Saturday, March 28, 2020

Music on My Mind

The Petersens, "I Am the Man, Thomas". Probably the classic version of this old song is that of Ola Belle Reed.


If our mind should be dead like Lazarus, then our material flesh and nobler soul must approach Christ with a confession, like Martha and Mary, and ask for his help. He will stand by us and command the hardness that lies upon our memory to be removed, and he will cry out with the loud voice of the trumpet of the gospel: "Come out of the distractions of the world!" He will loose the cords of our sin so that we can move vigorously toward virtue.

[Cyril of Alexandria, Commentary on the Gospel of John, Volume 1, IVP Academic (Downers Grove, IL: 2013), p. 95.]

Friday, March 27, 2020

The Structure of the Summa

There are lots of ways to approach the structure of Aquinas's Summa Theologiae. For instance, I think it's helpful to recognize its exitus-reditus structure (creation comes out from God and returns to Him), and also to recognize that the theological order is roughly that of the Creed. But one should always return to Aquinas's specific comments about it. The Summa begins not with Part I, Question I, but with a comment about purpose and structure:

Because the doctor of Catholic truth ought not only to teach the proficient, but also to instruct beginners (according to the Apostle: As unto little ones in Christ, I gave you milk to drink, not meat), we purpose in this book to treat of whatever belongs to the Christian religion, in such a way as may tend to the instruction of beginners. We have considered that students in this doctrine have not seldom been hampered by what they have found written by other authors, partly on account of the multiplication of useless questions, articles, and arguments, partly also because those things that are needful for them to know are not taught according to the order of the subject matter, but according as the plan of the book might require, or the occasion of the argument offer, partly, too, because frequent repetition brought weariness and confusion to the minds of readers.

Endeavouring to avoid these and other like faults, we shall try, by God's help, to set forth whatever is included in this sacred doctrine as briefly and clearly as the matter itself may allow.

Most of Aquinas's proemia are very business-like and do little more than divide up a topic, but occasionally, as here, he explains the structure of what he is doing. I think it's notable, and not fully appreciated, that Aquinas does not state that the purpose of the work is to instruct beginners (incipientes) but to hand down (tradere) whatever belongs to the Christian religion in such a way as is appropriate (congruit) to the education or cultivation (eruditio) of beginners. The purpose of the work is not to fit some conception of what a beginner is, but to teach the Christian faith, keeping beginners in mind. (I think a very common problem today is the failure ever to avoid the mistake that Aquinas avoids right here at the beginning. Catechesis, for instance, is not about teaching what you think high school students, say, can understand; it's about teaching the Christian faith in such a way as takes into account that you are teaching high school students. If you want to make the liturgy more accessible, the goal should be to provide the liturgy, taking advantage of whatever would make it more accessible, not changing the liturgy to fit what you think is accessible. And so forth. In my view, this is actually a general problem with how modern society approaches education in any field, and you find similar errors far beyond any religious question.) And Aquinas very admirably tells us exactly what this means: he's going to cut down on the ever-multiplying branches of arguments, he's going to follow the order that comes from the subject-matter itself, not discussions about it, and he's going to cut out repetition that creates loathing (fastidium -- the word is quite strong) and confusion in the audience. Thus the goal is to include what's relevant, briefly (breviter) and distinctly (dilucide), to the extent the material allows. You can learn a lot about teaching beginners from Aquinas.

He then, in Part I, Question I, discusses what is involved in sacred doctrine (sacra doctrina), the topic of the work, specifically what insofar as they will establish the limits of what is being discussed.

Part I, Question II gives the general structure of the work's content. The primary purpose of sacred doctrine is to hand down acquaintance with God (cognitio Dei) not just in Himself but insofar as He is the source and end of things (principium rerum et finis earum) and especially of the rational creature. Thus we get the basic structure of the Summa; as Freddoso translates it:

Therefore, since our intention is to lay out this doctrine, we will deal first with God (Part 1); second, with the rational creature’s movement toward God (Part 2); and third, with Christ, who, insofar as He is a man, is our way of going to God (Part 3).

With the Prima Secundae we get another proemium:

Since, as Damascene states (De Fide Orthod. ii. 12), man is said to be made to God's image, in so far as the image implies an intelligent being endowed with free-will and self-movement: now that we have treated of the exemplar, i.e., God, and of those things which came forth from the power of God in accordance with His will; it remains for us to treat of His image, i.e., man, inasmuch as he too is the principle of his actions, as having free-will and control of his actions.

There are several important things here that are often overlooked. Part II is specifically about what it means for human beings to be made to the image of God. Being made to God's image implies having a ruling power in one's own right (per se potestativus) that works intellectually (intellectuale) and by free choice (arbitrario liberum), or, in other words, it means being a source of one's own works (suorum operum principium). Aquinas is usually read as downplaying exemplar causation, but he explicitly takes the relation between the first and second parts to be describing God as our exemplar cause and human beings insofar as God is our exemplar. How is God our exemplar, how are we in His image? God out of His power creates the world so that it proceeds from Him; and we likewise have a power that makes us the source of works.

Since a power is defined by its end, Aquinas will then begin look at what the end of this power is (beatitude, union with God). He will then start looking at its exercise. Structure will be even more important for this part than the previous, and we get another major structural proemium at ST 2-1.6, in which he says that the point is to look at ways in which we achieve or fail to achieve this end; but practical knowledge (operativa scientia, knowledge having to do with our works), needs to examine particulars. What is required for moral examination (moralis consideratio) is to look at human acts both generally and in particular. This is the distinction the First Part of the Second Part (human action in general) and the Second Part of the Second Part (human action in particular); it's also why the Secunda Secundae is so much larger than the Prima Secundae -- looking at particulars is necessarily much more complicated than looking at general matters. The Prima Secundae will look at human action itself, ways we are acted upon that are relevant to our actions (passions), the sources of our actions either in the sense of what in us tends toward those actions (second nature like skill, virtue, and vice, with a focus on the latter two because they are more directly related to beatitude) or in the sense of sources outside ourselves that we need in order to act for our end of beatitude (law and grace).

That takes care of what in general is required to live as being in the image of God, but, again, we need to see particular. So what in particular do you have to do in order to act as the image of God (which, of course, is what we really need to know)? This brings us to one of the longest structural proemia in the Summa, and it is longer not because Aquinas is suddenly getting chatty but because he really does have to do more to explain why the book has the structure it does. Aquinas divides these particulars into two parts: particular virtues, which are common to all of us, and specific human states, which are different kinds of life. This is another thing that I think is often missed: only looking at the virtues gets us only a partial view of the particulars that are needed for moral life. We also need to look at our roles. I hadn't really thought of this before (and I am kicking myself for not recognizing it until writing this paragraph, because it is a point I have made in other contexts), but there is an old distinction between virtues and officia or offices that is quite clearly what St. Thomas has in mind here -- indeed, if you look at the Latin, when he actually talks about them, he relates status to officium and to gradus (rank), although he regards each of these as different. 'Officium' is often translated as 'duty', which is an OK translation if you understand by that a requirement for a role. One of the regular problems in modern virtue ethics, and it has been a problem since Hutcheson pointed out that Hume, the first major modern virtue ethicist, was guilty of it, is jumbling together virtues and offices. Everyone must be virtuous, but virtue does not and cannot express itself in the same way in everyone, because not everyone is living the same kind of life. Virtues we have in common have to be applied to our different places in life, and the tendency of virtue to particular kinds of actions in those contexts or roles or states of life is an officium. Some people are in charge, some are not; they need the same virtues but the requirements (duties or obligations, if you prefer) will be different. Some people are called to an active life, some to a contemplative life: same virtues, different offices expressing them due to different states of life. Some people are beginning in the virtuous life, some people are progressing in it, some people are virtuous; all the same virtue, but it's a sign of stupidity to demand the same things from each. In any case, you need to consider both virtues and officia, otherwise your moral examination is going to be flawed.

The second thing Aquinas takes into account is that when we look at moral particulars, there are several different ways to do it, and Christian theology in particular provides quite a few different ways to look at moral life. We can look at it in light of particular virtues, in light of particular vices, in light of particular gifts of the Spirit, in light of particular moral precepts (like the Ten Commandments), in light of the Beatitudes, etc. But, as Aquinas notes, if you treat all these individually you end up repeating yourself again and again, which, if you recall, is one of the things he explicitly said he was trying to avoid. So he says, he is going to go about things in the shorter and quicker way (compendiosior et expeditior), organizing it by virtue, and just adding the other things insofar as they relevant to each virtue. A major reason for doing this is that vices in particular are very unruly, and so whatever organization you pick, it needs to allow for the compendious and brief discussion of vices; but the most natural way to get the vices in order is to relate them to their opposed virtues. Then he concludes in his summing up:

Accordingly we may reduce the whole of moral matters to the consideration of the virtues, which themselves may be reduced to seven in number. Three of these are theological, and of these we must treat first, while the other four are the cardinal virtues, of which we shall treat afterwards (Question 47). Of the intellectual virtues there is one, prudence, which is included and numbered among the cardinal virtues. Art, however, does not pertain to moral science, which is concerned with things to be done, for art is right reason about things to be made, as stated above (I-II:57). The other three intellectual virtues, namely wisdom, understanding, and knowledge, agree, even in name, with some of the gifts of the Holy Ghost. Therefore we shall consider them while considering the gifts corresponding to those virtues. The other moral virtues are all in some way reducible to the cardinal virtues, as was explained above (I-II:61:3). Hence in treating about each cardinal virtue we shall treat also of all the virtues which, in any way whatever, belong to that virtue, as also of the opposite vices. In this way no matter pertaining to morals will be overlooked.

Note the last sentence, which is the essential point here: Et sic nihil moralium erit praetermissum, and thus nothing of morals will be missed. I think one thing that people often fail to recognize is that Aquinas is very explicitly picking one way to look at the moral life out of many legitimate ones, and he is guided by one very specific purpose, namely that this is the best way to cover everything without repeating yourself in a way that makes things unnecessarily tiresome for beginners. This is an action with trade-offs; covering everything without repeating yourself, although valuable for some things, is not always the best way to discuss a matter. One thing I've noted before, for instance, is that Aquinas's way of handling things leads to people not recognizing just how important the Beatitudes are for Aquinas (they are indeed in some sense more important than the virtues), because structurally they just get added to discussions of virtues and people are tempted to treat those discussions as mere appendices.

The real way to consider it is that moral life is like a tesseract, but we can only talk about it in slices or by projections. Different slice, different angle, and it can look very different despite being the same thing; different slices or projections are useful for different things. This means that you can go about discussing it different ways. You could talk about the moral life entirely in terms of the Beatitudes; this would have many advantages, including keeping the end directly in view. It's not the most straightforward way to talk about virtues and vices, since it would become difficult to keep track of how they all hold together, although you could in fact relate all virtues and vices to the Beatitudes. All of the other ways also have advantages and disadvantages. What you can't do -- at least without repeating yourself in a way that would quickly grow mind-numbing -- is cover the moral life completely by virtue and by vice and by Beatitude and by precept and by gift. The moral life is undeniably stunning in its infinite richness. What you don't want if you are trying to keep beginners in mind, however, is literally to stun them into blank-minded, eye-glazed educational comatoseness at the infinity of it. Since Aquinas has to cover the whole thing, he picks the one that's least likely to break the brains of beginners. Of course, even Aquinas's sketch of the virtue-projection of the moral life, one of his true claims to fame, is sometimes a bit mind-blowing. But there is more than one way to project that hypercube onto a flat surface; he is deliberately selecting one possible structure out of many, in order to achieve his specific purpose.

Part III of the Summa also has its structural proemium, of course:

Forasmuch as our Saviour the Lord Jesus Christ, in order to "save His people from their sins" (Matthew 1:21), as the angel announced, showed unto us in His own Person the way of truth, whereby we may attain to the bliss of eternal life by rising again, it is necessary, in order to complete the work of theology, that after considering the last end of human life, and the virtues and vices, there should follow the consideration of the Saviour of all, and of the benefits bestowed by Him on the human race.

I've been talking about features that Aquinas explicitly builds into his structure that have often missed, and there is an obvious one here, namely, one of the reasons why he has the huge double-epic Part II before Part III. Christ in His resurrection shows us the beatitude of undying life (beatitudinem immortalis vitae) and because of this, the last end of human life and virtues and vices naturally leads into the Christ and the benefits given by Him to humankind. In order to understand the beatitude Christ shows, you need to understand that human beings, as made to the image of God, are directed toward the ultimate end of beatitude, and in order to understand what good human beings receive from Christ, you have to understand what is good for human life (which we learn from seeing how the image of God is expressed in particular in the works of the virtues and vices). And this seems entirely right, and something that people often fail to grasp: our understanding of the good Christ has done for human beings is heavily limited by our understanding of what is good for human beings in the first place.

In any case, Aquinas's plan is to discuss first the mystery of the Incarnation, then the life of Christ as the Incarnate Word, then the sacraments as effects of the Incarnate Word, and no doubt ultimately to get to the ultimate benefits given to us by Christ -- heaven and salvation from hell and resurrection from the dead, as Reginald suggests in building the Supplement out of Aquinas's earlier writings. But, of course, he never finished and it was left incomplete. And so is all our good work on this mortal earth.


Intending to strengthen the human soul with the hope of eternal reward, Jesus took Peter, James, and his brother John, and led them up a high mountain. There, He revealed to them the mystery of the Trinity, foretold the humiliation of His passion, and showed them, through His transfiguration, the glory of His future resurrection. The Law and the Prophets bore witness to Him in the apparition of Moses and Elias; the Father and the Holy Spirit bore witness also, manifest as a Voice and a Cloud. And truly the soul devoted to Him, now established in the truth and raised to the summit of virtue, could make Peter's words its own and exclaim with him: "Lord , it is good for us to be here"--here, that is, in the peace and joy of seeing Your face; here, where the spirit, in a state of heavenly and ecstatic rapture, can hear secret words that man may not repeat.

Bonaventure, The Tree of Life 1.12.

[Bonaventure, The Works of Bonaventure I: Mystical Opuscula, José de Vinck, tr., Martino Publishing (Mansfield Centre, CT: 2016), p. 111.]

Thursday, March 26, 2020

Lent XVI

And besides, Moses and Elijah stood at Jesus' side, and spake with one another of His departure, which He was about, it says, to accomplish at Jerusalem: by which is meant the mystery of the dispensation in the flesh; and of His precious suffering upon the cross. For it is also true that the law of Moses, and the word of the holy prophets, foreshewed the mystery of Christ: the one by types and shadows, painting it, so to speak, as in a picture; while the rest in manifold ways declared beforehand, both that in due time He would appear in our likeness, and for the salvation and life of us all, consent to suffer death upon the tree. The standing, therefore, of Moses and Elijah before Him, and their talking with one another, was a sort of representation, excellently displaying our Lord Jesus Christ, as having the law and the prophets for His body guard, as being the Lord of the law and the prophets, and as foreshown in them by those things which in mutual agreement they before proclaimed. For the words of the prophets are not at variance with the teachings of the law. And this I imagine was what Moses the most priestly and Elijah the most distinguished of the prophets were talking of with one another.

Cyril of Alexandria, Commentary on Luke, Sermon 51.

Wednesday, March 25, 2020

Caramuel on Signification

'Baroque Scholasticism', sometimes 'second scholasticism', is the name generally given to the brief resurgence of scholastic thought in the sixteenth and seventeenth centuries. In the way that the history of philosophy is usually presented, this is treated as the period when scholasticism was collapsing, but this is not really very accurate; scholastic forms of philosophy were actually doing very well. There was an immense amount of creativity, continuing scholastic methods but also confronting new discoveries and ideas. But this creativity was itself perhaps the limitation of most of its major forms; massive creativity in philosophy involves a lot of improvising, and it is very difficult to study Baroque scholastics because, for instance, they will use words in new and unusual ways and propose ideas that they never have time to develop fully. This is not a sustainable way to do philosophy. At the same time, studying them is sometimes very interesting precisely because of this creativity.

Of all the Baroque Scholastics, one of the most creative was Juan Caramuel y Lobkowitz (1606-1682). A child prodigy with an extraordinary talent for languages, he quickly rose to everyone's attention and, after receiving his doctorate in theology, was moved around from place to place as needed until he died as Bishop of Vigevano in Italy. His literary output was truly vast, with over two hundred books, many of them not small, and covering practically every field of human knowledge. He was impressively polymathic even in an age of polymaths, and he liked to try out new ideas.

One of his many interesting proposals is found in his philosophical discussions of signification. He holds that signification is moral transubstantiation. Physical or natural transubstantation, of course, is found in the sacrament of the Eucharist, when the presence of Christ destroys the substance of bread while maintaining its accidents. Words gain meaning by moral transubstantiation. Thus the word 'anthropos' is just a vibration in the air (or lines on a page, if we are talking about written words). Man is a rational animal. So what does one have to do with the other? Just that the Greeks agreed that 'anthropos' should act in the context of common language just as if it were man; 'anthropos' is virtually man, not air, and thus it was transubstantiated virtually or morally: under the appearances of this vibration of the air is (morally, not physically) a different substance, man. Human beings by imposing meanings convert vibrations of air into appearances of other substances, so that for the purposes of language they no longer are air but those other substances, and thereby the appearances of this vibration of air become a sign of those substances. This is signification. To be more exact, people by agreement morally transubstantiate things into signs so that the change, the transubstantiation itself (what Caramuel calls formal transubstantiation as opposed to efficient transubstantiation), is what we call signification.

Obviously it does not matter whether we are talking vibrations of air, lines on a page, gestures, or anything else. This leads Caramuel to make a break with a common view, going back to Aristotle, that written words are in some way signs of spoken words which are in some way signs of concepts. If signification is moral transubstantiation, it will happen the same way regardless of which of these hosts we are talking about. The lines making up the word 'anthropos', referring to a man, will be morally transubstantiated not into the substance of air (which is the spoken word) but into the substance of man. Of course nothing stops us from using 'anthropos' to mean only the sound, since moral transubstantiation occurs by convention, but there is no requirement that the writing have any connection to spoken language. Similarly, if we take some other kind of sign, like the cross, we will get the same story. This, of course, has significant theological consequences. Why do Catholics adore the cross? Well, what is the cross here? It's not as if a crucifix on the wall or a cross on a chain is the True Cross itself; it's just a vertical bar crossing a horizontal bar. What is really being done is that the cross is being morally transubstantiated so that is an appearance not of two bars but of Christ, who is to be adored. This is in fact the only reason why one would adore the True Cross itself, for that matter. And likewise, when we use words like 'God', 'angel', these are for the mind verbal appearances of God, angels, etc. The name of God is virtually God.

It's important to grasp, of course, that moral or virtual or significative transubstantiation is not natural or physical transubstantiation; as the names imply, moral transubstantiation is a matter of will, natural transubstantiation a matter of nature. Human beings cannot do natural transubstantiation; that could only be done by a cause that makes things have the natures that they do, which is not true of our wills. The word 'Deus' does not have a divine nature; its nature remains a vibration of air. But Caramuel argues that there is an analogy between the realm of the will and the realm of nature. The vibration of air can occur in the context of human action, and in that context, it virtually contains under the appearance of sound this or that substance.

There are several obscurities in this account, as there usually are in Baroque Scholasticism. For instance, the rejection of the Aristotelian hierarchy of signs is much more radical a move than Caramuel seems to suggest, and scholastic discussions of what happens moraliter or virtualiter are usually difficult enough without adding in the extra complication of how this can virtually cease to be this substance and become that substance. But it's an interesting line of thought.

Echoing on the Music of Glorious Gabriel

Feast of the Annunciation
by Christina Rossetti

Whereto shall we liken this Blessed Mary Virgin,
Faithful shoot from Jesse's root graciously emerging?
Lily we might call her, but Christ alone is white;
Rose delicious, but that Jesus is the one Delight;
Flower of women, but her Firstborn is mankind's one flower:
He the Sun lights up all moons thro' their radiant hour.
'Blessed among women, highly favoured,' thus
Glorious Gabriel hailed her, teaching words to us:
Whom devoutly copying we too cry 'All hail!'
Echoing on the music of glorious Gabriel.

Lent XV

Nothing then is more blessed than the apostles, and especially the three, who even in the cloud were counted worthy to be under the same roof with the Lord.

But if we will, we also shall behold Christ, not as they then on the mount, but in far greater brightness. For not thus shall He come hereafter. For whereas then, to spare His disciples, He discovered so much only of His brightness as they were able to bear; hereafter He shall come in the very glory of the Father, not with Moses and Elias only, but with the infinite host of the angels, with the archangels, with the cherubim, with those infinite tribes, not having a cloud over His head, but even heaven itself being folded up.

John Chrysostom, Homily on Matthew 56.7.

Tuesday, March 24, 2020

The Devil's Verse

'The devil's verse' is a name you sometimes find popularly given to a famous palindrome:

In girum imus nocte et consumimur igni.

Sometimes you find it in a slight variation,

In girum imus nocte, ecce! et consumimur igni.

'Girus' is not a common Latin word; it's generally read as the Latinization of a Greek word, and if so it means 'circle' or 'ring'. Thus the translation would be, "Into the circle we go by night and are devoured by fire." The popular name perhaps arises from the sinister sound of it, but the saying is also often associated with moths circling a flame, which is what Augustus De Morgan explicitly had in mind when he applied to would-be circle-squarers in A Budget of Paradoxes:

The feeling which tempts persons to this problem is that which, in romance, made it impossible for a knight to pass a castle which belonged to a giant or an enchanter. I once gave a lecture on the subject: a gentleman who was introduced to it by what I said remarked, loud enough to be heard by all around, 'Only prove to me that it is impossible, and I will set about it this very evening.'

This rinderpest of geometry cannot be cured, when once it has seated itself in the system : all that can be done is to apply what the learned call prophylactics to those who are yet sound. When once the virus gets into the brain, the victim goes round the flame, like a moth, first one way and then the other, beginning again where he ended, and ending where he begun: thus verifying the old line

In girum imus nocte, ecce! et consumimur igni.

'Rinderpest' is also called cattle plague or steppe morain. It was a brutally nasty viral disease affecting the group of animals called 'even-toed ungulates', which includes cows, buffalos, giraffes, deer, and warthogs; in some populations fatality approached 100%. A vaccine was eventually developed in the twentieth century, well after De Morgan's comment. There are no known cases of rinderpest currently in the world, and have not been since 2001, due to a sustained half-century long eradication campaign; if this holds, it and smallpox are the only viral diseases that have ever been eradicated in the wild by human effort.

Lent XIV

Just as in the Baptism, where the mystery of the first regeneration was proclaimed, the operation of the whole Trinity was made manifest, because the Son Incarnate was there, the Holy Ghost appeared under the form of a dove, and the Father made Himself known in the voice; so also in the transfiguration, which is the mystery of the second regeneration, the whole Trinity appears—the Father in the voice, the Son in the man, the Holy Ghost in the bright cloud; for just as in baptism He confers innocence, signified by the simplicity of the dove, so in the resurrection will He give His elect the clarity of glory and refreshment from all sorts of evil, which are signified by the bright cloud.

Thomas Aquinas, Summa Theologiae 3.45.4ad2.

Monday, March 23, 2020


The miracles worked by Christ were arguments for the faith which He taught. Now, by the power of His Godhead He was to rescue those who would believe in Him, from the power of the demons; according to John 12:31: "Now shall the prince of this world be cast out." Consequently it was fitting that, among other miracles, He should also deliver those who were obsessed by demons.

Thomas Aquinas, Summa Theologiae 3.44.1.

Sunday, March 22, 2020


As medical issues have become more salient, I've seen a lot more of one of the most dangerous equivocations, the conflation of 'triage' in the loose sense of 'a system for allocating medical treatment' and 'triage' in the strict and proper sense of 'the system of allocating medical treatment wholly on the basis of present medical need'. The latter is a normative and justificatory concept; if something is triage in this sense, it is justified by actually identified necessity, and there is no need for any further justification beyond that. That was the whole point when Larrey started the triage revolution. No longer would medical decisions be made on the basis of evaluating patient's lives or value to society; the one consideration became, "Can this person in need be healed, and what's required to do it?" No longer would some be given special preference over others; the one consideration became, "Does this person need help more urgently than that one?" Faced with a footsoldier and a general, if the general's condition could wait and the footsoldier's couldn't, the footsoldier got the preference, simply because of that. Let politicians play politics with people's lives, weighing them and prioritizing them according to abstract schemes of preferability; the doctors did medicine. There was a rectification of names and everyone benefited.

However, as is unfortunately common with ethical terms in the modern era, it is increasingly common for people advocating their own dubious approaches to allocating medical treatment to give those approaches cover by also calling them 'triage'. 'Triage' in this loose sense does not justify anything; but, of course, that's the sophistry of it -- by calling your scheme of distribution 'triage', even if it is entirely antithetical to triage itself, you can pretend that you require no further justification. You can pretend, as some Italian doctors recently have, that scarcity of resources means you can deny the elderly medicine that can heal them, medicine that they might need more than a younger person with a stronger immune system, because it's a 'triage situation'. It's as morally odious as claiming that it's OK for police to go into the bank with guns blazing because it's a 'hostage negotiation'. The situation may be an emergency, but the proposed solution is neither necessary nor even appropriate for that situation.

In any case, here are some comments I made in 2012 in response to some similar sophistry.


The entire point of triage is that only need is considered. Triage systems were originally developed in a military context when field doctors started giving medical treatment not on the basis of rank but on the basis of need, as determined by purely medical criteria. This is what genuine triage is: it is a system, operating under a scarcity of resources significant enough to require careful discrimination of who actually receives those resources (most clearly in emergency or disaster, but resources do not necessarily have to be anywhere near that scarce to become an issue), where distribution of those resources is done purely on the basis of actual medical need according to established principles that only consider medical issues. Remember, it has always been the case that doctors have had to make hard choices based on scarce resources. Actual triage systems only developed when the principles governing those choices were no longer official rank, social status, subjective assessment, or any other nonmedical criterion. We can call those other resource-management systems 'triage' in a loose sense, but they are radically different for moral purposes, and cannot all be lumped together as if the justification for one were justification for another. Just as genuine triage management cannot, by its nature, be indiscriminate in the use of medical resources, so it cannot, by its nature, take into account anything other than medical need. And precisely the reason why triage is an important ethical as well as medical concept is that it operates in conditions of necessity according to principles wholly geared to dealing with the necessity; it's the medical necessity, and the proportion of means to the end of dealing with that particular necessity, that justifies triage decisions.

Make Friends with the Doctor

Make friends with the doctor, for he is essential to you;
God has also established him in his profession.
From God the doctor has wisdom,
and from the king he receives sustenance.
Knowledge makes the doctor distinguished,
and gives access to those in authority.
God makes the earth yield healing herbs
which the prudent should not neglect;
Was not the water sweetened by a twig,
so that all might learn his power?
He endows people with knowledge,
to glory in his mighty works,
Through which the doctor eases pain,
and the druggist prepares his medicines.
Thus God’s work continues without cease
in its efficacy on the surface of the earth.

My son, when you are ill, do not delay,
but pray to God, for it is he who heals.
Flee wickedness and purify your hands;
cleanse your heart of every sin.
Offer your sweet-smelling oblation and memorial,
a generous offering according to your means.
Then give the doctor his place
lest he leave; you need him too,
For there are times when recovery is in his hands.
He too prays to God
That his diagnosis may be correct
and his treatment bring about a cure.

Sirach 38:1-14 (NABRE)