A Rich Bioethics: Public Policy, Biotechnology, and the Kass Council

Four: In Defense of Rich Public Bioethics II: Mind and Body

F O U R In Defense of Rich Public Bioethics II Mind and Body According to Aristotle, the human is a rational animal. Humanity is simultaneously immanent and transcendent, belonging to and rising above nature. As an integration of reason-passion, the human’s rational and moral qualities are continuous with the living world. The human is a complex structure of needs—thus, goods—that often conflict, requiring work to understand their proper ordering. The difficulties of identifying and interpreting human nature sustained ethics for the following two millennia. Descartes, fed up with these endless complexities, cut the Gordian knot. He concluded in the Meditations that he himself is simply a thinking thing, and that his body, though attached to his soul, was not part of it but a distinct physical mechanism .This view severed humans from the animal kingdom; animals do not really act, but rather “it is nature that acts in them according to the arrangement of their organs,just as we see how a clock,composed merely of wheels and springs, can reckon the hours” (Discourse on Method 1637, 5). The second great divide, then, is not a split between the individual and society; it is a split within the individual. On one side is the determined, material body and on the other is the self-determining, non-extended intellect. Of 87 course, Darwin reasserted human continuity with the natural world and the animal kingdom, thereby vindicating Aristotle and retying the knot. But the modern reaction to this notion of a clearly hybrid nature has been largely a quest to purify the categories by affirming the dualism of mindbody . Humans are reduced either to bundles of urges (pain and pleasure) or to non-extended, autonomous wills that are choosers and rights bearers . The upshot, in Martha Nussbaum’s terms, is a tradition of political liberalism that has long been hiding from humanity by attempting to resolve this inherent tension of spirituality-materiality to one pole or the other.What we need—and the approach that rich public bioethics modestly advances—is to recover a“liberalism without hiding,”a political conception of the human being“whose capacities and whose dignity are thoroughly bound up with its animal nature” (Nussbaum 2004, 344). The mind-body divide is problematic for public bioethics because biomedical science and technology are posing questions about human nature as a whole.In order to protect human subjects from the utilitarian calculations of aggregate pains and pleasures, instrumental bioethics takes to the other side of the dualism. With Descartes and Kant, it locates the human essence in a disembodied intellect. While the Kantian distinction between persons (ends) and things (mere means) is an invaluable moral distinction, humans are not in fact disembodied intellects. Maurice Merleau-Ponty takes both Descartes and Kant to task on this point. Their “analytic reflection” detaches the subject as a distinct condition for the possibility of human experience.It seeks“an impregnable subjectivity ,as yet untouched by being and time”that is the constituting power of the world. But from the very beginning there is no divide between self and world. The human is a being-in-the-world. The body cannot be an object,because it is“that by which there are objects”(Merleau-Ponty 1962, 92). The living body is“the very possibility of contact, not just with others but with oneself—the very possibility of reflection, of thought, of knowledge . . . Far from restricting my access to things and to the world, the body is my very means of entering into relations with all things”(Abram 1996, 45, 47).1 Merleau-Ponty demonstrates how dualism and its fiction of the perspectiveless gaze estranges humans from the lifeworld of primordial experience ,unlearning the ability to describe the humanly meaningful realm of sight, sound, touch, emotions, and relationships.When we reason prac88 Rich Public Bioethics and the Kass Council tically about what is best to do, we are wondering what is best not in some abstract way, but what is best for the kind of creatures that we are. In isolating a property, namely rationality, as the only feature of moral significance , most Kantian theories stress personhood rather than human being and place humans in the same category as robots and intelligent aliens.2 But our concern in bioethics is with what it means to lead a good human life as a whole, as the living...