Sentience

While issues of animal rights and animal liberation have been hotly-debated in the public square and in philosophic discussions, national veterinary associations have walked on eggshells for decades, wanting to speak on issues of animal welfare, where consensus is far easier. Until recently. The American Animal Hospital Association (AAHA), which is a group that represents 16,000 veterinarians as members and more than 5,500 veterinary practices, stepped into the fray this past fall with a position statement that stakes out a strong statement on the moral status of animals. It marks the first time that a national veterinary medical group has done so. But it does not use the words “rights” or even “moral status,” but, rather, addresses “sentience.” In the words of AAHA, animals are “feeling, sensing beings capable of sentiency.”

This statement comes from an organization for which I generally have great respect, one that focuses on small animal (generally pet) practice, where I do my work, and which has logistical and philosophical differences with large animal, particularly food animal, practice. They know how all of veterinary medicine is the same, and in what ways its various forms must necessarily differ. They have advocated for a higher standard of care for small animal practices and have genuinely helped advance the profession’s view of pain management and compassionate handling. But I am not alone in my bafflement of their decision to use a word pregnant with meaning, like “sentiency,” in the association’s official statement.

Specifically, the statement says, “The American Animal Hospital Association supports the concept of animals as sentient beings. Sentiency is the ability to feel, perceive or be conscious or to have subjective experiences. Biological science as well as common sense supports the fact that the animals that share our lives are feeling, sensing beings that deserve thoughtful high-quality care. The care that is offered should provide for the animal’s physical and behavioral welfare and strive to minimize pain, distress and suffering for the animal.”

This definition of sentiency is fairly standard (it’s what Wikipedia opens with, for example). But it is confusing on a few levels as well. First, as others have noted, how do we define “animals”? The Executive Director says it should be interpreted as referring to companion animals, like dogs and cats, since that is the focus of AAHA’s efforts. But it doesn’t say that, and even “companion animals” include creatures that range from geckos and box turtles to mice and scorpions. This is sloppy work for a position statement that seeks to be both ground-breaking and (not too) comprehensive.

Second, sentiency is loaded with ethical and theological baggage. I can argue with some success that my patients seem to display wide-ranging emotions, have an ability to feel pain based on physiologic measures that are comparable to human beings, and certainly have memories of past events that contribute to the behaviors they display at a given moment. I cannot tell you that they have a will, or a sense of purpose, or actually whether they can suffer in the full metaphysical or spiritual sense that we know human beings can suffer. I am not willing to deny that it is possible for higher animals to suffer or have more complex emotional and mental capabilities than most think, rather than our own interpretation of their actions and responses that may be little more than anthropomorphism (which may itself reflect a more sophisticated spin on a good Disney film), but I will not claim to know it. I have never felt an ounce of desire to hunt, probably not so much because of the potential fear and pain for the hunted animal, though I don’t like that, but rather because of what it will do to my own soul. Call it my own version of “liberal guilt,” it has less to do with the animals than me, and explains why I can eat meat with little sadness even though it was once a living, breathing animal. For better (or likely worse) sentience may be translated “of human caliber.” And since we really only know our own kind, we must interpolate this to “animals.”

Finally, the clever use of “sentience” manages, at face value, to avoid the philosophical minefield of animal rights. But this is a Trojan horse. The great view of Peter’s Singer’s utilitarianism, the moral status of animals is equivalent to (or supersedes) humans based on ability to feel pain, is often distinguished from the more rights-based approach of someone like Tom Regan, where animals are “subjects-of-a-life,” biographical creatures. Sentience bridges the gap (artificial though it may be) and lends the credibility of organized veterinary medicine to both arguments. Sentience, as it will be popularly interpreted, will necessitate rights. I will gladly debate the moral status of animals, and work to see it addressed in my own work with state and national organizations. I am disappointed that the AAHA has taken the road they have, because I think it reflects both slipshod ethics and an emotional, sentimental path to what should have been an opportunity for an effective unity of philosophy and science.

Eugenics and the genetic testing of embryos and fetuses

In a recent article in the Australian media Julian Savulescu, a noted Oxford ethicist who is a visiting professor at Monash University in Melbourne, makes the contention that selecting which babies are born by doing genetic testing on embryos or fetuses and only allowing those that are desired to live to birth in the way that it is allowed in Australia shares the moral problems of past eugenics programs that we have rejected. His point is that the current practice in Australia allows selection of embryos by preimplantation genetic diagnosis and fetal testing with selective abortion only for diseases and not for sex selection or other non-disease characteristics. By allowing selection based only on diseases the society is saying that “lives with disability are less deserving of respect, or have lower moral status.” That is why we rejected the eugenics programs of the past.

Savulescu points out that “If either the embryo or the fetus has a moral status – then it would be wrong to kill either, whether or not a disability is present. If the embryo or fetus does not have a moral status, it should be permissible to destroy an embryo or abort a fetus for any reason. In this way, paradoxically, allowing testing for diseases, but not for other genes, is eugenic in objectionable ways.”

It would be easy to go from there to saying that genetic testing of embryos and fetuses for the purpose of selecting who will be allowed to be born should not be done based on the principle of the value of all human lives underlies our rejection of eugenics, but he does not go that direction. Instead he moves toward the permissibility of all embryonic and fetal testing by saying that lifting the restrictions on personal liberty imposed by limiting genetic testing of embryos and fetuses to testing for disease would resolve the moral objection that the current policy involves morally impermissible eugenics. He gets there by saying that since most people already accept the testing of embryos and fetuses for diseases, we should not say that all such selective testing is wrong based on the moral status of embryos and fetuses and the way to validate people’s acceptance of testing for diseases is to allow testing for non-disease characteristics.

Savulescu’s means of getting to his conclusion is an interesting and commonly used one to justify things that have previously been understood to be wrong. Rather than giving arguments for why we should believe that a human embryo or fetus does or does not have full moral status, he says we have already accepted a limited practice that would otherwise have been considered immoral, so we should accept a broader version of the same sort of practice. This is the process by which immoral behavior takes over a society, and also the process by which an individual falls into immorality. First justify a very limited violation of morality, and then once that is accepted use that to justify further immorality.
That is why we need to stand firm on basic moral values such as the dignity and value of every human life. Defending the moral status of the weakest and most defenseless human beings is essential to avoid the acceptance of things like aborting fetuses because they are female that currently seem obviously wrong, but may become accepted by a gradual breakdown of moral values.

Animal Rights – A Sidenote

The recent blog by Dr. Steve Phillips led me to deeper thought (and this excursus) on the idea of moral status and moral agency. While his comments reflected on the significance that blurring the two concepts has had on the ethics of embryonic stem cell research, it also has important implications for the idea of animal rights. Dr. Phillips addresses the writings of Mary Anne Warren, whose Moral Status- Obligations to Persons and Other Living Things, dedicated many words to animals.

Warren, a professor at San Francisco State University until her death in 2010, was a champion of the abortion rights cause. But she was also deeply influenced by Peter Singer’s views on animal liberation. She managed to avoid the inevitable outcome that Singer’s views would necessitate, specifically abolitionism of all animal confinement and human use. She has written of a “sliding scale” concept of animal rights that “…depends in part upon their sentience and mental sophistication.” In other words, she seems to use the ability of animals as moral agents to determine their moral status. While it is arguable that even higher non-human primates could be capable of moral agency, the level of mental sophistication of non-human animals seems, intuitively, like a reasonable way to address their level of welfare. I may be entirely unenthusiastic if my son chooses to go deer hunting but fine with a fishing trip. Others might find my distinctions illogical based on their own views, and that is okay. There is an inherent subjectivity to the moral status of animals, because they are, at least in Christian thought, not created in the same fashion as human beings. I daresay that this is a pretty palatable view of animal welfare and is what most people think, without really thinking, when approached with the idea of animal rights. I have, in fact, based the moral status of animals on their capacities, an altogether reasonable thing in the world of animals, while I cannot logically consider them moral agents, which Warren would seem to do. This is where her failure to differentiate the concepts muddies things.

If I lack the biblical distinction of the imago Dei (image of God) that distinguishes humans from non-human animals, don’t differentiate moral agency from moral status, and want to be consistent in the idea of animals as having variable levels of moral status, then I am forced to look at capacity as the basis for this status for everyone. This is the insidious nature of granting rights to animals, even “lesser rights,” however those can be quantified. Absent the imago Dei, I lose intellectual credibility when I say all human beings have the same moral status, but vary in their moral agency, but non-human animals vary in their moral status, and cannot be considered moral agents at all.

How, then, do we intellectually make exceptions for human beings? On this basis, we can’t. At some point, we are forced to make the rights of the human that are not in end-stage dementia, the unborn, and the profoundly mentally-handicapped submit to those of the cognitively superior, to the animals of greater “mental sophistication.”

Dr. Phillips has done a great service in distinguishing the concepts of moral status and moral agency. Be wary of those, like Mary Anne Warren, that do not.

Moral status vs. moral agency

A recent post about the personhood of human embryos made me think about the distinction between moral status and moral agency. Moral status relates to how we should treat an individual who has it or does not have it. Moral agency has to do with whether the individual is capable of making decisions or doing actions for which the individual is morally responsible. Both are characteristics that an individual being or type of being may or may not have. Most would say that any being that is a moral agent should be considered to have full moral status. That means that any being who is able to be held morally responsible for its choices and actions should be treated as having the same moral value as myself. However, there may be some individuals who have full moral status, but are not moral agents. That would mean that such an individual is a person who should be treated by me as having the same moral worth that I have even though that person is not morally responsible for his or her own actions. Some examples of those who we commonly understand to have full moral status, but who are not moral agents, include young children, those who have a mental disability that makes them unable to understand the difference between right and wrong, and those who have dementia or even temporary incapacity to make moral decisions.

When we as Christians take the position that a human embryo has full moral status because that embryo is a member of the human family who has been made in the image of God, we take that position understanding that an embryo is not a moral agent. I think that one of the reasons for the problems with capacity definitions of moral status like the one used by May Ann Warren is that it confuses moral status and moral agency. Being a moral agent is totally dependent on the capabilities of the individual. It depends on having the ability to understand the concept of right and wrong, the reasoning capacity to determine what actions are right, and the ability to control his or her actions. If one assumes that moral status is similar to moral agency then it makes sense for there to be similar capacities that determine who has moral status. But moral status is a totally different type of thing. It has to do with the nature of a being not its capabilities. How we treat something morally has to do with what kind or category of being that the individual is and that is not dependent on its capabilities. That is why we treat children and the disabled as full human beings even though they are not moral agents. That is why we should treat human embryos the same way.

Human rights and euthanasia

The Parliamentary Assembly of the Council of Europe recently added an amendment to a resolution on advance directives to state that “euthanasia, in the sense of the intentional killing by act or omission of a dependent human being for his or her alleged benefit, must always be prohibited”. It is refreshing that the body charged with harmonizing the human rights laws among European states, and which bases its decisions on the European Convention on Human Rights, appears to have understood that the protection of human rights should lead to the prohibition of euthanasia.

Those who promote euthanasia see human rights in terms of individual autonomy and the ability of an individual to do whatever he or she wants. If we understand more clearly what is involved in human rights it is easier to see why those charged with upholding human rights should prohibit euthanasia.

Universal human rights are based on an understanding that all human beings have an inherent moral worth by virtue of being human beings. There are no characteristics other than being a member of the human family that are needed for a person to have full moral worth. The intentional ending of an innocent human life is a violation of the inherent worth of that human life. Since the inherent worth of every human life is the foundation of universal human rights, euthanasia is an attack on the foundation on which all human rights depend.

The Council of Europe appears to have made that connection.

Bioethics and Christmas part 2

Even those without much Christian background know that Christmas is about the birth of the baby Jesus. Christmas carols, nativity scenes and creches, and even the pictures on Christmas cards depict the miraculous birth. What is interesting for bioethics is that the story starts before the birth.

Luke tells us in the first chapter of his gospel that the story began with an angel telling Mary that she was going to conceive a child through the intervention of the Holy Spirit without the usual sexual process. God didn’t take much time to do that because by the time she could get ready and hurry off to her relative Elizabeth’s house she was already pregnant. When she got there Elizabeth was in the sixth month of her pregnancy with her own angel-announced child. When Mary entered Elizabeth’s house, John (Elizabeth’s baby who later identified Jesus as the lamb of God) leapt in recognition of the presence of Jesus in Mary’s womb.

This detail of the story suggests that the incarnation impacts how we think about unborn human beings. Since Jesus became a human being it means that human beings have a special status as members of the class of beings that God chose to become. His beginning human life as an embryo and fetus that went through the usual nine months of prenatal life implies that the special status of human beings applies to human beings before they are born. The recognition between John and Jesus suggests the continuity of identity of individual human beings from early prenatal life to after birth.

Remembering that Jesus’ incarnation began nine months before his birth reminds us of the moral value of unborn lives. We should be just as amazed by that as those the shepherds told were amazed about his birth.

Bioethics and Christmas

I just got back from the Taylor Christmas chapel and as my thoughts have been focused on the amazing incarnation of Jesus, I thought I would share some thoughts over the next few weeks on how Jesus’ incarnation impacts bioethics.

One of the most fundamental principles of bioethics is the inherent value and dignity of all human life. Our ideas of equality for human beings and equal human rights, moral status, and justice all depend on our understanding of the value that each of us has as a human being. When Christians think about the value of human beings we usually think about creation and our biblical understanding of human beings from the account of creation in Genesis 1 and the moral laws given to Noah in Genesis 9. Both of these passages refer to human beings being made in the image of God. We find an understanding of our inherent moral worth in how we were made.

Jesus’ incarnation adds richness to our understanding of who we are as human beings. God made us in his image not just so that we could be enough like him that he could communicate with us and have a relationship with us, but so that Jesus could become one of us. He made us able to choose between right and wrong, knowing we would choose the wrong. He planned all along to have Jesus, the Son, leave his glory as eternal God to become one of us, so that he could be the ransom for our sin. Being made in God’s image helps us see why every human being has moral value. Being one of the class of beings that God chose to become, and for whom he chose to die helps us see that value even more.

Glory to God in the highest.

Voting on personhood

The issue of how we define personhood or how we define who has full moral status is one of the most fundamental issues in bioethics. It determines who is included in our considerations of ethical issues. The worldview of Christians who understand the Bible to be the foundation of our understanding of God’s moral truth and who hold to the traditional creeds of the church points to a biological definition of personhood. This biological definition would include every living human being from the time he or she became a separate biologic entity as a zygote following fertilization or its equivalent. This is in contrast to those who would define personhood functionally by the presence of what are considered human attributes.
Next week the people of Louisiana will vote on an amendment to the state constitution that would add the following statement, “Person defined. As used in this Article III of the state constitution, “The term ‘person’ or ‘persons’ shall include every human being from the moment of fertilization, cloning or the functional equivalent thereof.”
For those of us with a Christian worldview the proposed amendment raises two questions. 1) Is this definition correct? We would answer that with an unequivocal yes. 2) Is it prudent to add this definition to a state constitution? The answer to that is less clear. If by adding this definition the lives of defenseless unborn human beings are spared then it is clearly a good thing. If this amendment leads to a reaction at a national level which more deeply establishes personal autonomy as the legal priority over the value of the lives of those who are unable to speak for themselves then more unborn lives may be lost than if it were not passed.
We must always be clear in expressing what we understand to be God’s moral truth. When we venture into public policy we need to understand that we are working in a fallen world where that truth may not be understood and a focus on the self may distort it. We need wisdom to decide how to proceed because what is most prudent may not be clear.

How Important Are Those with Moral Status to Us?

I have a friend who is from Africa.  She sees a lot of things in this country from a different perspective that makes me think, and sometimes makes me uncomfortable.  We were recently in a discussion in a group at church about how we define who has moral status and how that impacts our moral decisions about human embryos and fetuses.  After the discussion she said she had noted that many Christians in America were quite passionate about the value of the life of those who were unborn, but didn’t seem to care as much about those who were born.  She said we stand up for the value of the lives of the unborn whom we will never know and who do not put any demands on us, but seem to neglect the value of the lives of those around us who are in need because valuing their lives would put demands on us.

I think my friend is right.  If we really believe that all human beings have full moral status we need to help people see the moral problems with abortion, destructive research on embryos, and the making and discarding of excess embryos in IVF, but we need to do much more.  We need to affirm the moral worth of those who have been born.  We need to care for widows, orphans, the poor, and those who are oppressed.  We can see God’s heart for them in the prophets and in Jesus.  There are many Christians who reach out to those in need and love them in tangible ways that express their understanding of their value as human beings.  More of us need to do that.  I need to do that more.