The memory of Schiavo will make its home in the lives of the people who actually knew her in profoundly meaningful ways for many years to come. And no doubt the public figure of Schiavo will likewise continue to resonate into the future, condensing into a few flashes of ineradicable imagery what are in fact the endlessly complex and emotionally fraught quandaries of bodies and lives rendered newly questionable in their limits, capacities and social intelligibility by ongoing and emerging technological developments.

So long as medicine remained primarily remedial, its recommendations were driven most conspicuously by the instrumental rationality of causes and effects, and our best assessments of just what these were and how best to influence them. What health consisted of in the first place and what was desirable about the achievement of that state were to an important extent simply treated as "givens." But as our prosthetic practices proliferate the ways in which people can live "livable " lives, we look less and less to medicine to remedy the ways in which our bodies deviate into pathological difference and more to deliver us into differences we desire.

Of course, the goal of producing and maintaining a "healthy body" through medical and hygienic practice has never in fact been a value-neutral ideal, and our diagnoses of disease, infirmity and illness have always been freighted with cultural and moral significance. But the scope and force of medical intervention is deranging our sense of the standards against which we would measure the distance of the variety of actually living human bodies from the "normative" body we would traditionally impose and maintain through recourse to that medicine. Already, we cannot be quite sure what we are capable of or what we can rightly expect or demand of our newly queer and prostheticized bodily selves.

Medicine is taking humanity on an unprecedented path from remedy to self-creation. But our assumptions and our language have not yet managed to keep up. Meanwhile, our hopes and desires and sometimes our demands range hyperbolically forward past our present capacities.

The heartbreaking and hysterical public spectacle of the dead but surreally lively prostheticized body of Schiavo attests to our perplexity and our present distress. There are many such spectacles to come.

What is a life?

In a recent editorial inspired by the Schiavo case, David Brooks claimed to discern as the main difference between conservative and progressive bioethical discourse that only conservative bioethics is properly moral in its concerns while progressives are somewhat blind to the "values" dimension of policy.

This is, of course, the dismissive or oblivious attitude we have come to expect public conservative figures to take whenever they encounter values with which they disagree. Remember, for example, the discussion just a few months back of the so-called "Values-Voter," which seemed to describe as "moral" only that segment of the American population that hated gay people enough to be mobilized by homophobia to vote palpably against their own stated interests.

But Brooks' discussion of the differences in the ways in which many conservatives and progressives talk about the dilemmas of a case such as Schiavo's does highlight important moral, cultural, temperamental distinctions that likewise illuminate the emerging terrain of bioconservative and technoprogressive positions as well.

Brooks claims that "[t]he core belief that social conservatives [have]... is that the value of each individual life is intrinsic. The value of a life doesn't depend upon what a person can physically do, experience or achieve. The life of a comatose person or a fetus has the same dignity and worth as the life of a fully functioning adult." And against the social conservatives, he suggests that progressives hold as their own "core belief that. quality of life is a fundamental human value."

Progressives don't, Brooks accuses, "emphasize the bright line between life and death; they describe a continuum between a fully lived life and a life that, by the sort of incapacity Terri Schiavo has suffered, is mere existence."

In this formulation, Brooks manages rather incredibly to paint progressives simultaneously as bureaucratic bean-counters altogether dead to the luminous ethical distinctions that drive the more epic moralism of their righteous conservative counterparts, while at the same time accusing them of flinging moralizing assessments about just whose lives get to count as lives "fully lived" as opposed to "mere existence" in a rampage of apparently arbitrary judgment.

Of course, hiding behind the anemic notion of "quality of life" in Brooks' accounting here is in fact a progressive moral value quite as luminous as anything he would attribute to conservative moralists, a value widely and passionately affirmed and on which the recent track record of conservatives is troubling indeed, whatever their occasional lip-service to the contrary: Consent.

Denying lives by denigrating consent

One has to wonder just why it is that conservatives proud to "err on the side of life" seem so regularly impelled in so doing to denigrate consciousness and violate consent.

For progressives, there is indeed a texture in personal life beyond the "mere existence" we share with shrimp and snails, and which demands broad affirmation on its own terms. Personal lives are uniquely lived in the webs of meaning and thought and conversation woven by public beings, lives that reverberate with choices, with desires, with injuries, with deeds.

All the while the armies of the conservative so-called "culture of life" seem to defend life only in some more vegetable or mineral mode always best exemplified by organisms that have not yet arrived among the community of poets and peers, or of those who have already departed from the scene.

Brooks proposes that "[t]he central weakness of the liberal case is that it is morally thin. Once you say that it is up to individuals or families to draw their own lines separating life from existence, and reasonable people will differ, then you are taking a fundamental issue out of the realm of morality and into the realm of relativism and mere taste."

But to denigrate the morality of consent as "the relativism of mere taste" is to confess a complete moral blindness to the way in which we actually want to do morality here in democratic civilization these days.

And it follows as night does day that those who denigrate consent will go on then to denigrate the dignity of actual democratic citizens with whom they happen to disagree. Notice how often "erring on the side of life" seems to conservatives to require a violation of the terms in which citizens with whom they disagree actually choose to live their own lives.

I think it is in fact safe to say with Brooks that in Bush's America "[t]he life of a comatose person or a fetus has the same dignity and worth as the life of a fully functioning adult."

That is to say, not very much.

Conservatives really seem to adore claiming to speak for nonpersons (especially fetal not-quite-yet persons, and stubbornly vegetative no-longer-quite persons) who cannot speak for themselves. How dearly they seem to love to put words into the mouths of those who are in no position to protest the imposition. What better way, after all, of multiplying their own voices in a world where sprawling majorities of actual people simply disagree with them, then to claim that their voice stands for countless voiceless voices as well as their own?

Conservatives pretend to extend the dignity and status of citizens to nonpersons, and in so doing inevitably evacuate actual citizenship of that status. In ascribing "dignity" so uncritically it is the social conservatives who stretch morality as thin as the skin of a soap bubble.

And it matters little to conservatives that their own morality is finally so thin since ultimately they seem to prefer to turn for their moral guidance to the dictates of authorities, claiming to speak for God, or Tradition, or Homeland when all is said and done, than to the more contingent contentious verdicts of their own best worldly and reasonable deliberation.

From disability to diversity

Technoprogressives maintain that technological development is becoming not just a disruptive but a genuinely revolutionary force. Technological change undercuts the normative weight of claims made in the name of the "natural" in ways that, conjoined to deepening democracy, technoprogressives insist can be made to be ultimately emancipatory for all.

For technoprogressives, the ongoing revolution in reproductive medicine and emerging genetic and neuroceutical medicine opens up consensual prosthetic practices of self-creation that will be this generation's historical contribution to the ongoing conversation of humankind.

I use the term "morphological freedom" to describe the ways in which consensual prosthetic practices are enlarging the scope of personal freedom, even while they derange our expectations, demand new responsibilities, and introduce unprecedented possibilities for injustice, violation and harm against which we must struggle interminably.

Along with many other progressives I felt disgust at the public figures who so loudly and cynically attached themselves to the distress of the family of Schiavo in bids for personal attention. I worried together with technoprogressives about the widespread American anti-scientific benightedness that blistered yet again to the surface of public discourse in the midst of the media circus, connecting up in the most ominous imaginable ways with conservative hostility to evolutionary science via the rhetoric of "intelligent design," hostility to environmental science via the rhetoric of climate-change denial, hostility to social science via the rhetoric of "abstinence-only education" and hostility to economic science via the rhetoric of market fundamentalism. And of course I shared the concerns of other liberals about legislative efforts to bypass the courts, insinuations of martial law, and all the rest.

But I also share the concerns of many "disability" advocates who found themselves at odds with some of the progressive and most of the technoprogressive consensus in this cultural moment and who worry that there is something quite pernicious in the conventional liberal discourse that claims that if only Schiavo had a real "chance at recovery" then liberals, too, along with social conservatives, would be demanding her "life" be protected and preserved.

These advocates for the differently enabled are rightly suspicious that the idea of "recovery" in such arguments mobilizes what amounts in fact to a highly restrictive normative concept of the sort of lives that are ultimately "lives worth living." Too often the notion of a properly "livable life" is a concept that denigrates many differently enabled people who, whatever their struggles or sorrows, live lives suffused with dignity, joy and value worth affirming and supporting the same as anyone else's.

Now, I strongly agree with the clinicians and experts whose thorough and repeated examination of the evidence located Schiavo's body in particular decisively with the dead rather than with the disabled. And in any case, I would insist like most progressives do on the absolute moral necessity to respect her own decisions and attitudes in a case like this, however these have been best ascertained by a number of courts, where matters of the care of her own body are concerned.

But it is clear nevertheless that the figure of disability is circulating here in ways that would have to matter to advocates for the differently enabled as well as to advocates and scholars of morphological freedom.

There are many "disabled" people who will seem superficially similar to Schiavo to an untrained eye, after all, and whose lives are routinely dismissed as "not worth living" in consequence. Advocates for the differently enabled fight fraught heartbreaking battles to champion the rights and standing of such people every single day.

What it must mean to respect the differently enabled as the actually fully real people they are is to respect them and support them in their differences whenever they affirm the value of these differences on their own terms, just as it must likewise require the best provision of prosthetic avenues for rewriting their bodies and lives in the image of their own desires, also on their own terms, to the extent that this is possible and wanted by them.

Consensual prosthetic practices

The process of "life" in medical technocultures is one of ongoing practices of genetic, prosthetic and cognitive modification in pursuit of personal meanings, responsibilities and pleasures that are bound to strain against the imposition of normative conceptions of "wellness," however construed.

From the perspective of morphological freedom it seems to me the standard of "recovery" is always therefore worrisomely conservative, naturalizing some contingent standard of proper health as more desirable than indefinitely many alternate possibilities.

Morphological freedom is precisely never a matter of any coercive imposition of a normative body in the name of a moral standard of "health," but is an embrace of genetic, prosthetic and cognitive modification practices in the name of a proliferation of ways of being properly and meaningfully in the world.

To the extent that the rhetoric of "recovery" impels us to misrecognize some manifestations of diversity as "disability," technoprogressives seem to me well rid of it.

And to the extent that technoprogressives will sometimes affirm the desirability of "better than well" healthcare provision this would seem to encourage a repudiation of the discourse of "recovery" as well.

It is especially interesting for me to note the extent to which so many of the differently enabled depend on ongoing cyborgization and prosthetic practices to find their ways to more enriching lives on their own terms: communicating through computer interfaces, locomoting in motorized conveyances, and engaged in sometimes lifelong medical procedures of extraordinary intimacy and profundity.

Now, these considerations do not nudge us into any kind of blanket morphological relativism, since we will still prefer our own personal paths of self-determination on the basis of reasons at least intelligible enough to satisfy the conditions of informed and competent consent. And in any case the proper public provision of the resources that enable prosthetic practices of self-creation also demands the maintenance of intelligible standards to ensure democratic accountability, fairness, security and meaningful deliberation in that provision.

Morphological freedom prevails to the extent to which discernible differences among peers arise from consensual prosthetic practices of self-determination or self-creation, rather than being imposed or unduly duressed by conditions of exploitation, violence or ignorance (any of which might broadly mobilize responsible intervention). What will be key for a properly technoprogressive bioethics that affirms morphological freedom will be a shift in focus from a moral(istic) concern with parochial standards of health, beauty or custom into an ethical concern with the meaningful consent of peers with whom one may or may not identify morally in the slightest.