Fabricated Man by Paul Ramsey, The Patient as Person by Paul Ramsey (review)

BOOK REVIEWS 745 Fabricated Man. By PAuL RAMSEY. New Haven: Yale University Press, 1970. Pp. 174. $7.50 (cloth), $3.75 (paper). The Patient as Person. By PAuL RAMSEY. New Haven: Yale University Press, 1970. Pp. 305. $10.00. Princeton ethician Paul Ramsey, in his two newest books, confronts problems in medical ethics which have occupied his attention increasingly in recent years. Fabricated Man incorporates two of his previously published essays, apparently with little editing. This makes for some repetitiousness , but the book as a whole is nevertheless a clear and readable study of major moral issues raised by aclYances in genetic science and technology. The Patient as Person discusses a wider range of medico-moral problems with emphasis on obtaining the patient's consent especially for experimental measures (with special reference to the ethics of experimenting on children) , the duty of caring for the dying, the determination of the moment of death, and the morality of transplant surgery. This book is based on the Lyman Beecher lectures on medical ethics given at Yale in 1969, a task for which Ramsey had prepared by means of two semesters' work as visiting research professor of genetic ethics at the Georgetown University Medical School. Both books are premised on a view of man, stated in consciously Barthian terms, as a being " created in covenant, to covenant, and for covenant," (Fl\1:, p. 38) 1 such that " covenant-fidelity is the inner meaning and purpose of our creation as human beings, ... of even the ' natural' or systemic relations into which we are born and of the institutional relations or roles we enter by choice." (PP, p. xii) Respect for the "sanctity of human life " is one essential facet of the attitude of " any man who, so far as he is a religious man, explicitly acknowledges that we are a convenant people on a common pilgrimage." (PP, p. xiii) l\foreover, since Christians understand " the humanum of man to include the body of his soul no less than the soul (mind) of his body," (FM, p. 47) man IS a " sacredness in the natural, biological order" as much as in the sociopolitical order. (PP, p. xiii) Accordingly, a sound ethics must recognize that just as man's sacredness as a social being prohibits his subjection to "complete dominion by 'society' for the sake of engineering civilizational goals," (PP, p. xiii) so also the sacredness of his physical existence forbids abuses of his body even if he freely undertakes them. Put simply, "something voluntarily adopted can still be wrong " (FM, p. 32) ; certain kinds of bodily behavior "are of quite questionable morality, and questionable for reasons that the voluntariness of the practice would not remove." (FM, p. 45) An ethics 1 Where necessary, the initials FM and PP are used in page references to indicate Fabricated Man and The Patient as Person, respectively. Italics in all quotations are original. 746 BOOK REVIEWS which supposes otherwise, denying any intrinsic morality to bodily acts and stipulating only that the freedom of the agent or agents be respected (as though coercion, pressure, or deceit were the only ways to violate personhood ) , suggests to Ramsey a kind of Cartesian dualism which depersonalizes the human body; such a position, which in effect puts man's bodily life " in the class of the animals over whom God gave Adam complete dominion," (FM, p. 86) is alien to authentic Christianity. Ramsey sees this erroneous view as more or less implicit in the eugenic proposals of certain scientists, (FM, p. 81) and in the exaggerated campaign of some liberal Catholic theologians against the alleged " physicalism " of traditional moral theology. (PP, pp. 178-187) Indeed, to the surprise of no one familiar with Ramsey's many earlier writings on general Christian ethics and on the morality of war, both of the present books show their author in close accord with traditional Catholic thought not only in affirming the view of man referred to in the previous paragraph but also in the strong rejection of situationism and subjectivism, and in the respect accorded to such classical principles as the double effect, the doctrine of ordinary vs. extraordinary means of preserving life, and the principle of...