klaus Dörner has so aptly characterised as a secret anti-motif of modernity, is already taking place using the techniques of genomic medicine. It involves combining the possibilities offered by genetic diagnostic testing with liberal use of abortion so that what is unashamedly described as a genetic defect, but is a real living human being, is unlikely to be allowed to remain alive. By strict use of deselection of disabilities 95% of children testing positive for Downs syndrome never see the light of day a new class of people who are discriminated against, the invisible disabled has already been established according to the disability activist Brigitte Farberer who spoke at a conference of the German Bundestag Commission of Enquiry in October 2000. These people are carriers of a not yet manifest genetic illness and thus according to the logic of the market economy of our society must reckon with being discriminated against, if the information is passed on during job seeking or when applying for health insurance.
The new Adam
One example from the brave new world that has finally arrived should be sufficient here: on 29th August 2000 a little Adam was born, the first to be selected for medical purposes under the microscope (see Der Spiegel 41/200).1 Adam was produced in vitro together with his embryonic siblings and beat his competitors in a physical fitness test in the laboratory. Adam was selected according to therapeutic criteria he had to contribute to healing his six year old sister, Molly, who was suffering from a serious genetic disorder of the bone marrow. The possibility of successful therapy amounted to being able to transplant umbilical blood cells from a compatible sibling into his sister. By normal reproduction there would of course have been a huge risk of the parents producing another genetically disabled child. The parents therefore avoided this until they heard of the possibility of pre-implantation diagnosis (PID). Then they underwent the following procedure: in four unsuccessful attempts, embryos were produced in vitro and genetically tested for the risk of a genetic abnormality, without resulting in a successful implantation of an embryo. On the fifth attempt, of 15 embryos produced, two were found to be acceptable and one of these was implanted Adam. According to reports, Molly has an 85 to 90% chance of her bone marrow defect being cured.
Freedom, integrity2 and corporeality
What can we say against this widespread instrumentalisation of the human being? How is it possible that at a time when on the one hand personal autonomy is a such a highly valued ideal and such great emphasis is placed on the rights of the individual whereas on the other hand the corporeal aspect of the human being degenerates into an object, becomes mere material? Obviously there no longer exists a sufficiently secure awareness of how subtly the corporeality and the individuality of the human being are connected. Here we can appeal to philosophy and ethics. But we have to admit that neither seem to offer hope against the Goliath coalition of science, politics and industry, though they dont have to simply cede without a fight their Davids luck to the sort of ideology which adapts bioethics to suit whatever instrumentalisation wishes are uttered by the people who want to carry them out. An ethical heritage still exists that can protect people from being used by others. We shall try to recall some of its essential components.
All ethics and concepts about basic human rights still take as their definite point of departure the idea of the human individuality. Talk of integrity of the human being and the idea of human rights both spring from an awareness of a supreme authority which delineates the human being as a human being and thus makes it worthy of protection. This essential humanity that is recognised, for example, in the German constitution as inviolable is conceived philosophically as that unique, absolute and irreducible aspect of the human being. This also includes the word individuality, which comes from the Latin meaning cannot be divided and concerning which Kant in his Metaphysic of Ethics wrote What has a value has a price. It can be replaced by something else that is equivalent. But a thing which is above all price, has integrity [Würde].
The term person is used in the same way in modern declarations of basic rights. This term which is still valid today was coined in scholastic philosophy. It connected with person the substantiality of a non-reducible and non-derivative being founded in itself. This view of person conceived substantially is however confused in the public mind today with a quite other meaning of the term which developed in the course of the early modern west European enlightenment. It was no longer a matter of a transcendental understanding of being but an empirical description of what is generalisable about a person. This approach was represented first of all by John Locke (1632 - 1704). Locke reversed the sequence of being and consciousness. For him self-conscious reflection no longer ensured the ever present substantiality of the person but the person existed only through this act and through no other. Only where self-conscious reflection takes place, thus ensuring the autonomy of personhood, can one talk of a person. Of course the converse can be concluded from this: without consciousness there is no person, a position which today albeit implicitly has become the sole arbiter.
The ethical dilemma this poses for setting a concept of personhood universally applicable for all operators first comes to light when, through progress in the sciences and the loss of instinctive value certainties, situations are created in which it is no longer absolutely clear whether all human life has a personal nature which puts it under the protection of basic rights. Today it is increasingly less obvious that a potential personhood is relevant, for instance, in the case of embryos, or the mentally handicapped or people who are dying. Thus in the current debate the scope of the definition person becomes the decisive criterion for life and death. Whether it is embryos or embryonic stem cells, brain dead, comatose, severely handicapped or incurably sick people, increasingly often the empirical understanding of person makes things easier in such ethical predicaments by simply fading out the criterion for what is human. Human life is ( ) not biological, but is to be understood and valued in the light of this personhood, says, for example, Hans Martin Sass, the exponent of preference-utilitarianism. Thus arises the catastrophic situation that a core concept of traditional ethics the one the whole subject revolves around namely recognising and protecting as valuable the true human being, is taken over by the ethics of appeasement and used against the human being. This is because every time essential philosophy emphasises the cognitive faculty and reflexive type of consciousness that is capable of self awareness as something as essentially human, nowadays there are representatives of utilitarianism who are quick to retort that it is just this essential component that is lacking in many conditions of human existence and therefore they do not have to be subject to the strict criteria of ethics of the human being.
The integrity of the unity of body, soul and spirit
In this context it is essential to awaken a new sense for the integrity of the unity of body, soul and person (i.e. spirit) which comprises the human being as a being that is developing. The developmental aspect is the important thing here. This is because the human being develops during the course of his life from conception to death. In doing so he awakens gradually to consciousness of himself as a person provided that the physiological and social conditions are provided. Let us go over this once more: the greatest and most important principle against which we measure the observance of an ethical safeguard is freedom, the idea of human integrity. The opposite of this unbounded integrity, which should be protected by ethics, is compulsion from outside. That is not just threatened by for example the extent to which one can express freedom in the narrow personal sense, which is protected by the right to express ones opinions. No, the corporeal integrity of the human being also comes under the criterion of needing its freedom safeguarded and being protected from heteronomy, i.e. from being at the disposal of others. And because of this, the child who is not yet conscious of itself should not be treated as a mere object. Just because he cannot be conscious of being instrumentalised at the time of his being subject to heteronomy does not mean that his integrity has not been interfered with. For instance, if a child is sold so that his parents can make a profit, despite being unaware of what is going on at the time, later, when he is conscious of his own integrity, he experiences the injury and therefore must be protected from that injury in the here and now. If integrity and freedom are valid then since the human being is a being which develops through various phases of its existence he needs to be protected from heteronomy at every stage of his development. This also overrules the objection that in the case of the use of stem cells from an embryo whose development after the harvesting of the necessary cell material is brought to an end, there is no longer a subject present who deserves protecting. Furthermore it violates our own integrity as people thinking and acting responsibly if we abuse this early stage of human life.
The body as the expression of the human being
An important theoretical excuse that underpins human genomic medicine lies in describing the body as a tool that is replaceable, one that simply serves the person and can be repaired by substituting from an ever increasing range of spare parts. This is traceable back to the dualistic picture of the human being of the rationalists. Against it we bring an understanding of the human being that integrates the corporeal dimension of the human being in accordance with its status as a free developing being.
One can regard the corporeality in the particular way that the philosophy of the Middle Ages spoke of matter in general, namely that it is the principum individuationis, i.e. meaning the basis of individual development. However, the process of individuation through corporeality takes place in a much subtler way than can be explained by a tool metaphor because the human being is a unity of living substance, soul and spirit each of which can of course be distinguished but none of which can be removed. From the point of view of philosophy, the idea of the material-spiritual totality of the human being can be encountered as early as Aristotle. He saw the human being as a whole comprising different members. The different members of the human being are permeated by the soul-spirit in different ways. In his On the Soul, Aristotle described the soul as the form, i.e. as the formative principle of the body. Even plants have a formative and maintaining principle that takes care of their physical form, a kind of formative soul referred to as the vegetative soul. In contrast, animals are determined by a sentient soul which shows in the behaviour of the particular species. Only with the human being is there a self-conscious, cognitive and individual spirit soul. It is important to note that Aristotle described this hierarchy of soul components in such a way that a particular higher level of soul organisation embraced the others, i.e. that the lower were so to speak contained in the higher, just as Aristotle himself puts it like a triangle inside the square. According to this the human being is not built up from below, but, so to speak, from above downwards. We can even see this principle at work in the animal kingdom. Different levels of existence in the hierarchy comprising individual organisms are modified in a given animal species in a species-specific way. And just as the vegetative and formative processes are made to serve the particular type of animal organism, so too the highest principle is at work in human beings, namely the possibility of a spirit-soul manifesting and acting in the body, right down to its physical form. The living human form is built up and penetrated throughout by the soul-spiritual element. This is why the human individuality is unique and irreplaceable, including the uniqueness of his corporeality.
It is thus impossible to change one of the components of the living human being without having an influence on the others. Mindful of this inseparable unity, the theologian Dietrich Bonhoeffer formulated the following in his Ethics: It is idealistic but not Christian to regard the body just as a means to an end. A means is of course dispensable once the end has been reached. This corresponds to the view of the body as a prison for the immortal soul, which is supposed to leave the body for ever after death. According to Christian teaching the body has a higher integrity. The human being is a corporeal being and remains thus in eternity. Corporeality and being human remain inseparably connected. These thoughts must in no way be taken as a one-sided assertion of human immortality. It is precisely those who are convinced of an after life in the form of reincarnation who can throw light on this inseparable link. However, in complete contrast to the anthropology of the Christian faiths, they see the threefold unity of the human being as the goal in the unfolding not only of creation or mankind but also of each human individuality itself. In contrast also to the beliefs about reincarnation in the Far East, western spirituality regards the corporeal element itself as a significant constituent of the human being and understands the connection of the human being with the world of matter not as something which was a mistake or a deception, but as the meaningful basis of individuation.
According to a western conception of reincarnation, this individualising aspect of the corporeal even expresses itself throughout a particular earthly life. This is because after laying aside a particular unique earthly body the very core of a persons being continues on its path of further development determined by what they have gathered as experiences. A particular I is to a certain extent none other than the spiritual residue of these experiences. And permeated by these experiences they strive once again for a new embodiment which results from the previous one and continues it in a meaningful way. Thus on this path of development the connection of the developing person with their corporeality is never torn apart. This means that without a specific corporeality there is no development of an individual spirit. Just as on the one hand the individual characteristics arise through embodiment, on the other the individuality itself organises and forms a new body. Corporeality is for this reason much more than just a goal of individuation. In the dimension of manifestation it is also part of the totality of the human being.
A claim to sacrosanctity
The classic early Judaeo-Christian idea of the unity of the human being, strengthened by scholastic philosophy, expresses itself in the basic rights to life and the inviolability of the body. But rationalism set restrictions to the idea in theory and modern medicine undermined it in practice even more so today. The idea is an expression of respect for the irreplaceable bodily form that belongs to the individuality, a bodily form whose integrity only a modern spiritually-oriented humanism would be able to re-establish. The philosopher Hans Jonas said something about this in his essays on Medicine and Ethics: My identity is the identity of the whole and complete individual organism, even if the higher functions of personhood reside in the brain. The whole bodily form including all organs has according to Jonas a claim to the sacrosanctity which is due to a subject of that kind according to human and divine law. This sacrosanctity requires that it is not used as a mere resource. A similar view is held by the medical ethicist Detlef Linke when, in view of the current discussion of human rights in the biological sciences, he argues: Human rights that are not rights of the human body are letting the human being down. This brief discussion was intended to show how both aspects belong together. Only in the course of an intensified understanding will a sense for the corporeal individuality of the human being that is today a victim of medical technology be regained and safeguarded.
1. For story see http://www.guardianunlimited.co.uk/Archive/Article/0,4273,4071639,00.html or search for the name Adam Nash in this context with a net search engine.
2. Translators note: The German word Würde is translated here as integrity. However it conveys an element of dignity or worthiness in certain shades of their meaning, i.e. worth beyond price.
Translated from the German by Dr David J. Heaf and published here with permission of the author.
The author, Jens Heisterkamp, is contactable at email@example.com For more work by the same author see www.info3.de
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