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“Theology of the Body and Medical Practice”Dinner Address to the National Colloquium for Catholic Bioethicists sponsored by the John Paul II Institute for Marriage and the Family, the Order of Malta and the Catholic Doctors Association of Victoria, Melbourne By Most Rev. Anthony Fisher OP Introduction Rashad Hassan Khalil, a leading Egyptian scholar of Sharia and former dean of Al-Azhar University’s faculty of Sharia, recently declared that complete nudity during sexual relations between a husband and wife annuls their marriage. The story was carried in major Islamic and secular media throughout the world and here in Australia.(1) In fairness we must recognize that many Christians and others in history have been every bit as hung up on the body and its dangers as any contemporary Muslim. We might also recognize that many Muslim scholars and believers would not agree with Khalil’s position. What’s more, modesty does have its place. When Hippocrates outlined the so-called ‘decorum paragraphs’ of his famous Oath he highlighted the importance of modesty and privacy issues in healthcare as elsewhere in life. The problem with Khalil’s position,(2) I would respectfully suggest, is that his narrow pre-occupation with decorum prevented him from seeing modesty within the broader context of the goodness of the human body and especially of all that is revealed in the self-gift of authentic spousal love. It is only a couple of months until the first anniversary of the death of one of the greatest men ever to sit in the Chair of Peter: a man already deservedly called ‘the Great’. It is only appropriate that tonight we should briefly reflect on the heart of his Theology of the Body and consider its application beyond the bedroom to such other places as the medical consulting room, the hospital ward and the bioethical committee room. For not only was John Paul great in life, but his very death revealed his commitment to the Christian theology of the body and the beauty it contained: a beauty expressed in the dignity of his own dying as much as his formal teaching on the subject. Paraphrasing his biographer, George Weigel, John Paul has left us in his Theology of the Body with a time bomb set to go off and renew Church and culture for the next century. Let us be a part of that renewal tonight. Tonight, I want to consider some aspects of that Theology of the Body and then to see what they might say to medicine today. Theology of the Body The Judeo-Christian tradition of reflection on human nature and thus on the body stretches back thousands of years to the Genesis of the Old Testament, through the New Testament, the Fathers and Scholastics, through to Paul VI in Humanæ vitæ. It was brought to a new height by the extraordinary work of John Paul II, especially in his series of Wednesday audiences between September 1979 and November 1984 now collected together in the book entitled The Theology of the Body. Right from the start of those allocutions John Paul insisted that the human body not only reveals human beings to each other but also, paradoxically, the God in whose image we are made. (3) John Paul went on to explore the multiple significances of the human body: as the sacrament of human and divine presence; as our link with the rest of material creation; as the site of nutrition, growth, genealogy, geography, sensation, perception, passion, memory, imagination, communication, worship and so much else; as the matter of the Incarnation, the Passion and the Resurrection of Christ and so the salvation of the world; as the stuff also of the sacraments, especially Matrimony by which two become one flesh and the Eucharist by which man receives God-in-the-flesh into the tabernacle of his body; as the battle ground of human temptation and divine grace, of violence and service; as the home of sexuality, fertility and all family and community life; as the Temple of the Holy Spirit and a revelation of the life of the Trinity Most Holy. Yet since the so-called Enlightenment we have all been encouraged to think of the body as a kind of machine with complex chemistry and electricity, sometimes beautiful and functional, at other times failing and in need of a medical plumber, electrician or renovator. Materialists would tell us that that is all there is to us: I call this the Zombie view of the human person as a soulless body. Enlightenment dualists, on the other hand, proposed that there is something more, the soul or self, a substance more or less distinct from the body, made of ‘spirit stuff’, who is either trapped in the body for a time or who uses the body for his purposes: I call this the Ghost view of the human person. While no serious Catholic holds the Zombie position, many live a kind of day-to-day practical materialism – as if there were no soul. Ironically they do so while thinking that body-soul dualism – the Ghost view – is the official Christian position. Thus they think that holy people properly hate their bodies and bodily lives, or treat them as something distinct from the real spiritual person within. The body must be tamed or tolerated in this life while the soul looks forward to liberation from the body at death. The thrust of John Paul’s Theology of the Body was to refute both Enlightenment materialism and dualism, to offer us a view of the human person as neither Zombie nor Ghost. (4) Put simply: we are all somebody. If I ask you to point someone out to me, you will describe peculiar aspects of the person’s external appearance rather than aspects of their peculiar internal character. We first identify and know people by what they look and sound like. If someone punches or kisses or tickles or feeds my body, they are doing this to me. Whatever happens to our bodies – sickness and health, hunger and satiation, location and movement, passions and perceptions – all affect the whole person. It is impossible to have any of these experiences just as bodies and not be affected personally. So our bodies are not just extrinsic costumes, machines or prisons for some internal ‘real me’ to use. They are constitutive of our being and they express or reveal us to others. Of course there is a spiritual dimension to us also. The soul is the principle of organisation of a living being; integrating us as the kind of being we are, insuring continuity and development though time, place, material change and, in the case of the human, life beyond death. Like the angels, we think and choose: we are our minds. But like the animals, we live and breathe: we are our bodies. Indeed all human life is embodied: we are in this life bodily creatures and, according to Christian faith, we will forever be again through the resurrection in the next life; between death and resurrection we will be incomplete. Indeed St Thomas Aquinas says that such separated souls are not true human persons. Human persons have bodies; or, better still, they are embodied. Despite popular sentimentality, then, we are not angels and never will be. We are, more truly, the envy of the angels, above all, because the Son of God became man and never an angel. But there is another reason, too, why we can be called the envy of angels. The French have a saying that the angels weep at the sound of a Champagne cork popping: for unlike us they will never taste Champagne. Only beings that are a unity of matter and spirit can both taste Champagne and appreciate it. And the Word-made-flesh who first manifested his power at a wedding feast in Cana by producing a very large quantity of the finest drop in history, became a member of our race in order to renew all creation in Himself. The theology of the body takes us beyond a biological and philosophical anthropology in demonstrating that our bodily-spiritual nature is infused with and communicates meanings about even higher things, meanings purposefully imbedded in our hardware by God to lead us to completing his image in us. Even when we do not consciously intend to communicate a particular meaning, even when we do not know what our actions really mean, the body “still speaks in the mysterious language of the personal gift”(5). As John Paul said in his groundbreaking encyclical Veritatis Splendor, “The person, by the light of reason and the support of virtue, discovers in the body the anticipatory signs, the expression and the promise of the gift of self, in conformity with the wise plan of the Creator(6).” The glory of that human person under grace, and so of the Creator and Redeemer of the human person, will ultimately be revealed not by the liberation of the soul from the body, but in the transfiguration of both; then we shall most fully share in that divinity manifested at Christ’s Transfiguration. In the meantime we live with yet untransfigured bodies. But those too are vehicles of grace. Love is not humanly expressed until vocal chords shake the air and communicate our thoughts into the ears of one whose eardrums beat that expression into cognition to elicit communion. Our voices and ears are designed for this. Our hands, too are made to touch, and our arms to embrace one another and our children. Our genitals and breasts are designed to enable and express marital and family life. Even our minds are made to think and communicate our interiority not by some language-free mental telepathy but in bodily symbols, and they rely on our brain to mediate perception, memory, imagination and more. Lest anyone think these were the preoccupations of one pope only, we might note that only last week Pope Benedict XVI reiterated the importance of a non-dualist and theological understanding of the body in his first encyclical, Deus caritas est. In paragraph 5 he writes:
Applying Theology of the Body to Medical Practice Well, what’s all this got to do with healthcare professionals and bioethics? The recent review of the Prohibition of Human Cloning Act 2002 and the Research Involving Human Embryos Act 2002 was conducted under the chairmanship of Mr Justice John Lockhart who died within days of issuing his report. The Lockhart Report is ethically very ‘thin’ indeed, but it is thick with recommendations of new moral adventives free of constraints. Despite the fact that the Australian Parliament voted in 2002 unanimously in favour of a ban on all human cloning, despite the fact that the UN passed a similar resolution as recently as March 2005, and despite the fact that the Australian Government supported that UN resolution, the Committee reported – unanimously – in favour of legalising cloning, as long as the cloned embryos are destroyed within two weeks of their creation. It also (unanimously) recommended the legalisation of the manufacture of: animal-human crosses, human embryos with multiple human parents or only one, and fresh IVF embryos, all for the specific purpose of destructive experimentation. Few would have foreseen that the Lockhart Committee would be making unanimous proposals so completely at odds with Australian community attitudes and more universal ethical principles. The Report resorts to quite brazen Orwellian ‘newspeak’ when it suggests that Parliament redefine the embryo so as to exclude the early embryo from the definition and thus from even minimal legal protection. At one point the Report chillingly describes human embryos as mere “cellular extensions” of adults rather than nascent human beings in their own right. Such commodification of human life was until now the realm of science fiction films such as The Island(7). Of particular interest to me tonight is the impoverished notion of the human person that is at the heart of this embryo industry wish-list and behind the willingness of some to give these technicians whatever they want. People can only take such a cavalier attitude to the human generative power and such a callous attitude to the early human lives that result if they have already swallowed the Enlightenment views about the human person I mentioned earlier. Either people think the human embryo (and perhaps the parents whose gametes are used to manufacture it) is merely a material object for farming and harvesting – a purely materialist conception of the human person – or they think that the self or consciousness has not yet popped in or emerged and so the embryo is not yet ensouled. But if we understand that we are embodied spirit at every moment our existence, then we will be much more cautious about treating the bodies of other human beings as mere cellular extensions or spare parts banks, or treating our procreative powers as merely ingredients for a manufacturing process. In a paper I gave to the Melbourne Conference of the International Association of Catholic Bioethicists last June(8), I argued that there is an abiding dualism amongst some Catholics as in the rest of society, that partly explains the desire to stop even effective, non-burdensome care for the persistently unresponsive. It is not that they are joining the euthanasist chorus who think the unresponsive are better off dead or that others would be better off if they were dead and so death should be hurried along. Rather it is that they think that such people are already dead, or as good as dead, mind-dead if not quite brain-dead, because their self, with its spiritual powers and acts has already left them and only the shell of their body survives. Worse still, perhaps, they fear that the patient’s soul is held prisoner craving merciful release from their broken body. There was plenty of that sort of talk around the Tony Bland Case in Britain, the BWV Case here in Melbourne and the Terri Schiavo case in America. From the point of view of a sound philosophical anthropology, let alone the Catholic Theology of the Body, such talk is mistaken. If the soul has really left someone, that is, there is no unifying principle uniting their functioning, then they are dead, and there will be plenty of external signs. Dead people’s bodies do not continue living for years. Zombie bodies – human bodies roaming without souls – are as impossible as ghost souls – human souls roaming without bodies. The are properly the stuff of adolescents’ films, not adult medical practice. If a person’s body is alive – unified and doing those things organisms do – then that person is alive, however disabled they might be. The Theology of the Body speaks to many other parts of healthcare too, not just to the beginning and end of life. I am sure this will be more fully unpacked in the years ahead. While concern for patient quality of life, for instance, is rightly a high priority today, we must ensure that such talk is not a cover for unreasonably neglecting or harming a patient’s body for that person’s supposed ‘quality of life’. Questions of what treatments are indicated, what ones futile, and what ones over-burdensome, are deeply affected by one’s understanding of the person. So, too, in reproductive health. While it is very important to assist people to exercise responsibility in parenthood, we must never assist them to address their fertility or infertility by sterilizing themselves or their marital love-making, or by having children manufactured in the lab. A sound theology of the body will in fact affect attitudes and activities across the whole range of issues treated in the Australian Code of Ethical Standards for Catholic Health and Aged Care(9). To understand what drives many of the conclusions of that document and what puts Catholic morality in line with the best of traditional health ethics but increasingly at odds with contemporary approaches, reflection upon the Catholic view of human nature is enormously helpful. I think such reflection also points the way to a future Catholic bioethics based systematically on the Theology of the Body. You will be relieved to know I do not plan to explore the implications of the Theology of the Body for each area of clinical practice tonight: you might very well suffer major indigestion. So I might finish with just one arena which brings us back to the beginning of my talk tonight. Nudity is not only an issue in the marital bed: it is also one in the hospital bed. The intimacy of the relationship between health professionals and patients raises all sorts of complexities about trust, boundaries, modesty, dignity, privacy and confidentiality. I imagine that it is easy for health professionals to say “you’ve seen one, you’ve seen them all” and to become rather blasé about the bodies of the people they are seeing and touching. It is not, after all, the nudity of spousal love and self-gift that is offered – a gift which spouses can take too much for granted. While spouses are properly in the position of freedom and equality patients are, as it were, stripped naked by forces beyond their control, exposed to veritable strangers, nude both physically and emotionally. Those who see the human body as a revelation of a unique person and a vessel of the divine, are likely to touch or gaze upon patients with a reverence rather different to those who see the body merely as dysfunctional plumbing and wiring. The Theology of the Body has challenged spouses and others to rethink the meaning of sexuality by placing it within the context of what it means to be a human being; it can likewise challenge health professionals and others to rethink the meaning of healthcare in the same framework. For something has eroded our appreciation for the mystery of the body. This is obvious enough in the commodification, commercialisation and trivialisation of sex in contemporary society. But it is an issue in healthcare as well. Something has enabled us to neglect to death some naked unconscious patients in hospital and to exploit to death some naked embryos in the laboratory. Their vulnerability should evoke in us a desire to cover and protect them, not out of fear of the body but out of reverence for it. A living personal relationship with Christ and his saints on earth and in heaven, should inform the Catholic health professional or institution much as the soul informs the body. As the body and the soul are inseparable in this life, so the doctor and his faith should be inseparable. It makes about as much sense to tell nurses to leave their values behind when gowning up as it does to tell them to leave their souls behind. In their witness, the Catholic health professional is “the guardian and servant of human life(10).” Saints are given in every age to embody God’s message for the times. If we really want to understand the application of Theology of the Body to medical practice we need only look to the holy dying of John Paul who poured himself out for the Gospel of Life and Love. The beauty of the drama was not cut short by euthanasist action or omission. He ensured that his own living and dying not be removed from the bigger picture of man’s nature and his vocation to life and death in Christ. While Terri Schiavo was being starved to death, John Paul continued to make a gift of his body and so of himself, uniting his suffering with Christ that the image of God in him might be brought to completion. John Paul the Great, pray for us. ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------- 1. E.g. Agence France-Presse 11 January 2006 and in many newspapers around that time. |
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