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St Thomas Aquinas on Disability and Profound Cogntive Imapirment (Abstract) This
dissertation raises a question regarding the relationship between the condition of
the body, moral virtue, and human flourishing. Our main objective is to reconstruct
Aquinas’s theological understanding of corporeal infirmity in order to depict, in
broad outline, a Thomistic theology of disability and cognitive impairment. A prominent
concern in this investigation is to understand, according to Aquinas, the significance
of the body in the perfection of human activity towards the realization of our natural
and supernatural end, as well as the implications of Aquinas’s view with respect to
persons who have a profound and utterly debilitating cognitive impairment. Remarks
on disability and impairment are found throughout Aquinas’s Summa Theologica and his
treatise De Malo. Although Aquinas did not compose an ex professo theological tract
on ‘disability,’ the integral and systematic character of what he says about these
matters implicates the whole of his thought and, in particular, his moral theology.
In his Summa, Aquinas brings together careful scriptural exegesis, patristic and medieval
sources, as well as the best philosophy of his day. The result, with respect to our
theological understanding of corporeal infirmity, is an innovative and far-reaching
depiction of a properly Christian understanding of these matters. In the experience
of corporeal infirmity, we are confronted with a question that pertains directly to
the proper object of moral theology. [1] Regrettably, there remains a notable lacuna
in contemporary Aquinas studies and Thomistic moral theology on the topics of disability
and cognitive impairment. In particular, the vulnerability of human beings to the
evil (malum poenae) of corporeal infirmity and the moral significance of profound
affliction has received very little attention. We intend that the interpretive work
of this investigation in the theology and philosophy of Aquinas will help address
that lacuna. We can describe the relevance of this project to the work of Thomistic
moral theology in stronger terms. Aristotle’s great insight was to understand that
any description of the good life and the happy life of the human being cannot be separated
from an account of how that life is possible for the kind of beings that we are, i.e.,
the biological constitution of the rational animal. Aquinas appropriated that Aristotelian
thesis and revised it in the light of the Christian doctrine of creation. So conceived,
integral to moral reasoning in the Thomistic theological tradition is the ability
to account for how faithful discipleship, Christoformic virtue, and cruciform love
are possible for the kind of beings that we are, i.e., our creaturely constitution:
mortal rational animals made in the image of God. Moreover—and here are the stronger
terms mentioned above—no moral theology can pretend to any measure of seriousness
if it does not account for how discipleship, Christoformic virtue, and cruciform love
is possible for the created rational animal while contingently and unequally bearing
the corporeal wounds of original sin. Specifically, grace restores and heals what
was lost at the fall (original justice), but baptism does not immediately heal the
wounds of original sin in our bodies (our trust in Christ entails the hope of bodily
resurrection). Yet, Christ calls us to discipleship, virtue, and love as we await
the restoration and healing of our wounded bodies in the consummation of glory. On
this understanding of the human predicament, our present concern is to provide a theological
account of what it means for the created rational animal to flourish with respect
to its natural and supernatural ends, even as it continues to bear the corporeal wounds
of original sin. The four chapters of this dissertation are divided into two
parts. Part 1 (chapters 2 and 3) is concerned with Aquinas’s understanding of the
first perfection or creaturely integrity of the human being. The objective is to depict
Aquinas’s account of the human being by showing how he made use of Aristotle and Augustine.
Towards that end, chapter 2 focuses on Aristotle’s metaphysical biology and his account
of human defect; Aquinas’s Augustinian doctrine of creation; and Aquinas’s appropriation
and subversion of Aristotle’s account of ‘defective human beings.’ Of particular importance
in chapter 2 is Aquinas’s engagement with the forms of irrational human behavior described
in Aristotle’s Nicomachean Ethics and Aristotle’s theory of natural slavery outlined
in Book 1 of the Politics (i.e., despotic rule over an essentially defective human
being who is incapable of discursive reasoning). Special attention is given to
the precise metaphysical defect of the ‘slave by nature,’ as distinct from other forms
of human defect on Aristotle’s terms. We show how Aquinas subverts Aristotle’s notion
of natural slavery (by rejecting the possibility of essential defect), while revising
Aristotle’s phenomenological description of the natural slave’s dispositional dependency
under the moral logic of merciful care for vulnerable and dependent persons. Specifically,
Aquinas stipulates the moral imperative to counsel and protect human beings who variously
and unequally ‘lack the use of reason’ due to an extraordinary injury of the cognitive
faculties. In chapter 3 we focus on Augustine’s account of the image of God and
the mind (mens); Aquinas’s appropriation and development of Augustine on the activity
of the imago trinitatis; Aquinas’s understanding of the rational soul as the substantial
form of the body; and the incorruptible aptitude of the rational soul to image God
by knowledge and by love. Part 2 (chapters 4 and 5) treats Aquinas’s understanding
of the second perfection or orderly operation of the human being, and the effects
of original sin upon that activity. The objective is to depict Aquinas’s account of
the purpose and perfection of the human being and to do so by showing how he went
beyond Aristotle and Augustine. Chapter 4 describes Aquinas’s understanding of the
operational limitations unequally experienced by particular human beings as a consequence
of original sin. We address, according to Aquinas, how the second perfection of the
human being in operation came to be wounded, and we formulate a metaphysical account
of evil suffered (or affliction). From that basis, a typological sketch of corporeal
infirmity and cognitive impairment on Aquinas’s terms is provided. The purpose of
this systematic overview is to reconstruct Aquinas’s theology of disability and cognitive
impairment, to show its internal coherence, and to indicate points of significance
from the aspect of our creaturely dignity and creaturely destiny. Chapter 5 describes
how those who ‘lack the use of reason’ participate in the sacramental life of the
Church (principally through Baptism and Eucharist). In particular, we treat Aquinas’s
understanding of the condition amentia (‘mindlessness’), where a person ‘lacks the
use of reason’ due to a profound and utterly debilitating impairment of particular
corporeal and cognitive faculties. We provide an account, on Aquinas’s terms, of the
moral implications of a profound cognitive impairment on the order of amentia. Our
interest is the way Christians afflicted with amentia can, on Aquinas’s view, participate
in the life of the Church and live the virtues. Specifically, just as the acquired
virtues dispose and enable a person to act in accordance with the light of natural
reason, which is proportionate to human nature; in the light of grace and consequent
of baptism, the infused virtues dispose and enable a person to act in a ‘higher manner’
and toward ‘higher ends,’ in relation to a ‘higher nature’—which is our progress toward
the perfect participation of the blessed in the divine nature. On Aquinas’s terms,
the consummation of grace and infusion of supernatural virtue at baptism can be understood
to capacitate someone who completely ‘lacks the use of reason’ with supernatural knowledge
and a supernatural principle of self-movement. So capacitated, there is no reason
to deny that a person afflicted with an amentia-like condition could be graced to
realize a meritorious magnanimity in knowledge and love of God. Likewise, on
Aquinas’s terms, there is good reason to believe that in baptism persons with profound
and utterly debilitating cognitive impairments are capacitated for Christian friendship—even
as they remain incapable of performing the acts ordinarily associated with Christian
friendship. That is to say, although profoundly impaired, through baptism a person
with an amentia-like condition is capable of the kind of friendship that is only possible
for creatures endowed with an immortal and incorruptible rational soul. It is a friendship
based on the fellowship of our deepest happiness, which is the consummation of grace;
where our creaturely likeness to God according to image (by knowledge and by love)
precedes and causes a supernatural likeness that we share as members of the Body of
Christ. Beginning with a thorough description of the human being and corporeal
infirmity, on Aquinas’s terms, and in light of his main influences, it is possible
to reconstruct his account of cognitive impairment as such, its moral implications,
and the moral significance of profound bodily affliction in the Christian understanding
of the good life. The goal is to bring to light the doctrinal and moral integrity
of what Aquinas says about physical disability and cognitive impairment—he says quite
a lot—and, subsequently, to make reasonable inferences on those matters where he is
silent. Fate is not destiny. Saint Thomas Aquinas helps us recognize our fate—we
who are or who will soon become weak, disabled, and cognitively impaired—in the light
and the hope of the Divine consummation of nature, grace, and glory. He helps us not
only to see but also to recognize that the existence of the mortal rational animal,
the image of God, is beautiful. It is the beauty that belongs to the One called Beautiful,
the exemplar after whom our likeness is for now but an imperfect shadow. Our infirmities,
the evil we suffer, and the afflictions of our mortal wretchedness is our fate; but
our fate will be redeemed and made perfect in the light of His glory, through the
Beauty of the Cross. [1] For Aquinas, the question of happiness is the principle concern
of all morality. To be happy is to live a good life, which is the life of moral virtue.
Affirming that basic judgment, Servais Pinckaers, O.P., remarks that “if the idea
of happiness is the initial consideration in moral theology, the place of suffering
will be obvious, for it is precisely the reverse of happiness. Suffering will then
be an element of moral theology from the very start…[the] banishment of the consideration
of suffering from ethics is an outgrowth of a rationalistic conception of the human
person.” Servais Pinckaers, The Sources of Christian Ethics (Washington, D.C.: Catholic
University of America Press, 1995), 25.
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