Finitude,Freedom and Biomedicine: An Engagement with Gilbert Meilaender’s Bioethics

The Normative Claim of Biological Nature: Two Views

The Primer introduces the duality of finitude and freedom by alluding to Gen. 2:7. Meilaender writes, ‘We are created from dust of the ground—finite beings who are limited by biological necessities and historical location. We are also free spirits, moved by the life-giving Spirit of God, created ultimately for communion with God—and therefore soaring beyond any limited understanding of our person in terms of presently “given” conditions of life.’ ⁵ Meilaender goes on to clarify this point in two ways. First, he warns against taking the duality of finitude and freedom as a dualism in which we assert our freedom against our biological nature and treat the latter as mere material at the disposal of our will. ⁶ Second, he stresses that the freedom with which we transcend our biological nature not only gives us control over our nature but also relates us to God. ⁷ However, in the Primer, the relationship to God serves only to limit our freedom over our finite nature. ‘Made for communion with God’, Meilaender writes, ‘we transcend nature and history—not in order that we may become self-creators, but in order that, acknowledging our Creator, we may recognize the true limit to human freedom.’ ⁸ Here, communion with God consists in an acknowledgment of God as our Creator, in whom we confront the limit to our control over our nature. Yet, as the Primer will go on to illustrate, within that limit a modest control over nature is permitted as a legitimate expression of freedom.

This broad picture can be filled out with some examples from the Primer. First, Meilaender argues that heterologous reproductive technologies, which involve third parties in procreation as gamete donors or surrogate mothers, are wrong in the first place because they involve the assertion of willful freedom against the biological ties that bind parents and children and are fundamental to procreation as a fully human act. ⁹ Second, he argues that to request physician-assisted suicide or euthanasia is wrong in the first place because to take one’s life is to assert godlike freedom over it, violating one’s status as a finite creature. ¹⁰ Third, Meilaender argues that living wills are suspect insofar as the testator asserts control over his or her biological life, presuming in a moment of autonomous transcendence (freedom) to determine what shall be the case for a life which characteristically begins and ends in dependence on others (finitude). ¹¹ In these and other cases, Meilaender blocks what he sees as a tendency of freedom to assert itself against biological nature in disregard of the latter’s claim on our action. At the same time, he shows in these cases how the claim of freedom can be acknowledged in a way that is compatible with the claim of our biological nature. Thus, he permits (though not without qualification) homologous reproductive technologies as a form of control of nature that also respects biological kinship ties. ¹² He permits refusal of life-sustaining yet burdensome treatments as expressions of a legitimate freedom to choose what kind of life one will live—a longer yet more burdensome one or a shorter yet less burdensome one—without the wrongful assertion of freedom over one’s life as such. ¹³ In the case of these and other issues treated in the Primer, freedom legitimately transcends and controls biological nature to a limited degree while respecting its normative claim on human actions that affect it.

To summarize, in the Primer our biological nature is a ‘given’ which must be respected; we confront God as a limit to the control we may exercise over our biological nature; and within that limit we are permitted a degree of control over our nature. This picture offers a forceful critique of contemporary bioethics and biomedical practice, but in my view it does not do justice to freedom or to our biological nature. As for freedom, the Primer tends to present it as control of nature or personal choice rather than as the capacity through which humans pursue goods or realize their moral vocation. It is a space of permissibility bounded by prohibitions. Lacking direction from within, it must be constrained from without. As for our biological nature, its goodness tends to be reduced in the Primer to its sheer ‘givenness’, while we do not relate to God in and through it but only in the freedom that transcends it, in which we confront God as the Creator who limits our freedom. The divine limit to our freedom clearly protects the claim of biological nature on our actions. But it is unclear how the mere givenness of biological nature makes a normative claim on us in the first place, and it is therefore unclear why it is worthy of protection from the overreach of freedom. ¹⁴

Should We Live Forever? presents a more attractive and more plausible picture of finitude and freedom. In this work, finitude is identified with the stages of growth, maturity, decline, and finally death that characterize humans as biological organisms. That we grow, mature, decline, and eventually die is of course given with our biological nature, but now Meilaender shows how it is also good, in a sense that, as he emphasizes, is analogous to the goodness of a banquet, which also unfolds in stages and which also would lose its value if it went on indefinitely. ¹⁵ The stages of biological life and even its mortality give human life a shape that contributes value to it that would be lacking in a life that unfolded in the form of undifferentiated duration and went on indefinitely. Meanwhile, freedom still involves control over nature (as in the Primer), but now Meilaender stresses that our desire to extend our lives reflects not just our will to control our nature but also our recognition of the abundant goodness of created things, which we can never adequately enjoy within the current limit of our lifespan, and which therefore make the desire for extended life an intelligible one (and one which Meilaender portrays sympathetically despite his ultimate suspicion of it). ¹⁶ In short, Should We Live Forever? skillfully and artfully works through the tension between the good of a biological life that ends in decline and death and that of an indefinitely extended life, doing justice to the claims of finitude and freedom alike.

However, Meilaender wants not only to portray this tension but to resolve it, and his resolution runs along somewhat different lines. Freedom’s pursuit of extended life in order to enjoy finite goods turns out in his analysis to be the disordered expression of a desire that can be satisfied only by the good of eternal life with God. ¹⁷ For its part, the goodness of a biological life that proceeds through growth and maturity to decline and death gives way to a duty to commit ourselves to those who will replace us. ¹⁸ In short, the tension between the goods of an extended life and those of a limited one tend in Should We Live Forever? to give way to an alternative picture in which extended life is a false substitute for or semblance of eternal life, and limited life is more a duty to others than a good on its own terms. I say that the one tends to give way to other; in fact, Meilaender wants to hold the two pictures together and to a considerable extent he succeeds in doing that. Nevertheless, he ends up holding (1) that our desires for the goods which life brings cannot be fulfilled by extending our lives but only by eternal life with God, and (2) that we should therefore accept our limited lifespan and treat it as an occasion to commit ourselves to those who will replace us.

This Augustinian picture better accounts for the normative claim of our biological nature and the problem with control of it than does the Niebuhrian picture that dominates the Primer. Our biological nature, in the form of growth, maturity, decline, and eventually death, claims us not in its sheer givenness but as the content of a duty that is basic to society and also to some extent as a good in itself (analogous to the good of a banquet). The problem with control of nature, in the form of efforts to extend life, is not that it instantiates an urge to mastery but that it instantiates a disordered desire for eternity. This account clarifies the normative significance of human biological nature and it does justice to the moral complexity of the motives for exercising control of nature. Nevertheless, I question whether this account is sufficiently Augustinian in its account of the normative claim of biological nature, and I wonder whether it can therefore be strengthened by rethinking that claim in terms of another Augustinian theme, according to which creaturely things are referred to God. From the perspective of this theme, our biological nature (in this case, its growth, maturity, decline, and eventual death) claims us not only as the content of a duty to others or as good in itself but insofar as it refers us in some way to God. Meilaender occasionally hints at something along these lines. The clearest instances are his remarks in both the Primer and Should We Live Forever? on procreation as human participation in intra-Trinitarian love. But he has not yet developed these hints at any length. The result is that, for all his determination to articulate and defend the claim of our biological nature, the latter does not seem to relate us to God. The normative status of our nature is thereby rendered vulnerable and nature appears destined to be regarded as inferior to freedom (insofar as freedom for Meilaender does relate us to God), both of which are inimical to Meilaender’s project of redressing the imbalance of the claims of freedom over those of finitude in contemporary bioethics and biomedical practice.

The Normative Claim of Biological Nature: Another View

In the sense that I have in mind, to say that our biological nature makes a normative claim on us insofar as it refers us to God is to say that we have been created by God to know and love God; that the creaturely nature that God brought into existence in making us, including our biological nature, is not neutral to this purpose but in some way refers us to it and equips us for it; and that we are called to live our lives as creatures in a way that conforms to this reference. Because Karl Barth has clearly and forcefully articulated the normative claim of biological nature along these lines, because his application of it to the human lifespan readily allows for an interface with Meilaender’s Should We Live Forever?, and because Meilaender is broadly sympathetic to his theology, I will focus on his version of the normative claim of biological nature. The focus on Barth in this context might surprise those who accept the accusation that he denigrates nature in favor of an overwhelming reality of grace, but in fact he has articulated in exemplary fashion the reference of our biological nature to God which, I am suggesting, Meilaender would do well to develop in order to strengthen his case for the claims of finitude.

According to Barth, the human creature is ‘determined by God for life with God’. ¹⁹ As this determination is from eternity, it will be reflected in the nature of the creature which God brings into existence with the creation of humans. Put simply, as God determines humans from eternity for life with God, the human which God brings into being will have a constitution that is suited to that determination, and not one that is hostile or even indifferent to it. Barth also holds that the determination of humans for life with God has been fulfilled for us by Jesus Christ, and since this was also resolved by God from eternity, and not subsequent to the sinful failure of humans to fulfill the determination on their own, it too will be reflected in the nature of the creature God creates. In short, human nature will reflect our determination for life with God that is constituted by God’s grace. In Barth’s words, ‘Even in his … human nature, man cannot be man without being directed to and prepared for the fulfillment of his determination, his being in the grace of God, by his correspondence and similarity to this determination for [life] with God.’ ²⁰ In this formulation, Barth states clearly and succinctly what it means to say that our biological nature refers us to God. But what is the content of this reference to God? In what does it consist?

Barth’s response to this question is found in his treatments of what for him are the features of human nature to which normative status most directly attaches, namely, relationality, the body–soul composite, and temporality. Perhaps the clearest instance—and in any case, the one that is most relevant here—is his reflection, in the context of temporality, on the fact that human life takes the form of a limited lifespan bounded by two events, birth and death, which we do not control. ²¹ A bounded lifespan seems at first to contravene our determination for life with God rather than to equip us for it. How could anything but ‘an unlimited, permanent duration’ be adequate to the abundant life which is our life with God? Moreover, life with God requires conformity to God’s perfection. What else but an unbounded life would be adequate for the pursuit of that perfection? Barth is sympathetic to these considerations and does not deny their force, but he nevertheless argues that a bounded lifespan is precisely what equips us for the life with God for which we are in fact determined by God, namely, the life with God that is accomplished for us by Jesus Christ. First, God fulfilled our determination for life with God by becoming incarnate in the bounded life of Christ, and his resurrection frees his bounded lifespan from its temporal confines so that it can count for the bounded lives of all other humans. From this perspective, the significance of the boundedness of our own lives becomes clear. Our bounded life, and in particular the fact that it begins and ends in events that elude our control, signifies in its very biological structure the dependence of our lives on the gracious gift of Christ’s incarnate life, which determines our lives from outside themselves. To quote Barth again, ‘By [our] nature, in virtue of its peculiar character as an allotted span, [we are] referred and bound to the gracious God as the One who is wholly and utterly outside [us] but wholly and utterly for [us].’ ²² Second, a bounded life also confronts us with the limits of our responsibility for our perfection. Without unlimited duration we cannot pursue infinite perfection. The boundedness of the lifespan thus signifies that it is not up to us to accomplish all that can be and must be accomplished for our determination for life with God to be fulfilled. Finally, it is in one’s birth and death that one is paradigmatically and definitively ‘irreplaceable, indispensable, and non-interchangeable’. In these two events which one does not control, one is uniquely, unqualifiedly and unalterably oneself. In contrast to endless duration, they thus give the life that runs from the one to the other the singular identity that is a condition for a specific vocation, with the limited yet intensive ethical responsibility it involves, while they also endow the contingent, the particular and the temporary with the significance and worth of the eternal.

In sum, Barth demonstrates how an aspect of our biological nature, namely, the biological lifespan bounded by birth and death, refers us to our determination for life with God, and more particularly to God’s fulfillment of it in our place in Jesus Christ. We live the life with God for which we are determined by conforming to the reference of our biological nature—in this case, by acknowledgment of our dependence on Christ and cultivation of the limited yet intense responsibility of our unique moral vocation. For Barth, this is what it means to say that our biological nature, in one of its many aspects, makes a normative claim on us and what it means for us to accept that claim.

The Normative Claim of Biological Nature: Four Levels

If Meilaender were to make room in his work for this understanding of the claim of finitude—room he already begins to make when he refers human begetting to the intra-Trinitarian begetting—his overall account of the normative status of human biological nature would include four levels. At the first level, normative significance is found in the givenness of biological nature which the Primer emphasizes. In my view, the normative significance of human biological nature at this level is questionable—in part because the extent to which biological nature is given is less than is often assumed by appeals to givenness, but more importantly because it is not clear why mere givenness makes a normative claim on us. It is therefore not surprising that the least persuasive of Meilaender’s judgments on bioethical issues are those that depend most heavily on the claim of givenness, such as the argument against living wills referred to above. At the second level, normative significance is found in the goods that are intrinsic to features of biological nature (such as the shape of biological life that unfolds in stages involving growth, maturity, and decline culminating in death), or perhaps more precisely, inhere in conscious human engagement with biological necessity. At this level, Meilaender’s position largely coincides with those of Hans Jonas, Leon Kass and Martha Nussbaum, all of whom have eloquently argued that the goods that inhere in conscious struggle with mortality are superior to those that would be available to beings who do not die or whose death is indefinitely deferrable. While this position sounds plausible, it is vulnerable to objections that it simply reflects the adaptation of preferences to adverse circumstances: unable to do anything about our mortality, we come to convince ourselves of its superiority over an endless or indefinitely extended life. More important from a Christian perspective, the claim that goods are inherent in our nature itself or in our engagement with it presupposes the immanence of nature-related goods; that is, their full intelligibility in terms of our nature alone, apart from any reference to what transcends nature. It is this presupposition that the fourth level rejects. But it is important not to neglect the third level, on which certain necessities of our biological nature have normative significance as the content of duties to others. I have mentioned Meilaender’s claim that in accepting the limited duration of the lifespan we fulfill our duty to those who will replace us. Meilaender rightly stresses this consideration, which is a more persuasive reason not to aim at extending the human lifespan than are the second-level considerations regarding the superiority of goods related to mortality. Nevertheless, the third level, like the previous two, still fails to show how our biological nature relates us to God and thus fails to overcome the denigration of the claims of finitude at the expense of the claims of freedom (which does relate us to God), perpetuating the very imbalance Meilaender has set out to redress. This shortcoming is corrected at the fourth level, at which, as we have seen, the normative status of our biological nature is found in its reference to God (or more precisely, to our life with God).

Finitude and Freedom Reconsidered

From the perspective of these four levels we may finally question whether the finitude–freedom schema ultimately serves Meilaender’s purpose or subverts it. On the one hand, the schema facilitates Meilaender’s rich and complex explorations of bioethical issues, which he resolutely refuses to reduce to either freedom (as mainstream bioethicists focused on autonomy tend to do) or finitude (as critics of contemporary biomedicine such as Francis Fukuyama and Leon Kass tend to do). On the other hand, the irreducible tension between finitude and freedom lends a tragic tone to Meilaender’s analyses that is only partially relieved by Christian hope. Should We Live Forever? points beyond this schema and its tragic tone by proposing the ecstatic as a third alternative to finitude and freedom, in which we are drawn out of ourselves to God who alone can fulfill our finite and free earthly lives. ²³ If the ecstatic transcends the tension between finitude and freedom, the fourth level described above, exemplified by Barth’s analysis of responsibility and vocation, dissolves it, insofar as, in Barth’s words, our creaturely nature is itself ‘freedom in limitation’. ²⁴ That phrase best captures what Meilaender wants to say, and what a Christian view of the human creature has to say, to contemporary bioethics and biomedical practice. ²⁵