To the Editors.

Respect for life

Thank you for the debate on the pro-life issue (February 8). Commonweal has again honestly looked at both sides of the question. However, your authors write as if there is no argument from compassion for pro-choice. Perhaps we Catholics can only change our thinking when we have to watch a child of our own suffer.

I recently read in the newspaper that "doctors helped a Texas woman give birth to a baby that is free of her family's curse of early Alzheimer's." To do it they genetically screened her eggs. Thanks to my own excruciating experiences, I say what a blessing. My son developed schizophrenia in his teens. I lived with his anguish. He wanted the fulfillment of making a contribution to the world. He wanted real work to do. He wanted to be loved by a woman and to become a father. I saw all his hopes crushed when his schizophrenic symptoms appeared. Ultimately he died in an accident that showed how little he cared whether he lived or died; some called it suicide.

It seems to me that human persons should open their eyes at birth in a body that has the power to carry out their aspirations and dreams. To knowingly bring a child into the world to suffer can't be respect for life.

CLAUDETTE KANE
Austin, Tex.

What Aristotle said

Jean Porter ("Is the Embryo a Person?" February 8) calls for philosophical arguments in favor of the position that early-stage embryos have "fully personal status"; John Collins Harvey ("Distinctly Human") offers such an argument drawing from the Aristotelian tradition. But I am not convinced by his argument and doubt that people not already disposed to this position will be either. Perhaps, though, Harvey can persuade me otherwise.

To the best of my understanding, the nub of his argument is that the "essence [of the human embryo]--that is, its nature or 'whatness'--is determined by its

human chromosomal constitution," which supplies the "substrata for the 'rationality' of the embryo in its early stages of development." (According to the Aristotelian tradition, the essence of human being is rationality.) These two claims may appear to be the same; but in fact they are significantly different. It is true that the embryo's becoming a human being depends upon its "chromosomal constitution" as the "substrata" for its development. But the fact that an embryo has the same chromosomal constitution that a fetus, baby, child, etc. have does not mean, without further argumentation, that the embryo has the same status as these later forms of life. Harvey's claim that the essence of the embryo is "determined" by its chromosomal constitution is equivocal. If he means that the embryo's chromosomal constitution establishes its terminus ad quem, namely, a human being rather than a cow, bird, or reptile, then all will agree. But if he wants to say that chromosomal constitution is determinative or constitutive of our essence--that our chromosomal constitution not only enables us to become human, but defines us as such--then he still has an argument to make, without, moreover, the resources of the Aristotelian tradition (for which it is form, not matter, that is determinative or constitutive of our humanity).

I also do not see how using the categories of potentiality and actuality can help. Certainly, an embryo is potentially a human being. But this fact does not mean that it is actually a human being. For Aristotle, form, not matter, not potentiality, makes the difference.

BERNARD G. PRUSAK
Boston, Mass.

Twinning

John Collins Harvey is to be commended for finally adverting to the elephant in the parlor: the position that complete hominization occurs at the moment of conception. He mentions that totipotent embryonic stem cells after four or five mitotic cell divisions (for example, sixteen to thirty-two cells, or, up to six days) from the original fertilized egg, if separated, have the ability to become "distinct" human beings. These identical twins or triplets develop from "the originally formed zygote." The original zygote is formed by "the process of syngamy," popularly called conception, which "is complete only twelve to eighteen hours after sexual intercourse."

Harvey, however, apparently fails to see the inconsistency of concluding that "from the stage that syngamy is completed in the egg, a distinctly unique living human being has come into existence." How then, can this "distinctly unique" human being "bud" into one or two additional distinctly unique human beings? Which one of the triplets is a "single substance" from the unicellular moment of conception? It appears that the twinning process involves a radical discontinuity from potentiality to actuality that has not yet occurred at an earlier stage of development.

Whatever the moral significance for experimentation on stem cells, the ontological difference between potentiality and actuality cannot be subsumed under the rubric of developmental continuity. It begs the question to conclude that a "human unicellular organism" is already a human nature with a "substrata" of rationality and therefore equivalently a human "person." What can be more significant than the ontological difference between a potential person and an actual person?

The argument of "simply an ordered serial development" ignores both the implications of monozygotic twinning and the ontological distinction between potentiality and actuality.

JOHN W. MCGEE
Houston, Tex.

The author replies:

Current embryology provides empirical data unavailable to Aquinas, who accepted Aristotle's embryology as scientific fact. The notion of "ensoulment," for Aristotle as well as Aquinas, is a strictly metaphysical category, and as such is inaccessible to scientific explanation. In particular, within Aquinas's theology, ensoulment is not a material principle. The soul is directly created by God and joined to matter to form a person. However, this is not the whole story!

Ensoulment instantiates an entirely new composite being. This is indeed a person "in potency" because it allows for the actualization of the potentialities present in the human being. This entity is also a new human individual who is, once again, present "in potency," for example in a situation of substantive perfection yet open to further development. The potential/actual distinction allows us to think a rather paradoxical situation: the human is perfect in itself (in its potency), and yet open to further development (what actually happens when we start acting in the world). In this way, we're not unlike the Kingdom--already but not yet. Like individuality, human rationality is "in potency," ready to evolve in the full Boethian definition of the person as rationalis naturae individua substantia. Now, however, it might be wiser and more in line with modern scientific facts to adopt the medievalist Richard of Saint Victor's definition of person as rationalis naturae individua existentia!

Monozygotic twining could be construed as a case of asexual reproduction (mitosis, when one cell divides into two), indeed a rare one that can result from an embryological developmental event at any stage from zygote to blastocyst. Asexual reproduction doesn't negate the individuality of the original cell from which the twinned cell arose.

JOHN COLLINS HARVEY, M.D.

Medical costs

Mary Alice and William Houghton ("Going Crazy," February 22) clearly explain the problems of managed medical care. What they documented is something that has touched me. What they said disturbs me in my role as patient.

However, there is one issue they fail to mention. Managed care was created because the cost of medical insurance provided as a benefit by employers was spiraling out of control. Managed care provided a middle ground between the situation as it was and termination of medical insurance as a benefit. It brought the costs to a level that the employers thought they could afford and were willing to pay.

As was pointed out, the ranks of the uninsured continue to grow. If we use Medicare as a case in point of single-payer systems, we find that costs are controlled by not fully reimbursing the providers for the costs of care provided. When reimbursements fall too far behind, political pressure grows to increase them.

In countries like Canada and the United Kingdom, costs are controlled by a strict gatekeeper. For example, at one time there were as many MRIs in Canada as there were in the average American metropolitan area (the size of Pittsburgh).

There is no simple solution to the problem of the cost of medical care. Therapies of today are considerably more expensive than they were fifty or a hundred years ago. Therapies of today address illnesses that were not treated or not even recognized fifty or a hundred years ago. The system as it exists now is imperfect. It is not obvious how to change it in a way that all parties involved, all stakeholders, will agree to.

RICHARD KUEBBING
Kennesaw, Ga.

Mark & Joan

Regarding Richard Alleva's commentary on Ken Burns's Mark Twain ("Missing the Dark Side," February 22), I was disappointed that Burns did not include Twain's quote, "I like Joan of Arc best of all my books; and it is the best." It is even more remarkable that Alleva did not mention this extremely religious book when writing for Commonweal.

Many of Twain's problems with organized religion are either clarified or confounded by sections of this book. If you have not read it, you should.

THOMAS BABCOCK
Three Lakes, Wis.

Cahill got it right

I was disappointed in Christopher Ruddy's review ("Good Pope, Bad Pope," March 8) of Thomas Cahill's Pope John XXIII, perhaps because I loved the book so much and hated being told I apparently "like [my] biography Manichean-style." I had just read the book out loud with a priest classmate as we drove together from Kansas City to Phoenix (he was driving). We relished the book and almost regretted arriving at our destination.

Perhaps too my disappointment lies in the recent death of Father Godfrey Diekmann, O.S.B., one of the giants of Vatican II and a theology teacher at Saint John's University, Collegeville, where Christopher Ruddy teaches theology. Father Godfrey was always underlining the grace of God's spirit in Pope John and in his convening Vatican II. As the Minneapolis Star Tribune quoted him, "I [once] said there was nothing like the council in a thousand years. I was wrong. There was nothing like it in two thousand years. It was a miracle."

The same newspaper reporter, Nolan Zavoral, covering Father Godfrey's funeral, quoted him on Pope John Paul II in another interview: "I think Pope John Paul is a holy man, I do. I just don't understand his thinking sometimes." And indeed that does seem to be the problem in the church today--the impression that one pope became an instrument of enormous reform that another pope appears to be attempting to rein in. I believe Thomas Cahill has done us a great service in reminding us of the importance of Pope John XXIII's pontificate, especially as we approach another conclave.

(REV.) EDWARD FLAHAVAN
Saint Paul, Minn.