Health and Human Flourishing: Religion, Medicine, and Moral Anthropology

2 Vulnerability, Agency, and Human Flourishing

c h a p t e r c h a p t e r 2 Vulnerability, Agency, and Human Flourishing Alisa L. Carse Introduction: The Challenge Vulnerability is an endemic feature of human life. In this respect we are not, at one level, distinctive. Like inanimate objects or artifacts, plants, and nonhuman animals, we can be worn down, broken, lost, or forgotten . Like all living things, both sentient and nonsentient—trees, bees, flowers, and elephants—we need nourishment, are challenged by disease, and perish. And like many nonhuman animals—dogs, baboons, dolphins, cats—we are dependent, social creatures who like to play, who are sensate and emotional, who are capable of suffering not only adverse conditions (e.g., of temperature, pollution, malnutrition, disease, ravaging storms) but also internal states of fear, confusion, and stress. We share with animals a susceptibility to, in Lisa Sowle Cahill’s vivid words, “the vicious, violent, 34 alisa l. carse selfish, and destructive” acts of others.1 Yet as humans we are also susceptible to committing acts of viciousness, violence, selfishness, and intentional destruction. That is, we are responsible agents, capable of moral and immoral conduct. This fact is tied to, among other things, our capacity for self-reflection and evaluative inquiry, to our ability to act on the basis of value judgments we make, purposes to which we deliberately commit. These capacities render us distinct in the universe of creatures. And this distinctness invites us to examine forms of vulnerability that are peculiarly human, distinctive ways that vulnerability configures human life and affects human flourishing. It challenges us as well to reflect on the implications for moral virtue and conduct of more realistically acknowledging human vulnerability than we traditionally have, both within preeminent philosophical circles in the Western tradition2 and within important strains of contemporary culture. It is these issues I wish to explore here. A crucial dimension of our distinctively human predicament is our dignitary vulnerability. We are creatures who are susceptible to dignitary struggle: we can be shunned, mocked, dishonored, and subjected to contempt , aversion, and indifference in ways that deeply challenge our sense of value and respect-worthiness, sometimes in spite of our efforts to remain immune, to take “the high road.” Persistent devaluation or sustained mistreatment can concretize the degradation of our status. When this happens, human reality falls short of what morality demands. Often we suffer this degradation. But sustained devaluation may render us insensitive to violation , oblivious to disrespect; indeed, it is often a condition of diminished self-respect, a sign of an insufficiently vital and motivating sense of our own intrinsic value and worth, that others’ devaluations fail to elicit our pain or protest. Yet when we feel degraded and when we don’t, being subject to degradation can be profoundly disabling to the confidence, trust, and self-possession required for healthy, effective human agency. Our dignity is a fragile, vulnerable good. As these comments no doubt suggest, we commonly think of “vulnerability ” in a negative sense: to be vulnerable is to be susceptible to loss, “injury[,] and insult.”3 I will here explore a broader understanding of vulnerability , examining ways it is in play in our suffering, our travails, and our thriving. First, it is in many cases precisely those factors essential to human flourishing that render us vulnerable. The loss of a child to illness or the rejection by a beloved can cast us into dark disorientation and pain—states of terrible yearning, grief, or desolation. Yet it is because we so deeply love our child or our friend that we are vulnerable to losing them. Similarly, the Vulnerability, Agency, and Human Flourishing 35 creative process confronts us with our vulnerability. Scientific work that demands patient, resilient, long-term commitment will sometimes come to naught. A pianist whose hands are rendered strong and supple through countless hours of devoted practice may lose use of them to arthritis. So too life can be derailed by devastating earthquakes or droughts, made miserable through political tyranny or the deprivation and anxiety imposed by poverty in unjust conditions. It is clear, then, that our flourishing is subject to the vicissitudes of fortune, to disease and disability, to the powers of nature, and to the choices and conduct of others—in short, to a world that is, in many ways, outside our control. But these reflections reveal a second point as well, namely, that while our flourishing can...