Christ told us where we would encounter him in this world, whether to our credit or shame, among the hungry, thirsty, naked, stranger, sick, and imprisoned (Matthew 25:31–46); he declares, that “whoever receives the one I send receives me, and whoever receives me receives the one who sent me” (John 13:20).

In the summer of 2021 I began driving an ice cream truck. My small contribution to Howdy Homemade Ice Cream, an ice cream shop that deliberately employs workers with intellectual, emotional, and/or physical disabilities, such as Down Syndrome, was to simply provide transportation for catered events so that Howdy Homemade’s workers were not only included but actively contributing their gifts in service for others to receive. At catered events in public parks, office buildings, private birthday parties, churches, soup kitchens, and more, young and old formed queues for ice cream that at times reminded me of the diverse crowd that processes to receive the Eucharist. The recent “Hiring Chain” advertisement by CoorDown well depicts my own aspiration, that some of these customers might observe Howdy Homemade’s workers in these different contexts and consider how they might create similar jobs in their places of employment, especially since so few good jobs with adequate pay and health insurance exist for people with significant disabilities.

There is probably a more technically efficient way to run an ice cream store than Howdy Homemade’s mode of operation. As John Swinton well describes in Becoming Friends of Time, people with disabilities tend to relate to time differently than those of us who have become habituated by modern life to following a clock, functioning more like machines than humans. But the reason Howdy Homemade narrowly survived the economic challenges of the pandemic is because the broader community of which the store is a part valued the humanizing goods HH contributes to the broader public, such as joy and hospitality, which derive from its founder’s self-consciously Christian aims and disposition.

Sadly, Howdy Homemade is an extraordinary exception to how people with Down Syndrome and other physical, emotional, and intellectual disabilities are regarded in the world today. Remembering how Christians throughout the centuries have understood humanity to have been created in the image of God is a continual need in order for us to rightly discern our time and place in this world of wonders and perils. Not only can such a vision clarify our obligations towards our fellow human beings. It must also unsettle and re-make how we imagine what it means to be a human being.

Down Syndrome and Inhospitality

In her December 2020 piece in The Atlantic, “The Last Children of Down Syndrome,” Sarah Zhang interviewed persons with Down Syndrome and families around the world who care for children with a range of more and less severe physical, emotional, and intellectual disabilities related to Down Syndrome. Alongside her nuanced and intimate depiction of their plight, Zhang’s analysis raises a disturbing prospect, that we might have a future altogether without human beings who have Down Syndrome:

Denmark is unusual for the universality of its screening program and the comprehensiveness of its data, but the pattern of high abortion rates after a Down syndrome diagnosis holds true across Western Europe and, to a somewhat lesser extent, in the United States. In wealthy countries, it seems to be at once the best and the worst time for Down syndrome. Better health care has more than doubled life expectancy. Better access to education means most children with Down syndrome will learn to read and write. Few people speak publicly about wanting to “eliminate” Down syndrome. Yet individual choices are adding up to something very close to that.

The complexities of abortion in the contemporary world are manifold; writing in Plough, Kirsten Sanders describes the decision making process of women considering an abortion as wrestling with ghosts. But the arrangement of our common life, encompassing vast healthcare systems and individual decisions, prevent most – and in some places, nearly all – people with Down Syndrome from ever being welcomed into this world. Routinely, pro-choice or pro-abortion advocates will criticize conservatives for trying to make abortion illegal while also advocating for austerity with respect to the welfare state, and rightly so. The conservative preference for an informal but strong network of local support from churches, family members, and friends is theoretically desirable. But in our increasingly fragmented and isolated modern world, where bonds that traditionally wove communities together are increasingly frayed, these networks are harder to form and maintain, such that policies of economic austerity can foster child poverty. Consequently, pro-life advocates are routinely stereotyped as valuing human dignity within the womb but not outside of it, not least when it comes to matters of poverty and justice in other arenas of political and socio-economical life.

However, a serious problem with that line of criticism is that countries with the very best social safety nets and the very best public health insurance in the world – the Nordic countries – have a slightly higher abortion rate than the United States. According to the Finnish Institute for Health and Welfare, “Some 57,000 induced abortions were performed in Finland, Sweden and Norway in 2019, that is, 12.4 abortions per thousand women of childbearing age (15–49 years).” According to the Centers for Disease Control, in the United States “in 2018, a total of 614,820 abortions were reported, the abortion rate was 11.3 abortions per 1,000 women aged 15–44 years, and the abortion ratio was 189 abortions per 1,000 live births.” So, while it is worthwhile to undertake whatever costs are needed to so support families in their material needs, to the benefit of parents concerned about their financial ability to care for children with intellectual and physical disabilities, it is not the case that public healthcare would necessarily solve this problem. In Iceland, the abortion rate is virtually one hundred percent where pre-natal screening indicates the child has Down Syndrome; in Denmark it is ninety-eight percent. As Zhang notes, there can be peer pressure not to end these pregnancies. Even if we regard universal public healthcare as a good worth pursuing, it not only does not reduce abortion rates but can actually increase them. According to a March 2022 report for the United States Senate Joint Economic Committee’s Social Capital Project, while medical advances have vastly expanded the life expectancy of people with Down Syndrome, up from 10 years of age in the 1960s to around 52 years of age in 2020, selective abortion means that in the last ten years about 67 percent of Down Syndrome pregnancies were aborted.

What’s So Great About Theological Anthropology in Pluralistic Societies?

In response to such trends, some point to the wonderful things people with Down Syndrome can do, accomplish, or enjoy. These truly significant accomplishments are indeed worth celebrating. Yet, as Justin Hawkins delicately warns, human worth and dignity are not determined by our perceived usefulness to others. People with Down Syndrome are not reducible to their achievements or capacity to enjoy things, nor is their existence reducible to inspirational examples for the ambition of others. But as wonderful as it is to find examples of people with intellectual and physical disabilities still accomplishing truly wonderful achievements despite all adversity, there are a great many parents of children with significant disabilities who may not ever accomplishment an athletic feat, hold a job, or speak – yet, even so, such people are no less human than you or I.

Our perceived utility to others, however great or small, might prove to be little more than the extent to which we can be exploited by dehumanizing forces and soon discarded, not least in the throwaway culture of land, animals, and human beings in the age of globalization.^[1] Rather than envisioning the systems and tools of society as serving the good of humanity, instead conditions can emerge where human beings serve the ends of the systems and tools of society in a vicious, deleterious cycle. Historically, humanity has shown ourselves more than capable of confusing real virtues such as compassion and mercy with violence and brutality, taking it upon ourselves to put people deemed worthless out of their misery, as Lebensunwertes Leben, life unworthy of life. The marginalization and disposal of the lonely elderly, ethnic minorities, the supposedly unproductive, and especially those human beings with physical or intellectual disabilities is not only tolerated but becomes celebrated and championed as humane and dignified. We not only forget, but actively avoid realizing, that even the most fortunate, affluent, and privileged among us, in time, will become utterly useless to our own selves and depend upon the compassion of others as our mortal bodies decay. We are taken from dust, and to dust we shall return, despite all presumption, accomplishment, distraction, or protestation to the contrary.

Cultivating a self-consciously theological account of human dignity might seem like a non-starter to cure the ills of our common life, a confusion of categories as sectarian private values are imposed upon the so-called neutral liberal order of our pluralist societies. The rhetorical moves possible within public reason tend to create a neat distinction between public goods, such as individual liberty, and private values, such as one’s religious preferences. A metaphysical account of what human beings are, particularly one that explicitly draws upon the discourse of Christian theology, indeed breaks the rules of the liberal game for acceptable public discourse.

Yet, it is no secret that everyone who participates in the procedures of public reason does so not only despite, but often precisely because of, their sincerely held private values. One might argue in public for sincerely held, private values on moral and social questions, but must find seemingly neutral ways to argue for this vision in public, perhaps advancing a technocratic argument about how a political ruling on a moral and social question would affect the gross domestic product. But the political organization of our common life inevitably involves some understanding or another of what human beings are, which necessarily exceeds the constraints and limits of supposedly value-free, public neutrality. We might conclude, with Justice Anthony Kennedy, that “At the heart of liberty is the right to define one’s own concept of existence, of meaning, of the universe, and of the mystery of human life,” but this raises significant questions about what the rights and liberties for those who due to intellectual disabilities are scarcely capable of conceptualizing existence.

Liberty in personal preferences, commitment to one’s local community, and consumer choices have their place. But purportedly value-free claims to neutrality are ill-suited tools for understanding and criticizing the market forces and organization of our common life which degrade the earth and deem some human beings as unworthy of life itself. For some problems, comprehensive doctrines and value claims are inescapable, not least on the question of which kinds of human beings should be welcomed and loved on the earth as our common home, or why persons who have Down Syndrome and other intellectual disabilities increasingly are unwelcome in this world.

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