Human dignity should not need defending. But Jefferson’s “self evident” truths are deemed so no longer.
That’s frightening because, if nothing else, it is impossible to defend universal human rights if we don’t perceive human beings as having unique dignity simply and merely because they are human.
That is why I was glad to see an article in the Cambridge Quarterly of Healthcare Ethics rebutting the “dignity deniers” in the context of an article about why–as one example–it is wrong to use a human ear as an ashtray. From, “Dignity and the Ownership and Use of Body Parts,” by Charles Foster (abstract):
Dignity, then, is objective human flourishing.
The “status” I refer to in my formulation of dignity should not be misunderstood. It does not depend on any notion of the imago dei (although I don’t at all discount the possibility that the imago dei might generate a result similar to mine), or on any account of human specialness that asserts that humans are intrinsically better than nonhumans. I deal only with human status, because this is an article about how humans should behave in relation to other humans.
When a defender of intrinsic human dignity can’t assume that humans have greater value than animals, it demonstrates how deeply Peter Singer-type thinking has penetrated bioethics. Cause for much alarm, but back to Foster:
The suggestion that there is such a thing as objective human flourishing sounds contentious. But isn’t it obvious enough? There are some things that are good for us (such as companionship and the absence of disease), and some that are not (such as isolation and arsenic). I remind myself of the overstated dangers of the is-ought gap…and contend that it is possible, at least in principle, to determine empirically what constitutes human thriving.
Of course, “thriving” is subjective. But Foster uses the term sufficiently broadly to make a more objective point (my emphasis):
Our main concern should be not abstract human thriving but the thriving of a particular human being. It is her humanization that should be the object of ethical discussion…
The self is part of the context in which the thriving must happen, and the body is inextricably tangled with that self. Another part of the context, of course, is the set of circumstances in which the person finds herself.
All of which boils down to the proposition that human dignity is objective thriving in the biological, societal, geographical, and other circumstances in which the individual finds herself.
In other words, the human being who is profoundly disabled and the athelete each have intrinsic dignity and must be treated in ways that recognizes their best potential thriving in their respective circumstances. This is in direct contrast to many bioethicists who would create an invidious distinction between the athelete and the profoundly disabled person based on invidious quality of life distinctions.
Indeed, Foster (mostly) defends the dignity of the permanently unconscious patient:
Is there any sense at all in which she can be said to be thriving? Yes, and two points can be made in support of this conclusion. First, her story (which in many ways is her) continues. The story is the necessary substrate for any ethical considerations that concern her.
And second, there are good stories and bad stories, and it is better for her (a betterness accurately described in terms of thriving) for her story to be a good one. That is why we rightly say that it would offend her dignity were her body to be used by medical students to practice rectal and vaginal examinations.
He also gets into a point relevant to the Terri Schiavo case:
There are the interests of her family and friends. The patient might be incapable of appreciating her relationships, but that does not mean that she does not have relationships, or that the appreciation of those relationships is not an important part of the thriving interests of others. Going to see her each day might be the only thing that keeps her parents going.
Foster writes that part of a good life is altruism, so why not use the unconscious patient for organs–as has frequently been proposed in bioethics. Because the patient’s dignity is inextricably connected with ours:
Everyone, in fact, has a dignity interest vested in this particular patient. The criminal recognizes that society as a whole is damaged by, for instance, a murder. This is not merely or mainly because, if murder goes unpunished, murders will proliferate and the risk of each one of us being murdered rises.
More important is what the fact of the unpunished murder says about the zeitgeist—about the ethical water in which we all have to swim. A society that tolerates murder is toxic, and the toxicity affects the ability of us all to thrive.
That last point goes well beyond killing for organs.
Foster next proposes a weighing and balancing formula that best protects human dignity in individual cases, more than I can discuss in a blog.
Foster’s prescription isn’t sufficiently protective because it still makes distinctions based on the capacities and quality of life of the individual. That is always dangerous.
But at least he pushes back forcefully against the dignity deniers who would essentially strip the most weak and vulnerable of their humanhood toward the end of killing and/or using their body parts and functions for utilitiarian purposes.