Beruflich Dokumente
Kultur Dokumente
HUMAN DIGNITY
USEFUL, USELESS OR DANGEROUS?
MARGARET SOMERVILLE
AM, FRSC, A.u.A (pharm.), LL.B. (hons), D.C.L.,
LL.D. (hons. caus.), D.Sc.(hons. caus.), D.Hum.L (hons. caus.)
1
SLIDE 1
1. INTRODUCTION
What we see as its basis in particular, secular or religious or both, and yet
again there is no consensus.
SLIDE 2
INTERNATIONAL INSTRUMENTS
PREAMBLE
2
Whereas recognition of the inherent dignity and of the equal and
inalienable rights of all members of the human family is the foundation of
freedom, justice and peace in the world
Whereas the peoples of the United Nations have in the Charter reaffirmed
their faith in fundamental human rights, in the dignity and worth of the
human person and in the equal rights of men and women and have
determined to promote social progress and better standards of life in larger
freedom
Article 1.
All human beings are born free and equal in dignity and rights.
Article 22.
Everyone, as a member of society, has the right to social security and
is entitled to realization, through national effort and international co-
operation and in accordance with the organization and resources of
each State, of the economic, social and cultural rights indispensable
for his dignity and the free development of his personality.
Article 23.
(3) Everyone who works has the right to just and favourable
remuneration ensuring for himself and his family an existence worthy of
human dignity, and supplemented, if necessary, by other means of social
protection.
SLIDE 3
PREAMBLE
...
Recognizing that ethical issues raised by the rapid advances in science and
their technological applications should be examined with due respect to the
dignity of the human person and universal respect for, and observance of,
human rights and fundamental freedoms ...
3
Also noting international and regional instruments in the field of bioethics,
including the Convention for the Protection of Human Rights and
Dignity of the Human Being with regard to the Application of Biology
and Medicine...
SLIDE 4
...
Proclaims the principles that follow and adopts the present Declaration.
General provisions
Article 1 Scope
1. This Declaration addresses ethical issues related to medicine, life sciences
and associated technologies as applied to human beings, taking into account
their social, legal and environmental dimensions.
Article 2 Aims
...
(c) to promote respect for human dignity and protect human rights, by
ensuring respect for the life of human beings, and fundamental freedoms,
consistent with international human rights law;
...
Article 3 Human dignity and human rights
1. Human dignity, human rights and fundamental freedoms are to be fully
respected.
4
2. The interests and welfare of the individual should have priority over the
sole interest of science or society.
SLIDE 5
...
Article 10 Equality, justice and equity
The fundamental equality of all human beings in dignity and rights is to be
respected so that they are treated justly and equitably.
...
Article 28 Denial of acts contrary to human rights, fundamental
freedoms and human dignity
Nothing in this Declaration may be interpreted as implying for any State,
group or person any claim to engage in any activity or to perform any act
contrary to human rights, fundamental freedoms and human dignity.
SLIDE 6
5
research should fully respect human dignity, freedom and human rights, as
well as the prohibition of all forms of discrimination based on genetic
characteristics...
SLIDE 7
Proclaims the principles that follow and adopts the present Declaration.
Article 1
The human genome underlies the fundamental unity of all members of the
human family, as well as the recognition of their inherent dignity and
diversity. In a symbolic sense, it is the heritage of humanity.
Article 2
(a) Everyone has a right to respect for their dignity and for their rights
regardless of their genetic characteristics.
Article 6
No one shall be subjected to discrimination based on genetic characteristics
that is intended to infringe or has the effect of infringing human rights,
fundamental freedoms and human dignity. ...
SLIDE 8
Article 10
No research or research applications concerning the human genome, in
particular in the fields of biology, genetics and medicine, should prevail over
respect for the human rights, fundamental freedoms and human dignity of
individuals or, where applicable, of groups of people. ...
Article 11
6
Practices which are contrary to human dignity, such as reproductive cloning
of human beings, shall not be permitted. States and competent international
organizations are invited to co-operate in identifying such practices and in
taking, at national or international level, the measures necessary to ensure
that the principles set out in this Declaration are respected.
Article 12
(a) Benefits from advances in biology, genetics and medicine, concerning
the human genome, shall be made available to all, with due regard for the
dignity and human rights of each individual. ...
SLIDE 9
Article 15
States should take appropriate steps to provide the framework for the free
exercise of Research on the human genome with due regard for the
principles set out in this Declaration, in order to safeguard respect for human
rights, fundamental freedoms and human dignity and to protect public
health. They should seek to ensure that research results are not used for non-
peaceful purposes. ...
Article 21
States should take appropriate measures to encourage other forms of
research, training and information dissemination conducive to raising the
awareness of society and all of its members of their responsibilities
regarding the fundamental issues relating to the defence of human dignity
which may be raised by research in biology, in genetics and in medicine, and
its applications. ...
Article 24
The International Bioethics Committee of UNESCO should contribute to the
dissemination of the principles set out in this Declaration and to the further
examination of issues raised by their applications... in particular regarding
the identification of practices that could be contrary to human dignity,
such as germ-line interventions.
SLIDE 10
NOTE:
7
Human dignity is nowhere defined in these instruments.
In other words, what human dignity consists of or what respect for it, in
general, requires we do or not do, is not spelt out in these documents.
8
... while human dignity in ... [the international instruments] 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, their affirmations of human dignity reflect 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.(p13)
In a 2002 speech, the late Sergio Vieira de Mello, at the time the United
Nations special representative in Iraq and a prominent human rights
advocate, described the relation of dignity and human rights this way.
9
the human family is the foundation of freedom, justice and peace in the
world". "Freedom from fear and want" was our common aspiration.
De Mello proposes that [w]e should nurture our sense of self as part of a
common humanity and that our common humanity is an inclusive one,
built on values such as tolerance and dignity.
In short, human rights are secondary to human dignity. Stated another way,
human rights establish the conditions that are required if inherent human
dignity is to be respected.
SLIDE 12
3. DEFINING DIGNITY
Historically dignity was an elitist or aristocratic concept. American
philosopher physician, Leon Kass puts it this way: the very
idea of dignity smacks too much of aristocracy for egalitarians... and, he
goes on to add, smacks ...too much of religion for secularists and
10
libertarians. Moreover, it seems to be too private and vague a matter to be
the basis for legislation or public policy.
Dignity was associated with rank and status. (The Greek concept of
comparative dignity.)
But this changed in the 19th century with the spread of democracy and
Christian idea of equality. (The Christian concept of equal dignity.)
Democracy required that everyone could be seen as having dignity, but there
was and still is no easy consensus on the nature of dignity, its basis or what
contravenes or respects it.
Political scientist Diana Schaub says we no longer agree about the content
of dignity, because we no longer share what Meilaender calls a vision of
what it means to be human.
11
SLIDE 13
Many of the eminent authors who contributed chapters and comments to that
report were responding to American bioethicist Ruth Macklins proposal
that dignity is a useless concept that should be abandonned, and that instead
we should just use concepts of respect for persons and respect for autonomy.
So, lets look at what some of the essayists who contributed to the
Presidents Council report had to say about human dignity.
SLIDE 14
12
In the latter regard, lawyer and author, Wesley J. Smith, would concur.
Starbucks ran a campaign called The Way I See It. Starbucks claims that it
has always supported a good healthy discussion, and in the tradition of
coffee houses that spark good conversations it acquired a collection of
thoughts, opinions and expressions provided by notable figures, which it
printed on its coffee cups to encourage good conversations amongst its
customers. Heres what Smith wrote as quote number 127:
The morality of the 21st century will depend on how we respond to this
simple but profound question: Does every human life have equal moral
value simply and merely because it is human? Answer yes, and we have a
chance of achieving universal human rights. Answer no, and it means that
we are merely another animal in the forest.
Along the same lines heres what some other contributors to the report have
to say.
SLIDE 15
13
So these commentators argue that dignity is intimately connected with
morality, but is it also necessarily connected with religion?
Many secular humanists argue that it is, which is the reason they label it a
useless, at best, dangerous, at worst, concept.
But are they correct that its necessarily a religious concept?
I have spoken about what I call the human spirit in my book, The Ethical
Imagination and its importance in dealing with ethical issues. Let me explain
what I mean by the human spirit.
14
We can call our capacity to experience that spirituality the human
spirit.
And human spirit is a term I use in a religiously neutral sense, so it's open to
people who are not religious and those who are, and, if religious, no matter
what their religion. In other words, a belief in the human spirit does not
require a belief in the supernatural or any religious belief, but it is not
antithetical to religious belief.
In short, we can all agree that we have a human spirit and having that
shared starting point is very important in searching for some shared ethics
in our contemporary, pluralistic, multicultural multi-religious secular
societies.
SLIDE 17
SLIDE 18
15
IS DIGNITY CONNECTED WITH SACREDNESS?
Theologian, the late Father John Neuhaus, writes that it was by ideas and
experiences outside the law that the concept of the dignity of the human
person was enshrined in the law. The word enshrined is used advisedly,
indicating the sacred sources of that dignity.
SLIDE 19
16
piety. I agree with him although what he calls piety Id call respect for
the secular sacred.
In talking about the secular sacred, I am proposing that the sacred is not
only a concept that applies in a religious or ritualized context, but also one
that operates at a general societal or secular level. Im proposing it as
a concept that, among other outcomes, might help us to find some shared
ethics, including in relation to what respect for human dignity requires, and
that we can endorse this concept whether or not we are religious, and, if we
are religious, no matter which religion we follow. I believe that each of us
needs to experience a complex interaction of knowing ourselves, relating to
others, appreciating our place in the great web of all life, and seeing
ourselves as part of the earth, the stars, the universe, and the cosmos. The
acute and continuous awareness of such a mind-blowing web of
relationships is what I have already described to you as the human spirit.
17
In summary, I am proposing that linking the secular and the sacred, by
adopting a concept of the secular sacred, can help to unite everyone who
accepts that some things are sacred, whether they see the sacreds source as
religious or purely natural or secular.
SLIDE 20
If we accept the sacred, whether the religious sacred or the secular sacred,
we will accept that certain aspects of life are sacrosanct; not everything that
could be done to life, in particular, human life, may ethically be done to it
and certain moral and ethical principles that should be respected and should
govern our conduct flow from that.
The sacred, then, requires that we respect the integrity of the elements that
allow us to fully experience being fully human; in doing so, we protect that
experience.
The sacred is a concept that we should use to protect that which is most
precious in human life, starting with life itself.
One place where we might find the secular sacred operating is in the
environmental protection movement, some aspects of which mirror those of
a religion. The movement functions through shared truths and ideology,
and the bonding that results from sharing those beliefs; it causes people to
focus on a reality external to themselves; it provides an opportunity for
transcendence belonging to and protecting something larger than oneself;
its adherents demonstrate a willingness to make sacrifices and to suffer to
promote the great cause they believe in; and they are concerned for future
18
generations, handing on their values and beliefs to their descendants.
Religious Studies scholars Paul Nathanson and Katherine Young have
proposed that such movements are secular religions. If we can have a secular
religion, it would seem logical that we can also have a secular sacred.
Sacredness may also protect our physical reality, in particular that of our
own bodies, and that of the world around us, or what I will refer to as nature.
The progression of sciences ability to change the human body has been
breathtakingly fast, starting with transplants and cosmetic surgery and
moving on to creating chimeras (human-animal combinations) and cyborgs
(human-machine combinations). For the people who promote and laud such
developments, the natural essence of being human has no element of the
sacred, and therefore contains nothing that must be protected and preserved
through restricting what we can do in light of what we ought not to do in
order to maintain the integrity of our humanness. We will further consider
such situations, shortly, but for the moment lets leave the sacred and return
to the Bioethics Council report to look at some other descriptions of dignity.
19
SLIDE 21
SLIDE 22
Likewise, Meilaender writes about two different senses in which one might
speak of human dignity. For instance, that the language of dignity might be
used to mark either a floor, a kind of respect and care beneath which our
treatment of any human being should never fallor it might be used to mark
a height of human excellence, those qualities that distinguish some of us
from others.
SLIDE 23
20
Sulmasy distinguishes between intrinsic and instrumental values the latter of
which he characterizes as a subclass of attributed values. Intrinsic value is
the value something has of itselfthe value it has by virtue of its being the
kind of thing that it is. ... Attributed values are those conveyed by a valuer..
(pp.474-475)
SLIDE 24
Importantly, Kerstein points out that to respect human dignity we must have
respect for both the human dignity of each individual and for the worth of
21
humanity as a whole. That means that individual consent is not necessarily
sufficient to ensure human dignity is not being violated. Moreover, Kerstein
sees treating people as means or ends as mutually exclusive categories.
SLIDE 26
22
To summarize, broadly speaking, it seems there are two basic concepts of
human dignity that are mutually exclusive. Intrinsic dignity means one has
dignity simply because one is human. Intrinsic dignity is status model -
dignity comes simply with being a human being. Respect is for what one is.
Extrinsic dignity means that whether one has dignity depends on the
circumstances in which one finds oneself and whether others see you as
having dignity. Dignity is conferred and can be taken away. Dignity depends
on what one can and cannot do. Extrinsic dignity is functional or
achievement model dignity comes with being able to perform in a certain
way and to not perform in other ways. Dignity comes with being a human
doing. Respect is for what one does.
These two definitions provide very different answers as to what respect for
dignity requires.
23
Under an inherent dignity approach dying people are still human beings
whose lives must be respected. Euthanasia breaches respect for life and
thereby contravenes their human dignity.
Under an extrinsic dignity approach dying people are no longer human
doings that is, they have lost their dignity - and euthanasia is seen as
remedying that situation and promoting their human dignity.
SLIDE 27
Heres what Kass has to say about the relevance of dignity to bioethics:
Today, human dignity is of paramount importance especially in matters
bioethical. As we become more and more immersed in a world of
biotechnology, we increasingly sense that we neglect human dignity
at our peril, especially in light of gathering powers to intervene in
human bodies and minds in ways that will affect our very humanity,
likely threatening things that everyone, whatever their view of
human dignity, holds dear. Truth to tell, it is beneath our human
dignity to be indifferent to it. (pp297-298).
SLIDE 29
24
And Meilaender cites Deryck Beyleveld and Roger Brownsword who have
distinguished three different ways in which the concept of dignity has, they
believe, been used in bioethics. The first they term human dignity
as empowerment. The central idea here is that ones dignity is violated
if ones autonomy is not respected, and this concept leads quite
naturally to an emphasis upon informed consent. ... The second concept of
dignity Beyleveld and Brownsword call human dignity as constraintthat
is, constraint on individual choices. [For example, dwarf throwing is
prohibited as offending human dignity, even though the dwarfs consented.]
A third concept, somewhat different from the first two, is that of dignified
conduct. (pp.273-274)
SLIDE 30
25
boundaries. The vast majority of people agree these practices are seriously
unethical and must be prohibited - but that requires national action and
international co-operation.
To test whether the sale of organs for transplantation offends human dignity,
Kerstein takes Immanuel Kants Formula of Humanity as a basis. He
approaches his analysis in two ways:
First, to treat others just as means is a failure to respect their dignity, so he
considers what treating persons as ends in themselves, not mere means
entails. This is an individual level analysis.
Second, he looks at whether any given act or omission is consistent with
respect for the worth of humanity, in general - respect for the special value
inherent in persons, that is, their dignity - to decide whether it contravenes
respect for human dignity and, therefore, is morally impermissible. This is a
societal level analysis.
26
exchangeable for the right price, those sales contravene human dignity,
because respect for human dignity requires upholding the principle that they
are not exchangeable.
SLIDE 31
The sale of organs involves using human beings simply as a means, rather
than as an end, in themselves; it is to treat human beings and human life as
objects or things, to commodify them. That offends the human dignity of the
"donor" and respect for human dignity, in general. It is to do wrong and, no
matter how much good we might realize, good ends do not justify unethical
means.
As well, only the very rich can afford to buy organs. It's one thing in terms
of equity and justice that we all do not have equal access to luxury cars, for
instance. It's quite another that only the very rich can buy parts of the bodies
of the very poor.
27
Central to the essence of our humanness is that we are morality-seeking and
meaning-seeking beings. The gift of an organ affirms both that essence and
important shared values that include altruism, generosity, courage, concern
and care for others. These are human characteristics that manifest,
implement and promote human dignity.
In contrast, the sale of an organ, by commodifying the human person and the
human body, shifts the taking and delivery of an organ from such an
affirmation to a breach of this same essence and these values.
Respect for fundamental human dignity and the special respect owed to the
human body require we preclude its sale. To do otherwise is to implement a
21st-century version of slavery where, instead of selling the whole person,
we sell their body parts. It is difficult to decide which is more reprehensible.
SLIDE 32
28
euthanasia is necessary to respect a dying persons dignity: You are in an
undignified state and we will correct that by eliminating you.
for human life and, if there were a perceived conflict, the latter should take
priority. In fact, the original primary purpose of the concept of dignity was
to ensure respect for life. Its paradoxical that its been turned on its head to
SLIDE 33
29
SLIDE 34
30
would most want remembered. Sessions are transcribed and edited, with a
returned final version that they can bequeath to a friend or family member.
[That is, the patient can leave a legacy, which is important in helping people
to die peacefully.] The objective of this study was to establish the feasibility
of dignity therapy and determine its impact on various measures of
psychosocial and existential distress.
...Terminally ill inpatients and those receiving home-based palliative care
services, ...were asked to complete pre- and post- intervention measures of
sense of dignity, depression, suffering, and hopelessness; sense of purpose,
sense of meaning, desire for death, will to live, and suicidality; and a
postintervention satisfaction survey.....
Ninety-one percent of participants reported being satisfied with dignity
therapy; 76% reported a heightened sense of dignity; 68% reported an
increased sense of purpose; 67% reported a heightened sense of meaning;
47% reported an increased will to live; and 81% reported that it had been or
would be of help to their family. Postintervention measures of suffering
showed significant improvement and reduced depressive symptoms. Finding
dignity therapy helpful to their family correlated with life feeling more
meaningful and having a sense of purpose, accompanied by a lessened sense
of suffering and increased will to live. ...
Dignity therapy shows promise as a novel therapeutic intervention for
suffering and distress at the end of life.
These are truly remarkable results. But to achieve them takes care, time,
commitment, research and expertise. In thinking about investing healthcare
and medical research dollars so as to enhance human dignity, we should
keep in mind studies such as that of Dr. Chochinov and his colleagues.
31
SLIDE 35
32
of dignity is that humans alone can choose what they want to be and that our
enhanced self might be our authentic self. But would emotional
enhancement, for instance, be respectful or disrespectful of dignity?
SLIDE 36
33
Compare that with the statement of fact that we are all ex-
embryos that being an embryo is the earliest form of each of
our lives
SLIDE 37
Habermas argues that respect for what he calls pre-personal human life is
necessary to maintaining our ethical understanding of what it means to be
human.
We form our most important collective values around the two great events in
every human life birth (or our perceived coming into existence which can
now be as an IVF embryo in a petri dish) and death.
Human embryo research will affect values of respect for human life formed
around birth.
Monash IVF story: Doctor stop. Could we please see our babies?
34
I cannot explore this issue here, but have done so elsewhere, however, I
believe that the right to come into existence through natural means and to
know biological identity and biological family is an essential part of
respecting human dignity the right to identity, to know through whom life
traveled down the generations to each of us, to know to whom we are
biologically related.
SLIDE 38
One of the central questions in deciding what is and is not ethical in using
the new technoscience is whether only humans have dignity that must be
respected or animals also have it?
Another way to ask this same question, one that is at the heart of some of
our most important current ethical debates, is: Are humans special?
Is there a discontinuity between humans and other animals?
Are humans and other animals different-in-kind or only different-in
degree?
35
Depending on how we answer these questions, our answers to the question,
Do humans deserve special respect? will also vary
Good facts are needed for good ethics so what impact might the new
technoscience have on human dignity?
SLIDE 39
These are not fanciful questions; they are all currently under serious
consideration.
36
Heres a quote from 12th April, 2009 Sunday NY Times Magazine. It comes
from a review by Charles Morris of Richard John Neuhauss book,
American Babylon: Notes of a Christian Exile:
While the idea has ignited some controversy, Church suggested that if
financing were available, we might go along with it. Another genome
specialist, however, asked whether we would place the clones in Harvard
or in a zoo.
SLIDE 40
Is there an essence of our humanness that we must hold on trust for future
generations?
37
Is respect for human dignity one way we can protect that essence and fulfill
that trust?
It is often said that nowhere are we at more ethical peril than when we
undertake quests such as the search for human perfection through science.
The Nazi horrors showed us the dangers of a political platform or public
policy approach that uses science and technology to search for perceived
biological perfection in ourselves, individually, and society as a whole.
Today, we can seek the perfect baby through designing it using genetic and
reproductive technologies positive eugenics. The perfect copy of our self
with cloning. The perfect war (risk free to us) with virtually controlled
(disembodied) combat technologies. The perfect athlete with drug use or
gene doping. The perfect body with cosmetic surgery.
38
Likewise, we can seek to eliminate those we see as imperfect negative
eugenics. We use new technology to carry out embryo biopsies (pre-
implantation genetic diagnosis) on in vitro fertilized embryos to identify and
discard those who are defective. We use prenatal screening to identify
fetuses with genetic or other disabilities, such as Downs syndrome, and
abort them. And, most recently, we have a do-it-yourself test that can be
used at ten weeks of gestation to see if the baby is male or female, so that if
we are having a baby of the wrong sex, we can abort it and try again.
And, in a context that is relevant to all of us because we will all face death,
we can seek both to achieve the perfect death and to eliminate imperfect
people through euthanasia and assisted-suicide.
Equating human perfection with having human dignity and seeking human
perfection as a way of enhancing human dignity opens up the possibility of
justifying these kinds of intervention. Why does that matter?
Those who are religious define what constitutes the essence of our
humanness as the soul - the sharing in a Divine spark. It is extremely
39
difficult to define what constitutes that essence for those who reject religion,
but many such people believe or at least act as though such an essence
exists. For instance, anybody who agrees that humans are special as
compared with other living beings and, therefore, deserve special respect,
is manifesting such a belief. However, as I explained previously, some
secular humanists expressly reject such a belief. They regard preferencing
humans (seeing humans as special as compared with other animals or even
robots) as wrongful discrimination in the form of what they call speciesism.
I believe that if we succeed in our search for human perfection or, perhaps,
even if we just engage in it - we will lose our authenticity, our human
essence, our messy, old, much-touched soul. We will be like copies of
masterpieces or like restored antiques: not originals, no longer unique, no
longer the real thing.
SLIDE 41
In short, Im suggesting that we need a deep respect for the natural if we are
to respect human dignity.
40
To implement that respect, I argue in my book The Ethical
Imagination that in using the world-altering powers of the new
technoscience, especially in relation to interventions on life itself, in
particular, in taking decisions that will affect our children and their
descendants down the generations, we should start from a basic presumption
in favour of respecting nature, the natural and life.
This presumption could be described as seeing the natural whether it is we
humans or other animals or our ecosystem - as having a certain dignity as
expressing the order of creation - and starting from a presumption of the
need to respect that.
That does not mean that nature, the natural and life must not be altered;
rather those altering them must justify doing so.
The concept of dignity must be used to maintain respect for the integrity and
authenticity of each person, and respect for human life and for the essence of
our humanness. The current danger, as I hope my various examples have
41
shown you, is that it could be used to realize precisely the opposite
outcomes.
42
CONCLUSION
I would like to conclude by quoting physician and ethicist Dr. Edmund
Pellegrino, Chairman of the Presidents Council on Bioethics :
May we engage in the necessary dialogue with courage, wisdom and mutual
respect.
43