Skip to main content

Human Value, Dignity, and the Presence of Others

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.

This is a preview of subscription content, access via your institution.

Notes

  1. 1.

    Even if it is debatable as to what ‘dignity’ itself connotes. A representative sample of recent work in ethics generally would include that from Hill (1992a, b), Kerstein (2002), Rosen (2012), Stark (1997), Velleman (1992), and Sensen (2011).

  2. 2.

    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.

  3. 3.

    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.

  4. 4.

    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.

  5. 5.

    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.”

  6. 6.

    Unless, of course, we pack into a notion of rights, “the right not to have one’s dignity demeaned.”

  7. 7.

    Bielefeldt calls this capacity a “destiny”, but there is not Kantian evidence to support his terminology.

  8. 8.

    This is Kant’s notion (Groundwork 4:434) that whatever has a dignity is irreplaceable, and since humanity possesses dignity, its members are irreplaceable.

  9. 9.

    See, for example, the RN training video, Cinema House Films Inc, Films Media Group, and Films for the Humanities & Sciences (Firm) (2006).

  10. 10.

    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.

  11. 11.

    There are many, many examples but see, at least Jacobsen (2009), Chochinav (2002, 2007), Lohne et al. (2010), Jacobs (2000), Leget (2013), and Nordenfelt (2004).

  12. 12.

    This view is implicit but not explicit in Audi (1997).

References

  1. Audi, R. (1997). Moral knowledge and ethical character. New York: Oxford University Press.

    Google Scholar 

  2. Benhabib, S. (2009). Claiming rights across borders: International human rights and democratic sovereignty. The American Political Science Review, 103(4), 691–704.

    Article  Google Scholar 

  3. Bielefeldt, H. (1997). Autonomy and republicanism: Immanuel Kant’s philosophy of freedom. Political Theory, 25(4), 524–558.

    Article  Google Scholar 

  4. Boxill, B. (1984). Blacks and social justice. Totowa: Rowman & Allanheld.

    Google Scholar 

  5. Buisen, M. (2010). Autonomy, human dignity, and the right to healthcare: A Dutch perspective. Cambridge Quarterly of Healthcare Ethics, 19, 321–328.

    Article  Google Scholar 

  6. Buss, S. (1999). Appearing respectful: The moral significance of manners. Ethics, 109(4), 795–826.

    Article  Google Scholar 

  7. Chochinov, H. M. (2002). Dignity-conserving care—A new model for palliative care. Helping the patient feel valued. Journal of the American Medical Association, 287(17), 2253–2260.

    Article  Google Scholar 

  8. Chochinov, H. M. (2007). Dignity and the essence of medicine: The A, B, C, and D of dignity conserving care. BMJ Journal, 335, 184–187.

    Article  Google Scholar 

  9. Cinema House Films Inc, Films Media Group, and Films for the Humanities & Sciences (Firm). (2006). Respect: Dignity, autonomy, and relationship-ethical issues in nursing. New York: Films Media Group.

    Google Scholar 

  10. Delmar, C. (2013). The interplay between autonomy and dignity: Summarizing patients’ voices. Medical Health Care and Philosophy, 16, 975–981, 976

  11. Diamond, C. (1991). Eating meat and eating people. In C. Diamond (Ed.), The realistic spirit: Wittgenstein, philosophy and the mind. Cambridge: MIT Press.

    Google Scholar 

  12. Enk, R. E. (2012). Dignity. American Journal of Hospice & Palliative Medicine, 29(1), 5–6.

    Article  Google Scholar 

  13. Feinberg, J. (1970). The nature and value of rights. Journal of Value Inquiry, 4, 243–257.

    Article  Google Scholar 

  14. Feinberg, J. (1980). Rights, justice, and the bounds of liberty. Princeton: Princeton University Press.

    Book  Google Scholar 

  15. Feinberg, J. (1992). The social importance of moral rights. Philosophical Perspectives, 6, 175–198.

    Article  Google Scholar 

  16. Gibbard, A. (1992). Moral concepts: Substance and sentiment. Philosophical Perspectives, 6, 199–221.

    Article  Google Scholar 

  17. Henley, K. (1977). The value of individuals. Philosophy and Phenomenological Research, 37(3), 345–352.

    Article  Google Scholar 

  18. Hill, T. E. (1992a). Dignity and practical reason. Ithaca: Cornell University Press.

    Google Scholar 

  19. Hill, T. E. (1992b). A Kantian perspective on moral rules. Philosophical Perspectives, 6, 285–304.

    Article  Google Scholar 

  20. Holtman, S. (2009). Autonomy and the kingdom of ends. In T. E. Hill Jr (Ed.), Blackwell companion to Kantian ethics. Oxford: Wiley-Blackwell.

    Google Scholar 

  21. Jacobs, B. B. (2000). Respect for human dignity in nursing: Philosophical and practical perspectives. Canadian Journal of Nursing Research, 32(2), 15–33.

    Google Scholar 

  22. Jacobson, N. (2009). A taxonomy of dignity: A grounded theory study. BMC International Health and Human Rights, 9(3), 1–9.

    Google Scholar 

  23. Kant, I. (1996). The metaphysics of morals. M. Gregor (Ed.). Cambridge: Cambridge University Press.

  24. Kant, I. (2012). Groundwork for a metaphysics of morals, revised edition. M. Gregor & J. Timmermann (Eds.). Cambridge: Cambridge University Press.

  25. Kerstein, S. (2002). Kant’s search for the supreme principle of morality. New York: Cambridge University Press.

    Book  Google Scholar 

  26. Leenen, H. J. J. (1994). Handboek gezondheidsrecht. Deel 1. Rechten van de mens in de gezondheidszorg [Textbook on Healthlaw., Part 1, Human rights in healthcare] (3rd ed.) (Vol. 3). Samson: Alphen a/d Rijn.

  27. Leget, C. (2013). Analyzing dignity: A perspective from the ethics of care. Medicine, Health Care and Philosophy, 16(4), 945–952.

    Article  Google Scholar 

  28. Lohne, V., Aasgaard, T., Caspari, S., Slettebø, A., & Naden, D. (2010). The lonely battle for dignity: Individuals struggling with multiple sclerosis. Nursing Ethics, 17(3), 301–311.

    Article  Google Scholar 

  29. Meyer, M. J. (1989). Dignity, rights, and self-control. Ethics, 99(3), 520–534.

    Article  Google Scholar 

  30. Nordenfelt, L. (2004). The varieties of dignity. Health Care Analysis, 12(2), 69–81.

    Article  Google Scholar 

  31. Pettit, P. (1988). The consequentialist can recognise rights. The Philosophical Quarterly, 38(150), 42–55.

    Article  Google Scholar 

  32. Pettit, P. (1997). Republicanism: A theory of freedom and government. Oxford: Oxford University Press.

    Google Scholar 

  33. Pettit, P. (2001). Capability and freedom: A defence of Sen. Economics and Philosophy, 17, 1–20.

    Google Scholar 

  34. Pettit, P. (2002). Keeping republicanism simple: On a difference with Quentin Skinner. Political Theory, 30, 339–356.

    Article  Google Scholar 

  35. Rosen, M. (2012). Dignity: Its history and meaning. Cambridge: Harvard University Press.

    Book  Google Scholar 

  36. Sensen, O. (2009). Kant’s conception of human dignity. Kant-Studien, 100(3), 309–331.

    Article  Google Scholar 

  37. Sensen, O. (2011). Kant on human dignity. Berlin: Walter de Gruyter.

    Book  Google Scholar 

  38. Stark, C. (1997). Decision procedures, standards of rightness and impartiality. Nous, 31(4), 478–495.

    Article  Google Scholar 

  39. Vellemen, J. D. (1992). What happens when someone acts? Mind, 101, 462–481.

    Google Scholar 

  40. Wood, A. (1999). Kant’s ethical thought. Cambridge: Cambridge University Press.

    Book  Google Scholar 

Download references

Author information

Affiliations

Authors

Corresponding author

Correspondence to Jill Graper Hernandez.

Additional information

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.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

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

Download citation

Keywords

  • Human value
  • Human dignity
  • Moral dignity
  • Immanuel Kant
  • Presence
  • Bioethics
  • Healthcare ethics