Uncommon Clarity

Daniel Callahan never stopped asking hard questions. The week before he died, on July 16, two days before his eighty-ninth birthday, Dan was still writing—despite the burdens of the pulmonary disease that had plagued his life for some years and would finally end it. He had just sent off another piece to someone, Sidney Callahan told me. She spoke in the what-would-you-expect tone of someone who had witnessed Dan’s prodigious productivity over sixty-five years of marriage. 

Dan was one of the most influential editors in the history of Commonweal and the preeminent creator of the field of bioethics. He was a good friend, as is Sidney, herself a Commonweal contributor and until a few years ago a member of its board of directors. Dan was also a mentor, a model, a colleague, a boss, and an inspiration. Not long after inviting me, age twenty-two, to write an essay for a book he was editing, he recruited me to join the Commonweal staff and eventually to join him at the Hastings Center, the struggling venture he had co-founded and that would become a major fountainhead for the international interdisciplinary field of bioethics. I was a modest witness to what I consider two interrelated phases of Dan’s life work.

It is a shock to me now to realize how brief was the first, the Commonweal Catholic phase. Dan began writing for the magazine in 1958. He was a graduate student in philosophy at Harvard, a Catholic finding his footing in a very secular setting. He actually worked at the magazine only from 1961 to 1968.

“Only” is a relative term. Those were the years of civil rights struggles, the Second Vatican Council, the war in Vietnam, campus turmoil, resurgent feminism, sexual revolution, urban riots, Humanae vitae, and assassinations from JFK to RFK by way of Martin Luther King, Jr. Dan wrote his way into and through all of that. The titles of five books he published in seven years capture the era: The Mind of the Catholic Layman (1963), Honesty in the Church (1965), The New Church: Essays in Catholic Reform (1966), The Secular City Debate (1966), and The Catholic Case for Contraception (1969).

Meanwhile, Dan and Sidney were raising six children, and she had written The Illusion of Eve: Modern Woman’s Quest for Identity (1965) and Beyond Birth Control: The Catholic Experience of Sex (1968).

Abortion: Law, Choice, and Morality (1970), the more than five-hundred-page product of two years of research, was the hinge on which Dan’s life swung to a half-century of work in medical and scientific ethics. The book took Dan to ten nations in Europe, Asia, and Latin America. If he had insisted on asking hard questions in his Commonweal years, about the role of the laity, contraception, honesty in the church, and the truthfulness of Catholic claims, he did no less in bioethics: about abortion, euthanasia, genetic engineering, embryonic stem-cell research, allocation of scarce medical resources, defining death, care of the dying, the promise and perils of technology, the dynamics of research, medical funding, and the cost of medical care.

Time and again, Dan provoked controversy, sometimes heated controversy, by defying the reigning assumptions of many colleagues in the worlds of medicine and biomedical research. He questioned their faith in unlimited progress, the priority of individual autonomy and the invocation of personal choice in resolving biomedical quandaries, and the reflexive elevation of health, and especially of extending life, over competing dimensions of human well-being. For two decades, books with titles and subtitles containing phrases like “setting limits” and “false hopes” and “what price better health?” and “how medical costs are destroying our health care system” spun out Dan’s questions like a string of firecrackers. He warned against technological and research “imperatives”—if we can do it or discover it, we should. He dismayed feminists by combining a pro-choice argument regarding the law with a stringent view of what, in fact, might justify abortions morally. He created a stir by advising President George W. Bush to maintain restrictions on the use of embryos for stem-cell research.  

These caveats weren’t coming from just anyone. Dan was, after all, one of the rare philosophers elected to the National Academy of Medicine, and a recipient of the Freedom and Scientific Responsibility Award of the American Association for the Advancement of Science.

Dan also challenged dominant styles in ethical reasoning and moral philosophy. He had gone to Yale in 1948 as a competitive swimmer and graduated in 1952 as an aspiring philosopher. But he found little satisfaction in the analytic philosophy he went on to encounter at Harvard. The questions that he wanted to address were practical, and the method had to be empirical and cultural. (Three-fifths of his book on abortion are devoted to empirical findings and cultural contexts.) There is no “Callahanian” system. He never opted for one or other of the contending schools of ethical theory, arguing that they were different tools appropriate to different contexts, whether physician-patient relations or national health policy. 

Dan’s style in moral reasoning was inseparable from his style in writing. Dan wrote constantly and easily—and gave good advice to many of us who didn’t. He eschewed technical argumentation (as he would have the word “eschewed”). Surgeon and bioethicist Sherwin Nuland went so far as to compare Dan’s essays to Montaigne’s attempts to philosophize on the basis of “a scrupulous observation of his fellow man and the world in which he lives.” Nuland, a master of such writing himself, called Dan a writer and thinker “of uncommon perception, logic, and clarity.” Clarity and accessibility are hallmarks of Dan’s prose, and there was a moral basis for them: he did not think that the ethical reasoning surrounding life-and-death issues should be the bailiwick of academic experts, but of the general concerned public. His writing was often marked by a wry, frequently self-deprecating, sometime mischievous, occasionally sardonic wit; and that too had a moral source, a conviction that ethical reasoning is an ongoing dialogue in which participants should acknowledge their prejudices and weaknesses and admit that their conclusions were provisional. 

Despite the relative brevity of Dan’s Commonweal experience, he often credited it as formative of his approach to bioethics, framing issues in broad cultural and factual terms for a general educated readership. About his loss of faith and departure from the church (and Commonweal) by 1968, he was both candid and low-key. He knew how much it surprised and disappointed some friends and particularly pained Sidney, a convert and serious believer and religious thinker. No, he wasn’t “angry” or oppressed. No, he didn’t “split” from the church over abortion, as more than one stereotypical account put it. What he described was a gradual seeping away of belief in Catholic truth claims, indeed in Christianity and God. In retrospect, I think there is more that could be teased out about the roots of this loss, to the benefit of those of us who care about it. The fact is that Dan’s taking leave of religious faith was never anything like his impatience with dogmatic secularism and its unwillingness to take religion seriously.   

Theologians like Paul Ramsey, William F. May, and Richard McCormick loomed large in the first years of bioethics. So did conceptual frameworks honed over centuries in moral theology. Dan prized these thinkers and their contributions as entry points to deeper issues; he was disappointed when their role was eclipsed by the skills of lawyers and philosophers as bioethics risked becoming a kind of “service industry” to health care. Years later he made an effort to revivify the religious current in the field, but felt that it really didn’t succeed.

It is always surprising when people discover that Dan’s moral sensibility may reflect his earlier Catholicism—as though that weren’t obvious. His resistance to the myth of scientific progress, to liberal individualism, to the prioritizing of choice apart from what is chosen, to skepticism about markets; his matter-of-fact recognition of tragic limits and a self-deceiving humanity (himself included) and the potential for abuse of new biomedical powers; his egalitarian view of ethics as a matter not of professional expertise but public discussion; his constant push for examining deeper issues of the common good and how we, not just individually but as a culture and society, should live—is it really so hard to discern the roots of Dan’s sensibility? 

Not that proprietary claims matter; what matters is that such a moral sensibility be nurtured and propagated. In a fine, comprehensive tribute, Mildred Z. Solomon, current president of the Hastings Center, writes of Dan’s “fundamental wariness of human power.” Without such a moral sensibility, she warns, we may become “vulnerable and naked” members of a society of “self-interested stakeholders”; we may become “tone-deaf and mute on matters having to do with patience and acceptance, community and mutual care, ambiguity, humility, fairness, and stewardship.”

I have made much of titles in this reflection. In 2012, MIT Press published Dan’s autobiographical “life in bioethics.” The book’s title was an apt summary: In Search of the Good. The last chapter was “Reaching the Finish Line.”