What It Means to Be Human: The Case for the Body in Public Bioethics by O. Carter Snead (review)

In What It Means to Be Human: The Case for the Body in Public Bioethics, a leading Catholic thinker in the law of bioethics has laid bare the "expressive individualist" anthropology structuring U.S. public bioethics, and proposed an alternative that accounts for human embodiment. Previously serving as General Counsel at the President's Council on Bioethics, O. Carter Snead presently directs the University of Notre Dame's de Nicola Center for Ethics and Culture, a leading source of scholarship and public dialogue about the Catholic moral and intellectual tradition.

The book claims that current public bioethics law has an undeclared, underlying anthropology that does not "reflect the full complexity of lived reality" (1). It fails to acknowledge that human beings are "embodied," which means that we are also vulnerable, dependent, and naturally limited. Instead, it presumes that people are "atomized individual wills" whose flourishing is constituted by "interrogating the interior depths of the self in order to express and freely follow the original truths discovered therein toward one's self-invented destiny" (5). Laws, regulations, and public policy grounded in this conviction thus fail to comprehend human needs or promote human flourishing. They leave the weak alone with their state-recognized privacy and autonomy. They ignore human beings' obligations to vulnerable others. They fail to promote genuine equality and freedom.

Snead subjects public bioethics to an anthropological inquiry to surface its unspoken convictions about human identity and flourishing. He then proposes a new anthropology, securely anchored in human beings' embodied state, for purposes of inspiring a new body of law attuned to humans' true needs and desires. And he applies these anthropological insights to craft principles and policy goals applicable to abortion, assisted reproductive technologies (ARTs), and end-of-life decisions.

Snead begins with a riveting and occasionally horrifying account of the history of U.S. bioethics laws. It began in the 1960s with publications exposing experiments upon unconsenting and vulnerable subjects, including Black males with syphilis (the Tuskegee experiments), and still-living aborted infants. The pattern for crafting bioethics laws is first set here: lawmakers react to past abuses; some portion of the scientific community continues to justify them; legislatures establish commissions to study the problem; and the law eventually enshrines the principle of "informed consent" presumably given by able, autonomous, rational human persons. This pattern shaped legal responses to later controversies over fetal-tissue research, genetic manipulation, assisted reproductive technologies, abortion, and end-of-life decision-making.

Interrogating these laws and policies, Snead determines that they reveal an anthropology of "expressive individualism," a term coined by Robert Bellah to describe a belief that human identity and flourishing involves expressing one's "innermost identity through freely choosing and configuring life in accordance with his or her own distinctive core intuitions, feelings and preferences" (69). Such an anthropology is dualistic. Human cognition and will are paramount. These use the body as an instrument for achieving personal projects according to subjective values, not beholden to exterior "givens" or the needs of vulnerable others.

Snead relies heavily upon the philosophical treatments of this anthropology in the works of Alasdair MacIntyre, Michael Sandel, and Charles Taylor, and applies their insights to public bioethics. He concludes that because this anthropology forgets the body it cannot factor in weaknesses, dependencies, and limits that characterize every human life. These include, at a minimum, childhood, disability, age, illness, cognitive limits, and even human beings' need for cooperation and dispute in order to understand themselves. Thus it also fails to foster laws and policies recognizing mutual social obligations and facilitating the building of networks of "giving and receiving that are essential to the survival and success of all human beings" (184).

In response, Snead recommends a new anthropology to inform lawmaking based upon humans' need for "uncalculated giving and graceful receiving...