This Mortal Flesh: Incarnation and Bioethics
In spite of the apparent benefits of recent and predicted advances in medical science which promise to enhance human well-being and extend life, many people experience a vague uneasiness about a brave new world where disease, suffering, and finitude in general might be vanquished. If we can replace limbs, repair organs, cure cancers, and even slow or stop the aging process itself, how will this affect humanity’s understanding of itself and its relationship to God? Brent Waters, Jerre and Mary Joy Stead Professor of Christian Social Ethics at Garrett-Evangelical Theological Seminary, argues forcefully that our unease with the fight against aging and death is justified theologically in light of God’s vindication of creation’s temporal and finite order in the resurrection of the incarnate Christ. This important and timely work depicts the primary challenge of Christian bioethics, not as offering a series of directives with respect to common medical moral dilemmas, but instead as offering a theological framework that allows Christians to ask and answer broader questions about the appropriate purposes of medicine itself, especially insofar as medicine is interpreted more and more frequently as a tool of self-transformation that has as its end the overcoming of human finitude.
Many of the individual chapters of the book were published or presented in other venues, and perhaps as a result of a difficult editing process, the structure, unity, and flow of the work are not ideal. Nevertheless there are important thematic elements that give unity to the book as a whole, and rather than offer a chapter-by-chapter summary, in what follows I will highlight those thematic elements. The chief argument and core strength of the book lies in its depiction and critique of what Waters calls the “post human” aspirations embedded in contemporary medical practices. Successes in regenerative medicine have made it increasingly possible to envision a world where we will be able to cure rather than merely treat our ailments. Advancements in the fields of genetics, stem cell research, nanotechnology, and prosthetics have made an indefinite extension of human life more thinkable, and even if currently we face technological and biological limits, efforts are underway to transcend those limits. At the outer edges of the post human project, there are those who imagine “uploading the information constituting one’s personality into a computer and downloading it into various media, thereby enabling virtual immortality” (97). Since Waters takes death to be definitive of the human condition, efforts to wage war against aging and death are tantamount to the gradual destruction of humanity in favor of a future which can only be described as posthuman.
The posthuman project becomes intelligible against a “late modern” cultural backdrop which Waters argues is essentially Nietzschean in shape and color. In this Nietzschean context, there are no given horizons of meaning or value in life, and no eternal Good which can serve as a check upon our aspirations and desires. To avoid immersion in a nihilistic abyss, humans must exercise the will to power, engaging in practices of self or cultural creation to attempt to fill the void. Life becomes a struggle to overcome the limits and vulnerabilities of finitude and to survive as long as possible to obtain as much flourishing as this life will allow, and medicine and technology become the primary tools in this fight against the power of death. It is medicine and medical technology that will enable humans to master nature and human nature (25).
Plausibly, one could object to this characterization of contemporary culture’s stance towards medicine simply by asserting that most do not view their regular encounters with healthcare as a war waged against death and finitude. Insofar as there is any genuine posthuman project afoot, it is a project for a few philosophers and scientists, not a driving force in ordinary lives. This objection, however, is effectively blunted by another of the book’s primary contentions, that our self-understandings and values are undergoing a kind of formation as a result of our embrace of technology’s promise to enhance our lives and increase our autonomy. Waters argues that “technology forms the patterns of daily life, as well as the values and convictions of the people who live out their lives within these patterns” (17). This point is reinforced vividly by a lengthy analysis of Aldous Huxley’s dystopian novel, Brave New World. The value of the novel is not in the success or failure of its predictions about how our world will actually turn out, but in its powerful illustration of the ways in which technological innovation shapes community, identity, and stability (18-27). While Waters seems to be staking out a reasonable position, some readers may desire some sociological evidence that medical advances have or will strongly influence our core attitudes towards mortality in the way he suggests. Nevertheless, if Waters is right in his belief that an increasingly efficacious set of medical therapies coupled with a postmodern denial of an eternal Good will infect us slowly with something approaching a hatred of finitude, then indeed we could be in danger of adopting some of the posthuman discourse as a part of our own self-understanding in ways that he argues are theologically troubling.
To evaluate the posthuman project theologically, Waters turns primarily to the doctrine of the incarnation, “for what Christians believe about the Word made flesh presumably shapes their normative convictions regarding the purpose and practice of medicine” (115). In particular, the death, resurrection, and ascension of Jesus are explored for their implications for Christian bioethics. Christ’s embodiment in mortal flesh bridges an otherwise unbridgeable gap between the eternal Good and the realm of temporal necessity. For Waters, “necessity” names “those things and conditions required to sustain human life and enable it to flourish over time,” and it is a mark of our human condition that our biological and social needs are to be construed as both essential conditions of life and “the source of pain and suffering”(120). Sustenance, shelter, and social arrangements that facilitate the meeting of our needs are required for life, but they are also scarce, limiting, and a source of competition. Though these “necessities” can be conceived of as beautiful because they are an indication of the space God created for a human being to become “something truly other than God, and therefore a proper object of God’s love,” they are never to be confused with the eternal Good itself(106). And yet Waters, influenced by the work of Oliver O’Donovan, argues that in Jesus’ resurrection from the dead, God vindicates the life of Jesus, and “since God is incarnate in this life, the vindication extends to all of creation” including suffering and death (125, 128). The ascension, the final act of the incarnation, completes the story, because “it is the risen and exalted Christ through which the good and the eternal delineates and redeems the necessary and the temporal” (128). A Christian’s proper response to finitude, then, is consent to a vindicated temporal order (one that includes death) and eschatological hope for redemption by the exalted Christ.
Against the backdrop of this theological framework, Waters argues that those who wield medicine as a weapon against mortality are actually seeking a kind of replacement for religion which attempts to transform temporal necessity into the good. This strategy “is doomed to fail, however, because the resulting product is merely a simulacrum of the eternal Good”(128). This posthuman rival to Christian discourse rehearses heresies of ages past. It is Pelagianin its embrace of self-perfection that “does not depend upon the initiative of a divine redeemer” (155). It is Manichean in its desire to be saved from a loathsome and limited body.
There is much to recommend in the reflections offered here, but the theological framework developed to steer humanity away from the view that aging is a disease requiring acure works best when pitted against those who would seek immortality as a form of self-indulgence or Nietzschean self-creation. But in these cases, it is not the desire for immortality itself that is problematic but a disordered desire to grasp individual flourishing above all else. Waters notes rightly that there is nothing intrinsically wrong with the desire for a long and active life as long as that desire does not displace the more fundamental desire for God; so perhaps other visions of Christian eschatology less inimical to a posthuman temporal future are possible, given that such a future would be oriented towards the fulfillment of the ideals of the Kingdom of God rather than a tool of self-indulgence. Waters could have strengthened his argument by engaging a wider range of such foils successfully within the larger Christian tradition.
In addition to the general critique of medicine construed as a part of the posthuman project, Waters offers the beginnings of a Christian response to some standard biomedical moral issues like reproductive technology, genomics, and stem cell research. Those looking for concrete answers about whether Christians should seek out preimplantation genetic diagnosis or support the abolition of embryonic stem cell research will be disappointed. Routinely in these chapters, Waters eschews the granting of answers and stakes out instead general theological parameters which should structure any answers given. This yields some worthwhile insights in itself, but many of these considerations are connected only tangentially, if at all, to the careful, deliberate, and deep theological grounding in the incarnation which animates the general response to the posthuman project. As a result, some of the arguments in this section of the book are more superficial and, I believe, less convincing. For example, with respect to stem cell research, Waters suggests provocatively that as Christians, we should consider bypassing the thorny maze of the moral status and personhood of embryos and see instead what might follow morally if we consider embryos as neighbors (83-88). Though the shift in category from person to neighbor is illuminating in some ways, it only works if we grant the assumption that non-persons can be neighbors, and this is a point of controversy merely asserted by Waters without any support or explanation (83).
All in all, however, this is a fine book, and Christian readers will appreciate its keen theological insights about the normative weight of the incarnation—insights which will help them to reexamine critically how they should approach various aspects of their own healthcare and to reflect more carefully on the ways that our rapid advances in medicine are shaping our culture’s basic convictions about the value and meaning of mortality.
