The Ethics of Sex and Alzheimer's

John Portmann

• Editore: Routledge
• Anno: 2013
• ISBN:
  9781135122119
• Edizione: 1
• Argomento: Theology & Religion
• Categoria: Religion

A growing epidemic, Alzheimer's punishes not only its victims but also those married to them. This book analyzes how Alzheimer's is quietly transforming the way we think about love today. Without meaning to become rebels, many people who find themselves "married to Alzheimer's" deflate the predominant notion of a conventional marriage. By falling in love again before their ill spouse dies, those married to Alzheimer's come into conflict with central values of Western civilization – personal, sexual, familial, religious, and political. Those who wait sadly for a spouse's death must sometimes wonder if the show of fidelity is necessary and whom it helps.

Most books on Alzheimer's focus on those who have it, as opposed to those who care for someone with it. This book offers a powerful and searching meditation on the extent to which someone married to Alzheimer's should be expected to suffer loneliness. The diagnosis of dementia should not amount to a prohibition of sexual activity for both spouses. Portmann encourages readers to risk honesty in assessing the moral dilemma, using high-profile cases such as Nancy Reagan and Justice Sandra Day O'Connor to illustrate the enormity of the problem. Ideal for classes considering the ethics of aging and sexuality.

1

Sexual Entitlement

Marriage is for Sex and Sex is for Marriage

Can you have a marriage if you don’t have sex? Following Paul of Tarsus, who orchestrated Christian thinking about sex two thousand years ago, we might be tempted to say no. Paul, like Augustine after him, took lust as a simple fact of life.¹ (Today, many scholars refer to St. Paul as “Paul of Tarsus.” I will use the names interchangeably and at times refer to him simply as “Paul”.) Since lust was natural, it was for Paul naturally a part of marriage. Indeed, lust was the reason why men and women marry. Once a man and wife start having sex, they shouldn’t stop. Nor should they deny each other sex: This is what he meant by “conjugal debt” or “conjugal rights.” Paul did not decree that spouses had to deliver every time one of them wanted sex; what he sought to do was maneuver into place a strong sense of moral entitlement. If he greased the path to sexual satisfaction, he also mechanized sex. For when one spouse is in the mood and the other is not, routine coitus can result.

Over the centuries, Christian theologians would refine Paul’s rudimentary idea by recognizing invalidated conditions such as impotence, leprosy, and captivity. Agreement on what we might think of as “escape clauses” eluded commentators. Beyond that, various theologians questioned the authority of a pope to dissolve marriages according to any escape clause. In this chapter I reach for an answer to the question of whether someone married to Alzheimer’s still has a conjugal right to sex.

Paul’s influential reference to conjugal rights in 1 Corinthians 7 does not come from out of the blue; the idea that a husband and wife owed sexual intercourse to one another (“conjugal debt”) comes from Judaism, with some modifications. Paul declares:

The husband should fulfill his marital duty to his wife, and likewise the wife to her husband. The wife’s body does not belong to her alone but also to her husband. In the same way, the husband’s body does not belong to him alone but also to his wife. Do not deprive each other except by mutual consent and for a time, so that you may devote yourselves to prayer. Then come together again so that Satan will not tempt you because of your lack of self-control. I say this as a concession, not as a command.

Shortly I will tie Paul’s thinking to its Jewish origins. Paul of Tarsus was a Jew writing before the term “Christian” had been invented. As crucial as Paul has been for Christian theology, it would be misleading to portray him as completely representative of Christian theology. For one thing, he expected the imminent return of Jesus of Nazareth, which means that his comments in 1 Corinthians 7 have an eschatological hue (that is, he thought of sex in terms of someone expecting the world to end shortly). In other passages regarding sex and the family, Paul does not sound so ascetic, so disapproving. For now, I point out that Paul does not mention physical infirmity in the passage just quoted. Generations of subsequent Christian theologians would nonetheless ponder the physical debility of a spouse and take up the question of whether sexual intercourse was crucial to a valid marriage.

Alzheimer’s was only “discovered” or named in 1906, and so it is hardly surprising that theologians have not addressed it specifically. What Jewish or Christian theologians have had to say about dissolving a union which by definition aims at permanency, however, may be helpful for anyone guessing at how Jews or Christians might judge the legitimacy of a marriage interrupted by Alzheimer’s. We will see that sexual entitlement – the right of both the wife and the husband to enjoy occasional sex with the other – would seem to present a serious obstacle to the marriage. My modest aim in this chapter is to establish the social importance of sexual entitlement within Western marriage.

Conjugal Rights

I do not claim to present an exhaustive overview of conjugal rights in either Judaism or Christianity. I will, however, try to provide a general answer to the question of whether observant Jews and Christians should still view marriage as a matter of sex, as opposed to friendship, or sharing material goods, or a meeting of the minds, or inheritance. That is, I will probe the limits of conjugal rights.

Of course, Christianity sprang from Judaism and maintained much of the spirit of Jewish theology, but Christian theology also absorbed some of the sexual asceticism of ancient Greece.² Paul praises those Christians who, like Greek ascetics, could live entirely without sex. Jewish theology does not praise such persons but instead urges marriage on everyone. Although plural marriage was never allowed in Christianity, it was in Judaism.³ Jewish law specified that a first wife must be treated as well as a second wife. Exodus 21:10–11 states that a second wife is not to be preferred over a first wife, not even if the first wife happened to be a slave:

If he marries another woman, he must not deprive the first one of her food, clothing and marital rights. If he does not provide her with these three things, she is to go free, without any payment of money.

A free person could be expected to enjoy any right enjoyed by a slave; as we read above, Exodus 21:10–11 includes conjugal relations among the minimal requirements of marriage (oddly enough, shelter is not mentioned).

Judaism took the idea of sexual obligation so seriously as to protect a woman’s sexual pleasure, not just her right to regular sexual activity. A man failed in his duty if the woman did not achieve an orgasm. Satisfaction of the wife is commanded; the law is called onah. For centuries, Jewish law permitted a woman to demand a divorce from her husband if he failed to fulfill his conjugal debt.

Rabbinic Judaism coalesced and became the dominant form of Judaism in the sixth century CE, after the codification of the Talmud, or oral law. What principally distinguished rabbinic Judaism was its emphasis on the Talmud, which became as authoritative as the Torah itself. Biblical scholars roundly criticize the straightforward application of rabbinic teachings to Paul’s writings, and it is important not to attribute to Paul more than he himself may have known. It would be a mistake to assert that Paul, a Pharisee, knew what the Mishnah had to say about onah. My point here is to indicate a noteworthy coincidence – that sexual satisfaction shapes Jewish and Christian thinking about marriage – and to introduce the notion of quality into the discussion. It was not enough for a Jewish husband to follow the letter of the law, sexually speaking; he had to follow the spirit of the law as well and ascertain that he had succeeded in finishing the task well.

Rabbinic Jewish law separated what Catholic theology would insist on combining: erotic pleasure and procreation. Onah remained a commandment separate from the commandment to procreate. Thus, sexual relations are required even with a woman incapable of conceiving, whether pregnant, nursing, or post-menopausal, no less than they are with one fully fertile. A husband was to make love to his wife as if she could conceive, even if they both knew she could not. Some authorities even understood the Talmudic permission to engage in “unnatural intercourse” as permitting occasional acts of anal or oral intercourse, even though these were clearly not procreative.⁴

Onah privileged women. The thinking was that men were bold enough to ask for sexual fulfillment; women were not. Furthermore, when a man experienced sexual arousal, his erection made that plain. An aroused woman, on the other hand, was considerably more difficult to detect, anatomically speaking. It was a man’s duty to “visit” his wife before making a long journey, on the premise that she would need to “save up for a rainy day,” with regard to sexual needs. Some ancient Jewish thinking seemed predicated on the expectation that a woman yearning for sexual release would stray if her husband were not at her side and capable of satisfying her needs.

In the infamous chapter in which Paul would later say that it is better to marry than to burn (1 Cor. 7), he made the idea of sexual entitlement a reciprocal right. No less than the Jewish rabbis who developed the idea of onah, Paul understood the obstacle lust posed to maintaining a happy marriage; if not controlled and regularly satisfied, lust could lead a man to seek “consolation” in the arms of a prostitute. Hebrew Scriptures take a matter-of-fact view of prostitutes, arguably more so than do many twenty-first century Americans. The story of Tamar and Judah revolves around prostitution, and Hebrew scriptures address the social freedom of prostitutes: The earnings of a prostitute were not acceptable as a temple offering (charitable organizations would today call it “dirty money”) and priests were not allowed to marry a prostitute or a divorced woman (Leviticus 21:7).

It cannot be said that Jews in general (and certainly not at all times and in every place) accepted the rabbinic theory of oral law as binding. As a number of scholars have shown, rabbinic teachings were not necessarily adopted by every Jew, everywhere, and at every time. Both Jewish identity and Judaism must be understood as diverse, unstable, and complex.⁵

Early Christians considered fornication a problem widespread enough to justify constant vigilance. This concern extends into modern times. One of the most contentious aspects of fornication in the first Christian centuries involved concubines, whose moral status remained unclear, even though they enjoyed legal protection. As evidence that some theologians did not consider concubinage fornication, the first Council of Toledo (400 CE) forbade married men to keep concubines, but allowed unmarried men with concubines the right to receive communion.⁶

The shadow of the conjugal debt fell over questions of fornication and poor health. The thirteenth-century theologian Aquinas, for example, held that a girl who was engaged to be married already belonged to her husband-to-be. Even if she were forcibly, violently abducted and robbed of her virginity by her intended, it could not be said that she had been raped.⁷ Pressing on the notion of debt, many theologians believed that a woman was obliged to have sex with her husband even if it endangered her health.⁸ Such reasoning might be extended to justify a person married to Alzheimer’s initiating sex with his or her spouse (of course, this sex would not endanger the health of the partner). Given how many Westerners object to the idea that a pregnant woman should deliver her baby if the way of doing so were to pose significant health risks, it seems reasonable to expect significant social opposition today to the idea that a woman should put her husband’s carnal needs before her own health.

Ancient and medieval theologians did not much concern themselves with the question of geriatric sex for the obvious reason that most people did not live past the age of fifty. The concept of “geriatric” would have applied to younger persons. Sickness, physical disability, and military commitments, on the other hand, were known to such Christian theologians, and they usually did not allow extra-marital sex even in the face of such obstacles. One exception to this tendency surfaces in a letter of Gregory II (751–731) to St. Boniface; Gregory holds that a man whose wife suffers from an incurable sickness should be allowed to take another partner.

As regards your question what a husband is to do, if his wife has been attacked by illness, so that she is incapable of conjugal intercourse, it were best if he could continue as he is and practice self-restraint. But since this demands exceptional virtue, the man who cannot live in continence, had better marry. But let him not fail to furnish her with support, since she is kept from married life by sickness, not debarred from it by some abominable offence.⁹

Gregory was overridden, however, and the Church maintained that marriage is unbreakable. By the time of Gregory, marriage was more or less practiced as a sacrament in the Christian West. Thus, divorce was not allowed (religiously) due to the belief that the grace of God present in sacraments cannot be undone (even if it can be received unworthily). It would be difficult to blame ecclesial authorities in distant centuries for not granting a divorce in the case of mental illness, in part because the concept of mental illness usually involved demonic possession. The conjugal rights of a husband were sacrificed to the sanctity of the marriage.

Concubinage was quite familiar to the medieval church and church fathers did sometimes allow men to take concubines.¹⁰ Taking a concubine did not end a marriage. “Throughout the world the Church held the severance of the marriage-bond to be impossible. Divorce with the right of remarriage was altogether unknown.”¹¹ Once consummated, Christian marriage could not be dissolved by any human authority; that said, some popes did exercise the power of dissolving non-consummated marriages.¹² Still today, the Roman Catholic Church will grant an annulment to some individuals and allow them to marry again; since the first, annulled marriage is not considered valid, the person granted an annulment is marrying for the first time in the eyes of the Church.

One curious exception to the rule that married people remain married until one of the spouses died later arose to make life easier for slaves exported from Africa to South America. Paul had already allowed (1 Cor. 7:10–16) that an unbeliever who converts to Christianity may legitimately leave his or her spouse, should the spouse remain an unbeliever. Normally, the second marriage of the new convert would have been considered adultery, even bigamy, but not in this instance. In 1585 Gregory XIII pres...

Indice dei contenuti

• Cover
• Half Title
• Title Page
• Copyright Page
• Table of Contents
• Introduction: Married to Alzheimer’s
• 1. Sexual Entitlement: Marriage is for Sex and Sex is for Marriage
• 2. Selflessness: Opting to Live without Sex While Still Married
• 3. Sex with Strangers
• 4. Senior Sex and Disgust
• 5. Desertion
• 6. The Sexually Deprived in American Prisons
• 7. Film and Fiction as Moral Cues
• 8. Sexual Generosity
• Conclusion: Love After Alzheimer’s
• Acknowledgments
• Appendix
• Notes
• Select Bibliography
• Index