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," March) wanted to be original, they failed, alas. Sixty years ago, some similar re- imagining was done by academicians who included among their tenets the following:

The living world is the womb of the high human mind. The All-Mother gives birth to Knowing, Being, and Mind. The concept of mother-child is, therefore, the correct expression of the God-world secret. We speak of a modern nature religion when we speak of the Mind-child God, who lives in the womb of the All-Mother. The basic religious feelings are Union, Holiness, and Blessedness. On the other hand, the Christian sentiments of Sin, Guilt, and Repentance are not really religious feelings. They are artificially engendered complexes in man.

It’s all there: a female deity, the apotheosis of childbirth, no more sin or "folks hanging on crosses and blood dripping and weird stuff."

The theological innovators of 1934 wanted to create a new Earth. They almost succeeded. The above tenets were formulated by Professor Ernst Bergmann, a pioneer in the Nazis’ German Faith movement that sought to supplant Christianity.

In their intentions, the radical feminists of Minneapolis are not Nazis. But Kathy Kersten is right: the "wonderful space" they seek to create "where we are truly to be ourselves," without limits imposed by Truth, would approach hell. Did approach hell.

John M. Owen
Postdoctoral Fellow
Harvard University
Cambridge, MA