Abstract
In the health care professions, the meaning of—and implications for—‘dignity’ and ‘value’ are progressively more important, as scholars and practitioners increasingly have to make value judgments when making care decisions. This paper looks at the various arguments for competing sources of human value that medical professionals can consider—human rights, autonomy, and a higher-order moral value—and settles upon a foundational model that is related to (though distinct from) the Kantian model that is popular within the medical community: human value is foundational; human dignity, autonomy, and rights derive from the relational quality of human dignity. Moral dignity is expressed though the relationships we cultivate, the communal ends we pursue, and the rights we enjoy. Correlatively, human dignity is inseparable from its ground (i.e., morality), and the relationship between these two is best represented for Kant in the humanities formulation. The foundational model of dignity ensures that human value is non-circularly derived, but is ultimately tied to expressions of individual human dignity that comes from the dignity of morality. Linking Kant’s dignity of humanity to the dignity of morality affords a unique and efficacious response to the discussion of human value. In one sense, dignity is amplificatory, since its worth is inextricable with that of autonomy and the rights afforded to the autonomous. But that isn’t to say that the worth of dignity is merely amplificatory. Rather, human dignity indicates the absolute inner value (MM 6:435) found in each individual in virtue of being human (MM 6:435, 462). That inner worth engenders certain universal rights—derivable from the dignity and fundamental rational appeal of morality—just as it provides for the possibility for a community of beings to seek to live the moral life.
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Notes
When referencing Kant, this paper will use the standard Academy referencing. G will stand for Kant's Groundwork for a Metaphysics of Morals and MM will refer to his The Metaphysics of Morals.
Sensen (2009) argues that Kantian ethicists mistake the dignity of humanity for the dignity of morality. Humans have an advantage over other natural objects because humans are free, but Sensen contends that it is only morality that has an unconditional value. Sen (2011) conceives of dignity as sublimity (Erhabenheit) or the highest elevation of something over something else. ‘Dignity’ expresses that something is ‘raised above’ all else. What it is raised above, and in virtue of what, depends on the context in which Kant uses ‘dignity’. For instance, he talks about the dignity of a monarch to refer to his rank as the ruler of his subjects. When Kant refers to the dignity of humanity, on Sensen’s view, he expresses the view that human beings have a prerogative over the rest of nature in virtue of being free.
That is, the sense in which dignity as a concept expatiates on a variety of normative components—such as social value that undergirds rights and autonomy.
Dignity therapy is an individualized therapy based on elements from psychotherapy that is designed to alleviate distress and enhance the end-of-life experiences of terminally ill patients by offering patients the chance to reflect on important aspects of their lives or what they want most remembered. “The therapeutic process begins with a framework of questions. Key elements of these questions are as follows and the reader is encouraged to read the report for completeness: Life history, How to be remembered, Important roles, Accomplishments, Things left to say, Hopes and dreams for loved ones, Passing along learned life lessons.”
Unless, of course, we pack into a notion of rights, “the right not to have one’s dignity demeaned.”
These views share, along with Kantian perspectives, the idea that the capability for moral autonomy gives individuals dignity. In this section, I distinguish these from Kantian perspectives, however, largely because the theories in this section take Kant to be giving preference to rule following rather than navigating through tough moral decisions. (See Henley, below, p. 349).
Bielefeldt calls this capacity a “destiny”, but there is not Kantian evidence to support his terminology.
This is Kant’s notion (Groundwork 4:434) that whatever has a dignity is irreplaceable, and since humanity possesses dignity, its members are irreplaceable.
See, for example, the RN training video, Cinema House Films Inc, Films Media Group, and Films for the Humanities & Sciences (Firm) (2006).
This example’s rhetorical force cannot be missed. Replace any minority group for those patients who have Ebola, and replace medical practitioners with any majority class, and you will have the moral justification that has been given time and again for the oppression of the minority class by the majority class.
This view is implicit but not explicit in Audi (1997).
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This paper benefitted from input received at the Human Rights Institute’s International Conference on the Grounding and Implementation of Human Rights at Indiana University-Purdue University Fort Wayne in April 2014, and research support was provided by a 2014 National Endowment for the Humanities Faculty Award.
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Hernandez, J.G. Human Value, Dignity, and the Presence of Others. HEC Forum 27, 249–263 (2015). https://doi.org/10.1007/s10730-015-9271-y
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DOI: https://doi.org/10.1007/s10730-015-9271-y