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The Image of God, Bioethics, and Persons with Profound

Intellectual Disabilities D e v a n S t a h l

Michigan State University

J o h n F . K i l n e r Trinity International University

Abstract All people are created in the image of God, which gives every human being a dignity that can never be lost or diminished. This article develops a biblically sound understanding of what it means to be in God’s image. Next, it explores how important such an understanding is for people with disabilities. Finally, it traces out a number of implications of that understanding for people with profound intellectual disability.

Keywords: agency, destiny, dignity, image of God, intellectual disability, justice, relationality

Devan Stahl, Ph.D. (St. Louis University), M.Div. (Vanderbilt Divinity School) is Assistant Professor of Clinical Ethics at the Center for Ethics and Humanities in the Life Sciences, Michigan State University. She chairs the Bioethics and Christian Theology Affinity Group of the American Society for Bioethics and Humanities and has published on genetics and disability. [email protected]

John F. Kilner, Ph.D. and A.M. (Harvard University), M.Div. (Gordon-Conwell Theological Semi- nary) is the Forman Chair of Theology and Ethics, Professor of Bioethics & Contemporary Culture, and Director of Bioethics Programs at Trinity International University. His 20+ books include the recent award-winning Dignity and Destiny: Humanity in the Image of God (Eerdmans, 2015).

The Image of God, Bioethics, and Persons with Profound Intellectual Disabilities From The Journal of the Christian Institute on Disability (JCID) Vol. 6.1-6.2 – Spring/Summer & Fall/Winter 2017

The biblical affirmation that all people are created in God’s image has long been a liberating force in the world, as documented in Dignity and Destiny and Why People Matter (Kilner 2015, 2017).1 It has inspired people to respect and protect the dignity of every human being. The creation of humanity in God’s image, rightly understood, makes a huge difference for people with profound intellectual disabilities (PID)2 in particular. It endows them with a dignity that demands humanity’s attention and best efforts in support. It re- quires of others—who are also created in God’s image—that they reflect such divine attributes as love and justice in their individual and societal response to the needs of those with such disabilities. If this is the case regarding the most readily-disparaged people with profound disabilities, then people with disabilities of all sorts stand to benefit as well. The problem is that misun- derstandings related to the image of God have too frequently neutralized its liberating power and even fostered oppression. Identifying and guarding against such misunderstandings must first take place if humanity’s creation in God’s image is to foster humanity’s flourishing, to God’s glory.

The common, basic misconception here is that being in God’s image is about how people are (actually) “like God” and “unlike animals.” This view understands being in God’s image in terms of attributes that people have now, most commonly people’s ability to reason, rule over (manage) creation, be righteous, or be in relationship. In this view, sin can damage such attributes and thus damage God’s image. Accordingly, people vary in the extent to which they have these attributes—and are in God’s image. For many, that means how much people warrant respect and protection as those in God’s image varies from person to person. The door to devastation is open as soon as people begin to define being in God’s image in terms of currently having God’s attributes. People who are lowest on the reason, righteousness,

1. The present essay draws upon some of the material presented in Kilner 2017, which is a chap- ter-length summary of parts of the fuller account in Kilner 2015—the fuller account providing substantially more documentation and illustration than space here permits. Material from Kilner 2017 used by permission of Baker Academic, a division of Baker Publishing Group.

2. The Diagnostic and Statistical Manual on Mental Disorders (DSM-5) and the American Associa- tion on Intellectual and Developmental Disabilities (AAIDD) agree that “[i]ntellectual disability is a disability characterized by significant limitations both in intellectual functioning (reasoning, learning, problem solving) and in adaptive behavior, which covers a range of everyday social and practical skills” (AAIDD 2017). DSM-5 classifies the severity levels of intellectual disability, also known as intellectual developmental disorder, as mild, moderate, severe and profound, based on adaptive functioning conceptual, social and practical domains (APA 2013, 318.2 F73). Generally, persons with profound intellectual disabilities have an IQ score of 20 or below as well as poor adaptive functioning, such as extreme difficulty with language development, social skills and performing daily tasks.

The Image of God, Bioethics, and Persons with Profound Intellectual Disabilities From The Journal of the Christian Institute on Disability (JCID) Vol. 6.1-6.2 – Spring/Summer & Fall/Winter 2017

rulership, relationship, or similar scale are deemed least like God and least worthy of respect and protection. This way of thinking has put people with disabilities in great jeopardy, particularly people with PID.

The problem here is not that a biblical idea has proven to be destructive, but that an unbiblical idea masquerading as a biblical idea has proven to be destructive. This unbiblical idea is at odds with what the Bible’s authors mean by being created in God’s image and how they employ this concept in life situations. Accordingly, this article will first develop a biblically sound understanding of what it means to be in God’s image. Next, it will explore how important such an understanding is for people with PID. Finally, it will trace out a number of implications of that understanding for people with such disabilities.

What It Means to Be in God’s Image When the Bible talks about something being an “image,” that means it has a connection with something else in a way that may also involve a reflection of it. Being the image “of God,” in particular, means having a special con- nection with God as well as being a substantial reflection of God. Having a special connection is significant, because mistreating the image means one is mistreating the original. Being a substantial reflection is significant, since that means the image displays attributes (capacities, traits, abilities, etc.) of the original to the extent that it is able. The idea that being an image sig- nifies having a special connection is evident, for example, in Daniel 3:1-7, which reports the Babylonian King Nebuchadnezzar erecting a large image in the province of Babylonia. Kings in the ancient Near East would periodi- cally erect an image to establish their presence as rulers where they were not physically present (Clines 1968; Middleton 2005, 104-7).

The other element often present in an image is the way that it provides a reflection of certain attributes of the original. In Old Testament times, images often displayed something about a king. In Daniel 3, the great height and gold surface of the image reflected the king’s grandeur and wealth. When the New Testament refers to Christ as God’s image, both connection and reflection are in view. In Colossians 1:15, for instance, Paul straightforwardly affirms that Christ “is the image of the invisible God.”3 Christ’s special con- nection with God is so close here as to constitute oneness. Moreover, Jesus is a substantial reflection of God—someone who can be seen, in contrast with

3. Unless indicated otherwise, all quotations of the Bible are from the New Revised Standard Version.

The Image of God, Bioethics, and Persons with Profound Intellectual Disabilities From The Journal of the Christian Institute on Disability (JCID) Vol. 6.1-6.2 – Spring/Summer & Fall/Winter 2017

the “invisible God” (Kelsey 2009, 966). The text surrounding 2 Corinthians 4:4 similarly communicates that Christ’s image-of-God status involves con- nection with, and reflection of, God.

Being vs. Being in God’s Image Whereas Christ “is” God’s image, the Bible states people are “in” or “accord- ing to” God’s image. The insertion of a preposition indicates people stand in some relationship with God’s image. The image-related passages in Genesis (1:26; 1:27; 5:1; 9:6) consistently insert a preposition between people and the image. Image-related passages in the New Testament directly or indirectly referring to Genesis (e.g., James 3:9; Col. 3:10) also insert a preposition.

It’s not plausible that in each of these passages the author is simply saying that people are God’s image, as if there were no prepositions there, and no need to add them.4 In fact, prepositions such as “in” or “according to” make quite a difference. Saying that someone is in the water is quite dif- ferent from saying that someone is the water. Saying that a violin is according to a paper blueprint is quite different from saying that the violin is a paper blueprint.

The Bible’s authors use prepositions to distinguish the rest of humanity from Christ. With Christ not overtly in view as a reference point in the Old Testament, the recognition there would simply have been that people are not yet God’s image but are created “according to” 5 the standard of who God is (in order to reflect God’s attributes to God’s glory).6 In the New Testament it becomes clearer that Christ as God’s image is the standard to which people need to conform. James 3:9 is particularly significant on this point since it conveys a New Testament author’s summary of how the Genesis idea should be understood.7

The Impact of Sin Failing to take seriously the distinction between Christ being God’s image and humanity being in God’s image has contributed to overlooking a second important distinction—that sin has damaged people, not damaged God’s image. If people were God’s image, then by damaging people, sin would

4. For further explanation, see Hughes (1989, 21). 5. The standard Hebrew and Aramaic Lexicon of the Old Testament by Ludwig Koehler and Walter

Baumgartner (2001, 104) specifies that “according to” is the best rendering of both prepositions, be and ke, in image-of-God passages in Genesis 1 and 5.

6. On the importance of this distinction see McDonough (2009, 91). 7. On the harmony of 1 Cor. 11:7 with this understanding, see Kilner (2015, ch. 3) and Hughes (1989, 22).

The Image of God, Bioethics, and Persons with Profound Intellectual Disabilities From The Journal of the Christian Institute on Disability (JCID) Vol. 6.1-6.2 – Spring/Summer & Fall/Winter 2017

plausibly damage God’s image. However, if people are created in (i.e., accord- ing to the standard of) God’s image, there is no damage done to the standard just because people are later damaged.

There is ample discussion and documentation in the Bible regarding the destructive impact of sin on people. Yet, at the same time, there is every indication people remain “in God’s image”—that no harm has been done to this status or to the image on which it is based (see Gen. 5:1; 9:6). People retain a special connection with God (though their relationship with God is badly damaged), and God still intends for people to reflect likenesses to God (though in actuality they largely fail to do so). The image of God is the standard of who people are created to be—embodied in the person of Christ— and that standard is not diminished in any way because of sin. Similarly, in sanctification it is people who are being renewed. God’s unchanging image is the standard for that renewal (see Rom. 8:29; 2 Cor. 3:18: Col. 3:10).

What Exactly Is in God’s Image? People, then, are created in (according to) God’s image, in a way unaffected by their fallenness. “People” (the “adam” of Genesis 1:27) refers not only to a single man named Adam but also to humanity as a whole. Contemporary readers can easily miss this point if they are located in societies like the United States that emphasize individuals, personal freedom, and autonomy. Connecting God’s image both to humankind as a whole and to each of the humans who constitute that “kind” of creation guards against a destructive over-emphasis on individuals or collectives.

Equally important, being in God’s image has to do with people as entire beings (whether humanity as a whole or its component members are in view). There is no suggestion that being in God’s image is constituted by particular “attributes” people have or once had (i.e., abilities, traits, capacities, or other things that people are, do, etc.). Select attributes (even if God-like) are not what are in God’s image—persons as a whole are.

As we will see in the following sections, people with disabilities are espe- cially at risk of being demeaned and oppressed when particular attributes rather than persons are considered to be in God’s image. The (generally unspoken) logic is that since attributes like reason, sensory abilities, and strength are what make people in the likeness of God and worthy of protec- tion, those deficient in such attributes are not as valuable as others. A similar logic is at work concerning one’s degree of wealth, skin color, etc.8 Biblical

8. Regarding this logic, see Cortez (2010, 282-83).

The Image of God, Bioethics, and Persons with Profound Intellectual Disabilities From The Journal of the Christian Institute on Disability (JCID) Vol. 6.1-6.2 – Spring/Summer & Fall/Winter 2017

affirmations that all people are created in the image of God provide a ringing denunciation of basing people’s significance on their particular attributes. As Martin Luther King, Jr. (2000, 88) has observed, “there are no gradations in the image of God.”

Image and Likeness Being “in God’s image” is actually an abbreviated way of referring to the biblical idea of being “in God’s image and likeness.” Because two terms are involved here, some people have mistakenly thought they refer to two differ- ent ideas. However, there is ample biblical and external evidence to confirm there is a single idea here that falls within the range of meaning of each term. Either term alone is sufficient to refer to this idea.9 Nevertheless, that idea does have two aspects, related to connection and reflection.

First, some sort of special connection between God and people is in view here, as previously explained. However, an image may or may not have any- thing to do with being like (i.e., sharing the traits or other attributes of) the original. Including “likeness” with “image” communicates the kind of im- age in view here somehow has to do with likeness to the original. It ensures reflection as well as connection are a part of the concept. The reflection cannot be referring to people’s actual reflection of God’s attributes today, however, because that is damaged by sin and varies in degree from person to person. Rather, the focus here is on God’s intention—who God wanted people to be at creation and still wants them to be today. Being created in the image and likeness of God—or in the image of God, for short—is thus about special connection and intended reflection. People have a special connection with God and God intends them to reflect God’s own attributes to the extent that they are able. The tremendous significance of human beings is completely secure, rooted in God’s unwavering intentions rather than in variable current human capacities.

Being in God’s image is not unrelated to the actual capacities, relation- ships, and functions that people have—but having those things is what nor- mally flows from being in God’s image, it is not what defines it. People who lack those things are not any less “in God’s image” than anyone else, because of what it means to be “in” (i.e., “according to”) God’s image. It means that God’s image (revealed to be Christ in the New Testament) provides the stan- dard for their existence and their growth. To whatever extent they fall short

9. See Kilner (2015, 124-28).

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of fulfilling that standard, God intends more for them and offers them the means now and eternally to become more.

Why Being in God’s Image Matters The implications this understanding of God’s image has for how best to view and treat people are extensive. Every person matters precisely because each has a special significance that comes from being in God’s image. This is not the dignity that varies according to circumstances, but the dignity that necessarily accompanies being human. Since God’s image has a cor- porate dimension to it and is not just something true of particular people by themselves, humanity’s existence in God’s image entails that everyone has this special significance. There is a basic equality among members of the human community. This does not mean that people should consider everyone to be equal or identical in every respect; rather, it suggests “that they deal with each person as uniquely sacred and ignore all claims to special sanctity” (Niebuhr 1996, 155). As ethicist Hans Reinders observes, human- ity’s creation in God’s image signifies “in the loving eyes of God… there are no marginal cases of being ‘human’” (Reinders 2006, 124). People who are socially marginalized need not define themselves by their circumstances or the demeaning viewpoint of those who would oppress them.

Such dignity is the foundation for the often-misunderstood concept of human rights. Tying rights closely to a clear sense of the dignity of all people is important. Otherwise, rights claims can degenerate into mere as- sertion of self with no regard for others. Human rights are really God’s rights over humanity more than one person’s rights over another. God is every person’s creator, so God is the one to direct how people treat one another. People have rights; but contrary to much secular thinking, they do not have a right to those rights. Those rights flow from the God-given dignity rooted in creation in God’s image. Moreover, just as humanity is not merely a collection of separate people but is also an interrelated whole, so humanity’s status as created in God’s image has implications for the whole of humanity. God intends justice to be a hallmark of human society, as it is of God’s own character. How the weakest people in a community are treated is an indicator of the extent to which a community is living out its status as created in God’s image.

People never warrant less than what justice requires, but they frequently warrant more—they warrant love. Love is essential to who God is, and is God’s ultimate intention for relationships of people with one another and

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with the natural world as well. Love involves giving more than the minimum required and requires more than utilitarian maximizing of social benefit. It generates true solidarity and communion. Such social blessings are as much human rights as are personal protections and provisions. Not only do all warrant receiving love because they are in God’s image—they also must love others for the same reason. People can empower others to love themselves— and their neighbors as themselves—by helping them to recognize everyone as created in God’s image.

Implications for Persons with PID Persons with PID are among those created in God’s image and, as a result, warrant special care and welcome. They have an image-based dignity that does not waver, regardless of their ability or potential ability (Yong 2007, 173; Rodriguez 2008, 50). Persons with disabilities have a special connection with God, and God intends them to become a reflection of God as well. For per- sons with disabilities, as for others, God’s intention must await resurrection after death before it can be completely fulfilled. Humanity’s creation in the image of God can make one of its most powerful differences in this world long before then, however, as people live out their image-related status by caring for those with PID.

Apart from the biblical affirmation that all are created in God’s image, the rights of all individuals are not secured and our duties toward other persons remain unclear. If people do not believe human worth is externally conferred, then they must look to internal characteristics to establish what about human beings makes them unique and, therefore, worthy of respect. For centuries, philosophers and theologians have tried to discover which human characteristics set “persons” apart from “non-persons” and give the former a unique dignity. Unfortunately, regardless of the characteristics se- lected, some humans are necessarily left out of the “personhood” category as a result. They are thereby considered devoid of human dignity and so not due the respect and protections that such dignity requires.

Past Mistreatment Where people have understood being in God’s image (and thus human worth) in terms of the rational capacities that humans possess, persons with PID are often deemed less worthy of respect and protection (Hall 1986, 108-9; Brink 2001, 93). Some Christian leaders in the history of the church, such as Thom- as Aquinas, have considered the image of God in mentally-compromised

The Image of God, Bioethics, and Persons with Profound Intellectual Disabilities From The Journal of the Christian Institute on Disability (JCID) Vol. 6.1-6.2 – Spring/Summer & Fall/Winter 2017

people to be “practically nonexistent” (1947, I.93.8).10 The result has been a degrading of all people with intellectual disabilities—a denial of their dignity (Primavesi 2003, 187; Hilkert 2002, 78). This has led to their exclusion from activities and communities in which they ought to be able to participate (Moore 2003, 106). They have been viewed at best as “marred images,” re- sulting in “perilous” outcomes (Reynolds 2008, 177).

Given this background, it is not surprising that when disabled people gathered at a symposium in Sheffield, England to compare their experienc- es, they repeatedly reported not being viewed or treated as “made in God’s image” the way that other people are.11 As one participant painfully tried to understand the source of the discrimination that she regularly experi- ences: “I became disabled—so was I once in God’s image, but am no lon- ger?” (Davies-John 2003, 124). Her experience participates in a long history in which some Christian leaders such as Emil Brunner have denied that normal protections apply to people with profound disabilities (e.g., those who are “grossly retarded”) because of the compromise to God’s image that they consider to have occurred.12 Apparently Martin Luther even advocated drowning a “feebleminded” 12-year-old child because his severely limited mental capacities appeared to evidence corruption of his reason and soul.13 Such treatment of people with disabilities was characteristic of the culture in which the early church developed,14 and has offered an influential pattern for the church’s treatment of people with disabilities whenever Christians have reduced being in God’s image to particular attributes.

The Nazi holocaust is another powerful historical illustration of how the idea of humanity in God’s image invites destructive misuse when people understand it to be referring to current human attributes. Adolf Hitler, as part of developing his approach to the weaker members of society in his 1927 book Mein Kampf, identifies the stronger members of society as “images of the Lord.” In contrast, the weaker members for Hitler are mere “deformities”

10. See discussion in Hoekema (1994, 37). 11. This symposium, a fruit of a World Council of Churches initiative, is discussed in Mayland (2003, 211). 12. For Brunner (1952, 57), the protection of being in the image of God “ceases where true hu-

man living ceases—on the borderline of imbecility or madness.” Wennberg (1985, 131), reflecting on whether all people are fully in God’s image and so have full moral standing, concludes: “the grossly retarded… need not be assumed to possess a moral standing as full as that of a normal human adult.”

13. Luther (1952, 387) reports this in a write-up of one of his famous “Table Talks.” See discussions in Kanner (1964, 7); Towns & Groff (1972, 38-39).

14. As Seneca (1995, 32) affirmed in the first century: “We destroy abnormal offspring at birth; chil- dren, too, if they are born weak or deformed, we drown.” Cf. discussion in Ferngren (2009, 101).

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of that image to be “cleansed” from society (Hitler 1939, 606). What resulted in Nazi Germany were categories of people who were untermenschen (subhu- man), those in whom the attributes that constituted God’s image were most deformed, marred, distorted, etc. They became the targets of Nazi efforts to eliminate people with disabilities or other frailties through neglect, forced sterilization, or killing.15

Dietrich von Hildebrand was one of a relative few in Germany at the time who recognized that it was precisely the biblical teaching that all of humani- ty continues in the undeformed image of God that offered the greatest defense against Hitler’s destructive initiatives. As he wrote, soon after being forced to flee Nazi Germany in 1933: “All of Western Christian civilization stands and falls with the words of Genesis, ‘God made man in His image.’”16 Hildebrand was exceptional among Christians in his recognition of the importance of understanding God’s image in a way that excluded the possibility of it being diminished. Sad, laments ethicist Lisa Cahill (2006, 58), has been “the dev- astating refusal by Christian theology to attribute the fullness of the imago Dei” to groups such as the millions exterminated in Nazi Germany.

The Current Challenge Today, Christians must be cautious in assuming biology alone informs the abilities, capacities, and potentialities of groups of people. What is deemed “natural,” “normal,” and deserving of moral attention may be dictated by persons in power whose interests are self-serving. The dignity of persons with PID remains precarious. Within the arena of bioethics, which is a field that helps to shape medical responses to persons with disabilities, debates con- tinue over the need for prenatal screenings to detect and potentially abort fetuses with genetic disabilities (Buchanan et al. 2000). Similar debates ad- dress the ethical rights of parents to euthanize newborns with disabilities that are expected to be profound (Giubilini and Minerva 2013). Naturally, secular bioethicists do not appeal to the image of God when determining whether disabled newborns lack personhood, but the logic is analogous. Much like those who claim the image of God is damaged in some persons,

15. Many influences helped to shape Hitler’s thinking, including the government-run program of forced sterilizations of intellectually disabled people in the United States. During the Nurem- burg Trials, that program was a primary precedent to which those defending the actions of Hitler and his followers appealed. See http:/buckvbell.com and Lombardo (2008). Others have noted the very same idea so captivating to Hitler—that God’s image can be damaged—has continued to be influential up to the present, to the detriment of the weakest people in society (Yong 2007, 173)

16. As translated in Crosby (2006, 9).

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philosophers and bioethicists debate the qualities and characteristics that comprise “personhood.” According to many philosophers (see McMahan 2003), one can be a human (a member of the species), but not a person (a being worthy of moral status). Non-persons, the thinking goes, should not be granted the same moral and legal status as persons. Without the belief that all humans have inherent dignity, people who do not measure up to some people’s definitions of personhood are vulnerable to social neglect and violence.

Without the presumption that all persons, regardless of their capabili- ties, warrant protections, some bioethicists have felt free to argue, based on quality of life standards, that some lives should be ended or at least prevent- ed (Singer 1993). Moreover, many bioethicists and medical professionals drastically underestimate the quality of life experienced by persons with dis- abilities and many discount the direct testimony of people with disabilities who describe the quality of their lives (Goering 2008). There is a continuing presumption in much of bioethics that self-determination is so bound up with well-being that persons who are unable to make autonomous choices will remain “unfulfilled” human beings (Ho 2008). For some bioethicists, dignity is a useless term, because respect for dignity is really just respect for autonomy (Macklin 2003). The trouble is that persons who cannot exercise autonomy are not afforded the same dignity as those who can. The ability of persons with PID to flourish or live the good life, therefore, seems severely limited if not impossible, given the psychological abilities that are commonly valued in contemporary culture.

The contention that persons with disabilities should not be abandoned, should not be killed, and should be recognized as a marginalized group de- serving of basic human and civil rights is not universally recognized. Some bioethicists argue persons with severe impairments should not be consid- ered persons with moral status, while others work to discredit the disability rights movement. For example, in their book From Chance to Choice: Genetics and Justice, four leading bioethicists claim the disability rights movement should not be considered a civil rights movement because impairments (un- like gender or race) are innately disadvantageous (Buchanan et al. 2000). For the authors, creating a just community does not require adjusting so- cial frameworks to include people with “major impairments,” because the changes required for accommodation would upset our economic system and disadvantage able-bodied people (see also Amundson & Tresky 2007). The logic goes that for the able-bodied to flourish, the rights of persons with disabilities must be denied. Lacking a common understanding of the

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universal dignity of all persons, a corresponding ethic that requires all per- sons be accommodated so they can have the means and space to flourish is not advocated.

Without a God who grants dignity as a gift to all people, it is difficult to find a purely rational basis for why anyone should treat all persons justly or why anyone would believe that people simply have dignity rather than believe people must earn, express, or be given dignity by others (Kilner 2017). To say that all people have an essential dignity turns out to be a belief statement. When Christians ask what makes them human, or what unites all persons as human beings, they must respond that it is God who makes people human and, therefore, God who confers dignity. Unless Christians insist all people are fully in God’s image, they ultimately cannot take it for granted that each and every person, regardless of her capabilities, capacities, or potentialities, is worthy of dignity and care.

Justice and Destiny Once Christians have established that all people have dignity as a result of being made in God’s image, the real work of discovering what it means to honor that dignity can begin. As previously stated, humans’ dignity is bound up with their destiny, and so honoring one another’s dignity also requires working together toward a shared destiny. For Christians, destiny involves the Kingdom of God. In the Kingdom of God people will live as God intended them to live, in just and loving relationship with one another in the likeness of God. The Kingdom is a state of being where persons as individuals and as a community are conformed to Christ. The already-but- not-yet nature of the Kingdom is analogous to human creation in the image and likeness of God. Just as being in God’s image is simultaneously about who human beings presently are and who they are destined to be, so too is the Kingdom of God part of both the present and the future. Although it is God who brings about the Kingdom and not human beings, humans can represent the Kingdom communally by living in just relationship with one another and with all of creation.

Unfortunately, the idea of the Kingdom of God has sometimes been used as a way to further marginalize persons who do not fit into the domi- nant structures of society. As noted previously, many communities that fail to recognize all people as being in the image of God have become commu- nities that reject certain people. They have even attempted to eliminate the people they believe prevent the community from flourishing. This was not

The Image of God, Bioethics, and Persons with Profound Intellectual Disabilities From The Journal of the Christian Institute on Disability (JCID) Vol. 6.1-6.2 – Spring/Summer & Fall/Winter 2017

only true of the Nazi regime, but it has been true of American Christians who believed certain people could prevent the Kingdom of God from ar- riving. In the 1920s, many Christians who supported the Social Gospel movement found themselves to be natural allies of the American eugenics movement. One of the most prominent ministers of the early 20th century, Rev. Harry Emerson Fosdick, praised eugenics’ “humanitarian desire to take advantage of the scientific control of life so as to change social conditions that mankind may be relieved from the crushing handicaps which now press it” (1922, 87). For Fosdick and others, impairments or “handicaps” were seen as impediments to the Kingdom of God. Accordingly, persons with certain impairments needed to be sterilized so they could no longer hinder the flourishing of the community. Rather than working to build communities in which all people could participate, many Christians have historically attempted to remove the individuals they believed prevented the rest of the community from flourishing. If, however, the way in which Christians treat the least powerful among them is a reflection of how they honor God, then exclusion or elimination is an inadequate response to God’s creation. Any theological ethic that excludes certain people based on their inabilities or inherent limitations fails to appreciate God’s intention for humanity in creation.

All human beings are in some sense limited, because they are not yet who they are destined to be in God’s Kingdom. The resurrection promises to transform individuals. Within the biblical narrative the exact nature of this transformation is unclear. What Christians do know is that they shall be like Christ (1 John 3:1-3). Theologians from Tertullian to Augustine to Aquinas have speculated about how our future eschatological bodies will look and function, and many have assumed the resurrected body will be free of what humans consider to be frailties (Yong 2007, 266). The danger of seeing the resurrected body as perfectly “able-bodied” is that doing so hinders people from seeing everyone now as fully in the image of God and appreciating the goodness of embodiment as humans currently experience it. For persons with disabilities, the promise of a future ‘cure’ or ‘fix’ to their bodies or minds only serves to reinforce the understanding that they are defective and more in need of transformation than their able-bodied counterparts.

When considering persons with Down syndrome, theologian Amos Yong provocatively suggests the perfected body promised in resurrection might retain the marks of disability or even their phenotypic traits and that persons with disabilities will be recognized for their proper role in God’s natural order and within the communion of saints (Yong 2007, 282).

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“The norm will be the resurrected Christ,” Yong contends, “not our con- ventions of able-bodiedness (2007, 274).” Too often, Christians confuse the eschatological body with the young, powerful, and beautiful bodies that Western culture prizes. Yong’s ontological understanding of the res- urrected body is debated,17 but his aim is to press what it means to be in the image of God as a person with a disability and how our eschatologi- cal imagination shapes the ways we interact with and make room for all people (2012).

We do not know how our future bodies will appear, but Christ’s wounded body testifies to the fact that the resurrected body will be both identifiable and surprising, continuous and discontinuous with our cur- rent selves. If Christ’s own resurrected body continued to bear his wounds, then there is no reason to believe that our own resurrected bodies will not continue to bear the marks of our own embodied experiences. Jesus’ resurrected body was not exactly disabled—he did after all walk through walls and conquer death. And for people, bearing the image of God in Christ will ultimately include reflecting such intended attributes as trans- formed “spiritual” bodies and imperishability (1 Cor. 42-49).18 Yet, Jesus’ wounds bear testimony to God’s love and vulnerability (Swinton 2011, 284). Somehow in Christ’s body, woundedness and wholeness are compati- ble, undermining the idea the resurrected body will conform to our current understanding of able-bodied normativity (Yong 2007, 274).

Agency and Relationality in Human Destiny If, as people in God’s image, Christians are charged with working toward their own flourishing as well as the flourishing of others, how can persons with PID participate in this flourishing? Although there is a tendency in disability theology to prize relationality over rationality, not all persons are capable of mutual relationship in the ways most people commonly under- stand it. Protestants in particular are often keen to assume being created in the image of God is about relationship, because the triune God created while the three persons of God were in mutual relationship (Westermann

17. In opposition to Yong’s vision of the resurrected body, certain theologians contend dis- ability is not ontologically essential to a person’s identity, and, therefore, can be eliminated in the resurrection without doing violence to a person’s identity (Mullins 2011). Yong counters that the accidental features of our lives “shape our identities in indelible ways,” and to separate our embodiment from our identity is “Platonism (at best) or Gnosticism (at worst)” (2012, 8).

18. See Kilner (2015, 299-310).

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1994). But just as being in the image of God cannot be reduced to ra- tionality, it also cannot be reduced to relationality. Relationships come from, rather than constitute, being in God’s image (Kilner 2015, 217). The problem with prizing relationship as the key identifier of creation in God’s image is that relationship often implies the intellectual capacity to understand one’s self as separate from others and to act intentionally with others (Haslam 2012). Not all persons are capable of such self-aware- ness and agency.

In attempting to describe what makes persons in the image of God, some theologians have specified that all persons have the capacity for rationality and relationality, even if they have not actualized those capac- ities. The trouble with this line of reasoning is twofold. First, it assumes that being in the image of God requires actually having a set of identi- fiable capacities (rationality, relationality, and so on). Second, it implies persons who lack such capacities are ontologically defective. The first problem has already been addressed throughout this article. As for the second problem, if being in the image of God is about the origin and telos of human life, then those who cannot participate in their telos will be seen as deficient. In discussing Kelly, a young girl he met with microcephaly, Hans Reinders (2008, 92) explains,

Even when questions regarding the protection of human beings like Kelly can be effectively answered on the grounds that she is of human descent, this does not answer the question of what it means for Kelly to lead a human life. . . . We do not only need to identify her origin as a human being; we also need to ask how she participates in our final end as a human being.

If Christians cannot meaningfully explain how Kelly participates in her fi- nal destiny, then they must believe she, and those like her, are fundamen- tally defective and must await a radical transformation in the resurrection.

We would do better to recognize that because all persons are created in the image of God, there is a way to understand persons with PID as participating in their own destiny. If, on the grounds of our shared status as created in God’s image, Christians believe no person is fundamentally defective, then they must acknowledge it is possible for people with PID to participate in that destiny now. This acknowledgment has two impli- cations. First, Christians must develop a theological anthropology that does not preclude persons with PID from being understood as human

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in the fullest sense. Second, Christians must work to create communities in which all persons are able to participate in their flourishing.19

Working to ensure that all people have the opportunity to participate in their image-related destiny will require careful attunement to the needs of a diverse group of people. All persons are limited in ways that prevent them from being fully conformed to Christ (Creamer 2009). There will not be a one-size-fits-all method for accomplishing this work. It will require: (1) seeking out persons who are particularly marginalized and giving their needs ethical priority; (2) getting to know people and their particular needs; (3) removing the barriers that prevent people from fully participating in society; and (4) entering into loving friendship with persons with PID.

First, as previously mentioned, justice requires both understanding the social context in which people live and giving priority to the weakest people in the community. Justice does not require treating all people equally; it may require giving preferential treatment to those who are least advantaged in society. There are clear indicators that our society disadvantages persons with disabilities, particularly persons with intellectual disabilities. Rather than looking to how individual impairments limit persons, we may instead consider how impairments lead to persons being disabled in society. Even in developed nations, persons with intellectual disabilities have suffered health inequalities as well as higher rates of mortality and morbidity, in part be- cause of barriers they experience in accessing health care (Ouelette-Kuntz 2005; Sutherland, Couch, and Iacono 2002; Krahn, Hammond, and Turner 2006). Persons with intellectual disabilities are more likely to experience socioeconomic disadvantage and social exclusion (Leonard and Wen 2002; Emerson 2004; Fujiura and Yamaki 2000). Due to the general lack of social, political, and educational support that persons with intellectual disabilities and their families experience—as well as the devastating effect this can have on their health, economic status, and general well-being—the vulnerability of this group demands special attention by the Christian community.

Of course, neither “disabled people” nor “people with profound intel- lectual disabilities” are a monolithic group. The needs of individuals with disabilities are always unique. This uniqueness demands people actually get to know people with PID and their caregivers, to learn what they in fact do need rather than assuming what they need. As disability scholars point out, most people have very little empirical or phenomenological knowledge of

19. For examples of theological anthropologies that provide grounding for these implications, see Reinders (2008) and Haslam (2012).

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what it is like to live with or experience disability (Scully 2008, 21). Evidence shows able-bodied people are not very good at imagining what it is like to have a disability (Scully 2008, 54; Ubel et al. 2005). The moral imagination, in reality, is limited. It is difficult to use our minds to understand what it must be like to have a very different kind of mind.20 Meeting people with PID takes effort, since persons with such disabilities are often precluded from participating in the dominant structures of society. IQ alone (which is one way medicine delineates mild, moderate, severe, and profound intellectual disability) is a poor indicator of what an individual might need from others (CDDH Fact Sheet [n.d.]). Abilities, capacities, sources of joy, and struggles will be different for different people.

Once Christians have come to know people with PID and their care- givers, they will be in a better position to discover what justice entails. If communities of people created in God’s image must create conditions in which all people can flourish, then it will be essential to try to remove the barriers that prevent certain people from being included and thriving in our communities. Removing barriers might mean access to medical resources, but it might also mean removing the social barriers that prevent flourish- ing, including attitudinal barriers. If, as discussed earlier, Christians are not convinced that the Kingdom of God is a place where everyone gets “normal- ized,” then our communities should not demand this either. Medical cures will bring some persons into community and allow them to flourish. Such cures, however, will not be available to all. Christians should not demand all people become “normal”; rather, they must desire that all become like Christ in ways that are both common to humanity and uniquely tailored to each person. As theologian Stanley Hauerwas (2004, 40) contends, “[t]he demand to be normal can be tyrannical unless we understand that the nor- mal condition of our being together is that we are all different.” Christians must work to form communities that are open to all people, in all of their states of embodiment, and in all of their uniqueness.

In addition to requiring Christians to create just communities, their creation in God’s image demands Christians love one another. Our standard and model is Jesus Christ. Christians love others, not because people always have qualities Christians admire or enjoy, but because God made each person worthy of love by loving all persons first. Reinders (2008, 27) reminds his readers that what persons with PID often need more than anything else is friendship. Rights are good to have, he adds, but rights do not make friends

20. Disability bioethicist Jackie Scully (2008) and others have called this the “disability paradox.”

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(2008, 42-43). By befriending others, even others who may not be able to reciprocate that friendship, Christians begin to enact a Kingdom ethic where all persons can participate in what is good. How people with PID participate in the love and friendship others share with them might remain mysterious, because we cannot always know how they receive that love or friendship. At the same time, participation in the life of God will ultimately be a gift from God and not an achievement born of human capacity. If no human being will be excluded from his or her destiny because of a biological impairment or a limited capacity for rationality, then Christians must love people with PID indiscriminately.

Conclusion For better or for worse, the influence of the image-of-God concept is not likely to disappear soon, since its potential to inspire continues to shape the guiding documents of a wide range of Christian traditions and denom- inations, including Protestant, Orthodox, and Catholic.21 Nevertheless, the doctrine of the image of God is always in danger of losing its constructive influence when people alter what it means, either consciously or uncon- sciously, to benefit themselves and to put down others.22 Persons with dis- abilities, particularly those with PID, are prime targets for denigration and neglect when their status as created in God’s image is denied. As this article has shown, the Bible teaches that all people are created in the image of God, which means that all people have a great God-given dignity and that all can participate in a glorious God-intended destiny. The real work of the Christian life, therefore, will not be to determine who counts as a person, but figuring out how to be in just and loving relationship with one another in communities that promote the flourishing of all. The Christian commu- nity must ensure persons with disabilities flourish, first by recognizing the ways in which social structures, including churches, marginalize persons and then working to bring them into loving and just relationship with the community. How best to accommodate, include, and befriend persons with disabilities will not be obvious or easy, but it is what justice demands if we believe all people truly are made in the image of God.

21. Protestant: Moltmann (1984, 12); Orthodox: Habib (1998, 36-37); Catholic: Ruston (2004, 270). 22. See Kilner (2015, ch. 1) for many further illustrations of the devastation caused by altering the

biblical meaning of the idea of creation in God’s image.

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References American Association on Intellectual and Developmental Disabilities

[AAIDD]. 2017. “Frequently Asked Questions on Intellectual Disability.” Washington, D.C.: AAIDD. https://aaidd.org/intellectual-disability/ definition/faqs-on-intellectual-disability#.WRW396KiB40.

American Psychiatric Association [APA]. 2013. Diagnostic and Statistical Man- ual of Mental Disorders. 5th edition. Arlington, VA: American Psychiatric Publishing.

Amundson, Ron, and Shari Tresky. 2007. “On a Bioethical Challenge to Dis- ability Rights.” Journal of Medicine and Philosophy 32: 541-61.

Aquinas, Thomas. 1947. Summa Theologica. Vol. 1. Translated by Fathers of the English Dominican Province. New York, NY: Benziger.

Brink, Paul A. 2001. “Selves in Relation: Theories of Community and the Imago Dei Doctrine.” In The Re-Enchantment of Political Science, edited by Thomas W. Heilke and Ashley Woodiwiss (85-120). Lanham, MD: Lex- ington Books.

Brunner, Emil. 1952. The Christian Doctrine of Creation and Redemption. Phila- delphia, PA: Westminster.

Buchanan, Allen, Dan W. Brock, Norman Daniels, and Daniel Wikler. 2000. From Chance to Choice: Genetics and Justice. Cambridge, UK: Cambridge University Press.

Cahill, Lisa Sowle. 2006. “Embodying God’s Image: Created, Broken, and Re- deemed.” In Humanity Before God, edited by William Schweiker, Michael Johnson, and Kevin Jung (55-77). Minneapolis, MN: Fortress.

CDDH Fact Sheet. [n.d.]. “Working with People with Intellectual Disabil- ities in Healthcare Settings.” The Center for Developmental Disability Health Victoria, accessed August 1, 2016. http://www.cddh.monash. org/assets/documents/working-with-people-with-intellectual-disabili- ties-in-health-care.pdf.

Clines, David J. A. 1968. “The Image of God in Man.” Tyndale Bulletin 19: 53-103.

Cortez, Marc. 2010. Theological Anthropology. London: T & T Clark. Creamer, Deborah. 2009. Disability and Christian Theology: Embodied Limits and

Constructive Possibilities. Oxford, UK: Oxford University Press. Crosby, John F. 2006. “The Witness of Dietrich von Hildebrand.” First Things

169 (December): 7-9. Davies-John, Elisabeth. 2003. “Disabled and Made in the Image of God.” In

Growing into God, edited by Jean Mayland (121-24). London, UK: Church- es Together in Britain and Ireland.

The Image of God, Bioethics, and Persons with Profound Intellectual Disabilities From The Journal of the Christian Institute on Disability (JCID) Vol. 6.1-6.2 – Spring/Summer & Fall/Winter 2017

Emerson, Eric. 2004. “Poverty and Children with Intellectual Disabilities in the World’s Richest Countries.” Journal of Intellectual and Developmental Disability 29: 319-37.

Ferngren, Gary B. 2009. Medicine & Health Care in Early Christianity. Baltimore, MD: Johns Hopkins University Press.

Fosdick, Harry Emerson. 1922. Christianity and Progress. New York, NY: Revell. Fujiura, Glen Tsutomu, and Kiyoshi Yamaki. 2000. “Trends in Demogra-

phy of Childhood Poverty and Disability.” Exceptional Children 66 (2): 187-99.

Giubilini, Alberto, and Francesco Minerva. 2013. “After-Birth Abortion: Why Should the Baby Live?” Journal of Medical Ethics 39: 261-63.

Goering, Sara. 2008. “‘You Say You’re Happy, but…’ Contested Quality of Life Judgments in Bioethics and Disability Studies.” Bioethical Inquiry 5: 125-135.

Habib, Gabriel. 1998. “The Universality of Human Rights.” Christian Social Action (December): 36-37.

Hall, Douglas J. 1986. Imagining God: Dominion as Stewardship. Library of Christian Stewardship. Grand Rapids, MI: Eerdmans.

Haslam, Molly. 2012. Constructive Theology of Intellectual Disability: Human Being as Mutuality and Response. New York, NY: Fordham University Press.

Hauerwas, Stanley. 2004. “Community and Diversity: The Tyranny of Nor- mality.” In Critical Reflections on Stanley Hauerwas’ Theology of Disabitliy: Disabling Society, Enabling Theology, edited by John Swinton (37-43). Bing- hamton, NY: Haworth.

Hilkert, Mary Catherine. 2002. “Imago Dei: Does the Symbol Have a Future.” The Santa Clara Lectures 8, no. 3.

Hitler, Adolf. 1939. Mein Kampf. New York, NY: Reynal & Hitchcock. Ho, Anita. 2008. “The Individualist Model of Autonomy and the Challenge

of Disability.” Bioethical Inquiry 5: 193-207. Hoekema, Anthony A. 1994. Created in God’s Image. Grand Rapids, MI:

Eerdmans. Hughes, Philip E. 1989. The True Image: The Origin and Destiny of Man in Christ.

Grand Rapids, MI: Eerdmans. Kanner, Leo. 1964. A History of the Care and Study of the Mentally Retarded.

Springfield, IL: Thomas. Kelsey, David H. 2009. Eccentric Existence, Vol. 2. Louisville, KY: Westminster

John Knox. Kilner, John F. 2015. Dignity and Destiny: Humanity in the Image of God. Grand

Rapids, MI: Eerdmans.

The Image of God, Bioethics, and Persons with Profound Intellectual Disabilities From The Journal of the Christian Institute on Disability (JCID) Vol. 6.1-6.2 – Spring/Summer & Fall/Winter 2017

______. 2017. “Special Connection and Intended Reflection: Creation in God’s Image and Human Significance.” In Why People Matter, edited by John Kilner (135-60). Grand Rapids, MI: Baker Academic.

King, Martin Luther, Jr. 2000. “The American Dream.” In A Knock at Midnight, ed- ited by Clayborne Carson and Peter Holloran (79-88). New York, NY: Warner.

Koehler, Ludwig, and Walter Baumgartner. 2001. The Hebrew and Aramaic Lexicon of the Old Testament, revised by Walter Baumgartner and Johann Stamm, translated by M. E. J. Richardson. Leiden, The Netherlands: Brill.

Krahn, Gloria L., Laura Hammond, and Anne Turner. 2006. “A Cascade of Disparities: Health and Health Care Access for People with Intellectu- al Disabilities.” Mental Retardation and Developmental Disabilities Research Reviews 12: 70-82.

Leonard, Helen, and Xingyan Wen. 2002. “The Epidemiology of Mental Retardation: Challenges and Opportunities in the New Millennium.” Mental Retardation and Developmental Disabilities Research Reviews 8: 117-34.

Lombardo, Paul A. 2008. Three Generations, No Imbeciles: Eugenics, the Supreme Court, and Buck v. Bell. Baltimore, MD: Johns Hopkins University Press.

Luther, Martin. 1952. Colloquia Mensalis. London, UK: Du-Gard. Macklin, Ruth. 2003. “Dignity is a Useless Concept.” British Medical Journal

327 (7429): 1419–20. Mayland, Jean (Editor). 2003. Growing into God. London, UK: Churches To-

gether in Britain and Ireland. McDonough, Sean M. 2009. Christ as Creator. Oxford, UK: Oxford University Press. McMahan, John. 2003. The Ethics of Killing: Problems at the Margins of Life. New

York, NY: Oxford University Press. Middleton, J. Richard. 2005. The Liberating Image. Grand Rapids, MI: Brazos. Moltmann, Juergen. 1984. On Human Dignity, translated by M. Douglas

Meeks. Philadelphia, PA: Augsburg Fortress. Moore, Zoë Bennett. 2003. “‘One Ladies’ One Normal: Made in the Image of

God – Issues for Women.” In Growing into God, edited by Jean Mayland (103-12). London, UK: Churches Together in Britain and Ireland.

Mullins, Ryan. 2011. “Some Difficulties for Amos Yong’s Disability Theol- ogy of the Resurrection.” Ars Disputandi: The Online Journal for Philosophy of Religion 11: 24-32.

Niebuhr, H. Richard. 1996. Theology, History, and Culture. New Haven, CT: Yale University Press.

Ouellette-Kuntz, Helene. 2005. “Understanding Health Disparities and In- equities Faced by Individuals with Intellectual Disabilities.” Journal of Applied Research in Intellectual Disabilities 18: 113-21.

The Image of God, Bioethics, and Persons with Profound Intellectual Disabilities From The Journal of the Christian Institute on Disability (JCID) Vol. 6.1-6.2 – Spring/Summer & Fall/Winter 2017

Primavesi, Anne. 2003. “Made and Remade in the Image of God.” In Growing into God, edited by Jean Mayland (187-91). London, UK: Churches To- gether in Britain and Ireland.

Reinders, Hans S. 2006. “Human Dignity in the Absence of Agency.” In God and Human Dignity, edited by Linda Woodhead and R. Kendall Soulen (121-39). Grand Rapids, MI: Eerdmans.

______. 2008. Receiving the Gift of Friendship: Profound Disability, Theological Anthropology, and Ethics. Grand Rapids, MI: Eerdmans.

Reynolds, Thomas E. 2008. Vulnerable Communion: A Theology of Disability and Hospitality. Grand Rapids, MI: Brazos.

Rodriguez, Rubén Rosaria. 2008. Racism and God-Talk: A Latino/a Perspective. New York, NY: University Press of America.

Ruston, Roger. 2004. Human Rights and the Image of God. London, UK: SCM. Scully, Jackie Leach. 2008. Disability Bioethics: Moral Bodies, Moral Difference.

Lanham, MD: Rowman and Littlefield. Seneca, Lucius. 1995. “On Anger.” In Moral and Political Essays, edited by John

Cooper and J. F. Procope (1-116). Cambridge: Cambridge University Press.

Singer, Peter. 1993. Practical Ethics, 2nd revised ed. New York, NY: Cambridge University Press.

Sutherland, Georgina, Murray A. Couch, and Teresa Iacono. 2002. “Health Issues for Adults with Developmental Disability.” Research in Developmen- tal Disability 23: 422-45.

Swinton, John. 2011. “Who Is the God We Worship? Theologies of Disabil- ity; Challenges and New Possibilities.” International Journal of Practical Theology 14: 273-307.

Towns, Elmer L., and Roberta Groff. 1972. Successful Ministry to the Retarded. Chicago, IL: Moody.

Ubel, Peter A., George Loewenstein, Norbert Schwarz, and Dylan Smith. 2005. “Misimagining the Unimaginable: The Disability Paradox and Health Care Decision Making.” Health Psychology 24, no. 4 (Suppl.): S57-S62.

Wennberg, Robert N. 1985. Life in the Balance. Grand Rapids, MI: Eerdmans. Westermann, Claus. 1994. Genesis 1-11: A Continental Commentary, translated

by John Scallion. Minneapolis, MN: Fortress. Yong, Amos. 2007. Theology and Down Syndrome: Reimagining Disability in Late

Modernity. Waco, TX: Baylor University Press. ______. 2012. “Disability Theology of the Resurrection: Persisting Questions

and Additional Considerations – A Response to Ryan Mullins.” Ars Dis- putandi: The Online Journal for Philosophy of Religion 12 (1): 4-10.