Charles Camosy, author of Resisting Throwaway Culture and Losing Our Dignity, on society’s changing view of life’s meaning and the value of suffering. We learned a lot of things from the pandemic — but one negative trend that we saw is definitely how easy it is to value one life over the other.
Some politicians even appealed to elderly people to sacrifice their lives so that young people can go out and enjoy their activities again. What value does our society give to the elderly or people with disabilities who are not “productive” anymore?
Well, a central thesis of my book Losing Our Dignity is that — given our secularized culture more broadly, and our secularized medical culture in particular — we have lost the basis for saying that all human beings are equal.
No longer being able to reference a common nature which bears the image and likeness of God, we have turned to concepts like autonomy, self-awareness, rationality and, yes, productivity.
For those who are honest about it, it is clear many members of the human family do not have these capacities in equal measure. Some do not have them at all. Some are no longer “productive members of society” and therefore have less implicit worth than someone who is.
On the other hand, most of us are afraid of becoming dependent on others when terminally ill or in a so-called “vegetative state.” Do you see value in this state of life? And how would you explain this understanding to someone without religious belief?
Christ commands us to see his holy face in the least among us and act accordingly. We have an understandable fear of being on the margins of the culture — being of less value in the ways that the culture understands value.
But a theological vision of the person doesn’t allow value to rest on how smart one is, how much one can remember, or even whether one knows one’s own name. Regardless of old or young, disabled or abled, conscious or unconscious, all human beings have the same value.
It is difficult to explain this to someone without similar theological beliefs, but one thing I have found — and which I call for in the book — is that dialogue which arrives at overlapping consensus can help get these conversations going.
For instance, does one’s own grandmother with later-stage dementia still count the same as everyone else? If yes, what does that imply for some of the other topics on which we disagree?
To what extent are all these tendencies fueled by the opportunity to save money? In the end, the dignity of the human person is compromised by economic interests…
Resource allocation is a significant concern in the book. We don’t need to look too hard at history to see that certain human beings lose their fundamental equality when they become a “burden” on the surrounding culture. Something similar is happening here.
We devised so-called “brain death” as a concept because we needed more organs for transplant. Abortion rights — and the marginalization of the prenatal child as less than equal — are very much connected in the current culture to resource allocation for women.
My book argues that the tremendous expense associated with caring for folks with later-stage dementia will tempt us to marginalize them as well — even more than we already have.
You explain in your book that healthcare and religion were once closely linked. Many hospitals are still owned or run by religious institutions, yet the former ideals of charity are fading… and money is tight. What are pathways to bring patients’ well-being back to front and center?
Well, a first step would be to recover a sense of medicine as a vocation and professional enterprise with its own ends. It isn’t just like a transaction at Burger King, where you “have it your way.”
It has its own ends and logic — the logic of healing and preventing disease and illness. Things that go beyond that logic are not proper to medicine, but they are creeping in as the market takes over the logic of the practice.
With the logic of the market, the only thing that medicine is, is whatever two people making a market transaction say that it is. That is a recipe, not for patient well-being, but for whatever serves capital, and especially investors.
Many people understand “dying with dignity” as the ability to determine their own death while they still have their full mental capacities, to avoid protracted suffering or a prolonged coma. And it is a thought that seems attractive — why shouldn’t I end life when there’s no more hope? However, as a Christian, I believe that I might still have to learn something or give time to my family to come to terms with the fact that my life will end soon. But how can you explain the importance of a natural death, even if that means living the last stage cognitively impaired?
It is interesting that we use the term “dignity” to both support medicalized killing (“death with dignity”) and reject it (“it violates the dignity of the human person”). This is part of the cultural crossroads at which we find ourselves, a kind of in between stage of the culture where we can’t even agree on what foundational words like “dignity” mean.
It is interesting to think about this in other contexts: the Gospel insists that the lives of the poor have much to teach us, despite the surrounding consumer culture saying the exact opposite.
There is something similarly countercultural about the kind of death you describe. Why shouldn’t we take the violent power of death into our own hands to avoid what the surrounding culture deems to be an indignity?
Well, it comes from a similar place: the Gospel teaches us to care for the dying person by controlling their pain, keeping them clean and honoring the fullness of their humanity — while never saying that it is better that they do not exist.
The judgment, after all, can and will be applied in some of the other contexts I mentioned above. True compassion, in the literal meaning of the word itself, means suffering with someone — not killing the sufferer.
Very often people fear being a burden to their loved ones. I think that a community where people accompany and help each other eases this fear. Do you see this happen? Are people who have a lot of social ties less afraid of the last stages of life?
Absolutely! And you and others associated with the Focolare have helped me see that in real life! When bearing each other’s burdens becomes a privilege, something we seek to do rather than seek to avoid, being dependent on loved ones no longer seems like being a burden.
And yes, our surrounding culture tells us something close to precisely the opposite. Even parents tell their children that they don’t want to be a burden on them — despite the fact that children demanded so much of their parents just a few decades before!
But the “burdens” that a child puts on a parent are instructive here: for most parents, though it is real work, they consider it a privilege to change diapers, wake up in the middle of the night, etc. Though even this is changing in our current culture, and children are seen more and more as a burden, perhaps we can build on the views and attitudes of a clear majority of parents who still see this as a privilege and think about it in a similar way at the end of life.
And what do you think of the possibility of involving robots in the care for the elderly?
We already don’t put enough human care into the elderly, and with this population doubling over the next generation, it is scary to think about what could come next. I think euthanasia is certainly on the horizon if we keep on the current path, but maybe an intermediate step would be to have robots “care” for this population.
Machines and computer programs can mimic certain aspects of human behavior, and this is already happening in some nursing homes, but it is far from the spiritual relationship of care which exists between ensouled creatures.
In fact, I think this might produce euthanasia: if folks believe they will be abandoned to robots in their final years and months, you can at least understand the temptation to move in this direction.
Lastly, what is your personal opinion — will we be able to give value to life from beginning to end?
It doesn’t look good now. If I were a betting man, I’d say that it will be up to the Church and other religious organizations to get all hands on deck to live this out in an intentional and dramatic way that is fundamentally countercultural. And I highlight what this might look like in the book.
But I also think that we could really use about a decade or so of really intense dialogical work with the culture about human dignity. What is at stake is too important not to try.
Charles Camosy is assistant professor for bioethics at Fordham University, New York
By Susanne Janssen