Combating an Ideology of ‘Choice’: Carter Snead Offers Remedy for US Moral Crisis

BOOK PICK: University of Notre Dame professor O. Carter Snead argues for a public bioethics that encourages the desire ‘to make the good of others our own good.’

This groundbreaking book argues that the laws, policies and rules of modern bioethics have lost sight of the truth that we are embodied persons who share an equal dignity and value at all stages of life and thrive in relationships of mutual love and care.
This groundbreaking book argues that the laws, policies and rules of modern bioethics have lost sight of the truth that we are embodied persons who share an equal dignity and value at all stages of life and thrive in relationships of mutual love and care. (photo: Harvard University Press book cover)

What It Means to Be Human

The Case for the Body in Public Bioethics

By O. Carter Snead

Harvard University Press, 2020

336 pages, $39.95

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When the U.S. Supreme Court “reaffirmed the essential holding” of Roe v. Wade in  Planned Parenthood v. Casey, the 1992 ruling framed access to legal abortion as a fundamental freedom that liberated women from unintended pregnancy, thus allowing them to pursue their life plans unimpeded. 

“At the heart of liberty is the right to define one’s own concept of existence, of meaning, of the universe, and of the mystery of human life,” wrote Justice Anthony Kennedy. 

His opinion prompted a scathing dissent from Justice Antonin Scalia, who said he had “never heard of a law that attempted to restrict one’s ‘right to define’ certain concepts; and if the passage calls into question the government’s power to regulate actions based on one’s self-defined ‘concept of existence, etc.,’ it is the passage that ate the rule of law.” 

Yet today the right to individual autonomy remains the dominant legal argument upholding abortion as the guarantor of women’s basic equality and flourishing. 

The late Justice Ruth Bader Ginsburg echoed this assertion in her dissent from the 2007 majority opinion in Gonzales v. Carhart, which allowed a federal ban on partial-birth abortion to stand. “[L]egal challenges to undue restrictions on abortion procedures do not seek to vindicate some generalized notion of privacy,” wrote Ginsburg; “rather, they center on a woman’s autonomy to determine her life’s course, and thus to enjoy equal citizenship stature.”

Beyond the high-profile battle over the survival of Roe v. Wade, similar often unexpressed assumptions have shaped laws and public debate dealing with end-of-life care, including physician-assisted suicide, as well as policies facilitating the largely unregulated IVF industry and related reproductive technologies. 

“I refuse to subject myself and my family to purposeless prolonged pain and suffering at the hands of an incurable disease,” stated Brittany Maynard, a young wife with terminal brain cancer who campaigned for the passage of a California bill legalizing physician-assisted suicide, in comments affirming her right to control the time and conditions of her death. Maynard committed suicide Nov. 1, 2014, and California’s assisted-suicide law went into effect in June 2016.

And while Catholic leaders, theologians and pro-life activists have both repudiated these arguments on moral grounds and promoted alternative solutions for people in similarly difficult circumstances, like palliative care and hospice, or adoption and crisis-pregnancy centers, the vision of human identity animating laws like the one Maynard championed is widely shared at the highest levels of the U.S. government and legal establishment. 

What It Means to Be Human: The Case for the Body in Public Bioethics by O. Carter Snead seeks to address the assumptions that drive this ideology of “choice” at any cost. 

A professor of law and political science at the University of Notre Dame, and the director of its de Nicola Center for Ethics and Culture, Snead defines “public bioethics” as “the governance of science, medicine and biotechnology in the name of ethical goods.” 

His groundbreaking book, praised in the pages of The Wall Street Journal as “among the most important works of moral philosophy produced so far in this century,” argues that the laws, policies and rules of modern bioethics have been shaped by a broad acceptance of individual autonomy as the foundation of human identity and rights. In the process, we have lost sight of the truth that we are embodied persons who share an equal dignity and value at all stages of life and thrive in relationships of mutual love and care. 

“American law and policy concerning bioethical matters,” Snead writes, “are currently animated by a vision of the person as atomized, solitary, and defined essentially by his capacity to formulate and pursue future plans of his own invention.” 

As he notes, the field of public bioethics was launched in the past century, in part, to address the egregious violations of safeguards designed to protect human research subjects, including informed consent. In one of the most shocking cases brought to light, the “Tuskegee Study of Untreated Syphilis in the African American Male,” conducted between 1932 and 1972 by the U.S. Public Health Service and the Centers for Disease Control and Prevention, poor sharecroppers were not told they had a sexually-transmitted disease, nor were they offered penicillin when that became available to treat their condition. 

But contemporary laws that now define personhood in the language of “expressive individualism,” with the “atomized self” center stage, are not grounded in reality, Snead argues. They devalue our most intimate relationships: mother and child, sister and brother, grandparent and grandchild. They also ignore the innate vulnerability of every person living in time with a corruptible human body. 

The author warns that those most likely to suffer from the flawed assumptions that undergird our public bioethics are the most vulnerable: the unborn child, the wheelchair-bound adult and the elderly patient with dementia. Indeed, laws that privilege autonomy render these persons invisible, and so run the risk of making our “obligations” to them invisible, as well.

“Our embodiment situates us in a particular relationship to one another, from which emerge obligations to come to the aid of vulnerable others, including especially the disabled, the elderly, and children,” he explains.

Building on the work of Alasdair MacIntyre, a Catholic convert, political philosopher and author of After Virtue and Dependent Rational Animals, among other influential texts, Snead argues for a public bioethics that fully accommodates our embodiment and encourages the adoption of virtues and practices that inculcate the desire “to make the good of others our own good.” 

The promotion of “generosity, hospitality, misericordia, gratitude, humility, openness to the unbidden, solidarity, dignity, and honesty” offers an antidote to fear and isolation. We can better accompany and protect persons in need, the author believes, when we provide space for family and friends, along with the religious and civil institutions that make up the broader community. 

At the same time, he makes clear that this vision of human flourishing is also an antidote for those most tempted to compromise their own humanity and values in the pursuit of self-definition — a particular weakness for highly individualistic Americans. Far from being harshly judgmental, he suggests that men and women who demand the right to prevent their suffering or to create a family at any cost are driven by a deep sense of vulnerability grounded in the belief that their bodies have “betrayed” them. And he concludes that it would be far more compassionate for modern bioethics to respond with honesty and mercy to this very human frustration with bodily limits rather than issuing permission slips that maintain the fiction of absolute autonomy. 

What It Means to Be Human is designed to engage the secular practitioners of public bioethics — lawmakers, academics and administrators — on their own turf. The author does not cite explicitly Catholic teaching to bolster his argument, though Pope St. John Paul II’s Evangelium Vitae, Veritatis Splendor and theology of the body catechesis, among other papal documents, also challenge the values and anthropology of modern bioethics and present a Christian vision of the human body as a gift and an expression of the person’s deepest values. 

Likewise, the author avoids taking direct aim at the politicization of contemporary bioethics amid the culture wars, a development that has discouraged open dissent from progressive social policies. 

For the most part, Snead assumes the good intentions of bioethicists who fail to see the contradictions at the heart of a system that advocates for the rights of the marginalized but stands ready to facilitate individual desires over inconvenient moral obligations. 

Nevertheless, those painful contradictions are on display all around us. 

In 2019, when New York lawmakers embraced a bill legalizing commercial surrogacy as a major advance for “LGBT” rights, Gloria Steinem, the feminist crusader for legal abortion, pushed back, arguing that the practice exploited the bodies of poor women and allowed “profiteering from body invasion.” And in California, where Brittany Maynard campaigned to secure her right to a death with “dignity,” disability-rights groups warned that the legalization of assisted suicide could weaken ethical safeguards and endanger those deemed unworthy of life.

In recent decades, the contradictions that lurked beneath our regime of legal abortion and Justice Kennedy’s deference to the “right to define one’s own concept of existence” have also become more glaring. 

Ultrasound technology, along with the testimony of abortion survivors and women who regret their decision to end the life of their unborn child, has exposed the brutal destruction of innocent life and the enormous harm abortion inflicts on women. 

In his analysis of Planned Parenthood v. Casey, Snead confronts Kennedy’s failure of moral imagination head-on.

The court, he writes, does not address “the complexity and risks of dividing the world of living human organisms into persons who bear human rights and ‘nonpersons’ who live at the sufferance of others, based on their interests and desires.” 

Snead seeks to remedy this tragedy. And this reader prays that his intended audience will take up the gauntlet. We desperately need an honest reassessment of laws and practices that permit the restless search for ever new boundaries of self-expression, endangering the most vulnerable among us and corrupting the soul of a nation.

This review was updated after posting.