Abstract:  In end-of-life clinical settings, the proper understanding of the concept of death is critical for the physician as well as for the patient and his family.  The various anthropological interpretations of death, in such situations, often seem to be irreconcilable especially between Christians and non-Christians. Karl Rahner’s transcendental anthropology provides a methodical basis for Christians to engage in and sustain a meaningful dialogue with non-Christians about the meaning and reality of death. The goal of this paper is to define pillars for such a dialogue by using Rahner’s transcendental anthropology. It draws conclusions essential for an informed and dialogical Christian stance as well as it articulates normative implications pertaining to withholding and withdrawing life sustaining treatment.

Keywords: death, end-of-life issues, Karl Rahner, transcendental anthropology   

“The death of man consists in the immediate confrontation of man, together with the whole of his history as a free person now consummated and complete, wih
the absolute mystery, with God.” ~ Karl Rahner
 

Introduction  

            A famous ethicist once claimed that in Europe death is a natural part of the life cycle, while in America death is still optional.  Ironical as this claim is, it brings to our attention the American view of death as something denied, controllable, deferrable, and even widely unaccepted.  There are several factors contributing to this “conspiracy” phenomenon that denies the reality of death.[1]  The most agreeable explanations, I think, are to be found in the capitalist and consumerist systems, and the optimistic faith in advanced medical technology.  Another factor of such denial lies in American materialism.  This implies an attitude towards the material order that is conceived as something to be used, dominated, and shaped by human will.[2]  Consequently the reality of death indicates material annihilation and termination of one’s existence, thus to accept such a finality seems to be paradoxical. 

In end-of-life clinical settings, the proper understanding of the concept of death is critical for the physician as well as for the patient and his family.  The plurality of decision-making processes under these circumstances is the indicator of different anthropological interpretations of death, that often seem to be irreconcilable, especially between Christians and non-Christians.

Karl Rahner, a well-known German theologian, considered the subject of death and afterlife being insufficiently articulated by the Catholic Church’s teachings.[3]  Therefore, he developed a new philosophical understanding of the relationship between human beings and the world.  He suggested that this strong relationship is maintained even after human death occurs.[4]  Thus, his transcendental anthropology provides a methodical basis for Christians to engage in dialogue with non-Christians about the meaning and reality of death. 

The goal of this paper is to define pillars for such a dialogue by using Rahner’s transcendental anthropology.  The first part of the paper delineates Rahner’s theory of human nature and freedom in light of the concept of death, the second section introduces contemporary views of the phenomenon of death, while the third part presents Rahner’s interpretation of death.  The fourth part will draw conclusions essential for an informed and dialogical Christian stance, and the last part articulates normative implications of such interpretation pertaining to withholding and withdrawing life sustaining treatment.   

I. Human nature and freedom

Rahner’s theory of death is derivative from his theory of human nature and freedom.  Primarily, according to Rahner, a human being is one spirit and matter.  A human being is made out of and knows himself through matter, thus, he is intimately linked with the world.  He is anchored in matter by its very nature existing in space and time.  However, a human being is also spirit.  His physical body is the concrete expression of its spirit entering into relationship with the material order.[5]  Furthermore, human beings’ existence takes place within a form of relatedness.  All forms of operations mirror this characteristic and reveal an essential immediacy: we always are in the world with the inseparability of the subject and object.  Thomas Sheehan explains Rahner’s transcendental anthropology in the following way: 

Human being is an otheredness that is always self-related, and a self-relatedness that cannot exist without being othered.  Since relation-to-another is the only way humans can relate to themselves, we may define human being as self-related otheredness. […] Otheredness means that human beings need to be affected by others – but are limited to being affected only by this-worldly corporeal others.  In Rahner’s phrase, human being is a “Geist in Welt,” a this-worldly spirit that cannot see beyond, or exist without – much less ever leave – this material world.[6]

Human beings experience the world and themselves through matter.[7]  One cannot understand himself without understanding the other and the world around him.  Cognition of the other enables one to know himself.  There is a strong relationality factor embedded in our human essence: relationality towards the world’s inanimate objects, relationality towards the others, and a desire to know otherworldly entities.  Given that we are spirit and not only matter, it is constituent of a human being to reach out towards incomprehensible mystery, the infinite.  Therefore, the realization of one’s finality occurs through one’s longing for the infinite.  One carries the willingness to reach out toward ‘otherness.’  Rahner calls this drive the vorgriff.  It is a longing for the absolute future, a reaching out to eternal life.[8]

Our natural longing for infiniteness also entails our fulfillment in freedom. 

Freedom is not understood solely in terms of having a choice and being able to deliberate on the basis of human reason.  Rahner understands human freedom as realization of oneself, a total and finalizing self-mastery in the reality of death.  Freedom is “the capacity to make oneself once and for all, the capacity which of its nature is directed towards the freely willed finality of the subject as such.”[9]  In death, freedom is a “once and for all” self-realization.  It is the manifestation of the person in front of God in his totality of life with the “freely governed core of the person, the ‘heart’”[10] waiting for judgment.  However, this “judgment” is present within the totality of one’s life exactly because freedom is a “permanent constitutive of man’s nature.”  Thus, his final salvation or damnation is embedded already in his life narrative.  Rahner explains: “Freedom is first of all ‘freedom of being.’  It is not merely the quality of an act and capacity exercised at some time, but a transcendental mark of human existence itself.”[11]  The “freedom of being” necessitates the freedom of self-understanding and self-exercise.  This self-realization by choice is imposed inevitably on man, continues Rahner.  It is a task that he cannot avoid.  It is always a self-realization towards or in the direction of God: 

The concrete freedom of man by which he decides about himself as a whole by affecting his own finality before God, is the unity in difference of the formal ‘option fondamentale’ and the free individual acts of man no longer attainable by reflection, a unity which is the concrete being of the subject of freedom having-achieved-itself.[12] 

Conclusively, freedom is free self-realization into finality entailing the human capacity for the eternal.  Rahner’s transcendental anthropology embraces a profoundly relational reality, one that perceives the phenomenon of death as the realization of one’s finality through the belonging to the infinite.  Such understanding of human nature and freedom is absent from contemporary ontological perspectives.  

II. The phenomenon of death from a contemporary perspective 

            A currently prevailing concept of death has its roots in Platonic and ultimately Cartesian dualistic view of human nature.  According to this view the body and the soul are two separate entities.  The soul is immortal and part of the transcendental or otherworldly realm, while the body is mortal, part of the physical realm.  Upon death the separation of the soul from the body occurs and the soul is “freed” into her immortal existence.  Hence we have the expression of the “immortality of the soul” in theology.  This dualistic anthropology inevitably conceives the return of the body to the material and physical order waiting for its reunion to the soul and for the final day resurrection.  This view places the essence of a human being in the entity of the soul.

            An opposite view of death was formed by existentialist philosophers, such as Sartre, Simone de Beauvior, and Albert Camus - to mention the most influential ones.  Their philosophy integrates a rebellion against death, an angry response and even a resistance against it.[13]  Simone de Beauvior considers death as an unnatural reality.  Although it is accepted as a universal phenomenon, she claims that death is an accident and an “unjustifiable violation.”[14]  According to this view, death means the cessation of the material and the spiritual aspect of a person rendering such phenomenon pointless and empty.           

            Although such existentialist understanding of death is part of the continental philosophical tradition, it can also be found in the American life-view. Death often becomes either commoditized and idealized in the United States, or denied to be a natural phenomenon of life.  Not only the reality of death is denied but the process of aging is transformed into an enemy to be fought.  This mentality is exemplified by the very existence of two campaigns dividing people into pro-agers and anti-agers.  Anti-aging campaigns often cross the line between therapy and enhancement by promoting various means to avoid the “maladies” of aging, to the extent of denying the process of aging.  Under the pretense of accepting the process of aging, pro-agers endorse their products very skillfully by urging consumers to find “real beauty” in the natural process of aging.[15]

In a capitalist and consumerist society everything can be sold so long as there are consumers for the product and the conditions are created to render a product indispensable.  A medicine declaring war on aging successfully turns death into an option, something to be controlled and manipulated, as long as a materialist view of life and fear of annihilation supersedes the reality of life.  Therefore, a different understanding of aging and death must be articulated, one that views death as part of the natural life cycle.   

III. Rahner’s view on death

According to Rahner, when understanding the concept of death, two dimensions, the material and spiritual, have to be counted for.  If the spiritual aspect is suppressed, it results in a naturalist anomaly reducing man to a mere animal; if the biological aspect is eliminated that results in a denial of death.[16]  Furthermore, Rahner delineates two other aspects of death.  On the one hand, death is passive because it is something that necessarily happens to us, it is a natural part of our lives, and it is a universal phenomenon.  Death, understood in these terms, causes anguish and despair.  It appears to be meaningless in which we experience powerlessness and a loss of control.  On the other hand, death has an active or personal aspect.  According to Rahner, death is not only a passive reality that happens to humans but also a personal act.  Death cannot be interpreted as the end of our physical life since that would entail first, that the body and the soul can be ontologically separated, and second, that we need not take death seriously.  Death affects our life by being present through one’s life narrative.  The meaning of narrative and personal integrity offers an insight into this two-fold reading of death.

Integrity has two denotations.  It is understood as a narrative totality, wholeness, completeness, and also denotes a personal sphere of self-determination.  One’s integrity is the “created and narrated coherence of life” and a “wholeness and completeness of a life story.”  Personal identity is the coherence of the life of a human being.  Such a life story is created by someone’s important life events, imbedded and cherished by memory. This also includes the interpretations of these events by the individual that ultimately forms the conviction of each for delineating what is valuable in life and demarcating future plans and goals in one’s life.[17]  From this point of view death is the narrative’s “final chapter.”  It is the end of one’s journey.  Life thus becomes historical, a process between a real beginning and a real end.[18]  The final chapter of a narrative cannot be surprisingly or abruptly different from the rest of one’s life narrative but it should be consistent with it, in a way anticipated yet mysterious.  On the same premises, someone’s death is not a sudden ending of one’s life narrative but a consummation of it.  It is not a single, isolated existential act by which everything else is judged but “an act which sums up all the others, the resume of a life-time,” and the “authentic expression” of oneself.[19]  In death, then, the fundamental moral option, which is ultimately for or against God, has matured over a lifetime and becomes definitive.[20]  Robert J. Ochs explains such a final choice the following way: “Our final act of integrity is precisely an act of integration, by which we finally manage to give a consistent meaning to our lives, so that it all makes sense and makes one sense.  Each free act involves an interpretation of oneself and one’s life, and death is the final interpretation we give our whole life.”[21]  In death, constitutively there is an act of freedom.  This free act is “ a liberty which says ‘yes’ not only to death itself, but also to its meaning, to the meaning of human existence.”[22]  Thus the final existential option entails, either a rejection of death by fleeing away from it, mostly denying and hence falling into an “inauthentic existence,” or a courageous acceptance of it as “one’s own unique possibility, as the light that illuminates everything of one’s existence, as one’s own “project.””[23]

The end of man as a spiritual person is an active immanent consummation, an act of self-completion, a life-synthesizing self-affirmation, an achievement of the person’s total self-possession, a criterion of himself, the fulfillment of his personal reality. At the same time, the death of man as a biological being is a destruction, an accident, which striked man from without, unforeseeably, with no assurance that it will srike him at the moment in which he has prepared himself for it interiorly.[24]

Death as a personal act is connected to freedom, time, and eternity.  In death ‘freedom-in-time’ becomes “definitive and final.”[25]  Death does not affect only the body or the soul but the whole human being defined by an intrinsic ontological unity of the body and soul.  Death affects human beings both on the material and biological level as well as on the level of “self-awareness, personhood, freedom, responsibility, love, and faithfulness.”[26]  On the same premises, eternity is best understood not as a continuation of time until eternity but as time “fulfilled and final.”[27]      

The central question of our subsequent inquiry is what happens to the ontological unity of spirit and matter once death occurs.  Rahner’s innovative response is the all-cosmic dimension of the soul.  The soul after the event of death ends its relationship to the individual’s physical body and continues a relationship with the universe within a unity to all things.  The “human spiritual soul” will maintain its relationship with the world, and after death it becomes not “a-cosmic” but “all-cosmic.”[28]  Thus, the soul is not removed from the world but becomes open and expressed in it.[29]

The spiritual soul, … , through her essential relationship to the body, is basically open to the world in such a manner that she is never a monad without windows, but always in communication with the whole of the world.[30]       

Even if we are able to articulate our “human” understanding of death from a Christian perspective, it can only be fully comprehended in light of Christology.  Death, for a believer in God, can only be interpreted in light of Christ’s death.  In Rahner’s theology, it is well-known that eschatology is always strongly connected to Christology.  Christ, in his death, experienced the existential aloneness, the powerlessness, and the emptiness of physical death.  This negative experience is articulated in his words: “My God, my God, why have you forsaken me?”  Christ’s death is the ‘final chapter’ of his life narrative.  In his death, Christ summed up the totality of his life and his freedom, and said ‘yes’ to God.  From his part, it was an act of freedom by which he accepted the mystery of God: “Father in your hands I commend my spirit.”  The full meaning of the Christian’s death as dying with Christ is expressed by Rahner in the following way:

Through the fact of Christ’s death, the justifying grace of God illustrates and confirms something which heretofore was not shown but was hidden from us, namely, that at the very moment in which sin reaches the fullest measure of its power, the grace of God increases in its power to conquer sin.  And through the death of Christ, when he surrendered himself to this innermost part of the world (hell), this grace became ours.  What he really accomplished in his death, and what his death really is, may be stated thus: his death, as an act of grace, helped to offer God the “flesh of sin” - which death really is – transforming it into a flesh of grace; so that we now can, through his grace, belong to God and to Christ in death, despite the fact that death, in itself, means remoteness from God.[31]

Human beings also undergo the same “dialectical experience of remoteness from and nearness to God, of doubt and faith, despair and hope, rebellion and love.”[32]  Death is not a single event at the end of life, but a final expression of all that is valuable in the wholeness and completeness of a life-time.  “Death is the assent in freedom to the mystery of God.”[33]  Thus the narrative of one’s lifetime becomes fulfilled in the narrative of Christ by one’s affirmative and free surrender to the love of God within the hope for eternal life.  As Rahner concludes, “death is not only a manifestation of sin, but also a revelation of our participation in the death of Christ, culminating in the appropriation of his redemptive death by mortal man.”[34]            

IV. A meaningful dialogue

            Based on the preceding analyses, the phenomenon of death can be interpreted as follows: (a) it is seen as absurd and meaningless, a sudden ending of physical life with no theological implications, an expression of despair and indifference; (b) it can be a denied reality; (c) or it can obtain an idealized perspective, viewed as a continuation of life into eternity, although riding on “new horses.”[35]  The Rahnerian interpretation conveys death as an act of freedom, continuously present through a lifetime, a fulfillment of one’s personal narrative, and an active affirmation of one’s faith.  If we want to meaningfully articulate the reality of death and thus engage in dialogue with non-Christians, then we need to delineate key discussion points.  Based on Rahner’s transcendental anthropology, these “meeting points” can be outlined as follows:

1.      Ontological premises: A human being is the unity of matter and spirit. He is defined by a strong relationality factor towards himself, the other, the world, and the universe.  From this is derivative the all-cosmic relationship of the soul to the world.  There is a fundamental ontological unity in which all things relate and communicate. 

2.      The metaphysical premise: Human beings, given their situatedness and historicity in the world, realize their finiteness yet constantly longing for the infinite, the transcendent.  

3.      The concept of life viewed through the prism of death: It is in man’s nature to long for finality or “consummation;” this is the tendency of the will.  Man naturally longs for fulfillment and completion and not for materialistic eternity.  Life is but a continuation between a beginning and an end, while eternity is the “plenitude of reality, a unity, and wholeness.”  Life is and should be interpreted as a process of dying.  Dying takes place through one’s life, while the phenomenon of death is only the completion of this process. 

4.      The consummation of one’s personal history: death is the “final chapter” of our life that we have to choose to write yet accept our human powerlessness when faced with it.

5.      The universality of death and its mystery: Death is a truth that we must accept and choose as an act of freedom.  Its inevitability is given not only by our biological nature but from the unity of our human nature as a whole, i.e., matter and spirit.  However, death has a hidden ontological character.  Darkness is the natural essence of death that results from this “dialectical union of spirit and matter.”  The unity of such opposites in human nature is the basis of the fact that the death of man “can be either salvation or damnation, punishment for sin or an act of faith.”      

6.      Freedom:  Human freedom is realization of oneself, a total and finalizing self-mastery in the reality of death.  In death, the soul ultimately accomplishes “the consummation of her own personal self-affirmation.”         

Normative implications of the Rahnerian view of death 

            Rahner argues that human death cannot be separated from human life.  Furthermore, it is very difficult to determine where is the borderline between human life and non-human life, human and non-human death.[36]  In other words, a biologist or a doctor might determine that life is still present at an organic or biological level, although, “human life” (affecting the whole person) is not existent any more.  This has normative implications on the physician since “questions do arise as to the circumstance in which, and the degree of intensity with which the doctor must still continue to strive to prolong [a life],…, alternatively at what point he can relinquish this struggle while still doing everything possible for the individual concerned in the way of ordinary care.”[37] 

Rahner’s transcendental anthropology offers an insightful perspective on the moral issue of withdrawing or withholding treatment.  Physicians are often faced with the ethical intricacy of end-of-life issues.  On the one hand, their vocation demands to care for their patients, whose life is entrusted to them, yet facing the reality of death; on the other hand, they need to respect the patients’ autonomy.  The physician as well as the competent patient (or in the case of incompetent patient, the family), whose life narrative is turning towards the final chapter, is deeply affected in such quandaries.  I would suggest that a philosophical resolution is possible based on the “free voluntary character of death” put forth by Rahner:

Death is an act. Certainly it is the extreme endurance, the event in which the forces of darkness and of rupture dominate man and leave him with no chance of escape, taking him from himself to the ultimate extremity of existence. Still, at the same time death is also not only an act, but “the act,” the act of freedom.[38]     

            The patient is a human being whose life is not only biological but human, a life that constitutes “a personal history which its own intrinsic nature” that “seeks its own consummation.”[39]  Given the intrinsic nature of this finality, a person’s life is not meant to be prolonged indefinitely but it has a “definite shape such that of itself it demands to be rounded off and to achieve a consummation which goes far beyond any mere state of further prolongation.”[40]  Based on such anthropological premises, the issue of withdrawing and withholding treatment receives a different dimension for the physician as well as for the patient and his family, a dimension that often seems to be forgotten when considering end of life issues. 

The materialist view of life and fear of annihilation undermines our relationality.  Such univocal view of reality denies our freedom, our “option fondamentale,” depriving a person from the opportunity to “having-achieved-itself” and to realize his finality that comes through his belonging to the infiniteness.  I would like to conclude the present philosophical elucidation with Rahner’s insightful words that speak for themselves:

When a doctor has done all that is in his power and still a dying man has finally died, then precisely as a man the doctor is not simply one who has suffered a catastrophic and meaningless defeat, but rather one who can willingly suffer the sick person to die, one therefore who has not failed to fulfill his task but on the contrary has effectively completed it. For in fact he has provided his fellow man with the span of life in the biological sense within which his specifically human life considered as the history of a free person has in fact been able to achieve its consummation. He has provided him with a span of biological life in this sense which was never for one moment intended to, or sought to be extended into the unforeseeable future.[41]        


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