Morals, Metaphysics, and Heart Transplantation: Reflections on Richard Selzer's "Whither Thou Goest"

MORALS, METAPHYSICS, AND HEART TRANSPLANTATION: REFLECTIONS ON RICHARD SELZER'S "WHITHER THOU GOEST" MICHAEL POTTS* Ronald A. Carson has recently argued that the propositional discourse of contemporary bioethics, while necessary, should be supplemented by "narrative discourse, using the figurative language of fiction, drama, and poetry" [I]. Propositional discourse ignores the role ofimagination in linking sensibility and rationality, thereby artificially separating intellect and emotion. The "unruly abundance of deep feeling about life and death, suffering and healing" tends to be obscured. What is needed in bioethics, Carson asserts, "is an infusion of imagination. Fewer propositions, more stories; not so many ethical arguments, more moral inquiry." There is much to commend in Carson's approach. One major reason propositional discourse overlooks the role of sentiment in morality is that its abstract nature ignores the concrete particularity of many of the moral dilemmas in which real human beings find themselves embedded. This is particularly true concerning moral issues which lie at the borderline of life and death, such as euthanasia, the definition of death, and organ transplantation . Concrete, individual, embodied human beings, beings who feel as well as think, are forced in such situations to confront fundamental questions which involve their whole being: issues of life and death, suffering and pain, and personal identity. These questions not only raise conceptual issues which are amenable to the language of discursive reason; they also bring out deep feelings about who or what a human person is and the proper way to treat a fellow human being. Sidney Callahan has argued that such feelings are not without value in moral decision making [2] . Her example is the feeling of revulsion evoked in some people when they heard that "dead human bodies are used in car crashes for research on automobile safety." This feeling of revulsion remains despite the fact that certain ?Department ofPhilosophy, Methodist College, 5400 Ramsey Street, Fayetteville, NC 28356.© 1998 by The University of Chicago. All rights reserved. 0031-5982/98/4102-1051$01.00 212 Michael Potts Morals and Heart Transplantation ethical systems, particularly utilitarianism, might argue that using human bodies in such a way is acceptable. Preconceptually, many people feel that using dead bodies to test car safety equipment is treating those bodies in an inhuman way. Martyn Evans has made a similar point about one of the final scenes of the movie Amadeus [3] . Mozart's dead body, which is in a sack, is unceremoniously dumped into a common grave, with a few shovels of lime following. Evans believes that the feelings evoked by that scene reveal a fundamental human intuition that "the human body is worthy of moral concern and respect even in death; it matters morally how we treat the dead." Evans claims that "the particular, the concrete, the seen can in certain contexts have decisive moral force against what we are told about the abstract, the underlying, the theoretical, the causal, the unseen." In a similar vein, Leon Kass discusses the attitudes of respect which medical students hold toward cadavers [4] . He asserts that in spite of the fact that these attitudes are opposed to the attitude toward the body held by contemporary medical science, "these initial reactions and thoughts strike me as sound." Kass criticizes the "powerful scientific way of analysis [which] would in fact and in thought dissolve the whole, and with it those original 'unscientific'—indeed natural—repugnances." Callahan, Evans, and Kass have a point: even if good theoretical arguments could be given for using dead human bodies in auto accident research , or for dumping all dead bodies into mass graves (perhaps to save money and space), or for treating cadavers as mere things to be used for some "good" purpose, a strong feeling remains that these practices are fundamentally inhuman. Conceptual discourse alone cannot do justice to these feelings; narrative, whether it be nonfictional narrative about actual events or fictional narrative, can do a betterjob. Narrative does not ignore the wholeness of life. Stories, with their development of character, situation , and sense of historical time, give us a sense of the concrete particularity ofexperience, including particular feelings and situations. Even fictional characters may give us better insight into nuances of human nature than conceptual...