More on Human Dignity (3)
So now.. what is the history of the definition and concept of human dignity and its application over the ages? As you will see, it is an ambiguous concept as I suggested in the last post but it is frequently used in discussions of morality. For a good historical review, I would now like to return to the working paper written by Adam Schulman, Ph.D. for the December 2005 meeting of the President’s Council on Bioethics. Again, I should include the disclaimer that the paper was prepared by staff solely to aid discussion and it does not represent the official views of the Council or of the United States Government. If you have the time, read about the history of human dignity as presented below. It has given me insight about the concept. ..Maurice.
2. The tangled sources of human dignity
If human dignity seems a malleable concept of uncertain application in bioethics, that is partly because the idea of human dignity comes to bioethics from several disparate sources. Each of these sources contributes something of value for bioethics; yet each source also brings its own peculiar difficulties to the application of the concept of human dignity to bioethical controversies. At least four such sources of human dignity seem worth mentioning:
a. Classical antiquity: The word “dignity” comes to us, via the Latin dignus and dignitas, from Greek and Roman antiquity, in whose literature it means something like “worthiness for honor and esteem”. This classical notion of dignity as something rare and exceptional retains some of its power even in our egalitarian age: witness the admiration we bestow on outstanding athletic and musical performance, on heroism in war, on courageous statesmanship, or on the selflessness of those who make sacrifices or undergo hardships for the sake of their young children, or their aging parents, or their neighbors stricken by misfortune or tragedy. But if dignity implies excellence and distinction, then to speak of “human dignity” raises the question, what is it about human beings as such that we find distinctive and admirable, that raises them in our estimation above other animals? Is there some one attribute or capacity that makes man worthy of respect, such as reason, or conscience, or freedom? Or is it a complex of traits, no one of which is sufficient to earn our esteem? These are not easy questions to answer; yet most would acknowledge that there must be something about humankind that entitles us to the special regard implicit in this sense of human dignity.4
One problem with the classical notion of dignity that has only grown more acute in our age of rapid biomedical progress is the complicated relationship between technology and human dignity (understood as grounded in excellence). Is the dignity of the soldier enhanced by the invention of modern weapons? Is the dignity of the athlete enhanced by drugs that improve his performance, or even by his reliance on trainers, nutritionists, and other experts? Some might argue that new technologies (“bio” and otherwise) serve human dignity by augmenting those traits that make human beings worthy of esteem; yet others might view such inventions as undermining human dignity, by making our excellence depend too much on the artifice of others.
A second problem with dignity in its classical sense is that it lends itself to invidious distinctions between one human being and another; it is not fully at home in democratic times, where it keeps uneasy company with the more characteristic democratic ideals of equality, freedom, easygoingness, and tolerance.5 Now for that very reason one might argue that human dignity is especially vulnerable and worth defending in democratic times. But to make the case for human dignity as a robust bioethical concept for our age, one would have to show that dignity can be something universal and accessible to all human beings as such.
There was in fact a school of philosophy in ancient Greece and Rome, the Stoics, who believed in dignity as a genuine possibility for all human beings, regardless of their circumstances, social standing, or accomplishments. For the Stoics, human beings have dignity because they possess reason, and the best life, the life according to nature, is available to anyone who chooses to live in a thoughtful or reflective way. And what our reason dictates, above all, is that everything necessary for our happiness and peace of mind is within our control; despite poverty, illness, or oppression it is always possible to live in a dignified way. Nothing that anyone can say or do to you can rob you of your dignity and integrity. For the Stoics, dignity is a profoundly democratic idea, in that it is just as likely to be found among the wretched as among the lofty: as possible for the slave Epictetus as for the emperor Marcus Aurelius.6
Yet while dignity as the Stoics conceived it is a universal possibility for all human beings everywhere, it nonetheless sets a rigorous and exacting standard that few of us, in practice, manage to attain. And while the Stoic teaching of indifference to bodily suffering might well prove to be a valuable discipline for those who have to live with pain, illness, or infirmity, the Stoic attitude of detachment from the things of this world—embodied in the principle that “nothing that can be taken from you is good”—means that particular bioethical questions are ultimately of little significance from the Stoic point of view.
b. Biblical religion: Another powerful source of a broader, shared notion of human dignity is the Biblical account of man as “made in the image of God.” This teaching, together with its further elaborations in Jewish and Christian scripture, has been interpreted in many different ways, but the central implication seems to be that human beings, because they are in some respects godlike, possess an inherent and inalienable dignity. One part of that dignity, suggested by the Book of Genesis, has to do with the special position of man in the natural world: within that realm man is like God in having stewardship or dominion over all things, because he alone can comprehend the whole and he alone concerns himself with the good of the whole.7 In this sense, “being made in God’s image” could even be taken to imply a special responsibility on our part to perfect nature in order to finish God’s creation. Interpreted in this way, the idea of human dignity could lend support not only to the practice of healing and medicine in general, but also, some might argue, to a defense of such activities as in vitro fertilization or even cloning, here understood as fixing nature in a godlike way.
Yet if man’s mastery of nature has some sanction in the Biblical teaching on human dignity, that teaching also points in another, humbler direction: for although made in God’s image, we are not ourselves divine; we are creatures, not creators. In this sense, “made in God’s image” has the implication that all human beings, not only those healthy and upright but also those broken in body or soul, have a share in this God-given dignity. Dignity in this sense would give ethical guidance to us in answering the question of what we owe to those at the very beginning of life, to those at the end, to those with severe disability or dementia, and even to tiny embryos. Seeing human beings as created in the image of God means, in some sense, valuing other human beings in the way a just or loving God would value them. It means seeing dignity where some might see only disability, and perhaps seeing human life where others might see only a clump of cells.
Yet because the Biblical account of human dignity points in different directions, its implications for bioethics are not always clear and unambiguous. In the controversy over stem cell research, for example, would the inherent dignity of man mean that human life at every stage is sacred, and that the destruction of human embryos is therefore forbidden? Or would it mean that healing and preserving human life is our preeminent duty, justifying all kinds of otherwise morally questionable research?
Some will argue that a concept of human dignity derived from the Bible (or other religious texts) is inherently unreliable, a mask for religious dogmas that have no legitimate place in secular bioethics. Thus Ruth Macklin, who advocates banishing the term “dignity” from medical ethics entirely, suspects that religious sources, especially Roman Catholic writings on human dignity, may explain why so many articles and reports appeal to human dignity “as if it means something over and above respect for persons or for their autonomy.”8 More recently, Dieter Birnbacher has suggested that the idea of human dignity, when invoked (as it has been in the cloning debate) to defend the natural order of human procreation against biotechnical manipulation, is nothing more than camouflage for a theological tradition that sees “the order of nature as divinely sanctioned.”9 Yet, while it might be problematic to rely on religious texts for authoritative guidance on bioethical questions, such texts may still be quite valuable in helping all of us—whether believers or not—to articulate and think through our deepest intuitions about human beings, their distinctive powers and activities, and the rights and responsibilities we believe them to possess. Furthermore, those who would dismiss all religious grounds for the belief in human dignity have the burden of showing, in purely secular terms, what it is about human beings that obliges us to treat them with respect. If not because they are “endowed by their Creator with certain unalienable rights,” then why are all men entitled to “life, liberty, and the pursuit of happiness”?10
c. Kantian moral philosophy: A daring attempt to set universal human dignity on a strictly rational foundation was made in the eighteenth century by the German philosopher Immanuel Kant. Kant’s primary purpose was to show how moral freedom and responsibility could still be possible in a world governed by the laws of mathematical physics. For Kant, in agreement with the Stoics, dignity is the intrinsic worth that belongs to all human beings and to no other beings in the natural world. All men possess dignity because of their rational autonomy, i.e., their capacity for free obedience to the moral law of which they themselves are the authors. Kant’s doctrine of human dignity demands equal respect for all persons and forbids the use of another person merely as a means to one’s own ends. Kant’s celebration of autonomy and his prohibition of the “instrumentalization” of human subjects have certainly had a lasting impact on modern ethical thought and on bioethics in particular (especially in the ethics of human experimentation and in the principle of voluntary, informed consent). And it cannot be denied that Kant’s account of what the moral law demands of us (his various formulations of “the categorical imperative”) has a certain austere majesty and logical economy that compel grudging respect if not wholehearted allegiance. Yet the application of Kant’s moral theory to bioethics remains problematic for a number of reasons.
First, Kant’s achievement in reconciling morality with mathematical physics was won at a great price: in locating human dignity entirely in rational autonomy, Kant was forced to deny any moral significance to other aspects of our humanity, including our family life, our loves, loyalties, and other emotions, as well as our way of coming into the world and all other merely biological facts about the human organism.11 His exclusive focus on rational autonomy leaves Kant with a rather narrow and constricted account of our moral life, one that has precious little to say about the moral significance of a whole range of biomedical interventions that currently arouse ethical controversy. If the rational will alone is the seat of human dignity, why should it matter if we are born of cloned embryos, or if we enhance our muscles and control our moods with drugs, or if we sell our organs on the open market?
Second, the doctrine of rational autonomy itself, clear and unambiguous though it may be in theory, can be difficult to apply in practice, especially in a biomedical context. Consider these examples: If dignity depends on the rational will, must we conclude that those human beings who do not yet have the powers of rational autonomy (infants), or who have lost them (those with dementia), or who never had them (those with congenital mental impairment) are beneath human dignity? How far can a person go in the use of mood- and mind-altering drugs before rational autonomy is compromised? Are choices made under the influence of such drugs less than free? On such basic questions in bioethics Kant’s account of human dignity does not offer clear moral guidance.
Third, Kant’s moral philosophy has bequeathed to later ethical thought a deplorable legacy in the form of the rigid distinction between deontology and consequentialism, i.e., between a morality (such as Kant’s) of absolute imperatives and one (such as utilitarianism) that considers the good and bad results of our actions. Nowadays, if human dignity is invoked in the discussion of some bioethical issue, the first question that is usually raised is whether the term is being used as a categorical moral principle (e.g., “human cloning is wrong in principle, because it violates some inalienable right of the child”) or as an argument based on consequences (e.g., “human cloning is wrong because of the degrading effects it is likely to have on the child, the family, and society at large”). Bioethics in practice requires a healthy measure of old-fashioned prudence and is not well served by a dogmatic adherence to the artificial division between an ethics of principles and an ethics of consequences.
d. 20th century constitutions and international declarations: Finally, another prominent yet problematic source for the introduction of “human dignity” into contemporary bioethical discussions is the frequent use of that phrase in national constitutions and international declarations ratified in the aftermath of the Second World War. By proclaiming a belief in “human dignity”, such documents would seem, at first blush, to point beyond the prosaic safeguarding of “rights” advocated in the American founding (“life, liberty, and the pursuit of happiness”) or in the writings of John Locke (“life, liberty, and property”) and other modern natural right theorists.
The preamble to the Charter of the United Nations (1945) begins:
We the people of the United Nations, determined to save succeeding generations from the scourge of war, which twice in our lifetime has brought untold sorrow to mankind, and to reaffirm faith in fundamental human rights, in the dignity and worth of the human person, in the rights of men and women and of nations large and small….
In the Universal Declaration of Human Rights (1948), recognition “of the inherent dignity and of the equal and inalienable rights of all members of the human family” is said to be “the foundation of freedom, justice, and peace in the world.” At least thirty-seven national constitutions ratified since 1945 refer explicitly to human dignity, including the Basic Law (Grundgesetz) of Germany (1949), which begins: “Human dignity is inviolable. To respect and protect it is the duty of all state authority.”12
As Doron Shultziner has emphasized,13 while human dignity in these documents plays the role of a supreme value on which all human rights and duties are said to depend, the meaning, content, and foundations of human dignity are never explicitly defined. Instead, the affirmation of human dignity in these documents reflects a political consensus among groups that may well have quite different beliefs about what human dignity means, where it comes from, and what it entails. In effect, “human dignity” serves here as a placeholder for “whatever it is about human beings that entitles them to basic human rights and freedoms.” This practice makes a good deal of sense. After all, what mattered most after 1945 was not reaching agreement as to the theoretical foundations of human dignity but ensuring, as a practical matter, that the worst atrocities inflicted on large populations during the war (i.e., concentration camps, mass murder, slave labor), would not be repeated. In short, “the inviolability of human dignity” was enshrined in at least some of these documents chiefly in order to prevent a second Holocaust.
Yet because of its formal and indeterminate character, the notion of human dignity espoused in these constitutions and international declarations does not offer clear and unambiguous guidance in bioethical controversies.14 Certainly the fact that human dignity is mentioned prominently in these documents is to be welcomed as an invitation to explore the question, “What is the ground of human dignity?” And the sensible idea of invoking universal human dignity in order to establish a baseline of inviolable rights—in effect, a floor of decency beneath which no treatment of human beings should ever sink—may well prove to be of some value in holding the line against the most egregious abuses of the new biotechnologies (e.g., the deliberate creation of animal-human chimeras). Yet if we are content to regard human dignity as nothing more than an unspecified “Factor X”15 in virtue of which we are obliged to treat all persons with respect, then some bioethicists have wondered why we should bother invoking it at all. Why not dispense with dignity and simply spell out precisely what “respect for persons” demands of us? Ruth Macklin adopts this viewpoint, arguing that respect for persons is a sufficient principle for bioethics, one that entails “the need to obtain voluntary, informed consent; the requirement to protect confidentiality; and the need to avoid discrimination and abusive practices.”16 Her approach may have the virtue of simplicity, but it does not explain why all persons are entitled to respect;17 and it is far from clear that all present and future controversies in bioethics can be resolved merely by providing informed consent, honoring confidentiality, avoiding discrimination, and refraining from abuse.
e. Summary: To recapitulate the findings of this section: Important notions of human dignity are to be found both in classical antiquity and in Biblical scripture, each with lasting influence on modern thought. Yet the classical conception of dignity (in the general sense of human worth, grounded in excellence) is of problematic relevance to present-day bioethics, in part because of its ambiguous relationship to technological progress and in part because of its aristocratic and inegalitarian tendencies; while the specifically Stoic notion of human dignity is of limited use in bioethics both because of the severe and exacting standard it sets and because of the basic Stoic attitude of indifference to the external world, including the suffering of the body. And although the Biblical teachings on human dignity are rich and evocative, they have ambiguous implications for bioethics, pointing both toward godlike mastery of nature and toward humble acknowledgment of the sanctity of human life in all its forms. Turning to the modern era, both the moral philosophy of Kant and various constitutions and international declarations of the twentieth century appear to provide support for a belief in the equal dignity of all human beings. Yet Kant’s idea of human dignity carries certain theoretical baggage that limits its utility for bioethics, while the recently ratified constitutions and declarations tend to invoke dignity without clearly specifying either its ground or its content, suggesting that the concept itself might well be superfluous. On the other hand, it is hard to see how ethical standards for the treatment of human beings can be maintained without relying on some conception of what human beings are and what they therefore deserve.
[References for this section of the Working Paper:
4. Of course there are some sophisticated thinkers who, in the name of animal rights, assail the very idea of a special status for man as an expression of naïvely anthropocentric “speciesism,” a word coined by analogy with racism and sexism. See Peter Singer, Animal Liberation, 2nd edition, New York: Avon, 1990; see also Bernard Williams, Ethics and the Limits of Philosophy, Cambridge: Harvard University Press, 1985.
5. That “dignity” retains an aura of Roman exclusivity even in modern times is suggested by a quotation attributed to humorist James Thurber: “Human Dignity has gleamed only now and then and here and there, in lonely splendor, throughout the ages, a hope of the better men, never an achievement of the majority.”
6. That the Stoic conception of human dignity might not be entirely incompatible with our lax American culture is suggested by the recent popular success of the Ridley Scott movie Gladiator (2000) and the Tom Wolfe novel A Man in Full (1998), both of which explore Stoic responses to misfortune. Consider also the example of Admiral James Stockdale, whose education in Stoic principles helped him survive with dignity through seven harrowing years as a prisoner of war in Vietnam.
7. See Leon Kass, The Beginning of Wisdom: Reading Genesis (New York: The Free Press, 2003), pp. 36 ff.
8. Ruth Macklin, “Dignity is a useless concept.”
9. Dieter Birnbacher, “Human cloning and human dignity.”
10. Whether the rights proclaimed in the Declaration of Independence rest ultimately on a religious or a secular foundation is, of course, a complex question that cannot be settled here.
11. One will not, for example, find much hint of human dignity in Kant’s definition of marriage as “the association of two persons of different sex for the lifelong reciprocal possession of their sexual faculties.” [quoted from Part I of the Metaphysics of Morals (1797).]
12. See Teresa Iglesias, “Bedrock Truths and the Dignity of the Individual,” Logos 4: 1, 114-134, 2001.
13. See Shultziner’s helpful review article, “Human dignity—functions and meanings,” Global Jurist Topics 3:3, 2003.
14. UNESCO’s recently adopted (though still provisional) Universal Declaration on Bioethics and Human Rights refers to “human dignity” or “the dignity of the human person” (in close conjunction with “human rights” and “fundamental freedoms”) eleven times but does not spell out what that dignity is or why human beings have it. Reflecting its status as a consensus statement among many nations, the draft suggests that “due regard” should be paid to “cultural diversity and pluralism,” but not so as to infringe upon or limit the scope of “human dignity, human rights and fundamental freedoms.” The text of the Declaration may be found online at www.unesco.org/shs/bioethics.
15. See Frank Fukuyama, Our Posthuman Future: Consequences of the Biotechnology Revolution (New York: Farrar, Straus and Giroux, 2002), chapter 9, “Human Dignity.”
16. Ruth Macklin, “Dignity is a useless concept.”
17. One recognizes, in the various principles of autonomy or “respect for persons” that populate contemporary bioethics, the remote and enfeebled descendants of Kant’s categorical moral imperative; yet the devotees of autonomy today are seldom willing to embrace anything like the metaphysical system Kant felt obliged to supply as the ground for his moral principles.]