"Socially crippled" — strangely, this phrase appears to be kosher while regular-old-crippled is out ("differently abled, thank you"). Either way, at Slate, William Saletan is raising a ruckus over the notion that "appearance alone can be grounds for a potentially lethal procedure" — in the case at hand, a face transplant.
Now, nothing seems more Lockean, in the run-amok way with which readers of this blog are becoming familiar, than the face transplant: a "triumph" of science that enables us to freely take on the risk of death on the operating table in order to pursue our freely-chosen desire for a new face. (The mug is to be taken from "a corpse", of course; waste not, want not, or no hoarding and no spoilage.) But Saletan’s case is a highly leveraged one: the patient here had by all accounts a really messed-up face. I don’t mean this laughingly: difficulty eating, breathing through a tube in the neck, etc., etc. I’ll let Saletan take over the narrative here:
Physical function is the traditional purpose of surgery. Social function is a newer concept but makes sense: You need facial muscles to interact with others. We’re still talking about functions; they just happen to be social. But then the Cleveland doctors take the next step: They remove functionality from the equation. Having a normal face is socially necessary, they argue, not just because of what your face does, but because of how it looks. Appearance alone can be grounds for a potentially lethal procedure.
Siemionow made this case in a book published last year. People with serious facial damage are "socially crippled in a society that appears to value beauty above all other human characteristics," she wrote . That’s what happened to the Cleveland patient. She "was called names and was humiliated," Siemionow told reporters yesterday. "When she was on the street, people were turning their heads." Eric Kodish, the Cleveland Clinic’s chief ethicist, added, "Human beings are inherently social creatures. A person who has sustained trauma or other devastation to the face is generally isolated and suffers tremendously." He concluded: "The relief of suffering is at the core of medical ethics and provides abundant moral justification for this procedure."
Yes, suffering cries out for relief. But when the suffering is social and the relief is surgical, where are we going? We’re drifting from a standard of necessity rooted in you to a standard—"socially crippled"—that’s dictated by others.
Somehow the whole conversation as Saletan and those he’s criticizing would have it strikes me as off on the wrong planet. Even our society does not "value beauty above all other human characteristics." I would venture that this is true of societies characteristically. Nor do I think it’s true that medical procedures are given "abundant moral justification" so long as they can make a plausible claim to relieving a patient’s declared suffering. ("But doctor, I despise my legs," "But doctor, I must have white-person eyelids," etc.). To be generous, some operations meant to alleviate a patient’s grievance have nothing to do with morality at all. ( Boob job ? Discuss.) Yet what I really want to underscore is that Saletan and his opposite numbers aren’t being clear enough about what societies really do place great emphasis upon: not being revolting. There is a vast, key difference between a beauty-worshipping Lockean society and a Lockean society that really hates beholding the horrible. It seems to me plain that the poor patient in question looked awful enough — on top of having what are plainly medical reasons for reconstructing a face — to sidestep any of Saletan’s concerns, which do gesture toward a concern I share but seem to me not to pass muster here.
Indeed, Saletan’s main concern is expressed in that "dictated by others" line. My concern is that we might plunge forward ever-further into ever-more-relativized and individualized definitions of morally unjustifiable suffering. The anguish of imperfection that haunts our envious, comparing selves cannot be pawned off on peer pressure alone. It speaks to something deep within us, as I think Rousseau understood, to a quality of the human soul. But as Nietzsche understood, to egg that quality along and to enable it — to recast it in Lockean fashion as something empowering of cleverly enterprising improvers of their own/ed natural body’s raw materials — is to drive us down a rabbit hole in search of the end of suffering. Not the suffering of others, mind you, but of ourselves! The end of the rainbow, Freud teaches us, is always sought in the dark recesses of our own soul. (As Rieff would have it, Freud’s own unwillingness to poke down to the "third unconscious" reveals what it conceals: that the longing at the center of guilt, where it is impossible to look any further inward, looks heavenward.)
