by Kenneth Vaux
Dr Vaux is professor of theology and ethics at the Institute of Religion, Baylor Medical School, Houston.
This article appeared in The Christian Century, April 16, 1975, pp. 384-387. Copyright by The Christian Century Foundation; used by permission. Current articles and subscription information can be found at www.christiancentury.org. This material was prepared for Religion Online by Ted and Winnie Brock.
Our ambivalences in the areas of abortion, euthanasia and elective suicide call us to coordinate our scientific knowledge with moral wisdom. Although the global problems in these areas are compelling, we cannot expect to resolve them without first reforming our personal values and life styles.
As spring breaks across the country and pushes north, two events remind us of humanity’s ascending powers in the realm of nature. Kenneth C. Edelin, M.D., is convicted by a Boston jury of the manslaughter of an anonymous emerging life born to an unknown, unwed black teen-ager -- a 24-week fetus. In Princeton a renowned educator, Henry "Pit" Van Dusen, and his wife, living in the descent of life with powers waning, decide to take overdoses of sleeping pills. Mrs. Van Dusen dies immediately; the former president of Union Theological Seminary lingers two weeks. Nature has always sent its springlike burst of joy at birth and its muted wintry chill of death. We have passively accepted, as if from God’s hand, what nature gives. Now nature and providence are challenged by our assertive will at those once-sacrosanct thresholds: life’s inception and life’s demise. Yet we remain uneasy with our intrusions.
The events cited above are not unique. Thousands of such actions have gone before and thousands will follow, but these two have arrested our attention because of the present state of our scientific powers and our resultant moral quandary.
Technology, Free Will and Moral Ambivalence
Both events stand in bold relief against the background of new technology. In Massachusetts v. Edelin sophisticated perinatal technologies come into play as viability, life-support and fetal research emerge as the key ingredients in the case. Some say that the state’s indictment was initiated when investigators, checking into research on dead fetuses, discovered the fetus Edelin had caused to be aborted some two months past. The introduction of technology at critical life thresholds has precipitated an HEW-imposed moratorium on fetal research until more satisfactory guidelines for biomedical and behavioral research can be developed. Many inquisitors are now making rounds.
Technology is implicated also in the matter of euthanasia. Reflecting on the Van Dusen case, John Deedy asks whether suicide should be reconsidered in the light of today’s life-prolonging biomedical technology (New York Times, March 2, 1975). The Van Dusens saw this considered, self-determined act as morally preferable to the customary American way of death, in which disease forces finally overwhelm technical medical management, leaving the dying person and those around him exhausted and resentful -- the grace of dying with one’s boots on long since gone.
The moral ambivalence of the new medical and scientific achievements also explains the public fascination with the two events: "Naked came I out of my mother’s womb, and naked shall I return thither: the Lord gave, and the Lord hath taken away; blessed be the name of the Lord" (Job 1:21, KJV). It may always be that we enter and leave this life naked. But the giving and taking we want our own way -- at least we think we do. Primal religious emotions reminiscent of those expressed by Job are evoked in these two situations in which the tragic must be rationalized. Respectful resignation to the ways of God and nature is one response. The Catholic "right to life" mentality and the broad Middle American ethos it symbolizes hold that human life is a sacred trust, that its meaning is anchored in transcending mystery, and that it should therefore be received and protected with awe. Let us acknowledge that this moral point has force, despite the belligerent insensitivity of its proponents tactics.
Another view stresses human initiatives and determination. This perspective emphasizes the physical aspects of the case and argues that they are normative: grams of weight, weeks of gestation, neurological and respiratory criteria. "Products of conception" is a term used in pediatric rounds: the abortus, the fetus, the placenta, the tissue. In the pregnant woman, focus is on the mechanics of the saline injection, the hysterotomy, the tearing of the placenta from the uterine wall, the psychiatric sequelae, the social stigmatization -- these are the important facts, medically and morally. Even Joseph Fletcher’s more thoughtful "Indicators of Personhood" (Hastings Report, November 1972) are similar criteria, taken from an observable, empirical, verifiable starting point. And while these factors are critically important for the ethical analysis, they are not sufficient.
Yet another view accents the plight of the woman who undergoes an abortion: her right to privacy, the tragic necessity imposed by unwanted pregnancies, the sociocultural milieu with its polarized emotions. These factors, of course, prevail in public-policy determination in a secular-pluralistic society. Perhaps they should, but that does not preclude their being morally objectionable.
Diverging Viewpoints on Euthanasia
The multivalent moral quandary is present also in the euthanasia issue. In the case of the Van Dusens, some would see suicide as murder. Time (March 10, 1975, p. 83) introduces its comment on the case with the striking words of the Westminster catechism -- a document written in the amazing Cromwellian age of Protestant orthodoxy when moral absolutes were thought to be not only propositional but "in the nature of things."
Question: What is forbidden in the Sixth Commandment?
Answer: The Sixth Commandment forbiddeth the taking away of our own life, or the life of our neighbor unjustly . . .
Blackstone, in his great commentary on English law, says:
Self murder, the pretended heroism but real cowardice of the Stoic philosophers who destroyed themselves to avoid those ills which they had not the fortitude to endure. The law of England wisely and religiously concurs that no man hath a power to destroy life but by commission from God, the author of it, and as their suicide is guilty of a double offence, one spiritual, in evading the prerogative of the Almighty and rushing into his immediate presence uncalled for, the other temporal against the King, who hath an interest in the preservation of all his subjects [Blackstone, Bk. 4, Ch. 14].
Though the king’s interest and expediency today might be better served by the demise of one or another of his subjects, the conserving tradition argues that we should welcome life to its last moment, see it as opportunity rather than burden, and fashion a society that will protect, sustain and preserve it with unfailing energy. The undergirding theology of this viewpoint is that life is a trial, a testing ground, an arena where purification and redemption are achieved through endurance and courage. In this view, stoics from Seneca to Van Dusen deny life that more profound depth which may be afforded by continued experience -- even suffering experience.
A diverging viewpoint emphasizes technological factors and human controls: irreversible coma, isoelectroencephalogram, diminished cerebral coherence, motor incapacity, incontinence, etc. Death -- or "unlivable" or "valueless" life -- is present when certain physical, neurological or sociological criteria are not met.
Our attitudes toward suicide and euthanasia are shaped also by extremely influential sociocultural values. Hemlock parties were common in ancient Greece. Hippocrates knew of them and apparently condoned them within his holistic concept of medicine. Indian societies like that of the Eskimos or the nomadic tropical tribes enacted great life-cycle rituals wherein the elderly would be set adrift on ice floes or would fail to ford the swift river with the rest of the tribe during a migration back to the mountains. The deep taboos and symbolic meanings surrounding birth and death linger even in our technically demythologized modern culture.
Though our moral ambivalence is disclosed in the diverging viewpoints -- theological, mechanical and sociocultural -- the basic uncertainty is deeper. The ethical and emotional crises that we experience today in relation to the thresholds of birth and death, the uncertainty as to where "personal" value may be located and anchored, and the resultant confusion in the realm of public policy and law are symptoms of the fundamental intellectual crisis of modern humanity.
"We look upon life these days from two opposing points of view," writes Carl F. Von Weizsäcker, "from man, and from physical science" (The History of Nature [University of Chicago Press, 1949], p. 122). The legacy of the modern scientific and philosophic revolution has been the isolation of value from material nature. The only common denominator between the "is" and the "ought" realm of human experience is the principle of uncertainty. While the Heisenberg principle gets us closer to the real nature of physical things, moral uncertainty is confusing and debilitating. Weizsäcker finally concludes that there is coincidence between what humanity believes and what science eventually learns. If his view is correct, then our deepest affirmations of the transcending values of life will ultimately coincide with our scientific determinations.
In order to resolve our present ambivalence we need to clarify what we mean by a "person" protected by the 14th Amendment. In order to find Dr. Edelin guilty, charged Judge McGuire, the jury had to determine that the aborted fetus had become a "person." The primitive mechanical criteria of extrauterine respiration was repeatedly invoked as the index of "personhood."
We need first to distinguish two definitions of personhood which interplay in our culture, rooted in two perspectives on life. One view locates person-hood in the biological, neurological and sociological criteria posited by our society. The other tradition -- rooted in Judeo-Christian practice transmitted through Roman, medieval and common law, then through European philosophy to the American Constitution -- stresses what E. J. Corwin has called "the higher law background" of our legal tradition.
Basic to American constitutional law and its growing tradition is what Corwin calls the American’s deep-seated conviction that the U.S. Constitution is an expression of the higher law. It is, in fact,
imperfect man’s most perfect rendering of what Blackstone saluted as the "eternal, immutable laws of good and evil, to which the Creator himself in all his dispensations conforms, and which he has enabled human reason to discover, so far as they are necessary for the conduct of human actions" [E. J. Corwin, "The Higher Law Background of American Constitutional Law," Harvard Law Review, 1928-29, Vol. XLII].
In this tradition human dignity or the endowed inalienable rights are secured by transcending purpose, not by calculated human determination. The theological traditions which constitute America’s moral heritage argue that personal value is bestowed, endowed, given by the Creator. Contra Freud, the faith behind our legal tradition holds that human beings do not project personality onto the transcendent but that transcending personality creates personhood in human beings. "I am prepared to affirm," writes Albert Outler, "that the primal origins, the continuing ground and final ends of human life are truly transcendental" (Perkins Journal, Fall i973, p. 30).
It is the discrepancy between this noble theological and constitutional vision and the harsh reality of the pragmatic that generates our moral bewilderment. In a like manner, ideal and compromise come into conflict in our psychological structure, creating ambivalence. In this area of "feticide" and elective suicide, our culture is vacillating, or even oscillating wildly. Public opinion wavers between the Roe v. Wade decision and an opposite pole in Massachusetts v. Edelin. Life-prolongation with a vengeance generates its polar opposite: "living-will" advocacy. Depending on one’s moral persuasion, we are either weaving downward to some final degradation or ascending by stages to a greater moral maturity.
Looking to the Future
I prefer to hope that our moral anguish will prompt us to coordinate our scientific knowledge with moral wisdom, so that the present crisis can be truly a crisis in a biblical sense -- a transformation which brings new faithfulness to God and a derivative humanism.
Science should soon yield a satisfactory birth-control pill, device or technique and/or an acceptable abortifacient. Although it seems that the human body resists our efforts to modify the endocrinological processes, we may be approaching the development of agents that mimic our body’s own inhibitions to conception and implantation. The Federal Drug Administration has recently authorized use of DES (diethylistilbestrol), a strong estrogen which functions to influence uterine contractability and to diminish the receptivity of the endometrium to implantation of a fertilized ovum. But this drug and the prostaglandins can have a devastating side effect -- vaginal cancer. Thus we still lack the gentle, nontoxic, publicly acceptable controls of fertility, conception and implantation that may one day obviate the tragic interim necessity of abortion.
The global picture should be alarming. Abortion is now one of the most widely practiced methods of birth control in the world. The Population Council reports that 10 million abortions are performed in the Soviet Union each year -- 2.6 for every live birth. In the U.S., 900,000 abortions were performed last year -- approximately three for every ten live births (New York Times, March 2, 1975). From another perspective, Bangladesh, the world’s eighth most populous nation (with .0003 of the earth’s land), has reduced its death rate to 17 per thousand (from 50 in 1900); its birth rate remains constant at 48 per 1,000. Chronic starvation and unconscionable misery will remain the lot of the people unless population control can be achieved by means of massive emergency aid, agricultural assistance, long-range development and education. Responsibility requires that we exert balancing controls at the thresholds of birth and death if we are to save the planet from "popullution" and its inhabitants from complete degradation.
Finally, an observation at the personal, familial and community level: Although the global problems are compelling, we cannot expect to resolve them without first reforming our personal values and life styles. Would it be possible to move away from the destructive anonymity that a "do your own thing" culture degenerates into and to construct new forms of supportive community and family life? Could the church and the secular society recover some sense of their constitutional obligations and care for unwanted children, or at least care for weary and harried mothers and fathers until they can renew the capacity to care? Could we recover the blessedness of bearing one another’s burdens, thus finding release from the obsessive grabbing, consuming, defending posture that has rendered our lives so shallow and sad?
Luther said the child is saved when the congregation "means" its baptism. Even in our secularized world each birth should not be regarded as a privatized, mechanical expulsion but viewed sacramentally as a baptism in which a life is claimed from the depths and lifted into our obliged presence. This kind of recovery of the value of generativity, to use Erikson’s phrase, would certainly ennoble our intervention and our caring at both thresholds of life. This manner of watching with one another at life’s thresholds is surely the will of the One who guards our coming and going.