Are Persons with Profound Intellectual Disabilities Sacramental Icons of Heavenly Life? Aquinas on Impairment

Introduction

If Augustine’s work may be thought of as the heart of Western Christian theological thought, then the work of St. Thomas Aquinas may be seen as its theological head. For no Christian theologian in the West has created as comprehensive and profound an edifice of theological reflection which approaches the influence of Aquinas, save perhaps Augustine. Aquinas is of course of particular importance in the Catholic tradition, where he has been granted a unique status as a kind of ‘official’ theologian of the Church. But his influence and importance is by no means limited to the Catholic tradition, and the last generation has seen a new flowering of theological work drawing on Aquinas from across the spectrum of Christian theological traditions. However, Aquinas has been widely thought to be no friend of those with mental disabilities. He has often been understood—by friends and foes alike—to focus on the human rational will to the seeming detriment of those human persons who are unable to exercise a rational will. This article will argue that Aquinas, rightly understood, has a remarkably different view of those born with and who live with severe mental disability.

What can we expect to learn from Aquinas with regard to how to understand disability, or ‘impairment’, which is the term used by Aquinas? If we are looking for an extended or systematic treatment, we will be disappointed. To the extent he discusses physical or mental impairments and those afflicted with them, he does so usually in passing. References to impairment come up quite frequently since Aquinas constantly uses analogies to the physical to help us understand spiritual perfection and deficiency. For example, in discussing the nature of ‘evil’ as a privation of being, he notes that ‘evil deprives a thing of some sort of being, as blindness deprives us of that being which is sight’. ¹ Similarly, in discussing moral rationality and in particular the culpability necessary for mortal sin, he contrasts the culpability of normal adults with that of the mentally insane [furiosi] or those lacking mental capacity [amentes], noting that ‘if the ignorance be such as to excuse sin altogether, as the ignorance of the furiosi or the amentes, then he that commits fornication in such a state of ignorance, commits no sin mortal or venial’ (ST I-II 88.6 reply 2). In these and many other instances, examples of persons with physical or mental disabilities are employed to illustrate general points about human nature, its end and its perfection, whether the perfection be physical, intellectual, moral or spiritual.

While Aquinas often used examples of physical or mental incapacity to illustrate a moral or spiritual point, he was no physiognomist. A number of late mediaeval thinkers revived the relatively common practice among the ancient Greeks of evaluating the character of a person by their physical features. These theologians sometimes explicitly demonised the disabled, seeing physical or mental disability as a sign of moral and/or spiritual depravity. There is no evidence that this is a view shared by Aquinas.

What are we to make of Aquinas’s matter-of-fact treatment of those whom we call the disabled? It surely cannot be because he was sheltered from the reality of impairment. In a time when the physically and mentally impaired were neither likely to be effectively treated or cured, nor were they typically institutionalised or hidden, Aquinas must have confronted on a regular if not daily basis the reality of physical and mental impairment. One possibility is that in Aquinas’s social, cultural and theological context, the category of ‘the impaired’ as a separate and distinct group of people would simply have no resonance. According to Aquinas, all humans, as wayfarers on the road to God, are to a greater or lesser degree impaired. While physical or mental impairments are not part of God’s intention in creation, they become part of the human condition as a result of original sin (ST I 96.3). But in heaven humans will be relieved of all imperfections, spiritual, moral, intellectual and physical. Referring to the Prophet Isaiah, Aquinas notes that ‘the reward promised to the saints is not only that they shall see and enjoy God, but also that their bodies shall be well-disposed’. And he goes on to quote Augustine that in heaven God gives the saint such a powerful soul that ‘from its exceeding fullness of beatitude the vigor of incorruption overflows into the lower nature’ (ST I-II 4.6).

Our task as wayfarers is to properly use our gifts and carry our burdens. Furthermore, Aquinas is far more concerned about moral and spiritual impairment than about mental or physical impairment, since the former, and not the latter, are what impair one’s destiny. To modern ears, when it comes to his discussion of physical and/or mental impairment, Aquinas is extraordinarily matter-of-fact about God’s providence and human suffering. For instance, in contrasting the significance of the death of a donkey with that of a human, he notes that

the death of a donkey is ordered to the good of a lion or that of a wolf. But the death of a man killed by a lion is directed not merely to the good of the lion, but principally to the man’s punishment or to the increase of his merit; for his merit can grow if he accepts his sufferings (De Veritate, 5 VI reply).

Or, as Aquinas puts it elsewhere, the ills of this life (Aquinas gives poverty and sickness as examples, but we could certainly include impairment in the list) ‘are an occasion of progress in virtue for some but aggravate the viciousness of others, according as men react differently to such conditions’. ² Aquinas is certainly not immune from the difficulties of our life as wayfarers brought about by various physical or mental maladies. For Aquinas, the chief expression of the virtue of courage lies in responding bravely to the ‘infirmities of the flesh’ (ST II-II 123.1).

Since Aquinas’s account of human nature and morality continue to be extremely important for contemporary work in theology and ethics, one might be tempted to focus on those accounts for addressing the question of impairment. Important as these categories may be, they can easily give rise to an incomplete and thus misleading view of his thought. For example, one might argue that since Aquinas’s account of the moral life begins and ends with a vision of the fully flourishing human being, of which a central feature is rationality, this would seem to preclude both the physically and especially the mentally impaired from attainment of the human telos. One might further think that Aquinas makes the use of rationality a condition for having an intellective soul, which in turn is a precondition for salvation.

While I will show that such claims are clear misrepresentations of Aquinas’s views, they are not entirely far-fetched in the light of some contemporary popular but reductionistic readings of Aquinas’s anthropology and ethics. To give a full, if brief, response to such a reductive reading of Aquinas, this essay will proceed in four parts. First, I shall briefly lay out the metaphysics of Aquinas’s understanding of human nature and destiny. Second, I shall examine how Aquinas understands and relates different kinds of impairments. Third, I will take up a case study to put Aquinas to the test. In the fourth section, I will seek to show, appealing to, for example, Aquinas’s accounts of baptism, eucharist, Providence, the resurrection of the body, and the gifts of the Holy Spirit, that far from impugning the human nature and goodness of the amentes (those with severe mental disability), Aquinas’s considered views of the amentes make them effectively sacramental icons of heavenly life.

Aquinas on Human Nature and Destiny

For Aquinas’s general understanding of impairment, we must begin with his understanding of the nature of human nature and destiny. In this section, ³ I will provide a synopsis of Aquinas’s presentation of the specific end (telos) of human beings, of the notion of goodness, and his understanding of body and soul, and of sensible and rational nature. In the next section we will connect these notions to his understanding of perfection and defect in human nature.

Aquinas’s Summa Theologiae was a revolutionary work of theology in his own day, not least of which for Aquinas’s novel employment of this Aristotelian architectonic for understanding human activity, reoriented by Aquinas to focus on the human wayfarer’s journey back to God as their ultimate end. What is the end of human beings? It is to find their proper place and perfection in creation. In Aquinas’s larger picture, the entire physical universe is ordered towards ‘ultimate perfection’, which is in turn ordered to God, and by its perfection gives glory to the goodness of God. Each creature manifests the goodness of God by living according to its own telos (ST I 47.2).

Like Aristotle, Aquinas begins his treatment of human beings’ return to God with a discussion of the final end or goal appropriate to the kind of creature that is a human being (ST I-II 1-5). How does Aquinas summarise the nature and thus the telos of human beings? A human being is ‘an intelligent being endowed with free-will and self-movement’ (ST I-II prologue). However, unlike other earthly creatures, humans cannot reach their true and complete end by use of their natural powers. The end for humans consists in happiness (beatitudo), which is a gift of God’s grace (ST I-II 5.6 and I-II 109.5). I will seek to show how important this point is when it comes to the possibility of beatitude for those who, either because of their young age or profound disability, do not have the use of discursive reason.

For Aquinas, ‘good’ in its most fundamental sense is simply participation in being, and ‘evil’ is a privation of being. More specifically, for a human being, goodness consists in its participation in the goods of human nature, whereas an evil is a privation of that which is appropriately to be possessed by humans according to their nature. As Aquinas puts it, ‘a thing is called evil if it lacks a perfection it ought to have [by its nature]. Thus if a man lacks the sense of sight, this is an evil for him. But the same lack is not an evil for a stone, for the stone is not equipped by nature to have the faculty of sight’ (CT §114). Here Aquinas by no means intends to indicate that sight or a lack thereof constitutes a moral good or moral evil. That only arises in the context of choices of actions that either conduce towards or away from the human good. But more fundamentally than the goodness or evil in human acts (the basis of morality), there is also goodness or evil in one’s nature, depending upon whether one has or lacks the appropriate potentialities and capacities fitting to human nature.

Along with his notions of beatitude and good, a third key element of Aquinas’s anthropology is his account of the human soul. By soul, Aquinas is referring to the Aristotelian notion of anima, i.e. that which animates a living being or makes it alive. The anima fundamentally distinguishes a living from a non-living being. Thus Aquinas’s notion of the soul as ‘the first principle of life’ (ST 75.1).

For Aquinas, different kinds of beings have different kinds of souls. In Aquinas’s schema, a plant has a vegetative soul, a non-human animal has a sensitive soul, and a human being has an intellective soul. What distinguishes these different kinds of soul is the kinds of capabilities associated with each kind (ST 78.1). A being that has a vegetative soul typically has the ability to reproduce itself, to process food, and to grow. A being that has a sensible soul also typically has the five exterior senses—sight, hearing, smell, taste and touch—as well as up to four interior senses (ST 75.1, 4). Beings (e.g. human beings) that have an intellective soul also typically have the capacity of intellection. In human beings, intellection typically takes the form of reason, namely, the capacity for deliberation and choice, which involves not merely the choosing of one alternative over another, but the ability to engage in reflection on one’s initial choice and to question and reverse one’s decision. ⁴ However, it is important to note that for Aquinas, the kind of being one has determines the kind of soul one has. And furthermore, a kind of being can only have one kind of soul. ⁵ Thus, for example, Terri Schiavo, throughout her life, was alive with a human soul, an intellective soul, whose functions included intellect, sensation, nutrition, reproduction, etc. In human beings, the intellective soul is the primary agent in nutrition, sensation and intellection, even if, in a particular individual, acts of intellection are hampered or effectively blunted altogether.

So far I have only been addressing ‘intellectual’ powers of sensible and rational souls. In addition to cognitive and quasi-cognitive powers, we also must understand Aquinas’s view of desire, both the desires which he attributes to both human and non-human animals (sensible desires), and those he limits to humans (rational desire). At this point we are moving, roughly speaking, from what we know to what we do. This is a movement in Aquinas from questions of theoretical knowledge to questions of practical knowledge, or as Aquinas puts it, ‘whereas a thing is apprehended as intelligible, a thing is desired as good’ (ST II 80.1 a2).

For Aquinas, desires are what fundamentally move us to act. Thus one cannot understand Aquinas’s discussions of human actions and dispositions (i.e. virtues and vices) apart from his conception of desire, since human actions and dispositions are rooted in the desires that are part of human nature.

According to Aquinas, both human and non-human animals pursue what they pursue, desire what they desire, because in a fundamental sense they perceive what they desire as good. This is Aquinas’s first principle of the natural law—i.e. his understanding of the fundamental intelligibility of the good—that ‘good is to be done and pursued, and evil is to be avoided’ (ST I-II 94.2). Furthermore, Aquinas understands both human and non-human animals to be inclined towards certain kinds of activities as appropriate to the kind of creature that they are. Thus, Aquinas speaks of animals having ‘natural inclinations’ towards certain kinds of activities which are inherently good for them qua members of their particular species, such as acting to stay alive by obtaining and consuming nourishment or by fleeing from danger, propagating the species and rearing the young, and living and getting along in social groups. Aquinas’s discussion of these sensible appetites (which covers emotions such as love, hatred, desire for pleasure, joy, sorrow, hope, despair, fear and anger) occupy a significant portion of the Summa Theologiae (ST I-II 22-48).

In addition, Aquinas attributes to human beings rational desire, which he calls ‘will’, i.e. desire guided by practical reason. And what is practical reason? It is the ability to moderate and direct the desires in ways that allow human beings to fully flourish as human beings, to find the happiness appropriate to human beings.

It is because of these intellective capacities (both in terms of knowing and desiring) that Aquinas attributes to a human being an ‘intellective soul’, which is non-material and exists in its own right. As such, it is not subject to decay (as are material things) and thus immortal (ST I 75.6). Thus, for Aquinas, the intellective nature of humans is what makes them in part incorporeal, and thus immortal and potentially fit for eternal life with God. ⁶

Modes of Creaturely Impairment

So far we have discussed key elements of Aquinas’s understanding of the destiny and nature of human beings. While an account of human nature is necessary for an account of human destiny, it is not sufficient. According to Aquinas, the destiny of human beings transcends that which their human nature is of itself capable. For human beings to reach their true end, their nature must be transformed and perfected by God’s grace.

Furthermore, to have an account of Aquinas on imperfection, one must first have an account of in what, according to Aquinas, consists human perfection. While Aquinas’s account of the perfection of human nature is broadly Aristotelian, i.e. the eudaimonia that can be expected by a life of flourishing perfected by the cardinal virtues, his account of human perfection is ultimately far different than this.

We have discussed the various powers of the intellective (human) soul: the physical or vegetative powers; the sensible or emotional powers; the cognitive or intellectual powers; and the moral or willing powers of the human soul. Accounts of God’s grace for humans typically focus on how God’s grace transforms the intellect and will. While these are clearly central to Aquinas’s account, the perfection of a human being necessary for the union of a human being with God involves not only a transformation of the person’s intellect and will, but also of a person’s physical body and emotions, as we see in Aquinas’s account of the resurrection of the body and his doctrine of spiritual instinct (see for example CT §168).

In the same way that human perfection involves the transformation by God of all aspects of the human person, so too humans can be impaired on a variety of levels: physically; emotionally; intellectually; morally; and spiritually. In this section, I discuss human impairment at each of these levels. While I discuss them separately, these levels are clearly related, as impairment at one level can cause or contribute to impairment at another level.

The first and most basic level of possible human impairment is at the organic or vegetative level. Organic processes like the functioning of the heart, lungs, kidneys, digestive system and so on are basic to the survival and well-functioning of human beings as simply living beings. If these systems are impaired, they will often lead to impairment in human function, such as what we see in modern medical conditions such as, for example, asthma, diabetes, cirrhosis or colitis, not to mention a variety of mental impairments that often have organic causes. Aquinas calls all of these ills physical evils, or evils of nature, since they are a privation of human physical perfection. Of course, if the impairment is great enough, it leads to death, which is the greatest of physical evils.

The second level of possible human impairment is of the senses. Fundamental to full human flourishing is the exterior sense abilities of sight, hearing, taste, touch and smell. Thus Aquinas refers to various sense defects such as blindness, deafness, inability to taste, or loss of the use of a limb. However, the exterior senses do not exhaust what Aquinas means by the senses, as Aquinas also speaks of the interior senses, or the ‘wits’. The interior senses are possessed both by human beings and various of the higher non-human animals, which is what allows them to survive and flourish according to their kind. So various species of higher animals (e.g. lions, gazelles, squirrels, chimpanzees and turtles) survive and flourish only because they possess to varying degrees senses that enable them to forage or hunt for food, recognise and escape or fend off predators, seek and engage in reproductive behaviour, and nurse and raise their young until they can survive and flourish on their own. Human beings, also being animal creatures, similarly possess interior senses or instincts as part of their nature, which are also key to their survival. Although Aquinas considers the functioning of the interior senses in human beings to be transformed by their rationality, the well-functioning of human senses—for example, to desire various goods, fear various dangers, live amicably with other persons, keep hope in pursuit of goods that are difficult to obtain—are necessary for human flourishing (ST I-II 22-48). Humans who are or become—to use modern terms—clinically depressed, or lose their memory or their common sense, are those who are or become impaired in these interior senses.

The third level of possible human impairment is that of the theoretical reason. Flourishing at the intellectual level lies in the possession of the various intellectual virtues. Aquinas discusses a large number of intellectual perfections and the correlative intellectual deficiencies or impairments, and he sees all these intellectual deficiencies as, like other impairments, having a range of degrees. To give only one example, Aquinas notes that human learning requires metaphors. He says that while those of great intellect can understand a lot from only a few examples, those of lesser intellect require many examples to learn a little. ⁷ However, despite Aquinas being a person of towering intellect, he by no means attributes to the human intellect ultimate significance or importance. For the true perfection of the speculative intellect requires that one go beyond what any human being is capable of on their own, and by grace to receive, for example, the theological virtue of faith, and the gift of wisdom.

The fourth level of human impairment is that of the practical or moral reason. This is the inability (or failure) to choose and act well, which is encapsulated in the moral virtues and vices. Aquinas is fully aware that some who are intellectually virtuous may be morally impaired, and vice versa. ⁸ But in many places Aquinas does place clear boundaries between mental and moral disabilities. For instance, in his discussion of folly (stultitia), or dullness of sense, Aquinas clearly differentiates between cases which are on the one hand involuntary, and on the other hand sins (ST II-II 46.1, 2). In some cases one may come by one’s stultitia by a ‘natural indisposition’, in which case there is no sin. In other cases, a person is stultitia, very bad in judging about spiritual things, because they have become preoccupied with sensual matters. And such folly is sin.

The fifth and ultimate aspect of human perfection/deficiency is the spiritual, receiving and continuing to live in the grace of God. This is encapsulated in the participation and growth in the infused moral virtues, the theological virtues, and the gifts, beatitudes and fruits of the Holy Spirit. While human growth and development in the spiritual level typically build on growth at the moral level, spiritual birth is in some cases independent of any act of the person (the baptism of infants). Furthermore, according to Aquinas, as a person grows at the spiritual level, this involves increased receptivity to the direction of the Holy Spirit, and progressively less of the agent’s moral deliberation and choice.

It is extremely important to note that for Aquinas, while moral choice is the typical seed of spiritual growth, it is ultimately not necessary and certainly not sufficient for the spiritual perfection of human beings. We shall see this from Aquinas’s discussion of the spiritual perfection of those human beings who through some defect or impairment of physical nature may never have the ability to make moral choices.

Having presented the essentials of Aquinas’s anthropology, we now return to the previously discussed objection to Aquinas’s account.

Does Impairment Undermine Status before God

As I noted in the introduction, Aquinas’s Aristotelian emphasis on rationality as the unique and thus largely defining characteristic of the human animal, and his explication of the human immortal and immaterial soul as intellective, leads some to understand Aquinas’s account of the human soul to be rationalistic, effectively (if not in intent) denying a human soul to those who are unable to perform rational acts. In a recent book, Hans Reinders has accused Catholic theology of tending to be exclusive in this way. ⁹ Although Reinders does not specifically accuse Aquinas of holding the view he critiques, it is clearly a view influenced by aspects of Thomistic doctrine regarding the human person. And Reinders’ critique is a great service to the Catholic tradition, important as it is for helping the Catholic tradition to clarify its understanding of persons with severe mental disabilities. In examining Reinders’ critique, I will show that Aquinas does not hold the view Reinders attributes to the Catholic tradition, and thus point the way forward for the tradition to adequately repudiate the view Reinders so helpfully critiques.

Reinders centres his critique on a case study, the example of Kelly, a twelve-year-old red-haired girl who is micro-encephalic. Reinders sums up her condition as ‘profoundly disabled’, which in Kelly’s case means that she is such that she

will not reach even a minimal stage of determining what she wants for herself. Words such as ‘I’, ‘me’, or ‘myself’ will never means anything to her, nor will any other word for that matter. As far as we can tell, Kelly’s condition does not allow her any ‘interior space’, by which I refer to the inner life, that part of me where I am with myself. It is concerning this inner space that the language of selfhood becomes intelligible in the first place. ¹⁰

In summary, from a Thomistic viewpoint, Kelly is one who will never be able to reason.

According to Reinders, the traditional Catholic view is committed to two ways of thinking about the severely disabled, what he calls the genesis and the telos views of human nature and thus of the profoundly disabled. The genesis view affirms Kelly’s humanity, whereas the telos view tacitly undermines it.

The genesis view is that human dignity and significance arise from the fact the person is born of human parents. This makes a human being a person, made in the image and likeness of God, and thus is attributed a moral dignity or sacredness simply by being a member of the human species. On this view, the particular capacities or lack thereof of the profoundly disabled person are irrelevant to an evaluation of their human dignity. As Reinders notes, this is a view emphasised by the Roman Catholic Church, particularly with regard to prenatal ethics, in treating pre-born human beings as having humanity from conception. ¹¹

In contrast to the genesis view, the telos view of human persons and human nature emphasises that to be human means to have and develop certain capacities of intellect and will. This can certainly be seen in Aquinas’s Summa Theologiae at the beginning of the secunda pars, where Thomas says:

[M]an is said to be made to God’s image, in so far as the image implies an intelligent being endowed with free-will and self-movement: now that we have treated of the exemplar, i.e., God, and of those things which came forth from the power of God in accordance with His will; it remains for us to treat of His image, i.e., man, inasmuch as he too is the principle of his actions, as having free-will and control of his actions (ST I-II prologue).

Here Aquinas appears to claim that a person must have free will and self-movement in order to be a subject of morality and to be in the image of God. Does this not severely question the humanity of the profoundly disabled from a Catholic perspective?

What then do we make of Reinders’ critique? Well, if we attend to what we discussed in most of the first section of this article, the critique can be made even stronger. Aquinas’s discussion of human action seems to be resoundingly the telos view as described by Reinders. The genesis view as presented by Reinders certainly appears in Catholic teaching, but Thomistic ethicists do not seem to argue the genesis view, at least as it is presented by Reinders. But, in fact, if one digs into Thomas, one finds that Thomas very clearly addresses the issue at the beginning of the treatise on human nature, the treatise that culminates in Aquinas’s discussion of the imago dei. At the beginning of that treatise (ST I 76), Aquinas resolutely argues for the unity of body and soul, that human beings from their ensoulment only have one soul, and their soul is an intellective soul.

While Aquinas does clearly argue for the fact that all human beings have an intellective soul, it is not something that Aquinas seems to see a need to reiterate in any discussion of the amentes. Why does he not see a need to emphasise that the amentes have a human (intellective) soul? One possible reason is connected to my suggestion in the introduction, namely, that it does not seem to occur to Aquinas that ‘impairment’ is a major problem in theological terms, and thus Aquinas never addresses it in a sustained way. So although Aquinas does not make a general argument in defence of the genesis view specifically in relation to the severely mentally impaired, he does have much to say not only about the humanity of humans without the use of reason, but also of their perfection and deification in heaven. His views about the lack of moral significance of severe intellectual disability is most clearly to be found in his discussion of the doctrine of the resurrection of the body; in his discussion of the Church’s sacraments, especially baptism; and in his doctrine of God’s Providential care of human beings.

Impairment and Beatitude

I earlier referred to Aquinas beginning his discussion of a human being’s journeying to God with that of the goal—the beatific vision of God. However, Aquinas’s discussion in the prima secundae focuses on the means by which a human being is typically to pursue their telos. To get Aquinas’s view of what human perfection looks like, or consists in, we must turn to his discussion of the resurrection of the body and of the qualities of the glorified body. There we see the significance of this for our understanding of the significance of the human body in Aquinas’s thought. In heaven, the human person will be perfected in both soul and body. With regard to human bodies in heaven, Aquinas tells us, commenting on 1 Cor. 15.52, that ‘there will be no deafness nor blindness, nor anyone defective’ (Aquinas, Sermons on the Apostles Creed, XIV.2). He goes on to say that all the elect, having been raised incorruptible and being changed and given perfect bodies, will have the bodies of someone 32 or 33 years old (Aquinas thinks this is the age at which human beings reach their ‘prime’ as human specimens. Whether he thought this because this was apparently Christ’s age at the time of his sacrifice, or he had independent reasons for thinking this the perfect age for a human being is unclear). For Aquinas, all forms of mental and physical ailment, which afflict all human persons by the time they die to a greater or lesser extent, will be transformed and perfected in their heavenly bodies.

But, one can ask of the Thomist, although the infirmities of the elect will be transformed and perfected in our heavenly home, will those who are profoundly mentally disabled be among the elect to have those disabilities overcome? For, if according to Aquinas one needs to have an intellective soul to be among the elect, and if one needs to be able to use reason in order to have an intellective soul, what then of the person who neither has, has had, or will have the ability to make rational choices. How can they be among the elect, and thus have their debilities overcome and their bodies perfected? ¹²

The fundamental response to this line of argument is that for Aquinas all human beings have intellective souls, whether or not they can perform human acts. The human soul has ‘built in’ the primordial powers of intellect and will. Their use depends upon sufficient sense experience in the case of normally developed individuals; those who have a laesio organi have the power of intellect but, alas, not its act, since it is prevented from full operation by some imperfection of the brain and/or other bodily organs.

However, perhaps Aquinas’s most beautiful treatment of this question with regard to the mentally impaired is to be found in his discussion of baptism, and is a logical extension of his justification for the baptism of infants. Aquinas argues that although infants without the use of reason cannot express their intention to be baptised (which is the general norm for one who is to receive baptism), infants are to be baptised because

The spiritual regeneration effected by Baptism is somewhat like carnal birth, in this respect, that as the child while in the mother’s womb receives nourishment not independently, but through the nourishment of its mother, so also children before the use of reason, being as it were in the womb of their mother the Church, receive salvation not by their own act, but by the act of the Church (ST III 68.9 reply to ob. 1).

This may seem a radical departure for Aquinas if one thinks of his thought as ultimately understanding human beings as rational animals whose flourishing is ultimately dependent on their rational wills. However, properly understood, this should be seen as another instance in which Aquinas gives priority of place to God’s gracious initiative to all humans. God provides all that all human beings need for salvation.

Aquinas extends the logic of baptism for children to cases of the mentally ill (furiosi) and the severely mentally impaired (amentes). Those who are without the use of reason ‘from birth, and have no lucid intervals, and show no signs of the use of reason’ should be baptised for the same reason the Church baptises infants. After noting this, Aquinas takes up an objection. The objection is that unlike infants whom we expect to have the use of reason at some future point, we do not expect some of those who are mentally ill or severely mentally impaired to ever have the use of reason. Thus, the objection concludes, there is no more reason to baptise those who are severely mentally ill or impaired than there is to baptise non-human animals who do not have the use of reason. To this Aquinas responds that humans who lack reason lack it accidentally, ‘through some impediment in a bodily organ’, unlike the lack of reason in non-human animals who lack an intellective soul (ST III 68.12 ad. 2). So he concludes the argument does not apply to severely mentally ill or mentally impaired human beings.

Aquinas further elaborates on the nature of the gift God gives in baptism to those without the use of reason, both infants and the mentally impaired. According to Aquinas, God gives them the gift of wisdom (ST II-II 45.5 ad. 3). To understand the meaning and significance of this, it is important to understand that for Aquinas the two central kinds of dispositions that shape our character as Christians are virtues and gifts. On the one hand, there are the human virtues, which even when infused by grace, are the perfection by reason of the emotions (appetites) fundamental to human nature.

However, the dispositions that Aquinas calls the gifts of the Holy Spirit are dispositions to respond directly to the promptings of the Holy Spirit. In a way one who is full of the gifts of the Holy Spirit transcends the need of reasoning, since they respond directly to the promptings of the Holy Spirit. Furthermore, Aquinas notes the gifts are especially important in heaven, where humans will be completely subject to the direction of the Holy Spirit (I-II 68.6).

As there are seven key virtues (faith, hope, charity, practical reason, justice, courage and temperance), so too there are seven gifts of the Holy Spirit (understanding, knowledge, fear, wisdom, counsel, piety and fortitude). In his treatment of these seven virtues in the Summa Theologiae, he assigns to each a corresponding gift of the Holy Spirit (although the first two gifts are associated with faith, and there is no gift associated with temperance). Aquinas assigns the gift of wisdom to infants and the mentally impaired in their baptism. This is noteworthy, in that the gift of wisdom is the gift of Holy Spirit corresponding to charity, which is the preeminent virtue, and the form of all the other virtues.

But how, we may ask, do infants and the severely mentally impaired have the gift of wisdom, if they do not have the use of reason and thus cannot perform rational acts? Here we must recall that for Aquinas the gifts of the Holy Spirit are dispositions rather than acts. Of course, in human beings with the use of reason, these dispositions are displayed in action. But, as Aquinas notes, in those with the gift of wisdom, intellectual virtues are not needed, since they have this wisdom connaturally (ST II-II 45.2 resp). Infants, who do not yet have the use of reason, are also baptised and given the gift (which is a disposition) of wisdom, which according to Aquinas is fitting because in ‘being reared from childhood in things pertaining to the Christian mode of life, they may the more easily persevere therein’ (ST III 68.9). Baptism regenerates the Christian infant and gives them a ‘leg up’ on their life as a wayfarer on their journey through life, and assists them in persevering in the Christian life. However, the severely mentally impaired, having been baptised and thus cleansed from the stain of original sin, and having been endowed with the Holy Spirit’s gift of wisdom as a disposition in their soul, are unable to sin. Since the severely mentally impaired are thus unable to separate themselves from the love of God, they are in a sense sacramental icons of heavenly life.

Some will no doubt argue that I am engaging in a flight of fancy, even sentimentality, to attribute to Aquinas the view that the severely mentally impaired are sacramental icons of heavenly life. Especially since I provide no direct textual evidence that Aquinas makes this claim. Furthermore, having earlier argued that Aquinas is rather plain speaking in calling imperfection imperfection, how could those fundamentally impaired in the use of reason be called ‘icons’ of heavenly life? But this is to put the order of nature prior to the order of grace, whereas Aquinas’s view is precisely the opposite. ¹³ In asking whether practical reason is in all who have grace, Aquinas answers that baptised infants do in fact have practical reason, ‘as to disposition but not as to act, even as in the severely mentally impaired (amentibus)’ (ST II-II 47.14 ad. 3). In other words, at least for Aquinas, those who are baptised are given the gift of infused prudence, and do have the disposition of practical reason. For Aquinas, this disposition will be turned to act not in this life, but in the resurrection of their bodies, when all their ‘natural indispositions’ (as all our natural indispositions) will become properly disposed. What makes the severely mentally impaired icons (unlike those of us who not only have dispositions but acts of practical reason) is that the ‘natural indispositions’ that need to be properly disposed in the severely mentally impaired are trivial compared to the moral and spiritual ‘indispositions’ that need to be corrected in those of us who do act. Thus the severely mentally impaired may be said to be closer to heavenly perfection than those who can and do act.

Conclusion

In this brief examination of Aquinas on impairment, I have tried to show that while Aquinas does not directly address the modern notion of ‘disability’, he does address questions of human impairment at all levels. Though it is natural for moderns to think that questions of physical or mental impairment are of paramount importance, for Aquinas they are not nearly as important as moral or spiritual impairment.

In terms of the status of those with a profound mental impairment, the question was raised as to whether such persons, with the inability to perform human acts, can have rational souls, and thus can be expected to be granted eternal life with God. If one approaches this question purely philosophically, in the Aristotelian perspective upon which Aquinas draws, one might have to conclude that such persons cannot reach the ultimate end for humans which is built on the human ability to act. If acts of reason precede and are required for grace, then no, it would seem such persons could not receive grace.

However, while Aquinas indeed draws extensively on Aristotle for the architectonic of an account of the possibilities of developing and perfecting human nature apart from God’s grace, Aquinas utterly transforms this architectonic by understanding the spiritual life as graced from the beginning. Furthermore, Aquinas’s architectonic is always in service to helping us understand the practice of the Church. ¹⁴ Once one reads Thomas’s metaphysical anthropology in light of his accounts of the sacraments, one cannot help but see Thomas as having an important contribution towards a contemporary Christian theology of impairment.