LIFE, SANCTITY OF

The sanctity of life is the theological or philosophical understanding that all human life has an inherent dignity, worth and sacredness that sets it apart from all other beings within the world. This perspective does not assert that human life is sacred in the sense of being divine, but that its very essence is distinct within the biological world and of incalculable worth, thus warranting protection throughout the course of its entire existence. The sanctity of life as a doctrine has both religious and philosophical roots and is applied to a wide range of bioethical issues such as abortion, euthanasia, genetic engineering, and cadaver organ transplants. Advocates often consider this understanding of human life to be the foundation of moral civilization, and have applied it to issues outside of bioethics such as human rights, suicide, and care for the poor and weak in society.

Religious Foundations

Various religious traditions have articulated and defended a concept of human sanctity in reference to their overarching worldview conceptions. In the Hebrew tradition the doctrine is rooted in human creation in the image of God: "Then God said, 'Let us make humankind in our image, according to our likeness; and let them have dominion over the fish of the sea, and over the birds of the air, and over the cattle, and over all the wild animals of the earth, and over every creeping thing that creeps upon the earth.' So God created humankind in his image, in the image of God he created them; male and female he created them" (Genesis 1:26–27, NRSV). The creation in God's image became then for the Hebraic tradition the foundation for protecting human life and for justice when it was de-sacralized (Genesis 9:6). The duty to protect human life extended to the necessities for life, such as food and clothing (Deuteronomy 24:6, 12–13), and especially to justice for the poor and disenfranchised (Leviticus 19:15, 33–34).

Within the Jewish tradition the taking or defacing of human life is morally wrong because it violates a sacredness that "inheres in life itself, and that life, by its very being calls forth an appropriate human response, whether of veneration or restraint" (Kass, p. 235). The tradition does not teach that humans are God, but rather, "To be an image is also to be different from that of which one is an image. Man is, at most a mere likeness of God" (Kass, p. 242).

Jakobovits notes that in Jewish law and moral teaching, "The value of human life is infinite and beyond measure, so that any part of life—even if only an hour or a second—is of precisely the same worth as seventy years of it" (Jakobovits,p. 380). In contrast to Roman Catholic thinking and some Protestants, this intrinsic value does not extend to the life in the womb. "An unborn fetus in Jewish law is not considered a person … until it has been born" (Rosner, p. 136). For most Jewish scholars this does not give automatic sanction to abortion, for as Rosner points out, "The destruction of the unborn fetus, although legally not considered murder, can be considered to constitute 'moral murder'. The unborn baby has a heartbeat, a brain, arms, legs, and nearly everything with which a healthy newborn baby is endowed" (Rosner, p. 146). Within the various branches of Judaism there is wide variation on the issue of abortion, though fairly uniform agreement that a person is not present until birth. At the other end of life, Jewish moral teaching repudiates active euthanasia or assisted suicide on the grounds that it cheapens life and constitutes murder.

The Christian tradition, incorporating and building from the Hebrew Scriptures, similarly articulates the sanctity of human life on the basis of creation in God's image. This has not only been a warrant for rejecting the willful taking of human life, but also for treating every human life with respect and dignity. Thus, the epistle of James calls for restraint of the human tongue on the basis of this foundation: "No one can tame the tongue—a restless evil, full of deadly poison. With it we bless the lord and Father, and with it we curse those who are made in the likeness of God" (James 3:8–9). The application of human dignity rooted in the imago dei is often extended more broadly to social realities, in that it forms the foundation and the ideal of inalienable rights and intrinsic human values that have long been articulated in Western cultures.

The Christian church has also grounded the sanctity of human life in the doctrine of the incarnation, God taking on human flesh in the person of Jesus Christ. As theologian Karl Barth put it, "The respect of life which becomes a command in the recognition of the union of God with humanity in Jesus Christ has an incomparable power and width" (Barth,p. 339). Barth and other theologians argue that the very fact that God became human in Jesus of Nazareth and then died for human beings is an affirmation that human life has great worth and value.

The sanctity of life tradition stemming from Judeo-Christian sources has historically argued that the value of human life is not dependent upon its being valued by others or by the presence of certain functional capabilities such as rationality or relationality. Rather, sanctity and dignity inhere within the human person. Thus, with regard to bioethical issues of life and death the late Protestant ethicist Paul Ramsey argued against a benign neglect of infants with severe physiological handicaps on the grounds that their value is not dependent on extrinsic characteristics. He noted, for example, that a Tay-Sachs baby is born destined to die, but their dying is no different from our own dying. "For about the first six months it is like any other baby; living and growing and presumably enjoying human existence as any other infant would. In religious perspective there is no reason for saying those six months are a life span of lesser worth to God than living seventy years before the onset of irreversible degeneration" (Ramsey, p. 191).

The Roman Catholic Church has been without doubt the most consistent voice in defense of the sanctity of life. In the words of the Church's catechism, "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.… No one can under any circumstance claim for himself the right directly to destroy an innocent human being" (Catechism, p. 544). As Pellegrino and Thomasma put it, "The person is to be affirmed as a person, possessing dignity simply because he or she is a person. Man is a personal being, created and loved by a personal God and destined to be united face-to-face with the Creator" (Pellegrino and Thomasma, p. 143).

The Roman Catholic application of this doctrine extends not only to abortion and euthanasia, but also to matters such as research on human subjects. "Research or experimentation on the human being cannot legitimate acts that are in themselves contrary to the dignity of persons and to the moral law. The subjects' potential consent does not justify such acts" (Catechism, p. 553).

The sanctity of human life is by no means only found in the Jewish/Christian traditions, though these traditions have given the most explicit renditions of the doctrine due to their common theology of creation. Traditional and contemporary Islamic teaching does not generally use the language "sanctity of human life," but there is a conception of the sacredness of human life: "And do not kill anyone whom Allah has made sacred, except for a just cause" (Qur'an 17:33). In the contemporary setting the Islamic Code of Medical Ethics states that "Human life is sacred…and should not be willfully taken except upon the indications specified in Islamic jurisprudence, all of which are outside the domain of the medical profession" (van Bommel, p.211). A sense of sanctity seems to be implied in the teaching that humankind is granted a vice-regency (khalifa) by Allah, but that role must be carried out consistent with the commandments of Islamic moral law. In the Islamic tradition ensoulment or becoming a person takes place at 120 days in the gestation period. Thus, "It can be said that although abortion in the first 120 days of gestation is morally wrong in Islamic law, it is not considered to be murder or even killing. Rather, abortion in this early period would fall into the categories of bodily injury or breaking of an oath, both of which require some type of penance" (Rogers, p. 129).

Philosophical Foundations

The sanctity of life doctrine is not limited to religious foundations. Various philosophers have attempted to articulate the unique, intrinsic value of human beings on the basis of experience and/or reason. Immanuel Kant, for example, argued that a person should be treated as an end, not as means to an end. The foundation for this assertion is that humans are rational and autonomous beings who thus possess a freedom which must be protected. Human freedom for Kant is not a license to do with life as we please, but rather a warrant for maintaining and protecting human dignity as an absolute inner worth. The problem in Kant's account, for those who today affirm the sanctity of life, is his insistence on rationality as its foundation; for if rationality is no longer present it would seem that human sanctity or personhood is no longer present, if indeed rationality is its foundation and primary indicator.

In the contemporary scene Arthur Dyck has argued for the sanctity of life on the grounds that it is a necessary prerequisite for communal life in society. As Dyck sees it, "Our lives did not and could not originate and persist because we valued it but because someone else valued it, parents to begin with, but also a whole network of individuals and groups. Our lives depended upon and continue to depend on the persistence of the moral behavior that makes life, and the communal protection of it, possible at all" (p.52). Killing, including oneself, is thus morally wrong because it undermines mutual moral responsibilities which are necessary for human life to exist.

Humans throughout history, says Dyck, have had a natural love of life that has been enshrined even in law as a protection of the sanctity of human life. He notes, for example, that the U.S. Supreme Court in 1997 rejected the individual's right to exercise control over one's life to the point of seeking assistance in suicide. In rejecting the right to assisted suicide the Court appealed to the American Bar Association's Model Penal Code: "The interests in the sanctity of life are represented in the criminal homicide laws" (p. 59). Dyck, therefore, concludes that there is a moral structure for life's worth and protection, which is based legally, not on religious doctrines, but on the necessary requirements for communal life in society. "If laws were permitted to embody the idea that in some circumstances life loses its worth, or that some people lack sufficient worth to have their lives protected, individuals would no longer enjoy equal protection of the law so far as their lives are concerned" (p. 60).

Challenges to the Sanctity of Life

There have been various challenges to the sanctity of life doctrine from both religious and philosophical frameworks. These challenges have invariably led to different conclusions on a host of bioethical issues.

One set of challenges has been metaphysical, arguing that the human person is not inherently different in nature from the rest of biological life. Thus, there is no warrant for a notion of exclusive human sanctity. Peter Singer, for example, argues against speciesism, the view that Homo sapiens life is to be valued above all others. "The wrongness of inflicting pain on a being cannot depend on the being's species, nor can the wrongness of killing it. The biological facts upon which the boundary of our species is drawn do not have moral significance" (p. 128). Thus, he contends that the sanctity of life doctrine is false, for there is no special value to a being by virtue of its species identity.

In contrast to the sanctity of life doctrine, Singer argues that the primary moral criterion for determining the protection of life is its ability to experience pain and pleasure. There are many beings that are capable of experiencing pain and pleasure who do not fit the ordinary conception of personhood (i.e., animals), and there are beings who are often considered persons that are not capable of experiencing pain and pleasure (i.e., some newborn infants and severely mentally disabled adults). Thus, says Singer, "If we value our own pleasures … then the universal aspect of ethical judgments requires us to extend our positive evaluation of our own experience of these pleasures to the similar experiences of all who can experience them" (p. 139). This leads Singer to a strong affirmation of animal rights on the one hand, and to a belief that in some cases deformed children may be euthanized.

Peter Singer utilizes a utilitarian framework for his ethical judgments, but his ethics, including his rejection of the sanctity of life doctrine, ultimately rests on metaphysical commitments about the nature of life. Sanctity of life adherents note that the root difference between Singer and themselves is distinct foundational world views.

A second challenge to the sanctity of human life commitment is theological in nature. Some have argued that the conception overstates the nature of human essence and is idolatrous in its insistence that human life is sacred, an attribute reserved only for God. Margaret Mohrmann believes that the notion of sanctity of life is intrinsically idolatrous. "Theologically speaking there can be no argument based on a purported 'sanctity of life', both because there is no 'life' as such and because we are on very shaky ground when we speak of anything or anyone but God as unqualifiedly sacred" (Mohrmann, p. 22). She notes that "Christians do not believe that God is somehow generically present in something called 'life'. We believe that God is present in individual human persons" (p. 30). And God alone is sacred.

Adherents of the sanctity of life perspective generally counter that such conceptions are caricatures of their understanding. They believe that sanctity of life in no way implies that human life is sacred in the sense of being divine, but rather is set apart by God and hence distinct within the created order.

A third challenge to sanctity of life thinking is the charge of medical vitalism, the notion that all means must be utilized to keep a human being alive in the face of death. Vitalism is the view that because human life has incalculable worth, there must be a commitment to keeping patients alive at all costs. Many critics of the sanctity of life perspective have assumed that vitalism is an inherent part of the tradition.

But advocates of human dignity and worth respond that vitalism is not implied in the commitment to human sacredness, for there is natural cycle to human life, even under divine providence, that must be accepted. Gilbert Meilaender, a strong advocate of the sanctity of human life, notes that "we indefinitely transcend our historical location. But it is as embodied creatures that we do so, and our person cannot be divorced from the body and its natural trajectory. This is not vitalism; it is the wisdom of the body" (Meilaender, p. 22).

A fourth challenge to sanctity of life formulations is the emphasis on quality of life as an ethical criterion. In contrast to the assumption that all human life has an inherent value and dignity, a number of bioethicists have suggested that quality of life measures ought to be determinative in ethical dilemmas throughout the course of life. Joseph Fletcher a number of years ago argued that for one to be considered a person, four functional traits must be present: neocortical function, self-awareness, relational ability, and happiness (1974, pp. 4–7). There is a clear rational bias in this formulation of personhood, as he questions whether one with an IQ below 40 is a person and concludes that those below 20 are clearly not persons. As Fletcher sees it, "Mere biological life, before minimal intelligence is achieved or after it is lost irretrievably, is without personal status" (1972, p. 1).

Other bioethicists and philosophers have argued similarly for quality of life indices over against sanctity of life. Mary Anne Warren, for example, believes that we can never get away from some notion of speciesism (contra Singer), but she does believe that we must make distinctions within humans on the basis of their capacities. Warren sees two ways in which we speak of humans: humans in the genetic sense, and humans in the moral sense. Being a member of the human species does not ensure that one is human in the moral sense. Warren believes that inclusion in the moral community of humanity entails qualities such as consciousness, reason, self-motivated activity, self-awareness, and the ability to communicate (pp. 457–458).

Sanctity of life advocates counter that while quality of life may be a medical category used to determine when treatment is futile, it is not an ethical category to determine human dignity or personhood.

Applications of Sanctity of Life

The sanctity of human life is not the only ethical norm utilized by its advocates. Nonetheless, they claim, it is a foundational assumption for bioethical issues surrounding life, death, and human treatment.

One of the applications of the doctrine is in the ethics of abortion. Sanctity of human life does not automatically imply that a human or person is present from the moment of conception, but its advocates tend in that direction because human value and dignity is not dependent on functionality. Continuity in human life is usually emphasized, and thus the protection of a fetus or human embryo is just as important as protecting a healthy, mature adult. As a result, most advocates of the sanctity of human life reject abortion on demand and the use of embryonic stem cells in research and therapy.

Sanctity of life is also applied to death and dying issues. Advocates, as noted above, do not generally espouse vitalism and the necessity of futile treatment, but they do raise strong ethical objections to euthanasia or assisted suicide, contending that allowing to die and causing to die are not identical. Sanctity of human life proponents emphasize the role of palliative medicine and compassionate presence as is provided by hospice care in the face of pain and impending death.

Other applications of the sanctity of human life include organ transplants and genetic engineering. In transplantation one of the crucial issues is triage, the allocation of scare resources. Advocates of human sanctity argue that justice in this realm should not depend on merit or the way one is valued in society, but rather must entail a blind-folded egalitarian justice which gives equal opportunity to all potential candidates. With regard to genetic engineering, human sanctity usually means not transgressing one's essential humanness and not utilizing experimental measures for the sake of knowledge, at the expense of human dignity.

In summary, the doctrine of the sanctity of human life teaches that "all human beings possess equal dignity and worth regardless of the level of maturity they have achieved.… Thus, all humans—not just those who are rational or self-conscious—retain the right to life" (Hui, p. 148).

dennis hollinger

BIBLIOGRAPHY

Barth, Karl. 1961. Church Dogmatics, III-4. Edinburgh: T&T Clarke.

Catechism of the Catholic Church, 2nd edition. 1997. Washington, D.C.: United States Catholic Conference.

Dyck, Arthur J. 2002. Life's Worth: The Case Against Assisted Suicide. Grand Rapids: Eerdmans Press.

Fletcher, Joseph. 1972. "Indicators of Humanhood: A Tentative Profile of Man." Hastings Center Report 2(5): 1–3.

Fletcher, Joseph. 1974. "Four Indicators of Humanhood: The Inquiry Matures." Hastings Center Report 4(6): 4–7.

Harris, John. 1999. "The Concept of the Person and the Value of Life." Kennedy Institute of Ethics Journal 9(4): 293–308.

Hui, Edwin C. 2002. At the Beginning of Life: Dilemmas in Theological Bioethics. Downers Grove, IL: Inter Varsity Press.

Jakobovits, I. 1979. "Medical Experimentation on Humans in Jewish Law." In Jewish Bioethics, ed. Fred Rosner and J. D. Bleich. New York: Hebrew Publishing Co.

Kass, Leon R. 2002. Life, Liberty and the Defense of Dignity: The Challenge for Bioethics. San Francisco: Encounter Books.

Meilaender, Gilbert. 1995. "Terra es Animata: On Having a Life." In Politics and the Human Body, ed. Jean Bethke Elshtain, and Cloyd, J. Timothy. Nashville: Vanderbilt University Press.

Mohrmann, Margaret E. 1995. Medicine as Ministry: Reflections on Suffering, Ethics, and Hope. Cleveland: The Pilgrim Press.

Pellegrino, Edmund, and Thomasma, David. 1996. The Christian Virtues in Medical Practice. Washington, D.C.: Georgetown University Press.

Ramsey, Paul. 1978. Ethics at the Edges of Life: Medical and Legal Intersections. New Haven: Yale University Press.

Rogers, Therisa. 1999. "The Islamic Ethics of Abortion in the Traditional Islamic Sources." The Muslim World LXXX(2): 122–129.

Rosner, Fred. 1991. Modern Medicine and Jewish Ethics, 2nd edition. New York: Yeshiva University Press.

Singer, Peter. 2000. Writings on an Ethical Life. New York: Harper Collins.

von Bommel, Abdulwahid. 1997. "Quality or Sanctity of Life?" In Holy Scriptures in Judaism Christianity and Islam: Hermeneutics, Values, and Society, ed. Hendrik M. Vroom and Jerald D. Gort. Atlanta: Ropodi.

Walters, James W. 1997. What is a Person?: An Ethical Exploration. Urbana, IL: University of Illinois Press.

Warren, Mary Anne. 2001. "On the Moral and Legal Status of Abortion." In Biomedical Ethics, 5th edition, ed. Thomas A. Mappes, and David Degrazia. New York: McGraw-Hill.