A Counter-Response

As members of the National Association of College and University Chaplains
(NACUC), we want to offer a response to the article “The Homosexual
Movement: A Response by the Ramsey Colloquium” (March). Since this
essay sets out to “form a moral judgment regarding this new thing
in our public life,” namely, “The Homosexual Movement,”
it seems imperative that other scholars and clergy make their response
to the Ramsey Colloquium. As chaplains in colleges and universities across
the country whose ministry is with and among all students, faculty, and
staff, including lesbians and gay men, we offer the following response.

The members of the Ramsey Colloquium assert that they (and presumably
all people) simply “are who they are” and that our bodies “participate
in our personhood in a fundamental way”; they then continue and write
of one’s sexual orientation as though it were governed by whim or fad-a
“movement,” a matter of “recreation or taste, not unlike
one’s preference in diet, dress, or sport . . . simply a difference in
lifestyle”-a lifestyle that they judge to be in the same category
with alcoholism and violence.

It seems extraordinary to us that a group of eminent scholars, writing
in 1994, could write in such a superficial and impersonal manner about
an aspect of human nature that, in their own words, defines one’s personhood
“in a fundamental way”; they clearly overlook the growing body
of scholarly, religious work about sexuality and religion. Further, it
seems to us that the writers challenge their own logic when they treat
sexual orientation as though it were a mere fad or “movement”
but then go on to acknowledge that “some scientific evidence suggests
a genetic predisposition for homosexual orientation.”

The writers of the Ramsey Colloquium article declare that “it
is dehumanizing to define ourselves or our personhood as male or female
by our desires alone,” suggesting that lesbians and gay men have so
defined themselves. It is, however, the Ramsey Colloquium members themselves
who so dehumanize everyone of homosexual orientation, without distinction,
precisely by defining them exclusively according to their desires. There
is no reference to the longtime commitment, lovingkindness, and caring
unto death demonstrated by many gay and lesbian people. There is no reference
to the many stable, two-parent lesbian and gay families in which children
are being raised. There is no reference to the ways in which families are
destroyed when parents and siblings “disown” their gay and lesbian
family members. And there is no reference to the contributions that gays
and lesbians make to family life.

Instead, the writers repeatedly allude to the effects of those desires
in an exclusively negative manner with assertions of “sexual promiscuity,
depression and suicide . . . within the homosexual subculture,” as
well as “seduction and solicitation.” Has evidence of these been
the prevailing discovery of the writers concerning the gay men and women
whom they number among their friends, colleagues, and families? Are such
friends and colleagues “doing damage to innumerable individuals and
to our common life”? While the authors focus on the so- called “sexual
revolution,” we suggest that the sexual revolution should be viewed
with the concurrent civil rights movement; together these movements helped
foster justice and integrity in all human relationships, be they sexual
or not. The writers, however, focus only on the sexual revolution and put
gay and lesbian sexuality in the same category with “permissive abortion,
widespread adultery, easy divorce, radical feminism” as well as “predatory
behavior.” One might gather a long list of dehumanizing, manipulative,
often violent behaviors demonstrated by persons of heterosexual orientation,
such as rape, wife- battering, child molestation, incest, and murder, stories
about which we read in each day’s newspapers; would that be sufficient
evidence to judge all heterosexual people as moral threats to society?

What is more helpful to and supportive of all people, regardless of
sexual orientation, is the development of sexual ethics that apply to all
relationships. Such ethics include the qualities of love, trust, mutuality,
justice, monogamy, and covenant, along with many others. The witness of
countless lesbian and gay relationships proves that these qualities can
and do exist in intimate, loving relationships between members of the same
sex; likewise, those qualities can and do exist in relationships between
members of the opposite sex. The gender of the individuals in any given
relationship is not the defining characteristic of what makes the relationship
good or bad, healthy or unhealthy, life- giving or destructive.

In the words of the Ramsey Colloquium, we wholeheartedly affirm that
“Our bodies have their own dignity, bear their own truths, and are
participant in our personhood in a fundamental way.” We affirm this
truth for all people, straight, lesbian, and gay.

Joan Austin, Elizabethtown College; James P. Breeden, Dartmouth College;
Martha Cash Burless, Mount Union College; Deene Clarke, Am herst College;
John Colatch, Ferrum College; Janet Cooper Nelson, Brown University; Ben
Curry; Ron Flowers, Wesley Foundation at Georgia State University; Jan
Fuller Carruthers, Hollins College; Peter J. Gomes, Harvard University
and the Divinity School; Larry Green; David Harper, Dickinson College;
Donovan E. Hull, Hamline University; Robert L. Johnson, Cornell University;
Stanley B. Johnson, University of Pennsylvania; Rabbi Joseph H. Levine,
DePauw University; Stuart C. Lord, DePauw University; Tom Modd, University
of Texas Medical Branch, Texas A&M (Galveston), Galveston College;
C. Jay Pendleton, Pfeiffer College; Janna Roche, Hamilton College; Frederick
J. Streets, Yale University; Cynthia A. Terry, Yale University; Charlie
Wallace, Willamette University; Joseph C. Williamson, Prince ton University;
D. Darrell Woomer, Lebanon Valley College

An Exchange on Life and Death

While I was fascinated by Daniel Callahan’s article in “The Sanctity
of Life Seduced” and the responses to it (April), I was concerned
by the automatic acceptance of some facts and conclusions that do not hold
up under scrutiny. As we all know, good ethics must be backed by accurate
facts.

Take the “persistent vegetative state,” an offensive and
dehumanizing term coined in 1972 and used to describe a level of brain
injury that assumes the permanent loss of upper brain function. Proponents
of not feeding the “vegetative” have long been frustrated by
the lack of a diagnostic test for this condition and the surprising number
of reports of “vegetative” people who recover, sometimes even
to full mental function. This includes not only media stories about people
such as Carrie Coons, but also studies like the one reported in the June
1991 issue of Archives of Neurology which found that 58 percent
of people with a firm diagnosis of PVS recovered consciousness within the
three-year follow-up interval of the study. Just as importantly, the researchers
were unable to identify factors that could predict in advance which patients
will ultimately wake up. It is hard to escape the conclusion that PVS has
become a political, rather than a medical, diagnosis.

As a nurse who has personally witnessed the recovery of supposedly
hope less patients, I am not surprised by these studies and reports. What
has surprised and frightened me is the practical reality that many brain-
injured people are no longer even given the chance to recover. For example,
families have been told that their brain-injured loved one has a nil or
virtually nil chance of recovery within hours after the precipitating
event despite the lack of certitude. The false picture of Nancy Cruzan
as an unmoving, unresponsive corpse hooked up to an array of machinery
is a powerful and terrifying image to these families in crisis. It does
a terrible injustice to people for us doctors, nurses, and ethicists to
pretend to know things we cannot know- presumably in order to spare patients
and their families potential further suffering. Have we become so callous
about death that we can be comfortable with denying a person even a chance
at recovery?

Another fact Mr. Callahan’s article fails to mention is that the controversy
over assisted feeding has spilled over to other care and other conditions.
For example, the non-technological spoon-feeding of the supposedly “vegetative”
Christine Busalacchi was considered just as ethically useless as tube feeding
by Fr. Kevin O’Rourke, the director of the Center for Health Care Ethics
at St. Louis University . . . . It has proved both legally and ethically
impossible to limit non-feeding to just the “vegetative.” The
result has been the opening of a virtual Pandora’s box of ethically rationalized
death decisions such as rationing and even, in some cases, physician-assisted
suicide.

I also must take issue with the anti-technology conclusions of Mr.
Callahan. I fear he forgets that medical innovations, both technological
and non-technological, result from a desire to cure, treat, or palliate
suffering conditions, not out of a desire to torture people. For example,
feeding tubes were not invented over one hundred years ago to “cure
death” or interfere with the peaceful, painless deaths our ancestors
supposedly had. Feeding tubes were invented to relieve real cases of real
suffering. For example, it would be maddening to watch a three-year-old
starve to death because his throat was irreparably burned. It is thus not
surprising that some compassionate person would invent a way to feed people
who cannot swallow.

Mr. Callahan is right when he describes an “inability to eat”
or “a failing desire to eat” as a part of the natural dying process.
This is true, for example, in end-stage cancer when, as organs fail, the
body cannot assimilate or excrete food and fluids. In these cases, we do
not deny food and fluids, but rather we give people what little they desire
or need. Feeding tubes are not instituted in these cases because food and
water are futile and would cause more discomfort as fluids build up in
the body. These people do not dehydrate to death; they die of their cancer.

However, it is a very different matter in situations of anorexia nervosa,
obstruction, paralysis, diminished consciousness, etc. To equate the inability
to walk to a refrigerator or to get food past a damaged esophagus, etc.,
with a true dying process is patently false. Moreover, while truly dying
people experience little if any discomfort from a reduced intake, dehydration
is a miserable condition for the non- dying. I often care for people with
an admitting diagnosis of dehydration. Quite frankly, these people feel
and look rotten. They are weak, frightened, and often confused. After successful
treatment, they perk up and are elated with the change in their condition.
We are not prolonging death, we are treating an uncomfortable condition.

After twenty-five years of nursing, dealing with bioethical issues
on both a personal and professional basis, and serving on both medical
and nursing ethics committees, I have witnessed a sea change in ethics
from what is right to what is legal to now what is cost-effective .
Even the newly sacrosanct ethic of family or individual “choice”
regarding a right to die is fast eroding under the juggernaut of new ethical
thought that redefines “futility” and agonizes over “wasting”
health care resources. Witness the recent case where a young Detroit couple
were replaced as guardians after failed attempts by health care providers
to induce them to discontinue the treatment of their critically ill, brain-damaged
two-month-old.

Recovery is now being redefined as full or near-normal return of mental
and physical function, which flies in the face of the reality all of us
in health care know and reinforces the unhappy bias that the disabled have
long tried to dispel.

Mr. Callahan presents us a false choice between either an awful, technologically
prolonged death or a simple, painless passage into the Great Beyond without
“technology.” Instead, I have often presided at the deaths of
people where the only medical interventions employed were to provide comfort.
I have often silently blessed the discoverers of morphine, oxygen tubes,
and air beds as I held hands with the dying patient and his or her family.

I have also silently wondered at the great gift of life as I fed, washed,
and talked to the comatose, the confused, the severely disabled, and the
truly dying. I have often sat with families and patients discussing do-not-resuscitate
orders, the pros and cons of treatments, hopes and dreams, and inevitably,
in some cases, how death will come. Not once did I feel that the patient
or I was diminished in dignity or wasting health care resources.

Thus, I must take exception to Mr. Callahan’s view that health care
providers are prone to a “technological seduction.” I am just
one of many doctors and nurses who advocate against overtreatment just
as strongly as we advocate against undertreatment. But medicine is not
perfect; mistakes do happen. Just as some people die during a simple appendectomy,
outcomes are often unpredictable. Decisions about technology are not automatically
wrong if the outcome is less than hoped for or expected.

Rather than fighting a supposed “technological seduction,”
I submit that the biggest problem in ethics today is a “death seduction.”
I suspect that it is a fear of loss of control and a disdain for dependency,
as well as a fascination with cost/benefit analysis, rather than an acceptance
of inevitable death that leads many ethicists to support the so-called
“right to die.” (Oddly, the development of newer and exotic technologies
such as in vitro fertilization have been virtually immune from a similar
cost/analysis and criticism of technological seduction.)

Sadly, Mr. Callahan’s views inevitably distort the reality of inevitable
death for all of us into a “duty to die” for some of us.

Nancy Guilfoy Valko, R.N.

St. Louis, MO

Daniel Callahan replies:

I find Ms. Valko’s letter somewhat baffling, uncertain whether we disagree
as much as she implies or whether I have made the factual errors she attributes
to me. She begins by talking about the persistent vegetative state, noting
that there have been many mistaken diagnoses. But at no place in my article
did I discuss the special problem of diagnosing the condition. In fact,
I fully agree with her about the many mistakes that have been made, and
no less agree that it’s wrong to give up on patients too quickly; of course
every patient should have a chance at recovery.

I think she is herself wrong, however, to say that “PVS has become
a political, rather than a medical, diagnosis.” The problem is that
any diagnosis of the syndrome (it is not a specific disease) must be probabilistic
and based on indirect evidence. This is also true of Alzheimer’s Disease,
definitively diagnosable only in a postmortem autopsy-but no one doubts
the existence of such a condition. As Ms. Valko herself says at the end
of her letter, “medicine is not perfect; mistakes do happen.”
Why does she not apply her own standard in the case of mistaken diagnoses
of PVS, instead of implying it is a fictitious condition?

It is quite true that I did not mention that “the controversy
over assisted feeding has spilled over to other care and other conditions.”
I was not trying to write an article on the full range of conditions under
which it might, or might not, be justified to terminate treatment. I have
done that in The Troubled Dream of Life and, with her, I do not
believe it right to limit feeding under any of the circumstances she mentions.
I also agree that a person who cannot walk to a refrigerator is not dying
and I have explicitly denied there is evidence to show we are “wasting”
money on the dying (in Setting Limits , pp. 130-133).

I do not believe that I come to anti-technological conclusions. Technology
can not only helpfully and validly save and extend life, but it can also
provide many means of comfort for the critically ill and dying. My concern
is our culture’s obsession with technology, which too often leads us to
use it unthinkingly and insensitively. As I said in the article, “If
technology threatens to leave us worse off, and we nonetheless feel obliged
to use it, we have then indeed become its slaves.” I also argued that
“doctors should feel as great an anxiety that a patient will die a
poor death from technological excess as the present anxiety that the patient
will die because there is too little technology.” When she says that
she worries both about undertreatment as well as overtreatment, it seems
to me that Ms. Valko and I are not that far apart.

Finally, I find no basis whatever in the article I wrote for saying
that my “views inevitably distort the reality of inevitable death
for all of us into a ‘duty to die’ for some of us.” I reject totally
the idea of a duty to die, and always have. It is unwarranted and insulting
to attribute that view to me.

Thinking About Abortion

Hadley Arkes (“Abortion Facts and Feelings,” April) ignores
the distinction between “human” and “person” alluded
to by Jenny Teichman and Richard John Neuhaus in Correspondence (same issue)
and recognized centuries earlier by Aquinas.

If persons are created “in the image of God,” unique DNA
and developing organ systems are less relevant to the debate over abortion
than the stage of development of the nervous system and cerebral cortex
that would permit the “Godlike” functions of being aware and
of being able to interact consciously with one’s environment. Neurobiologists
have found that human fetuses do not reach that stage until some time after
twenty- eight weeks of gestation and thus should not be regarded as persons
before that time. Certainly, of course, pregnant women may and generally
do “ascribe” personhood to wanted fetuses much earlier.

In the real world 91 percent of abortions are performed during the first
trimester and fewer than 0.01 percent after twenty-four weeks (viability).
So the trimester formulation of Roe v. Wade makes sense.

Finally, voting records in Con gress, as Catholics for a Free Choice
has reported, show that pro-choice lawmakers are generally much more likely
than their anti-choice colleagues to support legislation that could be
characterized as “pro-life” in the broadest sense.

Edd Doerr

Americans for Religious Liberty

Silver Spring, MD

Hadley Arkes makes a fine case for trying to pass laws that will not
only save some lives but establish a philosophical basis for more pro-
life action. To this list, I would add a law that I think would send shock
waves through both the pro-life and pro-choice movements. This would be
a law to require anesthesia for any fetus with a functioning nervous system,
before an abortion is performed.

Such a law would have many virtues. First, it would save many children
from the incredible pain that is now inflicted upon them. It would be a
merciful law, one that would permit death but not permit suffering.

Second, it would force everyone to focus on the fact that the nervous
system of a fetus is developed very soon, and that many forms of abortion
must be horribly painful to the victim. Congressional hearings on this
law would bring the essence of abortion before the American people.

Third, requiring anesthesia would be a strong sign of the dignity and
worth of the fetus. It would clearly indicate that the unborn child is
not some mass of tissue, but a small, living creature.

Fourth, those who argue against such a law would be put in the difficult
position of defending causing suffering by the innocent. It would indeed
be a terrible position to defend.

Kevin Clark

Front Royal, VA

Hadley Arkes replies:

Until that primate we loosely call a “human being” can actually
speak to us in sentences, he cannot tell us of the reasons that animate
his acts. Until that moment, we must ever remain on shaky ground if we
claim to pronounce on the question of what he “knows,” or of
what he is “conscious.” Professors in the neural sciences are
always warning us about the temptation to draw inferences about “internal
states” from “output states.” A newborn child flails about
and sucks his thumb, and observers suffer no strain in imputing “consciousness”
to this lively being before them. But the child is no more luminous, in
revealing what it knows, than it was when it was sucking its thumb within
the womb-well in advance of twenty-four weeks. There are ample signs to
suggest that the child is “responding to its environment” well
within the first trimester-if that happens to be a test of “consciousness.”
But why should it be, any more, say, than any other sign of liveliness
or “life”? Long ago, we could take EEG readings from the fetal
brain as early as forty-three days. But then, why should that be taken
as more of a sign of life than that evident “vital” process,
which is driving everything forward; that vital principle, already engaged,
sustaining growth, and insuring that the brain and heart and everything
else will appear at their proper stages and do this distinct work?

The test then for consciousness gives way to the test for life itself.
And indeed, why should that not be? Does Mr. Doerr suppose that somewhere,
along the scale of consciousness, the organism undergoes a change of species?
We are dealing, from the first moments, with beings who are never anything
other than human beings. The distinction between a “person” and
a “fetus” is nothing more than a contrivance of rhetoric: It
is put forth with the trappings of a scientific distinction, as though
it marked beings in different kingdoms or species. But Mr. Doerr deceives
both himself and his readers if he imagines that he is really offering
here a distinction of scientific consequence. The function of this distinction
is not to describe, but to carry out a moral shift: By describing the child
in the womb as something less than a “person,” we justify a decision
to remove from that child the protections of law that would attach to any
other human being.

Under the false colors of the neural sciences, Mr. Doerr has simply
devised another variant on a common fallacy: the willingness to draw moral
conclusions on the basis of “facts” that are wholly wanting in
moral significance; facts that cannot supply the ground of a moral conclusion.
If he is laboring under the assumption that what he is offering here is
even plausible as neural science, I would be happy to supply him with phone
numbers and some useful tutors. But behind his argument is something more
than a scientific mistake, and it will not be corrected with more precise
information. I detect in his letter a powerful motive to find a rationalization
for the killing that constitutes abortion, preferably by showing that there
is no killing, because there is nothing there to be killed. This motive
is by now so common that this form of argument is widely diffused in our
public discourse.

Back to Rome?

I found Pastor Leonard Klein’s commentary “Lutherans in Sexual
Commotion” (May) to be a very impressive critique, both in terms of
historical and theological-political analysis, of the movement for “sexual
relativism” at the cost of basic scriptural authority and truth. I
applaud his keen sense of objectivity and judgment in dealing with such
a divisive issue within his own faith community . . . .

However, it is not the existence of vocal and active “secular”
elements within the Christian community that is the most disturbing and
dangerous problem. Raucous debate over theological understanding, social
morality, and scriptural truth is not bad in-and-of itself. We have plenty
of these same voices and special interest groups within the Roman Catholic
Church also.

The most dangerous issue at hand is not the content of the debate,
but the context, or lack thereof, in which it is being conducted. In other
words, the danger to orthodox Christianity does not lie in unorthodox and
politically motivated laypersons. The real threat to orthodoxy and biblical
and historical truth exists in the procedural liberalism that is unavoidably
present within the Protestant ecclesia.

Pastor Klein clearly explains this inherent weakness in the “representative”
Protestant bureaucracy: “Another reason for the specific shape of
this misfortune is the commitment of the ELCA and most other Protestant
denominations to representation as the best way to seek theological and
ethical truth.” In addition, he poignantly points out that these difficulties
are exacerbated by the existence of apostate clergy and bishops who are
failing to fulfill their office of “defenders of the faith.”.
. .

My question to Pastor Klein and to others is: If the Protestant commitment
to representational theology is fundamentally flawed, and those who are
charged with defending the faith seem to be arbitrary and capricious, why
should mainline Protestant denominationalism continue?

Furthermore, Pastor Klein eloquently explains his view of why true
Lutheranism has been abandoned. He sums it all up in this statement: “At
the Rubicon of Protestantism, there was no modern Protestant in the room.
Luther and company were medieval catholics on a mission to reform.”
Therefore, Lutherans et al. must consider whether or not the reforms that
Luther fought for have been accomplished. If the answer is “yes they
have,” then the right thing to do (for themselves, Christendom, and
the true Word of God) is to return to Catholicism . . . .

Robert V. Swain

Seattle, WA

In Leonard Klein’s “Lutherans in Sexual Commotion,” it cannot
go unobserved that the notion of the ELCA standing “on the conservative
side of mainline Protestantism” is at best an attempt at humor, at
worst an utter falsehood (or misguided observation). Nor, as his article
goes on to demonstrate, would it pass for much in the way of a compliment,
either.

As a Missouri Synod Lutheran (LCMS) I thank Pastor Klein for not considering
the LCMS to be a mainline body. While I initially regarded his judgment
as somewhat insulting, upon further reading I considered it to be quite
complimentary. I thank him for clearly distinguishing the ELCA from the
LCMS throughout the article.

That being said, Pastor Klein’s other observations are both enlightening
and accurate. Today’s Christian church-all Lutherans included-needs more
people like Pastor Klein to stand up and be counted . . . .

What passes for serious scholarship and reflection among certain circles
of pastors, theologians, academicians, and administrators would have been
considered heresy in earlier times . . . . Finding and cultivating strong,
conservative leadership should be a high priority for the church-at all
organizational levels-in the years ahead. Maybe then the church can effectively
fulfill its true mission.

Arthur D. Lyons

Kennesaw, GA

Praise from Spain

As a First Things subscriber who has been living and working
in Spain for several months now, I have not written to you for quite some
time, partly because I get my issues about a month late. This time, however,
as late as it gets to you, I couldn’t resist.

The symposium on Veritatis Splendor, as well as your responses
to the encyclical’s critics (January and February), were commendable. One
thing that lends First Things integrity as an intellectual journal is the
degree to which you quote and allow “air time” for those who
disagree with you. In many instances, you follow well the old Socratic
practice of “giving enough rope to an opponent so that he may hang
himself.” A great example was the quotation of the National Catholic
Reporter writer who held up a “positive, affirming, all-embracing
. . . big umbrella” Christ, against the “negative, authoritarian”
bad-boy Pope of the encyclical. That was fun reading . . . .

Larry A. Carstens

Santiago de Compostela

Spain

A Little Luddite Humor

Many thanks to First Things for giving your readers David Carlin’s
“For Luddite Humanism” (April). It would have been difficult
to digest and sort all the somber brilliance of Daniel Callahan and his
respondents on medical ethics in the same issue without Carlin’s identification
of the players-the GDs, Gradual Dehumanizers; the IDs, the Instant Dehumanizers;
and the MLs, the Moral Luddites (though the symposium did lack a true IDer).

David Carlin brought needed humor to the high seriousness of First
Things . Please bring him back.

Joseph English

Bronxville, NY

For Polarization

Your March issue contained some quotes of Archbishop Keeler’s criticism
of the press coverage when the Pope was in Denver (“Journalism and
Getting the Story Straight,” Public Square). It would be hard not
to agree with the remarks the Bishop has made about the faults of the secular
press. It seems to me, though, that the Bishop is dodging the real issues
that are raised by the press, however biased . . . .

The Archbishop says that “The real ‘American Catholic Story’ is
that the Church in this land grew last year alone by one million members.”
I have no doubt that the Bishop has statistics to prove this assertion.
What bothers me is that the Pope made the point, in one of his instructions,
that many people are calling themselves Catholic, but do not have that
right. The Holy Father did not seem impressed with mere statistics . . .
.

The remark of the Archbishop that most reveals a Pollyanna attitude
is this: “We need to help the media to understand that the real ‘American
Catholic Story’ is the story of millions of people who love the Church,
who are not polarized over issues . . . .” There is not a thing wrong
with being polarized over issues. There are great moral, liturgical, dogmatic,
and theological issues that we must be polarized over. If one loves the
Church he should be polarized. Catholics are Catholics because they are
polarized, or should be, towards the Christian view of life . . . .

Thomas Norton

Dillwyn, VA

Re-Imagining Evil?

If the “RE-imaginers” at the interdenominational conference
in Minneapolis last November (“A New Heaven & a New Earth,”