This article appears in the May 2001edition of the Catholic Medical Quarterly
HEALTH CARE - SERVING HUMAN LIFE
Reflections on Evangelium Vitae
Bishop Donal Murray
Talk delivered at the Annual Symposium, April 2001, in Manchester
DENIAL OF SOLIDARITY ' DENIAL OF LIFE
In the early sections of the encyclical Evangelium Vitae, Pope John Paul reflects on the story of Cain and Abel. Cain tries to evade God's challenge by saying, 'Am I my brother's keeper?' In doing so, he shows, as the Pope puts it, that he 'does not wish to think about his brother and refuses to accept the responsibility which every person has towards others'.
This refusal of responsibility in the first book of the Bible is paralleled in the reality of the contemporary world:
This reality is characterised by the emergence of a culture which denies solidarity and in many cases takes the form of a veritable 'culture of death'. This culture is actively fostered by powerful cultural, economic and political currents which encourage an idea of society excessively concerned with efficiency.
It is significant that the Pope links the culture of death with the denial of solidarity. We can all too easily see in the world around us instances of violence against life ' genocide, euthanasia, abortion, torture, slavery and so on. These are fruits of the culture of death. But we need to recognise that the deeper roots of the culture of death lie in a failure to appreciate the meaning of human life and the consequent failure to understand and live the solidarity which that meaning demands.
Often, I suspect, people's sense of the meaning of life is formulated on the basis of unexamined assumptions. It is easy, for example, to assume that our own cultural perspective is the only possible one and that it is an entirely objective standpoint.
Nowadays there is a widespread unexamined assumption that only science is capable of giving us the real, objective truth. It is also assumed that science demonstrates that a complete explanation of the origin of human life is to be found in the evolutionary process of the survival of the fittest.
This would mean that, however implicitly, one would see life simply as the fruit of a bitter, pitiless struggle. The life which survives is the one which has most efficiently conquered its environment and subdued its rivals. The development of life is the victory of the strong at the expense of the weak. Successful living in that perspective would mean the acquisition of power, status and resources. These, incidentally, are the very temptations that Jesus rejected in the desert!
That is not to say that scientific truth can be disregarded. But, in seeking to understand reality, what can be scientifically proved and measured is not necessarily the most significant truth. When a scientist tells us that a human being is made up for the most part of water, with some carbon, calcium and other elements in lesser quantities, we can acknowledge that this is a true answer to the question, 'what constitutes a human being?' But it is an answer from a very limited perspective. A deep understanding of the mystery of the human person will not be arrived at through an ever more sophisticated chemical analysis.
But as scientific information becomes more complex and impressive ' for instance in the context of the human genome project ' it is more tempting for people to believe that 'the fault, dear Brutus, lies not in our stars but in our genes'.
THE GIFT OF GOD AND THE CALL TO COMMUNION
God is the source of all life. We may well recognise an evolutionary principle or drive set into creation by the Creator, which has led to the emergence of life in microbes and plants and animals. Human beings may be seen as part of that process, but that is not the whole truth, nor the most important truth, about human life.
Whatever light the theory of evolution, or indeed the study of the genome, may shed on human existence, an adequate understanding of the origin and meaning of human life needs to see it above all as a personal gift of God
The Catholic tradition teaches that each human being is brought into existence by a particular creative act of God: 'Every spiritual soul is created immediately by God'. In that act, God makes the human person in his own image and likeness; God, who wishes all to be saved and come to a knowledge of the truth (I Tim 2:4), invites the human person to share in the divine life; God addresses the human person as a being created for his or her own sake .
None of these statements refers exclusively, or even primarily, to the Christian, who shares in the divine life through Baptism. They are true of human beings simply as human. Every human being is immediately created by God, made in the image of God and called to salvation and to the knowledge of God's truth. To be human is to be individually addressed by that word of God.
The full significance of God's personal creation and call is revealed in Christ, not as something alien and foreign to the longings of the human heart, but as their fulfilment, a fulfilment entirely beyond any human capacity to achieve:
The Church knows that this Gospel of Life, which she has received from her Lord, has a profound and persuasive echo in the heart of every person ' believer and non-believer alike ' because it marvellously fulfils all the heart's expectations while infinitely surpassing them.
Human life, therefore, does not find its ultimate origin or meaning in struggle and competition. It is not to be claimed as a right that has been earned, or taken as a prize that has been won by conquest. It is to be received as a gift freely given. The goal of life is not a commodity in short supply; it is a share in the unlimited life of God. Thus, 'revelation teaches us that life in its origins is not the self-assertion of the fittest, but love; and that human beings are the image of this original life'. The meaning of human life is found in love. It is only in self-giving that human beings can fully discover their true selves. Successful living consists not in the acquisition of power, status and resources but in giving oneself.
That is why 'the emergence of a culture which denies solidarity' is so closely linked to the growth of a culture of death. To know that the meaning of human life is found in love is to know that solidarity is an essential element in human flourishing and that a refusal of solidarity is a refusal of life.
Without the solidarity of the human community, a person would not learn to speak, to be moral, or to love. There could be no language if there were no one to speak to. There could be no morality as we know it if there were no interaction with other people. There could be no love if there were no one to love us and to be loved. Without the solidarity of the human community, there would be no fullness of human life.
The Golden Rule, which is found in many religions and cultures, demands that we see every human being as a person whom we should treat as we would wish to be treated ourselves. Christian revelation goes further:
One's neighbour is then not only a human being with his or her own rights and a fundamental equality with everyone else, but becomes the living image of God the Father, redeemed by the blood of Jesus Christ and placed under the permanent action of the Holy Spirit' Beyond human and natural bonds, already so close and strong, there is discerned in the light of faith a new model of the unity of the human race, which must ultimately inspire our solidarity. This supreme model of unity, which is a reflection of the intimate life of God, one God in three Persons, is what we Christians mean by the word 'communion'.
Without the solidarity of the Christian community, a human being could not come to believe in the message of Christ. It is only through the scriptures and the living faith of the community that the Gospel is spoken in the world. 'How will they hear of him unless there is a preacher for them? And how will there be preachers if they are not sent?' (Rom 10:14,15) It is through the community of the Church, Christ's body, that we learn 'to see in every human face the face of Christ'.
We are dependent on one another because every human being is vulnerable, fallible, mortal and ignorant of many things that he or she needs to know. It is not possible genuinely to respect the life of a human being, fallible and mortal like oneself, unless one is willing 'to accept the responsibility which every person has towards others'.
The commandment 'Thou shalt not kill' is not observed simply by refraining from murder. It indicates a minimum below which a free individual should never under any circumstances descend. But, from that minimum, people, 'must start out in order to say 'yes' over and over again, a 'yes' which will gradually embrace the entire horizon of the good (cf. Mt 5:48)':
The commandment 'You shall not kill' thus establishes the point of departure for the start of true freedom. It leads us to promote life actively, and to develop particular ways of thinking and acting which serve life. In this way we exercise our responsibility towards the persons entrusted to us and we show, in deeds and in truth, our gratitude to God for the great gift of life (cf. Ps 139:13,14). The God of the Covenant has entrusted the life of every individual to his or her fellow human beings'
The answer to Cain's question is that we are indeed responsible for one another.
A SPECIAL RELATIONSHIP
The health care vocation has an honoured place in Christian tradition. But it should not be seen in isolation from the life of the whole Christian community. It is a particular response to the universal call to recognise that the God of the Covenant entrusts the life of each individual to all of us.
I want to reflect on Medicine, Morals and the Third Millennium in this wider context, which is the foundation for a Christian vision of health care. Health care is a particularly intense expression of the responsibility we have for one another. The patient entrusts his or her life to the doctor or the health care team in a way that makes that responsibility very explicit and immediate.
From the point of view of the patient this entrustment is often total. A sick person may feel utterly frightened and helpless and be suffering acutely, physically and mentally. Perhaps for the first time, the patient's life and future seem to have slipped out of his or her control. The patient is dependent and has to trust in others to a degree that, perhaps, they have not known since infancy. I believe it is vital, in all the discussions about the complicated issues that arise in bio-ethics today, that we do not lose sight of the underlying relationship of trust between patient and carer which is the foundation of all that is done in the name of medicine.
The new century will almost certainly bring utterly unanticipated changes both for good and for ill to the world of health care. Already, we may sometimes wonder whether our moral reflections may be missing the point because we are unaware of some new developments, already well advanced, which will pose far more significant ethical questions than the issues that currently occupy our attention.
The human genome project, for instance, will raise great moral challenges, but many of them are not yet discernible. Before the century is out, there may well be even more dramatic challenges arising from as yet unimagined breakthroughs. It is important, therefore, even as we look at the particular ethical issues of our own day, that we should also remain focussed on the underlying question of the meaning of health care. This in turn rests on an understanding of the meaning of human life and of human solidarity. These will remain the foundations on which our response to whatever the future brings should be based.
THE UNITY OF THE PERSON
The mention of the human genome project suggests that we look a little deeper. Even if it does not necessarily lead to the conclusion that everything in human consciousness and behaviour can be explained in terms of genes, it may subtly strengthen the idea that the human being is no more than a highly sophisticated machine. People may or may not suppose that this machine is driven by some kind of spiritual core. They may also have an idea that that, if that core does exist, it may be much less in control than it imagines.
The advances in computers and the dream of creating artificial intelligence may lead many to suspect that even what we think of as our spiritual core is nothing more than an extraordinarily sophisticated machine. They may feel that what we call the human spirit is no more than the product of particularly complex interactions of material elements and impulses.
One may often find, therefore, in contemporary thinking an attitude that regards the soul or spirit either as identical with the body or as a being quite detached and separate from the body ' a 'real me', struggling to control this recalcitrant physical envelope.
This is not the reality of our experience or of our existence. A human body is not just one among the objects in the physical world. In one sense, of course, it is an object, with size and weight and shape. More significantly, however, it is a subject. For some human person, this physical body is 'I'.
'I' am not a sort of spiritual puppet-master hidden away somewhere deep in my brain; I am a living body. Anything that is done to my body is done to me; anything that is done freely by my body is done by me.
Some of the actions performed by this body are not done freely; they are just events in the world that follow the scientific laws of physics or physiology ' like falling down or snoring. Other actions, however, from the point of view of the person, are 'my actions', expressing 'my choices', 'my values' and 'my attitudes'. The various limbs and organs of the human body are not just objects of anatomical study or diagnosis. 'My arms' and 'my heart' are part of what I mean by 'me'.
It is fundamental both for medicine and for morals, and therefore for bioethics, to recognise the unity of the human person. Medicine deals not with a machine attached in some mysterious way to a conscious core, or a machine which through some particularly complex physical processes produces consciousness, but with a person who is an embodied spirit.
The poignancy of the situations that doctors often have to deal with and the respect that is due to the patient both come back to this. The doctor's relationship is not merely with a physical body but with a person.
It can be tempting sometimes to see the patient as confined and trapped in an ailing body. But that is not the whole reality. It is also true, for instance, that he or she cannot even express that frustration except through and in that weak or damaged body, which is not a mere thing, separate from the patient. To try to divide the person into a totally free and healthy centre and a sick and imprisoning body does not do justice to the reality of human experience. It is not just the body which is sick but the person.
The person who has unlimited aspirations lives within the limitations of time and space and ability and, perhaps, of failing health. And yet the physical universe and the physical body are not just limitations, they are the only medium through which the unlimited longings and hopes can be expressed and experienced. They are also, we believe, the setting of our journey towards the fulfilment of our unlimited hopes.
COMMUNICATION AND COMMUNION
Part of that separation of the person and the body arises from a misunderstanding of what it means to be a person. Pope John Paul refers to a mentality which 'recognises as a subject of human rights only the person who enjoys full or at least incipient autonomy'; he also refers to 'the mentality which tends to equate personal dignity with the capacity for verbal and explicit, or at least perceptible, communication'. He points out that, if one follows these lines,
' there is no place in the world for anyone who, like the unborn or the dying, is a weak element in the social structure, or for anyone who appears completely at the mercy of others and radically dependent on them, and can only communicate through the silent language of a profound sharing of affection.
The reference to 'perceptible communication' is interesting. Communication and relationships are more than verbal communication 'Communication is more than the expression of ideas and the indication of emotion. At its most profound level, it is the giving of self in love'.
The discussions on the status of the embryo and when life begins focus our attention on the individual human being in the womb, or indeed in the test tube. We rightly point to the particular genetic make up of this unique individual.
But he or she is more than an individual. The tendency of our culture is to be very individualistic. Perhaps that can lead us to forget another essential aspect of the human person. To speak of a human being is to speak of already existing relationships. Every human being is a member of what we describe as 'the human family'. More concretely, one cannot be a human being without being a son or daughter, a grandson or granddaughter, and possibly also a niece or nephew, a brother or sister, or a cousin.
Long before we could speak or be conscious, we were caught up in relationships which were a part of our identity from the very beginning and which would remain part of our identity forever. The human response of love and recognition, communication in the narrow sense, does not simply begin when a baby speaks for the first time. That first verbal communication is a response to a relationship that began to exist as soon as this son or daughter was conceived.
The deep urge in many people to seek out their birth parents whom they never knew, testifies to this sense of a relationship which exists even if it was never consciously expressed.
Communication has its source and its goal in the unity of the human race with its Father and Creator. The word which God speaks to each new human being in the act of creation is already a word spoken to a being in community. The human being is an image of God not just because of his or her intellect and free will, but through the community of persons in which we were created from the beginning. 'So God created humankind in his image, in the image of God he created them; male and female he created them' (Gen 1: 27):
He has willed to make women and men holy and to save them, not as individuals without any bond between them, but rather to make them into a people who might acknowledge him and serve him in holiness.
On a wider scale, to speak of a human being is to speak of someone called to be part of the family of God, united in truth and love in a way that resembles the union existing among the divine persons:
In affirming that the spouses, as parents, cooperate with God the Creator in conceiving and giving birth to a new human being, we are not speaking merely with reference to the laws of biology. Instead, we wish to emphasise that God himself is present in human fatherhood and motherhood quite differently than he is present in all other instances of begetting 'on earth'. Indeed God alone is the source of that 'image and likeness' which is proper to the human being, as it was received at Creation. Begetting is the continuation of Creation.
The fact that the development of an embryo may be still at a very early stage, the fact that a severe congenital condition may seriously restrict that development, the fact that a person may never again be capable of conscious interaction with others, does not negate that call of God, or that relationship to the human family. Every living human body is a person, a member of the human community and of the family of God.
THE CORE AND THE CONSEQUENCES
When the Pope identifies the core of the Gospel of Life, he speaks, as we have been doing, of communion, bodiliness, relationship and the gift of self. The core of the Gospel of Life is:
' the proclamation of a living God who is close to us, who calls us to profound communion with himself and awakens in us the certain hope of eternal life. It is the affirmation of the inseparable connection between the person, his life and his bodiliness. It is the presentation of human life as a life of relationship, a gift of God, the fruit and sign of his love. It is the proclamation that Jesus has a unique relationship with every person, which enables us to see in every human face the face of Christ. It is the call for a 'sincere gift of self' as the fullest way to realise our personal freedom.
These are the concepts that guide us in looking at the consequences for health care of the basic questions that face us: How can we ensure that health care is in harmony with the culture of life? Can we be alert to the dangers that could draw it into the culture of death?
NOT INSTITUTIONS BUT COMMUNITIES
We might approach those questions by looking at some of the consequences that the Pope himself draws from the Gospel of Life. One of these consequences is that respect for life requires that science and technology should always be at the service of the human person and of the person's integral development. Health care at its most fundamental is a relationship between persons. One of the priorities in the new century will be to maintain that sense of personal service.
The challenge that faces us as research expands our knowledge and medical technology becomes ever more complex and specialised, is to try to ensure that the person of the patient does not get lost. We have all seen very capable and self-assured people becoming passive and helpless in the unfamiliar and frightening context of a hospital. Indeed the hospital can sometimes look to an incoming patient like an awesomely complicated institution that would run much more smoothly if it were not for all the sick people who get in the way!
We are all aware of the danger that the distress and uncertainty of an individual, might be neglected while overworked health care personnel struggle to bring their particular professional expertise to bear on 'their' aspect of the patient's problem. We have all heard stories of the wise old GP who makes a correct diagnosis at first glance when batteries of tests have failed to do so because the tests were not looking for the right thing!
The drive for efficiency in the provision of health care is inevitable and right, given the vast amounts of public money that are spent. But I sometimes wonder whether the efficiencies are always calculated with a real understanding of the nature of health care.
Medical people complain that administrators do not understand the strictly medical issues. That may sometimes be true, but I have a broader concern. Even in terms of efficiency, the speed of recovery, reducing bed-nights and so on, what would be the effect of ensuring that each patient in a hospital could be sure that someone on the health care team really had the time to listen to his or her worries and to understand them? In the past, nurses seemed to have very much more freedom to sit and listen. To the extent that this has been eroded, I suspect that the system may have become less efficient, even in statistical terms.
Like other institutions in society ' such as the churches, politics and education ' medicine suffers from a generalised distrust and alienation. If this continues to grow the very cohesion of society will be at risk. A great part of the reason for this alienation is that what should be, and used to be, seen as an expression of community or communion, is now perceived as an 'institution'. We hear a great deal, for instance, about 'the institutional church'.
When I reflect on that phrase, it seems to me that it refers to the church viewed from outside. Just as the human body can be viewed as a mere physical object with its chemical composition, its weight and size, so the Body of Christ can be seen as a mere structure.
'The institutional church' is spoken of without a sense of belonging or involvement, abstracting from any awareness that the church is about my deepest relationship with God and with all the brothers and sisters of God's Son, Jesus Christ. 'The institutional church' usually means a structure in which the speaker feels that he or she 'does not count' and for which the speaker feels no responsibility. It usually means a structure without a soul!
That underlying feeling of detachment can easily become hostility when people see real flaws and failures in the institution or in its 'professional' personnel ' child abuse, organ retention, irregular political donations.
People may well approach health care with a sense of alienation. The hospital is seen as an institution doing things to and for the patient, but the patient does not expect to play any active or responsible part in the process. There may well be a feeling that his or her needs and anxieties do not count for much in the functioning of this huge structure. If that is the case, there is something fundamentally wrong. The idea that the patient plays no part in the process of healing is quite false:
The bodily, instinctual, psychological and spiritual ego of the patient is an active part of the reconstruction of the lost well-being.
This, presumably, is what is at work in the placebo effect, when a patient's condition improves even though nothing has been done which would explain the improvement.
The hospital should rather be a community, in which the patient believes that his or her feelings and anxieties count. The sick person should be able to feel that he or she is seen as a person and not just as a case or a collection of symptoms. This involves, as the Pope put it, openness to the patient's interiority, world, psychology and culture. It 'involves a simultaneous giving and receiving, that is the creation of that communion which is total participation'.
The challenge that this poses, as scientific and technological advance continues apace, is an uncomfortable one. I will put it very bluntly in the words of a man who has spent his life in health care, Pierluigi Marchesi, former Prior General of the St John of God Brothers:
To humanise a hospital ' or, rather, introduce into the hospital the dimension of humanity, understanding, respect, and response to the patient's needs and motivations ' means that all health professionals must seek continual improvement ' a kind of leap which few universities have proposed, beyond the arrogance of power and so-called scientific knowledge, to plunge into a process of identification with the suffering individual, a process which enables us to comprehend before acting and give rise to hope, trust, and a therapeutic partnership.
THE INCOMPARABLE VALUE OF EVERY HUMAN PERSON
Another consequence of the Gospel of life is that, 'Human life, as a gift of God, is sacred and inviolable'. 'Society as a whole must respect, defend and promote the dignity of every human person, at every moment and in every condition of that person's life' '. 'Human life is sacred because from its beginning it involves 'the creative action of God', and it remains forever in a special relationship with the Creator who is its sole end' no one can, in any circumstance, claim for himself the right to destroy directly an innocent human being'.
Wherever one is faced with a living human being, one is faced with an inviolable life. Sometimes we may be tempted to use words which disguise this reality. At the end of life, while the patient is not yet dead, it is not right to say, 'he is only a vegetable; she is only a shell'. The human person is a living body. If the body is living, the person is living. The person is not some guiding force inside the body which might have slipped away, leaving the body like a driverless car with the engine ticking over. At the beginning of life it is not right to say, 'this is only a collection of cells; this is just the product of conception'. When a human life has begun, it is God's gift; it is a unique individual. This life is of more value than many sparrows (Mt 10: 31); it is more valuable than anything in the inanimate universe.
The encyclical specifically points to two major issues in defending the inviolability of human life in our world ' abortion and euthanasia. The Holy Father condemns them in the most specific terms. There is no need in this gathering to point to the enormous scale of the destruction of human life through abortion. There is every reason to fear that euthanasia will pose a steeply increasing challenge in the years ahead. Already, one country in the European Union has made it legal.
In both cases, abortion and euthanasia, we need to stress that there can be no such thing as degrees of belonging to the human family. Either a being is human or it is not. If a life which has the potential to blossom into consciousness and ultimately into eternal life has begun, then we must treat that living being as member of the human family. This remains true even if there are controversies and questions about the precise moment when the life of a person begins:
Respect for human life is called for from the time that the process of generation begins. From the time that the ovum is fertilised, a life is begun which is neither that of the father nor of the mother; it is rather the life of a new human being with his or her own growth. It would never become human if it were not human already.
It is particularly important that we do not fall into the trap of thinking that the respect due to a particular person's life can be measured in proportion to the 'quality' of that life. One often notes that the concept of 'quality of life' is being used as a means for valuing lives. It is one thing to judge that a particular form of treatment is not worthwhile because it will achieve little for the patient or is likely to be more harmful than beneficial. It is quite another to judge that a person's life is not worthwhile or not worth saving, because it is of such poor quality.
Obviously, in making the former decision, one of the considerations will be to ask what the treatment is likely to be achieved for the patient in terms, for instance, of conscious, pain-free, independent, active life. But that consideration is legitimate only in deciding whether the treatment will yield worthwhile benefits to the patient, not in deciding whether the patient's life is worthwhile. A human life is always worthwhile.
BEGOTTEN OR MADE?
It is very likely that the new century will bring a whole range of new questions about the inviolability of life. We will be faced not just with issues about taking life but also with issues about changing life.
The hope of curing genetically inherited diseases like cystic fibrosis or haemophilia through gene therapy is obviously greatly to be welcomed. If that could be safely done through germ-line therapy, so that these diseases were never passed on in the first place, so much the better. But it may not be that simple. Germ-line therapy raises very particular problems.
It is likely, before the century is very old, that we will be faced with the possibility of genetic therapy which would not just seek to eliminate disease, but would aim at 'perfecting' an individual in the area of intellect or memory, in the area of emotion or personality, or merely aesthetically. This would raise problems enough if it were a matter of somatic therapy, affecting only a consenting individual. But one can also anticipate such questions arising in relation to germ-line therapy, which will affect the individual's descendants. Then the problems will be infinitely greater.
I will just indicate a number of points that strike me about the moral implications of that kind of choice.
The first is that germ-line therapy has a potentially uncontrollable effect on future generations. After a couple of generations, if some adverse effect emerged, it might not even be possible to trace all the descendants of the person with the altered gene. The damage might be very difficult or impossible to undo. Even when gene-line therapy is administered to eliminate a fatal disease, any adverse effects may strike even those descendants who have not inherited the disease. Experiments on animals have so far shown that germ-line therapy involves high levels of morbidity and mortality on embryos subjected to it.
Secondly, we need to ask whether we know as much as we think we do about the human genome. Even if one can establish that a particular gene has a particular effect, how sure can we be that this is its only effect? Are we sure that genes operate only as individual switches, or might they also operate in a virtually unlimited series of combinations with each other?
Thirdly, we should not be too quick to assume that we know what would count as 'perfecting' the human person. I remember hearing about a fire in a residential home in which there were a number of disturbed and occasionally aggressive children. As soon as they saw the fire, these little lads ran to the store room, soaked blankets, threw them over their heads and ran into the building to rescue the people still inside. They succeeded in saving everyone. It struck me that, if someone had removed their gene for aggression and assertiveness, and replaced them with genes for responsibility and prudence, they would have stood there and done nothing! The aggressive person may be the person who can survive in a crisis or take control in an emergency. It would be foolhardy to try to make everyone into the kind of person with whom we would feel comfortable. If we succeeded, the human race would be in trouble if global warming or some disaster were to bring about a situation that would require skills and traits that we do not have much use for. There is always, as I said, a temptation to the arrogant assumption that one's own cultural perspective is the only possible one!
Most importantly, we will have to ask ourselves this fundamental question. How can we reconcile this newfound knowledge and ability with seeing human life as a gift of God?
If we are offered the possibility of changing the appearance and the personality of future generations, how can we avoid buying into the idea of the human being as a machine to be produced and redesigned according to our whims? At what point might we radically alter the genetic makeup so that the question would arise as to whether what was produced was a member of the human family?
We can already see on the not too distant horizon the prospect of a cloned human being. We have already heard the warnings from the Roslin Institute about the irresponsibility of such an undertaking, given the uncertainties and the failure rate of the procedures they have pioneered.
Even if the technique were foolproof, there would be horrendous moral implications. Having produced a human being for the precise purpose of being identical to someone else, how could that person have the freedom to be him or herself? How could we resist the temptation to see the cloned person as a product of our ingenuity rather than as the gift of God?
There are many different kinds of scientific intervention in the process of human generation. If one sees the human being as a machine and procreation as a technical process of bringing sperm and ovum together and providing a suitable setting for the development of an embryo, it will not matter greatly what technique is used. The concern will be for effectiveness.
If one looks rather at the mystery of how a new member of the human family is called into existence by God, the matter will appear differently. Procreation is meant to occur in the context of a conjugal act; it is not a manufacturing process but a fruitful relationship:
The status of the child as 'begotten not made' is assured by the fact that she is not the primary object of attention in that embrace which gave her her being. In that embrace the primary object of attention to each partner is the other. The I-Thou predominates. The She (or He) which will spring from the I-Thou is always present as a possibility, but never as project pure and simple. And precisely for that reason she cannot be demeaned to the status of an artefact, a product of the will.
The human person is meant to come into existence in an act of self-giving and permanently committed love, not as the product of medical or biological techniques. Procreation occurs in the meeting of persons, not just in the combination of gametes. The result of procreation is not merely a fertilised ovum but a being brought into existence by God and loved for his or her own sake:
The human person must be accepted in his/her parents' act of union and love: the generation of a child must therefore be the fruit of that mutual giving which is realised in the conjugal act through which the spouses cooperate as servants not as masters in the work of the Creator who is love.
Every human 'I' comes into existence in the context of the 'we' of his or her parents, and in a wider sense the context of the 'we' of his or her grandparents and relatives and the context of the 'we' of the whole human family. That is the context that techniques of artificial fertilisation distort, even when the biological parents of the child are married and will accept their child with love and gratitude to God.
Much more unacceptable would be the production of a cloned human being who would have no parents but only a human template, an adult 'twin', who wishes for some reason to bring into existence a younger replica of him or herself.
A CONTEMPLATIVE OUTLOOK
The vision of human dignity which underlies what I have been saying does not reveal itself to a superficial glance. It requires reflection on the meaning and purpose of life and a sense of the mystery of the human being ' an embodied spirit, an infinite longing in a limited universe, a soaring search for truth and beauty and moral nobility in the context of imperfect knowledge, flawed creativity and moral frailty.
That is why the Pope tells us that to appreciate and celebrate the Gospel of Life we need to foster in ourselves and in others what he calls 'a contemplative outlook':
It is the outlook of those who see life in its deeper meaning, who grasp its utter gratuitousness, its beauty and its invitation to freedom and responsibility. It is the outlook of those who do not presume to take possession of reality but instead accept it as a gift, discovering in all things the reflection of the Creator and seeing in every person the Creator's living image. This outlook does not give in to discouragement when confronted by those who are sick, suffering, outcast or at death's door. Instead, in all these situations it feels challenged to find meaning, and precisely in these circumstances it is open to perceiving in the face of every person a call to encounter, dialogue and solidarity.
He goes on to make it clear that this is not a call directed simply to religious and clergy. It is a call to 'all of us' to rediscover the ability to revere and honour every person'. Perhaps it is surprising, as we face such practical problems from abortion to genetic manipulation, that we find ourselves called to contemplation.
The surprise we may feel, however, may simply indicate the depth of our need to recognise that life is a mystery. The Pope is issuing a call to renew our sense of awe and wonder in the face of God's gift of human life. The response to that call will face us with the most demanding practical implications of building a new culture of life and solidarity. We will face those demands by no means least in the field of health care.
Bishop Donal Murray is the Bishop of Limerick
JOHN PAUL II, Evangelium Vitae (EV), 8.
 EV 12.
 Catechism of the Catholic Church, 366.
 VATICAN II, Gaudium et Spes 24.
 EV 2, cf. GS 45.
 SPAEMANN, R., 'On the anthropology of the Encyclical Evangelium Vitae', in Evangelium Vitae, Pontificia Academia pro Vita, Libreria Editrice Vaticana 2001, p. 446.
 Gaudium et Spes, 24.
 JOHN PAUL II, Sollicitudo Rei Socialis, 40.
 EV 81.
 EV 75.
 EV 76.
 EV 19.
 Pontifical Council for the Instruments of Social Communication, Communio et Progressio (1971), 11.
 VATICAN II, Lumen Gentium, 9.
 Cf. Gaudium et Spes 24.
 EV 43.
 EV 81.
 EV 81.
 MARCHESI, P., 'The medical world in suspense', in Dolentium Hominum (DH) n.1, Vatican 1986, p. 15.
 JOHN PAUL II, to the Conference on the Humanisation of Medicine, Osservatore Romano (English edition), 7 December 1987.
 MARCHESI, P., 'To effect change'' in DH n.7, Vatican 1988, pp. 107, 108.
 EV 2.
 EV 81.
 EV 53.
 EV 62, 65.
 CONGREGATION FOR THE DOCTRINE OF THE FAITH, Declaration on Procured Abortion (1974), 12.
 THE CATHOLIC BISHOPS' JOINT COMMITTEE ON BIOETHICAL ISSUES, Genetic Intervention on Human Subjects, London 1996, p. 33.
 O'DONOVAN, O., Begotten or Made?, Clarendon Press 1984, p. 17.
 CONGREGATION FOR THE DOCTRINE OF THE FAITH, Donum Vitae B, 4, c.
 EV 83.