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  • John Lantos

A humane society after Dobbs?

O. Carter Snead’s book, What it Means to Be Human, is really two books. One is an idealistic program for cultural renewal. The other is a diatribe against a philosophy that he calls “expressive individualism.” Both are presented as a critique of the ways that bioethics has influenced law in the United States, of what he calls “public bioethics,” defined as “the governance of science, medicine and biotechnology in the name of ethical goods.”

Our public bioethics, he claims, “are currently animated by a vision of the person as atomized, solitary, and defined essentially by his capacity to formulate and pursue future plans of his own invention.” This approach, he claims, systematically ignores or disparages the needs of those without the capacity for such autonomy and obliterates any sense that we have obligations to those people.

In Snead’s analysis, expressive individualism’s core belief is that the highest aspiration of human flourishing is to investigate one’s individual truths, to pursue a destiny of one’s own invention. Snead’s primary critique of this view is that It ignores humans who cannot flourish in those ways and so ends up being a philosophy of the healthy and the powerful whose rights are protected by law to the detriment of the dependent and the disabled.

There is much to admire in this critique. The book resonates with idealistic advocacy for a caring society based on the ideas of “uncalculated giving and graceful receiving.” His model for this is parenting. He writes, “Becoming a parent makes it (sometimes painfully) clear that one’s good is not entirely self-contained to the truth and goals found solely by interrogating one’s inner depths.” Parenting, he argues, is an example of an admirable, non-instrumental, non-individualistic relationship in which the parent takes on the obligation to give generously without any expectation of return. It should and could be, Snead argues, a model for other human relationships in a good, fair, just society. In such a society, we would all recognize that we, like children, are dependent creatures who need others to support our thriving. In an editorial written after the Dobbs decision, he sketched out ideas for what policies such a state should support. “We must all work to provide for the needs of mothers, children and families in crisis.” This will “require new government programs and increased spending, greater support for and delegation to nonprofit care providers.” It will require more paid parental leave and more funding for schools and day care. Snead imagines a society in which we all take care of each other with generosity and no expectation of repayment or reward.

He doesn’t articulate the specific economic policies that would be necessary to support such a society but, if he did, he would inevitably end up with a radical critique of free-market economics and would likely develop a vision of a robust welfare state. In these passages in the book, his philosophy seems somewhere between Elizabeth Warren (“There is nobody in this country who got rich on his own.”) and Bernie Sanders (“… it is unconscionable that in the wealthiest country in the world, we do not properly invest in early childhood education.”) One might have expected such a book to be greeted by accolades from the left and condemnation from the right. After all, the National Review slammed Sanders’ child care proposal as “sinister” and The Wall Street Journal called paid parental leave programs “devoid of reason.

It is surprising, then, that both the NR and the WSJ loved Snead’s book. The Wall Street Journal, in a glowing review by Yuval Levin, named it one of “the most important works of moral philosophy produced so far in this century.” The National Review lauded the book for explaining “our society’s deeply mistaken notions of freedom, autonomy, and what we owe to each other.” At the same time, the book was largely ignored by traditional liberal journals and newspapers. It was never reviewed in The New York Times, though they named it one of the ten best books to read about abortion. It hasn’t been discussed in most non-Christian bioethics journals. Amazon quotes reviews in the National Review, First Things, and The Christian Post. The response to the book – warm admiration from the right and cold disdain from the left - suggests just how polarized bioethics has become. This is particularly striking because Snead works hard to articulate an approach that bridges the divide between conservatives and liberals, between religious and secular approaches to bioethics. The reasons for the polarized responses are clear when Snead gets beyond philosophical generalities and, instead, analyzes specific issues and debates in bioethics. He focuses on three issues that, in his view, illustrate the differences between those who advocate for “expressive individualism” and those who follow his own more communitarian philosophy. The former, according to Snead, Those issues are abortion, assisted reproductive technology, and assisted suicide.

Snead expertly reviews the evolving legal debate about abortion (though the book was written before the Dobbs decision). Abortion, in his view, is the epitome of the difference. He starts from the belief that the fetus is human and that, therefore, we have familial/parental obligations to the fetus. These are obligations that are not chosen but that are nevertheless binding. In arguing for these, he highlights the arguments made by Supreme Court Justice Ruth Bader Ginsberg in her dissent in Gonzales v. Carhart (2007) Snead is particularly critical of the idea that abortion supports a woman’s control over her own destiny and her autonomy to determine her life’s course. These beliefs, in Snead’s view, lead inevitably to a society in which the weak, vulnerable, and dependent among us, those who cannot exercise their autonomy, will be ignored, mistreated, and even killed to allow the expressive individualism of others to flourish. He suggests that Ginsberg sees the mother and child (pregnant woman and fetus) as strangers struggling with one another over scarce resources rather than as parent and child who should be bound by the mutual obligations that take into account the radical dependence of the fetus/child.

The differences between the two world views seem stark. But, in many cases, they are more nuanced than Snead’s arguments suggest. He does not address many other debates in contemporary society that laid the philosophical groundwork for abortion-related jurisprudence. The legal debates about abortion that Snead expertly reviews and analyzes mirror similar debates about contraception, about gay marriage, and about the right to withhold or withdraw life-sustaining medical treatment. In each of these domains, the vision of “expressive individualism” has expanded our right to control our fertility, to love and marry whomever we choose, and to make decisions about when to seek life-prolonging treatment. It is unclear, by Snead’s arguments, whether he supports such expansions of our autonomy or whether, instead, he sees those domains, too, as ones in which expressive individualism is a pernicious force.

A key difference between the philosophy of expressive individualism and Snead’s more restrictive collectivism is that the former allows a diversity of responses. It does not prohibit those who hold Snead’s views from living a life based upon them whereas Snead’s collectivism quickly becomes coercive. In his view, there is only one correct view of human society and of our obligations to one another. As noted above, it is a generous and idealistic view. But it is also one, as he notes, that is substantially different from our current society. To imagine that our society could become a more robust welfare state, with greater support for its most disempowered members, and then to leave out the details of how to get there, makes the book seem disturbingly incomplete.

Snead (with Mary Anne Glendon) recognizes that our current society is quite different from the one he imagines. They write, “The greatest challenge is to transform the culture…to extend the hand of friendship not only to families in crisis but also to those who disagree with us…It is only when we show through our actions the goods of unconditional love and radical hospitality at the core of the culture of life movement that we will change hearts and minds. Time to get to work.”

The discussions of assisted reproduction and end-of-life decisions have anothe flaw. They lack nuance. These practices address a wider range of situations and choices than arise in the abortion debates. Assisted reproduction is, arguably, a radically pro-life practice. Snead does not focus on that aspect. Instead, he focuses on its use to select genetic traits in offspring. In this argument, his foil as an advocate of “expressive individualism” is John Robertson and, particularly, Robertson’s arguments that individuals should not be legally restricted in their use of in vitro fertilization. He doesn’t analyze the difference between selection for disease reduction and selection for other reasons such as gender choice or enhancement of appearance or intelligence. Doctors and bioethicists struggle with these complex issues. It is not clear that Snead’s emphasis on the fact that we are embodied, vulnerable, and dependent upon others clarifies the issues raised by prenatal (including pre-implantation) screening or end-of-life decision making. It is unclear, from Snead’s arguments, whether he is only opposed to assisted suicide or whether, as his arguments suggest (but don’t really explore), he is also worried about policies regarding the foregoing of life-sustaining treatment. As with abortion or PGD, or, by extension, contraception or gay marriage, his arguments could easily be extended to cover other many manifestations of “expressive individualism” beyond the ones discussed in this book.

Reviewers have praised Snead for his arguments that we are “interdependent, vulnerable, and embodied human beings…indebted to others for the self-sacrificial and uncalculated care extended to us from the very beginning. Optimistic readings find hope in his attempt to find commonalities, rather than differences, among people at opposite sides of the political spectrum. The book can be read as a vigorous critique of ableism and support for laws that counter discriminatory attitudes, as a call for a society that “supports the needs of the unwed woman, the psychotic and mentally impaired, the infertile couple, and dying or senescent individuals who lose the capacity for decision making,” or as “an honest reassessment of laws and practices that permit the restless search for ever new boundaries of self-expression, endangering the most vulnerable among us and corrupting the soul of a nation.”

Unfortunately, Snead doesn’t address the vexed question of what it would mean to restrict freedoms now, as we wait for such a cultural transformation. He doesn’t address the possibility that such a transformation will not happen and that we will be left with the worst of both worlds, with outlawed individualism and inadequate collective support for the most vulnerable. He doesn’t even begin to imagine the political coalitions that would have to form in order to achieve such a transformation or the specific legal structures that might catalyze and then support such a transformation. These omissions result in a book that tries to straddle the left-right divide but ends up with concrete proposals for restrictions on freedom but only vague hopes for compensatory gains in equality and social support.

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