This paper argues that the medical conception of health as absence of disease is a value-free theoretical notion. Its main elements are biological function and statistical normality, in contrast to various other ideas prominent in the literature on health. Apart from universal environmental injuries, diseases are internal states that depress a functional ability below species-typical levels. Health as freedom from disease is then statistical normality of function, i.e., the ability to perform all typical physiological functions with at least typical efficiency. (...) This conception of health is as value-free as statements of biological function. The view that health is essentially value-laden, held by most writers on the topic, seems to have one of two sources: an assumption that health judgments must be practical judgments about the treatment of patients, or a commitment to "positive" health beyond the absence of disease. I suggest that the assumption is mistaken, the commitment possibly misdescribed. (shrink)

Self-consciousness, many philosophers agree, is essential to being a person. There is not so much agreement, however, about how to understand what self-consciousness is. Philosophers in the field of cognitive science tend to write off self-consciousness as unproblematic. According to such philosophers, the real difficulty for the cognitive scientist is phenomenal consciousness--the fact that we have states that feel a certain way. If we had a grip on phenomenal consciousness, they think, self-consciousness could be easily handled by functionalist models. For (...) example, recently Ned Block commented. (shrink)

To write of “the” philosophy of transhumanism is a little daring. The growth of transhumanism as a movement and philosophy means that differing perspectives on it have formed.

This essay examines St. Thomas Aquinas’s views on different types of impairment. Aquinas situates physical and moral impairments in a teleological account of the human species, and these impairments are made relative in light of our ultimate flourishing in God. For Aquinas, moral and spiritual impairments are of primary significance. Drawing on Philippa Foot’s account of natural goods, we describe what constitutes an impairment for Aquinas. In the Thomistic sense, an impairment is a lack or privation in relation to that (...) which is appropriate to the human being, known by our nature and ultimate perfection. For Aquinas, perfection lies in the transformation necessary for union with God. (shrink)

The privation theory of evil (PTE) states that evil is the absence of some good that is supposed to be present. For example, if vision is an intrinsic good, and if human beings are supposed to have vision, then PTE implies that a human being’s lacking vision is an evil, or a bad state of affairs. The mere-difference view of disability (MDD) states that disabilities like blindness are not inherently bad. Therefore, it would seem that lacking sight is not a (...) bad state of affairs. Thus PTE and MDD seem to be in tension. This essay discusses that apparent tension and explains how it might be resolved without doing violence to either view. Given the prominence of PTE in the history of Christian theology, and the wide support for MDD among disability theorists, it is worth finding a way to harmonize these two views. (shrink)

Book reviewed in this article: Principles of Biomedical Ethics. By Tom L. Beauchamp and James F. Childress.

Many debates in arenas such as bioethics turn on questions regarding the moral status of human beings at various stages of biological development or decline. It is often argued that a human being possesses a fundamental and inviolable moral status insofar as she is a “person”; yet, it is contested whether all or only human beings count as persons. Perhaps there are non-human person, and perhaps not every human being satisfies the definitional criteria for being a person. A further question, (...) which will be the primary focus of this paper, concerns what essential features of personhood endow persons, human or otherwise, with their moral status and the inherent rights they concomitantly possess. A survey of the history of philosophical theorizing on what it means to be a person yields a broad consensus upon the key capacities being rational thought, self-consciousness, and autonomous volition. It is not sufficient, however, simply to cite these capacities, but to explain why these particular capacities bear moral import. A more recent concern has developed regarding the possible future existence of so-called “post-persons” who, due to their enhanced cognitive and emotive capacities, may be morally superior to mere persons and thereby possess a higher moral status. This paper will conclude with an analysis of the extent to which this concern is warranted. (shrink)

Amos Yong claims that persons with disabilities like Down Syndrome will retain their disability at the resurrection. In section I, I will make some preliminary remarks in order to properly frame the discussion. In section II, I will lay out Yong ’s account of the resurrection and offer some difficulties along the way. Section III will examine what appears to be the main source of justification for Yong ’s claim. It is what I shall call Stanley Hauerwas’ dictum which states (...) that to ‘eliminate the disability means to eliminate the subject.’ In this section, I shall draw out three sets of bizarre entailments and difficulties that arise from Hauerwas’ dictum. Section IV will offer some concluding remarks and suggestions for further development on the doctrine of the resurrection from a disability perspective. (shrink)

IN THIS PAPER, I PROVIDE A FORMULATION of Thomas Aquinas’s account of the nature of human beings for the purpose of comparing it with other accounts in both the history of philosophy and contemporary analytic philosophy. I discuss how his apparently dualistic understanding of the relationship between soul and body yields the conclusion that a human being exists as a unified substance composed of a rational soul informing, that is, serving as the specific organizing principle of, a physical body. I (...) further address the issue of Aquinas’s contention that a human rational soul can exist without being united to a body and show how this ability of a human soul does not contradict the thesis that a human being exists naturally as embodied. I will also respond to two related questions. First, what accounts for the individuation of human beings as distinct members of the human species? Second, what is the principle of identity by which a human being persists through time and change? (shrink)

In this critique, Martha Nussbaum argues that our dominant theories of development have given us policies that ignore our most basic human needs for dignity and self-respect.

Some bioethicists have argued that moral bioenhancement, complementing traditional means of enhancing individuals’ moral dispositions, is essential if we are to survive as a species. Traditional means of moral enhancement have historically included civil legislation, socially recognized moral exemplars, religious teachings and disciplines, and familial upbringing. I explore the necessity and feasibility of pursuing methods of moral bioenhancement as a complement to such traditional means, grounding my analysis within a virtue-theoretic framework. Specifically, I focus on the essential intellectual virtue for (...) proper moral reasoning, prudence, and whether proposed methods of moral bioenhancement could facilitate the cultivation of this virtue within the psyches of moral agents. I conclude that certain means of bioenhancement may serve to augment the ability to reason prudentially and assist moral agents to align their wills with their higher-order rational desires, though such means require those higher-order desires to already have been formulated independently. (shrink)

It is widely assumed that disability is typically a bad thing for those who are disabled. Our purpose in this essay is to critique this view and defend a more nuanced picture of the relationship between disability and well-being. We first examine four interpretations of the above view and argue that it is false on each interpretation. We then ask whether disability is thereby a neutral trait. Our view is that most disabilities are neutral in one sense, though we cannot (...) make simple generalizations about disability's relationship to well-being in other important senses. After defending this view, we discuss its practical implications for selective abortion for disability, nondisabled people's interactions with disabled people, and the use of QALYs in health policy. (shrink)

Christian hope of resurrection requires that the one raised be the same person who died. Philosophers and theologians alike seek to understand the coherence of bodily resurrection and what accounts for numerical identity between the earthly and risen person. I address this question from the perspective of disability. Is a person with a disability raised in the age to come with that disability? Many theologians argue that disability is essential to one's identity such that it could not be eliminated in (...) the resurrection. What anthropology undergirds these claims is not often explicated. I argue that Thomistic hylemorphic anthropology provides the best context to understand the human person such that disability is not essential to identity. In the resurrection, we shall become truly ourselves. The marks of disability may remain, but Thomistic anthropology expresses the coherence of bodily resurrection in which one may hope for healing which eliminates the disability but not numerical identity. (shrink)

Although almost completely ignored, Aquinas’s account of persons with severe intellectual disabilities is key to his understanding of human persons and their salvation. Aquinas extensively addresses questions of human impairment, and for Aquinas physical and mental impairment are not nearly as important as moral or spiritual impairment. Contrary to those who focus on Aquinas’s account of rationality and suppose he thinks that a person must exercise rationality in order to be moral and in the image of God, Aquinas’s view is (...) that persons with severe mental impairments have a distinct spiritual advantage, due to the impeccability of the gift of wisdom given them in their baptism. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Happiness of “Those Who Lack the Use of Reason”Miguel J. RomeroHuman beings would have been created uselessly and in vain were they unable to attain happiness, as would be the case with anything that cannot attain its ultimate end.(De Malo, q. 5, a. 1, ad 1)A STUDY OF “those who lack the use of reason” in the thought and spirit of St. Thomas Aquinas has much to offer (...) the patient reader. We better understand what it means to be a rational animal, the image of triune God, when we investigate why, exactly, “mindless persons” (amentes) are not exceptions or even outliers in Aquinas’s account of the creaturely dignity and perfectibility of the human being.Aquinas remarks with some regularity on persons afflicted with the condition amentia, which is variously and inconsistently interpreted (in translation) as “imbeciles,” “fools,” “madmen,” “lunatics,” “the demented,” or “the insane.” The amentes are persons who lack the use of reason in a profound and debilitating way; and, as I will show, the fact that we are sometimes found in this state informs Aquinas’s analysis of human nature and, in particular, Aquinas’s teaching on the good wrought by Christ for the members of his body. Our guiding question is this: Thinking with Aquinas, how do we account for the natural and supernatural happiness of those of us who lack the use of reason?My purpose in this article is to explore what Aquinas has to say about the happiness of persons who are baptized and [End Page 49] confirmed by the Church, and who have what neuro-psychologists would describe as a profound cognitive impairment. The question is particularly striking when we recall that, for Aquinas, the distinguishing aptitude of the human being (proper to our intellectual nature and coordinate with our creaturely perfection) is the operation of an incorruptible intellectual capacity—a capacity, however, that is only reduced from potentiality to act when the corruptible “internal sense organ” is disposed to receive, in terms of health and circumstance, a coordinated sense impression of material species. Thus, a further question emerges: According to Aquinas, what is the perfective effect of grace in this life upon the nature of a person who completely lacks the use of reason due to an organic corruption or disorder of the ‘internal sense organ’?The discussion is divided into five parts. I begin (part I) by locating those who “lack the use of reason” within the theological infrastructure of Aquinas’s moral psychology and I identify the main problematic. With respect to that problematic, the principal conceptual resources provided by Aquinas are then outlined and two challenges are identified (part II).The first challenge is methodological, concerning the speculative import of the sacramental life of the Church. Francisco de Vitoria’s Relectio de eo ad quod tenetur homo veniens ad usum rationis (1534) highlights for us (part III) a constellation of judgments relevant to interpreting Aquinas on these themes, in particular, Aquinas’s formulation of prerational intellectual acts vis-à-vis the participation and membership of “mindless persons” in the sacramental life of the Body of Christ.The second challenge is to show the continuity between Aquinas’s account of the human being and his practical remarks on those who lack the use of reason. Specifically, given the various ways that, and degrees to which, the human being can lack the use of reason, I trace (part IV) Aquinas’s analysis of the power and operation of intellect, focusing on the intellectual acts which can be impaired and, concurrently, the intellectual acts which cannot be impaired in a living human being. Aquinas’s remarks on those latter acts not only reflect the [End Page 50] significance of the doctrine of the image of God in his account of human nature, but, even more, they shed light on the prosthesis of sacramental grace in his understanding of the properly human happiness capacitated and purposed in all whom God has called in Christ—a call to discipleship and devotion that includes those of us who have a profound, lifelong cognitive impairment (Rom 8:28; 9:11; Eph 1:3-14; II Tim 1:8-11).I conclude... (shrink)

In this essay, I present a conception of physical impairment as a privation of the actualization of one or more of a creature’s natural capacities. This broadly Thomistic, non-ableist conception of impairment affirms the intrinsic dignity of the person with the impairment. As a result, it stands between the conceptions of disability as a mere difference and disability as a bad difference. Finally, I show how arguments in favor of disabilities’ remaining in heaven generally presuppose a denial of this conception (...) of impairment. (shrink)

What is good, how do we know, and how important is it? In this book, one of our most respected analytical philosophers reorients these questions around the notion of what causes human beings to flourish. Observing that we can sensibly address what is good for plants and animals no less than what is good for people, Kraut applies a general principle to the entire living world: what is good for complex organisms consists in the exercise of their natural powers.

Discussions of genetic enhancements often imply deep suspicions about human desires to manipulate or enhance the course of our future. These unspoken assumptions about the arrogance of the quest for perfection are at odds with the normally hopeful resonancy we find in contemporary theology. The author argues that these fears, suspicions and accusations are misplaced. The problem lies not with the question of whether we should pursue perfection, but rather what perfection we are pursuing. The author argues that perfection, properly (...) understood, has an enormously positive function in the Roman Catholic tradition. The author examines three sources: the Scriptures, the scholastic tradition, and ascetical theology. He examines contemporary criticisms of perfectionism and suggests that an adequate virtue theory keeps us from engaging perfectionism as such. The author then shows how a positive, responsible view of perfection is an asset to our discussion on enhancement technology. (shrink)

I investigate Thomas Aquinas's metaphysical account of human death, which is defined in terms of a rational soul separating from its material body. The question at hand concerns what criterion best determines when this separation occurs. Aquinas argues that a body has a rational soul only insofar as it is properly organised to support the soul's vegetative, sensitive, and rational capacities. According to the ‘higher‐brain’ concept of death, when a body can no longer provide the biological foundation necessary for the (...) operation of conscious rational thought and volition, a substantial change occurs in which the rational soul departs and the body left behind is a ‘humanoid animal’ or a mere ‘vegetable.’I argue that the separation of soul and body does not occur until the body ceases to function as a unified, integrated organism. A rational soul is not only the seat of a human being's rational capacities; it is also the principle of the body's sensitive and vegetative capacities. Since Aquinas defines a human being as a composite of soul and body, and not with merely the exercise of rational capacities, the determination of death requires incontrovertible evidence that the body has ceased all the operations that correspond to the soul's proper capacities. The evidence of this is the body's loss of its integrative organic unity and the criterion for determining when this loss occurs is the irreversible cessation of whole‐brain functioning. (shrink)

Debate concerning human enhancement often revolves around the question of whether there is a common “nature” that all human beings share and which is unwarrantedly violated by enhancing one’s capabilities beyond the “species-typical” norm. I explicate Thomas Aquinas’s influential theory of human nature, noting certain key traits commonly shared among human beings that define each as a “person” who possesses inviolable moral status. Understanding the specific qualities that define the nature of human persons, which includes self-conscious awareness, capacity for intellective (...) thought, and volitional autonomy, informs the ethical assessment of various forms of enhancement. Some forms of cognitive and physical enhancement may be desirable from the perspective of what constitutes the “flourishing” of human persons in our fundamental nature; while other forms of enhancement, such as emotive or so-called “moral” enhancement, run the risk of detracting from human flourishing when evaluated from the virtue-theoretic perspective Aquinas promotes. (shrink)

Book reviewed in this article: The Needs of Strangers. By Michael Ignatieff. The Health Economy. By Victor Fuchs. Just Health Care. By Norman Daniels.