Chapter 8 from A Guide to Child Health - A Holistic Guide to Raising Healthy Children
Drs Michaela Glöckler and Wolfganf Goebel , Floris Books 2013
8. The Meaning and Purpose of Illness
8.1 What is the purpose of childhood illnesses ?
During their children’s visits to the doctor, parents sometimes ask questions that are part of a larger context and deserve lengthy answers. Among these are questions about the meaning or purpose of specific diseases. In this chapter, we will tackle this issue with regard to the classic childhood illnesses.
Meaning and development
The experience of pain and suffering can enrich human lives or point to new developmental possibilities. This is not true of animals. Because the behaviour of mature animals is almost perfectly adapted to their circumstances, undergoing illness or suffering pain cannot make a lion more perfectly lion-like or a dog more dog-like. In contrast, the pain and suffering encountered on life’s journey can alert human beings to new opportunities for development, and we can continue to become “more human” as long as we live. Therefore, although it has been the custom since ancient times to put suffering animals out of their misery if we are unable to help them quickly, the growing acceptance of assisted suicide for humans on supposedly humanitarian grounds is much more questionable. The concept of euthanasia or “mercy killing” testifies to a profound misunderstanding of the spiritual nature of the human being and the role of pain and suffering in human biographies (see also Section 9.3). Although the physician’s task is to do everything possible to relieve suffering and bring about healing, enduring painful experiences is an essential part of human existence, as is death.
Because different illnesses affect different parts and processes of the human body and produce different experiences for the individual soul- spiritual being occupying that body, it makes sense to reflect on the specific meaning and purpose of different types of illness.
Illness and the members of the human constitution
The human “I” is active in the element of warmth, while our emotions work in the element of air within the human body. Similarly, vegetative life processes take place in the fluid element, and the individually configured physical body manifests in the solid element. The laws governing solids, liquids, and gases – that is, the states of matter – and heat, which pervades them all, offer the human being differentiated possibilities of expression. Rudolf Steiner called these four different complexes of laws, which interact in a unique way in each person, the four members of the human constitution. The following overview summarizes what he said about them :
• The complex of laws governing solid structures – “physical body” – mediates the emergence of form and structure in space.
• The complex of laws governing functions active in fluids – “life body” or “ether body” – mediates the appearance of life processes and temporal connections and sequences.
• The complex of laws governing functions active in air – “soul body” or “astral body” – mediates the expression of emotions, mobility, and consciousness.
• The complex of laws governing functions active in warmth – “I-organization” – mediates the development of intentionality as the vehicle of the individual human spirit. • '
The significance of these members for the life of the human soul and spirit is addressed in other parts of this book. In this chapter, we will emphasize the bodily aspects of their influence because in childhood a soul-spiritual being focuses on “incarnating” into the body and learning to feel at home there. The more suitable the body (or the more suitable it becomes as the child develops), the easier this process is. How many people today feel like strangers to themselves because they are not totally comfortable in their bodies or cannot express themselves through them ? The role of medicine and education is to create conditions that permit the healthiest possible incarnation process. Childhood illnesses play an important part in working through and individualizing specific parts of the body.
Illnesses with high fevers are primarily an indication that the “I” and its warmth activity are intervening in vegetative functions, influencing metabolic processes more strongly than usual and triggering fever-induced immune processes. A child with whooping cough, on the other hand, takes possession of his body’s respiratory organs and functions in a new way, allowing the soul or astral body to work strongly. Diseases that involve significant swelling of lymph nodes or glands, allow children to get a new grip on their vegetative processes – the life or ether body becomes more active. The water-filled blisters of chickenpox contain endogenous matter that needs to be eliminated from the domain of life. These blisters and the subsequent development of small scars subtly alter the child’s physical form.
The thrust of the symptoms of childhood diseases may be directed either outward (as in skin symptoms) or inward (in the diseases involving the blood or individual organs). This difference is most evident in the contrast between smallpox (now eradicated) and diphtheria.
The body’s response to each illness is a one-sided or unbalanced activity summoned up by the child’s “I” in an effort to alter the interaction among the members of his or her constitution. If we attribute symptoms exclusively to germs and recovery to the disappearance of pathogens, the most important questions remain unanswered. What is the relationship between a particular illness and the being of this patient ? Why does the illness affect someone else differently or not at all ? What is the relationship between the pathogen and the essential nature of the illness ? The medical histories of different individuals are never exactly the same. One had a bad case of measles but a mild case of scarlet fever, the other the opposite. One person never contracted whooping cough, another never had mumps. Individual differences of this sort reveal something about the being of the person in question, something we ordinarily fail to consider. But how do we develop susceptibility to a particular illness ? Because Rudolf Steiner’s spiritual research, which provides some insight into this question, also encompassed life after death and the law of reincarnation, we will also briefly discuss their relationship to illness.
Life after death
As Rudolf Steiner describes the process, the physical body is laid aside at death, and during the next three days and nights (when the wake is held in some parts of the world) the life body gradually also detaches from the other members of the deceased person’s constitution. Since the life body is thought-like in character (see also page 277) and encompasses the entire scope of the person’s development from conception to last breath, its release is experienced as a grandiose tableau of memories that spans the entire earthly life that has just ended. All the details of the person’s life are revealed again. After three days and nights, the ether body is absorbed into the general thought-substance of the universe, just as the substances in the corpse are absorbed into the totality of the material world. All superficial or non-binding aspects of the overview disappear ; what remains is like an extract of everything the person was truly able to unite with his or her being during life.
The next step is the release of the soul body. This process takes longer, approximately one-third as long as the person’s elapsed life (that is, as long as the total amount of time that he or she spent sleeping). In literature and in many religious texts, this period of life after death is described as “purgatory” or purification. Here we relive all of our past life’s soul experiences, but not as we underwent them during life. Instead, we experience what others went through because of us. (We have similar experiences unconsciously every night as we sleep.) For example, instead of re-experiencing his own satisfaction and “righteous” indignation, a person who publicly exposed someone else’s wrongdoing now experiences all the details of what the other person felt during this event. Our experiences during the period of purification not only objectify our past soul experiences but also serve as a starting point for shaping our destiny in the next earthly life. If in our past life we wronged someone else, we resolve to balance out this action. As our next life’s destiny develops, it incorporates the possibility of doing good when we meet that person again.
This aspect of how destiny develops also has consequences for our future predisposition to specific illnesses. For example, a person who did not develop loving relationships during her last life feels this as a deficit after death. The experience of how her behaviour affected others and caused them pain is imprinted deeply on her being. Although she had certain reasons for her reticence during earthly life, she now sees it in a different, objective light and realizes the limitations and inadequacy of her self-centred earthly perspective. (Religious traditions refer to this process as “judgment” or seeing past events from the right perspective.) On her journey between death and rebirth, the new understanding that imprints itself on her being may predispose her to a specific illness.
Health and the ability to love
We have said that being healthy means being able to confront the world’s phenomena freely and with interest. Two aberrations are possible here – on the one hand, withdrawing from the world in order to brood and believing that the truth that will change the world can be found only within ourselves ; on the other hand, succumbing completely to the allure of daily life, increasingly renouncing self-assertion, and being driven by events like a leaf in the wind. Inner integrity in the first instance and self- sacrifice in the second – both positive attributes unless taken to extremes – become unbalanced. Being healthy means being able to make flexible use of our options as the situation demands, a quality that Schiller called “play.” We can speak of illness only when people lose self-control or are so fixed within themselves that they can no longer alter their situation by themselves. Their relationship to the world is so seriously disturbed that they find themselves unable to take the world seriously enough (in the first case) or themselves seriously enough (in the second case). Both the self-sacrificer and the egotistical loner lose the ability to love. This ability, however, is the inner foundation of human health. On the one hand, it means being able to take part in the world’s affairs with interest, allowing the people and events in our surroundings to become alive in our own souls ; on the other, it means holding back and allowing others to be free.
In Christianity, love as the goal of human development is called a new commandment (John 13:34). The many possibilities of illness that we are exposed to show us how difficult it is to obey this commandment and how far we still have to go to reach this goal. The human soul in search of its own humanity oscillates unceasingly between the dangers of egocentricity and self-sacrifice. When we first experience this fateful fact, we may question to what extent we can be held responsible for our strayings from the path : “Aren’t we forced to be what we are and to act as we do ?” “We can’t escape from our own skin, can we ?” At this point, the issue of human freedom moves into the foreground. There are many advantages to blaming our inability and problems on circumstances, constitutional weakness, or other people – that is, on anyone and anything except ourselves.
Freedom and necessity in destiny
Freedom to do something or to refrain from doing it is closely linked to our ability to do it. Freedom applies when we are choosing between options, not when we are laboriously acquiring capabilities. We all feel “unfree” when we have to learn something. How much lack of freedom, for instance, is involved in preparing for an exam ? Did anyone ever learn to do arithmetic without obeying, mathematical laws ? Once we have passed the exam or learned arithmetic, however, our freedom increases in that our ability to act has been expanded. The same is true with any necessity of destiny. It simply defines the circumstances necessary for acquiring a specific ability. Once that ability has been acquired, however, we achieve a new level of freedom that makes us more mature and more complete. Hence individual freedom presupposes “individual necessities,” that is, a personal destiny made up of specific conditions. Recognizing this fact is a central concern of Christianity, the essence of which can be summed up as the merging of the two ideals of freedom (as the result of learning processes) and love (as the result of interest in and receptivity to others) as if in a single focal point. From this perspective, every illness also represents a necessity, a condition under which we can acquire an ability that we will later be able to use freely. Similarly, illness can be seen as a “private lesson” from the lord and companion of our destiny, that is, God Himself. The first rule of treating illness, therefore, is to do everything possible so that the patient can reap the benefits of the experience and (if at all possible) be led toward healing. After all, the only possible meaning and purpose of illness is to become healthy again – healthy in body, soul, and spirit, with new consciousness and enhanced capabilities. Our task is to support this process.
8.2 Ethical Issues
It is clear from our discussions thus far that there is no such thing as a meaningless illness or a life not worth living. Our conceptions, personal desires, and capacity for understanding, however, may prevent us from properly asking or answering the question of the meaning of illness or disability.
Almost no question leads us so deeply into connections of destiny as the issue of good deeds. The Greek-derived word “ethics” means a doctrine of good behaviour and good actions. Here, too, scientific discussion, especially in the field of medicine, has faced increasing difficulties in recent decades. After World War II especially in Germany, where experiences under the Nazi regime were fresh in people’s minds – legislation prohibited euthanasia in any form. The situation looks different now, and not only in Germany. Throughout the world, people are invoking scientific, legal, and economic reasons for questioning whether incurable illnesses and disabilities and long-term geriatric dementia have any meaning or purpose. However, some important questions relating to destiny are being asked. For example, what does terminating a pregnancy mean for the unborn child, the mother, and the physician who performs the abortion ? What does brain death or donating or receiving an organ transplant mean for the human body, soul, and spirit ? How do the circumstances surrounding a person’s death affect life after death ? What does senile dementia mean if not seen from exclusively materialistic perspectives ?
As soon as our perspectives on human life expand to consider the human body, soul, and spirit as extending beyond birth and death, ethical questions are transformed into questions of individual responsibility for one’s own destiny and the destiny of others. One’s motive for action then takes centre stage. After all, motive is what determines the quality of an act. What are the real reasons for or against a particular immunization, a specific therapy, physician-assisted death, or terminating a pregnancy ? What personal, professional, or health-related motives are at work ? Any system of ethics that takes the human soul and spirit seriously never asks about the act itself without also asking about the motives that lead to it and about the perpetrator’s relationship to its consequences. In addition to insight and understanding, profound fears, concerns, anger, love, trust, and hope shape ethical reality and influence the quality of an action. The consequences of such actions, however, constitute the destiny of children and adults.
For example, parents who allow their child to be vaccinated against measles out of fear of encephalitis need to know that encephalitis can also be triggered by other infections.1 The pre-eminent issue in this case is how to support the child with our own best forces, how we develop confidence in his destiny and attempt to help him find his way into his body and into his own life. We surround our decision with thoughts and feelings that strengthen the child’s experience of existence and his constitutional state of health. Each decision, however, may have both positive and negative consequences. There is virtually no such thing as a decision that is “all good.” For example, if my hope in having my child vaccinated against measles is to prevent possible damage, of course my motivation sounds good. On the other hand, by having her immunized I also deprive her of an opportunity to exert herself in coming to grips with this illness, an opportunity that would result in more permanent immunity and a better match between her body and her incarnating soul and spirit (see Section 8.1). In each decision, a great deal depends on how we live with its consequences. To what extent can we stand behind the positive consequences of our actions and counteract any negative consequences ?
From this perspective, it is becoming increasingly impossible for ethics to take direction from existing values and norms. It is in the process of being transformed from normative ethics into individual ethics. Regardless of the legalities that apply, each action must always be judged individually, and an individual must take responsibility for it. Even if, as in the Netherlands, euthanasia is permitted by law under certain circumstances, the physicians, relatives involved (and even the patients after death) must live with the consequences of their actions and take personal responsibility for them, for they are the ones who perform the act. The same is true of legislative regulation of organ transplants. Even when brain death is the legal criterion for organ removal, the donor, the receiver, and the doctors performing the operation are linked in relationships of destiny that the participants should enter into deliberately and responsibly.
For example, we have vivid recollections of one of our patients, an eleven-year-old girl with polycystic kidneys who received a transplanted kidney from her identical twin sister. Without the transplant, she would have survived for only a few more weeks or months. Of course, for a living donor to contribute an organ is a more transparent situation than receiving an organ from a dying person. In the latter case, however, it is all the more necessary for all of us as potential donors or receivers to make conscious efforts to understand the processes and circumstances surrounding both the donor’s death and the recipient’s extended life. Anyone who has carefully weighed up the reasons for becoming a donor or a recipient as aspects of personal destiny will live with the consequences of their decision very differently from situations where doctors or legislators decide the issue. In individual ethics, the decisive criterion for judging the ethical validity of any action is always whether the action promotes or hinders human values and human development. This judgment must always be left to the individuals it is all the more necessary for potential donors and recipients to grapple with the issues in advance, so their decisions are made as freely and responsibly as possible.
Prenatal diagnosis
Today we are aware of a number of hereditary illnesses and congenital malformations that can be predicted with the help of chromosomal analysis during pregnancy. In addition to ultrasound diagnosis of congenital malformations, diagnostic options in the first three months now include a computer-generated risk analysis based on a combination of specific blood titres in the mother and nuchal transparency measurement in the unborn child. Other options include placental puncture (in week 11 or 12) and amniocentesis (after week 15), which supply genetic material for diagnosing chromosomal abnormalities (such as trisomy 21 in Down syndrome, chromosome 15 in Prader-Willi syndrome) and diseases (such as cystic fibrosis) that are associated with specific genes.
The purpose of prenatal diagnosis is usually not to treat the illness it reveals, which is usually impossible, but rather to permit timely termination of the pregnancy.
It has never been proved that having disabled or chronically ill children severely compromises their mothers’ mental health. Nonetheless, this medical indication is invoked and abused on a daily basis for aborting babies who would be born disabled or chronically ill.
Furthermore, it is almost never mentioned in this connection that amniocentesis can damage a healthy baby or cause miscarriage, yet the risk is as high as one percent ! The destinies concealed by this statistic do not employ lobbyists and therefore remain nameless and unknown. Ethical questions are always also questions of very individual destinies that have both a past and consequences for the present and future.
If in utero diagnostics is recommended to prevent malformed, congenitally ill, or otherwise seriously disabled children from being born, the underlying assumption is that such lives are not worthy of human beings. On the other hand, if we acknowledge that human beings exist before birth and that even a life of severe disability has meaning and purpose, the questions acquires another dimension and the decision will be less easy.
From the perspective of individual destiny, the often despairing question, “Why me ? Why is my child disabled ?” leads to other questions. “Why do you need me in particular ?” “What connects me to you ?” “What can I do to further your destiny ?” “What do my own experiences and insights owe to you and your suffering ?”
Of course no one actively wishes for illness or for a chronically ill child. But the modem medical achievements of prenatal diagnosis make it appear that we have a choice. This freedom of choice, however, is illusory, because the baby, whether healthy, disabled, or ill, is already there. Who can eliminate the possibility that the child made a prenatal decision to come into the world in this way ? If we don’t want the baby the way he is and send him back into prenatal life, the question remains whether the suffering the mother avoids outweighs what we inflict on the baby by depriving him of the possibility of incarnating.
Thoughts of this sort are not simply a problem for parents and experts – we are all affected by it. Even if it is more comfortable to leave decisions for and against in utero diagnostics, artificial insemination, and genetic manipulation, or experimental cloning to experts, the church, or the government, every adult citizen needs to work on these questions. This is the only way to develop a sense of responsibility based on personal insight, which is the foundation of a new morality, a new “ethical individualism,” as Steiner called it. 2
8.3 Born too late? Life before birth
Children bring their own destinies with them into this world. After the birth of a baby, parents frequently experience that they develop relationships with neighbours who were almost strangers before. Children get to know their age peers in the neighbourhood and develop a variety of friendships as well as problematic connections. This process continues in school, resulting in different constellations within each class – lonely or excluded individuals and the cliques, intense friendships, and enmities that shape the character of children’s daily lives. It is interesting to consider what all must come together so that a child meets (or fails to meet) these particular people in this particular place and in this particular year.
The choices made available by contraceptives, abortion reform, in vitro fertilization, treatment of sterility, and early diagnosis of congenital malformations have not only vastly increased women’s freedom of choice, but they have also made it incomparably more difficult for the unborn to be born to a specific mother and to incarnate at the particular time and in the particular place that will allow them to meet the other crucial individuals in their lives.
Many women clearly sense whether a child wants to come to them or not. Often, a woman will report that she has felt for years that a child is waiting in the wings for her. When the feeling disappears, it may leave behind either a sense of sadness or the happy feeling that the child has found a different solution and will now leave her in peace.
Rudolf Steiner’s research makes it clear that an unborn person’s approach to a new incarnation can be very difficult and complicated :
For example, a soul intending to incarnate knows that it needs to experience a certain type of upbringing and absorb a certain kind of knowledge during childhood in its next earthly life. The soul also knows which parents will be able to ensure that these experiences will indeed occur. This set of parents may not be able to provide a happy life in other respects, but if this soul were to choose different parents, it would be unable to achieve its most important goals with regard to this particular incarnation
We must not imagine that life in the spiritual world is always so very different from life on Earth. An unborn soul may experience tremendous internal conflicts because it knows, for example, that it can expect to be mistreated as a child by the abusive parents it feels obliged to choose. Many souls approaching rebirth experience terrible inner struggles, and these struggles are visible all around them in the spiritual world. In other words, these struggles are not exclusively internal, private conflicts but are projected outward for all to see. In very graphic imaginations, we perceive the internal conflicts of souls approaching their next incarnations. 3
When we apply the realities of spiritual life and the spiritual world to everyday earthly life, many aspects of family planning that we now take for granted become open to question again, and thoughts about the unborn begin to influence how we think about our own life. We begin to listen to intuitive ideas and the voice of conscience. Our perspective on our own life situation – what we ourselves and our partners need or feel is right – undergoes a shift when we consider the unborn, whose presence becomes more tangible when we think about them and listen for them.
The use of hormonal or barrier contraceptives may initially force an unborn child to wait in the surroundings of the couple selected as parents. After a certain time, however, if that soul has reasons for wanting to belong to a specific generation or peer group, it is forced to seek out a similar couple or a couple in the immediate area, who will enable it to absorb the specific impressions it needs and to meet the people who were its first choice as parents.
Drs Michaela Glöckler and Wolfganf Goebel , Floris Books 2013
8. The Meaning and Purpose of Illness
8.1 What is the purpose of childhood illnesses ?
During their children’s visits to the doctor, parents sometimes ask questions that are part of a larger context and deserve lengthy answers. Among these are questions about the meaning or purpose of specific diseases. In this chapter, we will tackle this issue with regard to the classic childhood illnesses.
Meaning and development
The experience of pain and suffering can enrich human lives or point to new developmental possibilities. This is not true of animals. Because the behaviour of mature animals is almost perfectly adapted to their circumstances, undergoing illness or suffering pain cannot make a lion more perfectly lion-like or a dog more dog-like. In contrast, the pain and suffering encountered on life’s journey can alert human beings to new opportunities for development, and we can continue to become “more human” as long as we live. Therefore, although it has been the custom since ancient times to put suffering animals out of their misery if we are unable to help them quickly, the growing acceptance of assisted suicide for humans on supposedly humanitarian grounds is much more questionable. The concept of euthanasia or “mercy killing” testifies to a profound misunderstanding of the spiritual nature of the human being and the role of pain and suffering in human biographies (see also Section 9.3). Although the physician’s task is to do everything possible to relieve suffering and bring about healing, enduring painful experiences is an essential part of human existence, as is death.
Because different illnesses affect different parts and processes of the human body and produce different experiences for the individual soul- spiritual being occupying that body, it makes sense to reflect on the specific meaning and purpose of different types of illness.
Illness and the members of the human constitution
The human “I” is active in the element of warmth, while our emotions work in the element of air within the human body. Similarly, vegetative life processes take place in the fluid element, and the individually configured physical body manifests in the solid element. The laws governing solids, liquids, and gases – that is, the states of matter – and heat, which pervades them all, offer the human being differentiated possibilities of expression. Rudolf Steiner called these four different complexes of laws, which interact in a unique way in each person, the four members of the human constitution. The following overview summarizes what he said about them :
• The complex of laws governing solid structures – “physical body” – mediates the emergence of form and structure in space.
• The complex of laws governing functions active in fluids – “life body” or “ether body” – mediates the appearance of life processes and temporal connections and sequences.
• The complex of laws governing functions active in air – “soul body” or “astral body” – mediates the expression of emotions, mobility, and consciousness.
• The complex of laws governing functions active in warmth – “I-organization” – mediates the development of intentionality as the vehicle of the individual human spirit. • '
The significance of these members for the life of the human soul and spirit is addressed in other parts of this book. In this chapter, we will emphasize the bodily aspects of their influence because in childhood a soul-spiritual being focuses on “incarnating” into the body and learning to feel at home there. The more suitable the body (or the more suitable it becomes as the child develops), the easier this process is. How many people today feel like strangers to themselves because they are not totally comfortable in their bodies or cannot express themselves through them ? The role of medicine and education is to create conditions that permit the healthiest possible incarnation process. Childhood illnesses play an important part in working through and individualizing specific parts of the body.
Illnesses with high fevers are primarily an indication that the “I” and its warmth activity are intervening in vegetative functions, influencing metabolic processes more strongly than usual and triggering fever-induced immune processes. A child with whooping cough, on the other hand, takes possession of his body’s respiratory organs and functions in a new way, allowing the soul or astral body to work strongly. Diseases that involve significant swelling of lymph nodes or glands, allow children to get a new grip on their vegetative processes – the life or ether body becomes more active. The water-filled blisters of chickenpox contain endogenous matter that needs to be eliminated from the domain of life. These blisters and the subsequent development of small scars subtly alter the child’s physical form.
The thrust of the symptoms of childhood diseases may be directed either outward (as in skin symptoms) or inward (in the diseases involving the blood or individual organs). This difference is most evident in the contrast between smallpox (now eradicated) and diphtheria.
The body’s response to each illness is a one-sided or unbalanced activity summoned up by the child’s “I” in an effort to alter the interaction among the members of his or her constitution. If we attribute symptoms exclusively to germs and recovery to the disappearance of pathogens, the most important questions remain unanswered. What is the relationship between a particular illness and the being of this patient ? Why does the illness affect someone else differently or not at all ? What is the relationship between the pathogen and the essential nature of the illness ? The medical histories of different individuals are never exactly the same. One had a bad case of measles but a mild case of scarlet fever, the other the opposite. One person never contracted whooping cough, another never had mumps. Individual differences of this sort reveal something about the being of the person in question, something we ordinarily fail to consider. But how do we develop susceptibility to a particular illness ? Because Rudolf Steiner’s spiritual research, which provides some insight into this question, also encompassed life after death and the law of reincarnation, we will also briefly discuss their relationship to illness.
Life after death
As Rudolf Steiner describes the process, the physical body is laid aside at death, and during the next three days and nights (when the wake is held in some parts of the world) the life body gradually also detaches from the other members of the deceased person’s constitution. Since the life body is thought-like in character (see also page 277) and encompasses the entire scope of the person’s development from conception to last breath, its release is experienced as a grandiose tableau of memories that spans the entire earthly life that has just ended. All the details of the person’s life are revealed again. After three days and nights, the ether body is absorbed into the general thought-substance of the universe, just as the substances in the corpse are absorbed into the totality of the material world. All superficial or non-binding aspects of the overview disappear ; what remains is like an extract of everything the person was truly able to unite with his or her being during life.
The next step is the release of the soul body. This process takes longer, approximately one-third as long as the person’s elapsed life (that is, as long as the total amount of time that he or she spent sleeping). In literature and in many religious texts, this period of life after death is described as “purgatory” or purification. Here we relive all of our past life’s soul experiences, but not as we underwent them during life. Instead, we experience what others went through because of us. (We have similar experiences unconsciously every night as we sleep.) For example, instead of re-experiencing his own satisfaction and “righteous” indignation, a person who publicly exposed someone else’s wrongdoing now experiences all the details of what the other person felt during this event. Our experiences during the period of purification not only objectify our past soul experiences but also serve as a starting point for shaping our destiny in the next earthly life. If in our past life we wronged someone else, we resolve to balance out this action. As our next life’s destiny develops, it incorporates the possibility of doing good when we meet that person again.
This aspect of how destiny develops also has consequences for our future predisposition to specific illnesses. For example, a person who did not develop loving relationships during her last life feels this as a deficit after death. The experience of how her behaviour affected others and caused them pain is imprinted deeply on her being. Although she had certain reasons for her reticence during earthly life, she now sees it in a different, objective light and realizes the limitations and inadequacy of her self-centred earthly perspective. (Religious traditions refer to this process as “judgment” or seeing past events from the right perspective.) On her journey between death and rebirth, the new understanding that imprints itself on her being may predispose her to a specific illness.
Health and the ability to love
We have said that being healthy means being able to confront the world’s phenomena freely and with interest. Two aberrations are possible here – on the one hand, withdrawing from the world in order to brood and believing that the truth that will change the world can be found only within ourselves ; on the other hand, succumbing completely to the allure of daily life, increasingly renouncing self-assertion, and being driven by events like a leaf in the wind. Inner integrity in the first instance and self- sacrifice in the second – both positive attributes unless taken to extremes – become unbalanced. Being healthy means being able to make flexible use of our options as the situation demands, a quality that Schiller called “play.” We can speak of illness only when people lose self-control or are so fixed within themselves that they can no longer alter their situation by themselves. Their relationship to the world is so seriously disturbed that they find themselves unable to take the world seriously enough (in the first case) or themselves seriously enough (in the second case). Both the self-sacrificer and the egotistical loner lose the ability to love. This ability, however, is the inner foundation of human health. On the one hand, it means being able to take part in the world’s affairs with interest, allowing the people and events in our surroundings to become alive in our own souls ; on the other, it means holding back and allowing others to be free.
In Christianity, love as the goal of human development is called a new commandment (John 13:34). The many possibilities of illness that we are exposed to show us how difficult it is to obey this commandment and how far we still have to go to reach this goal. The human soul in search of its own humanity oscillates unceasingly between the dangers of egocentricity and self-sacrifice. When we first experience this fateful fact, we may question to what extent we can be held responsible for our strayings from the path : “Aren’t we forced to be what we are and to act as we do ?” “We can’t escape from our own skin, can we ?” At this point, the issue of human freedom moves into the foreground. There are many advantages to blaming our inability and problems on circumstances, constitutional weakness, or other people – that is, on anyone and anything except ourselves.
Freedom and necessity in destiny
Freedom to do something or to refrain from doing it is closely linked to our ability to do it. Freedom applies when we are choosing between options, not when we are laboriously acquiring capabilities. We all feel “unfree” when we have to learn something. How much lack of freedom, for instance, is involved in preparing for an exam ? Did anyone ever learn to do arithmetic without obeying, mathematical laws ? Once we have passed the exam or learned arithmetic, however, our freedom increases in that our ability to act has been expanded. The same is true with any necessity of destiny. It simply defines the circumstances necessary for acquiring a specific ability. Once that ability has been acquired, however, we achieve a new level of freedom that makes us more mature and more complete. Hence individual freedom presupposes “individual necessities,” that is, a personal destiny made up of specific conditions. Recognizing this fact is a central concern of Christianity, the essence of which can be summed up as the merging of the two ideals of freedom (as the result of learning processes) and love (as the result of interest in and receptivity to others) as if in a single focal point. From this perspective, every illness also represents a necessity, a condition under which we can acquire an ability that we will later be able to use freely. Similarly, illness can be seen as a “private lesson” from the lord and companion of our destiny, that is, God Himself. The first rule of treating illness, therefore, is to do everything possible so that the patient can reap the benefits of the experience and (if at all possible) be led toward healing. After all, the only possible meaning and purpose of illness is to become healthy again – healthy in body, soul, and spirit, with new consciousness and enhanced capabilities. Our task is to support this process.
8.2 Ethical Issues
It is clear from our discussions thus far that there is no such thing as a meaningless illness or a life not worth living. Our conceptions, personal desires, and capacity for understanding, however, may prevent us from properly asking or answering the question of the meaning of illness or disability.
Almost no question leads us so deeply into connections of destiny as the issue of good deeds. The Greek-derived word “ethics” means a doctrine of good behaviour and good actions. Here, too, scientific discussion, especially in the field of medicine, has faced increasing difficulties in recent decades. After World War II especially in Germany, where experiences under the Nazi regime were fresh in people’s minds – legislation prohibited euthanasia in any form. The situation looks different now, and not only in Germany. Throughout the world, people are invoking scientific, legal, and economic reasons for questioning whether incurable illnesses and disabilities and long-term geriatric dementia have any meaning or purpose. However, some important questions relating to destiny are being asked. For example, what does terminating a pregnancy mean for the unborn child, the mother, and the physician who performs the abortion ? What does brain death or donating or receiving an organ transplant mean for the human body, soul, and spirit ? How do the circumstances surrounding a person’s death affect life after death ? What does senile dementia mean if not seen from exclusively materialistic perspectives ?
As soon as our perspectives on human life expand to consider the human body, soul, and spirit as extending beyond birth and death, ethical questions are transformed into questions of individual responsibility for one’s own destiny and the destiny of others. One’s motive for action then takes centre stage. After all, motive is what determines the quality of an act. What are the real reasons for or against a particular immunization, a specific therapy, physician-assisted death, or terminating a pregnancy ? What personal, professional, or health-related motives are at work ? Any system of ethics that takes the human soul and spirit seriously never asks about the act itself without also asking about the motives that lead to it and about the perpetrator’s relationship to its consequences. In addition to insight and understanding, profound fears, concerns, anger, love, trust, and hope shape ethical reality and influence the quality of an action. The consequences of such actions, however, constitute the destiny of children and adults.
For example, parents who allow their child to be vaccinated against measles out of fear of encephalitis need to know that encephalitis can also be triggered by other infections.1 The pre-eminent issue in this case is how to support the child with our own best forces, how we develop confidence in his destiny and attempt to help him find his way into his body and into his own life. We surround our decision with thoughts and feelings that strengthen the child’s experience of existence and his constitutional state of health. Each decision, however, may have both positive and negative consequences. There is virtually no such thing as a decision that is “all good.” For example, if my hope in having my child vaccinated against measles is to prevent possible damage, of course my motivation sounds good. On the other hand, by having her immunized I also deprive her of an opportunity to exert herself in coming to grips with this illness, an opportunity that would result in more permanent immunity and a better match between her body and her incarnating soul and spirit (see Section 8.1). In each decision, a great deal depends on how we live with its consequences. To what extent can we stand behind the positive consequences of our actions and counteract any negative consequences ?
From this perspective, it is becoming increasingly impossible for ethics to take direction from existing values and norms. It is in the process of being transformed from normative ethics into individual ethics. Regardless of the legalities that apply, each action must always be judged individually, and an individual must take responsibility for it. Even if, as in the Netherlands, euthanasia is permitted by law under certain circumstances, the physicians, relatives involved (and even the patients after death) must live with the consequences of their actions and take personal responsibility for them, for they are the ones who perform the act. The same is true of legislative regulation of organ transplants. Even when brain death is the legal criterion for organ removal, the donor, the receiver, and the doctors performing the operation are linked in relationships of destiny that the participants should enter into deliberately and responsibly.
For example, we have vivid recollections of one of our patients, an eleven-year-old girl with polycystic kidneys who received a transplanted kidney from her identical twin sister. Without the transplant, she would have survived for only a few more weeks or months. Of course, for a living donor to contribute an organ is a more transparent situation than receiving an organ from a dying person. In the latter case, however, it is all the more necessary for all of us as potential donors or receivers to make conscious efforts to understand the processes and circumstances surrounding both the donor’s death and the recipient’s extended life. Anyone who has carefully weighed up the reasons for becoming a donor or a recipient as aspects of personal destiny will live with the consequences of their decision very differently from situations where doctors or legislators decide the issue. In individual ethics, the decisive criterion for judging the ethical validity of any action is always whether the action promotes or hinders human values and human development. This judgment must always be left to the individuals it is all the more necessary for potential donors and recipients to grapple with the issues in advance, so their decisions are made as freely and responsibly as possible.
Prenatal diagnosis
Today we are aware of a number of hereditary illnesses and congenital malformations that can be predicted with the help of chromosomal analysis during pregnancy. In addition to ultrasound diagnosis of congenital malformations, diagnostic options in the first three months now include a computer-generated risk analysis based on a combination of specific blood titres in the mother and nuchal transparency measurement in the unborn child. Other options include placental puncture (in week 11 or 12) and amniocentesis (after week 15), which supply genetic material for diagnosing chromosomal abnormalities (such as trisomy 21 in Down syndrome, chromosome 15 in Prader-Willi syndrome) and diseases (such as cystic fibrosis) that are associated with specific genes.
The purpose of prenatal diagnosis is usually not to treat the illness it reveals, which is usually impossible, but rather to permit timely termination of the pregnancy.
It has never been proved that having disabled or chronically ill children severely compromises their mothers’ mental health. Nonetheless, this medical indication is invoked and abused on a daily basis for aborting babies who would be born disabled or chronically ill.
Furthermore, it is almost never mentioned in this connection that amniocentesis can damage a healthy baby or cause miscarriage, yet the risk is as high as one percent ! The destinies concealed by this statistic do not employ lobbyists and therefore remain nameless and unknown. Ethical questions are always also questions of very individual destinies that have both a past and consequences for the present and future.
If in utero diagnostics is recommended to prevent malformed, congenitally ill, or otherwise seriously disabled children from being born, the underlying assumption is that such lives are not worthy of human beings. On the other hand, if we acknowledge that human beings exist before birth and that even a life of severe disability has meaning and purpose, the questions acquires another dimension and the decision will be less easy.
From the perspective of individual destiny, the often despairing question, “Why me ? Why is my child disabled ?” leads to other questions. “Why do you need me in particular ?” “What connects me to you ?” “What can I do to further your destiny ?” “What do my own experiences and insights owe to you and your suffering ?”
Of course no one actively wishes for illness or for a chronically ill child. But the modem medical achievements of prenatal diagnosis make it appear that we have a choice. This freedom of choice, however, is illusory, because the baby, whether healthy, disabled, or ill, is already there. Who can eliminate the possibility that the child made a prenatal decision to come into the world in this way ? If we don’t want the baby the way he is and send him back into prenatal life, the question remains whether the suffering the mother avoids outweighs what we inflict on the baby by depriving him of the possibility of incarnating.
Thoughts of this sort are not simply a problem for parents and experts – we are all affected by it. Even if it is more comfortable to leave decisions for and against in utero diagnostics, artificial insemination, and genetic manipulation, or experimental cloning to experts, the church, or the government, every adult citizen needs to work on these questions. This is the only way to develop a sense of responsibility based on personal insight, which is the foundation of a new morality, a new “ethical individualism,” as Steiner called it. 2
8.3 Born too late? Life before birth
Children bring their own destinies with them into this world. After the birth of a baby, parents frequently experience that they develop relationships with neighbours who were almost strangers before. Children get to know their age peers in the neighbourhood and develop a variety of friendships as well as problematic connections. This process continues in school, resulting in different constellations within each class – lonely or excluded individuals and the cliques, intense friendships, and enmities that shape the character of children’s daily lives. It is interesting to consider what all must come together so that a child meets (or fails to meet) these particular people in this particular place and in this particular year.
The choices made available by contraceptives, abortion reform, in vitro fertilization, treatment of sterility, and early diagnosis of congenital malformations have not only vastly increased women’s freedom of choice, but they have also made it incomparably more difficult for the unborn to be born to a specific mother and to incarnate at the particular time and in the particular place that will allow them to meet the other crucial individuals in their lives.
Many women clearly sense whether a child wants to come to them or not. Often, a woman will report that she has felt for years that a child is waiting in the wings for her. When the feeling disappears, it may leave behind either a sense of sadness or the happy feeling that the child has found a different solution and will now leave her in peace.
Rudolf Steiner’s research makes it clear that an unborn person’s approach to a new incarnation can be very difficult and complicated :
For example, a soul intending to incarnate knows that it needs to experience a certain type of upbringing and absorb a certain kind of knowledge during childhood in its next earthly life. The soul also knows which parents will be able to ensure that these experiences will indeed occur. This set of parents may not be able to provide a happy life in other respects, but if this soul were to choose different parents, it would be unable to achieve its most important goals with regard to this particular incarnation
We must not imagine that life in the spiritual world is always so very different from life on Earth. An unborn soul may experience tremendous internal conflicts because it knows, for example, that it can expect to be mistreated as a child by the abusive parents it feels obliged to choose. Many souls approaching rebirth experience terrible inner struggles, and these struggles are visible all around them in the spiritual world. In other words, these struggles are not exclusively internal, private conflicts but are projected outward for all to see. In very graphic imaginations, we perceive the internal conflicts of souls approaching their next incarnations. 3
When we apply the realities of spiritual life and the spiritual world to everyday earthly life, many aspects of family planning that we now take for granted become open to question again, and thoughts about the unborn begin to influence how we think about our own life. We begin to listen to intuitive ideas and the voice of conscience. Our perspective on our own life situation – what we ourselves and our partners need or feel is right – undergoes a shift when we consider the unborn, whose presence becomes more tangible when we think about them and listen for them.
The use of hormonal or barrier contraceptives may initially force an unborn child to wait in the surroundings of the couple selected as parents. After a certain time, however, if that soul has reasons for wanting to belong to a specific generation or peer group, it is forced to seek out a similar couple or a couple in the immediate area, who will enable it to absorb the specific impressions it needs and to meet the people who were its first choice as parents.
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1 A study in Bavaria revealed that within an eleven-year period, the decrease in cases of measles encephalitis as a result of immunization was more than equalled by the increase in other forms of encephalitis ; unfortunately, the total number of reported encephalitis cases actually increased. See Windorfer and Grüneweg, Bundesgesetzblatt, 1993, 3 : 87, and Windorfer, A. and M. Kruse, Zentralnervose Infektionen im Kindesalter. Sozialpadiatrie, 1992, 15 : 690.
2 Steiner, Rudolf. Intuitive Thinking as a Spiritual Path: A Philosophy of Freedom, Anthroposophic Press, USA 1995.
3 Steiner, Rudolf. Lecture given on Oct 11, 1913. In Okkulte Untersuchungen iiber das Leben zwischen Tod und neuer Geburt. Domach 1990. Trans. C. Creeger. English published as Links between the Living and the Dead, Rudolf Steiner Press, UK 1973.
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1 A study in Bavaria revealed that within an eleven-year period, the decrease in cases of measles encephalitis as a result of immunization was more than equalled by the increase in other forms of encephalitis ; unfortunately, the total number of reported encephalitis cases actually increased. See Windorfer and Grüneweg, Bundesgesetzblatt, 1993, 3 : 87, and Windorfer, A. and M. Kruse, Zentralnervose Infektionen im Kindesalter. Sozialpadiatrie, 1992, 15 : 690.
2 Steiner, Rudolf. Intuitive Thinking as a Spiritual Path: A Philosophy of Freedom, Anthroposophic Press, USA 1995.
3 Steiner, Rudolf. Lecture given on Oct 11, 1913. In Okkulte Untersuchungen iiber das Leben zwischen Tod und neuer Geburt. Domach 1990. Trans. C. Creeger. English published as Links between the Living and the Dead, Rudolf Steiner Press, UK 1973.
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