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The value of dignity in and for bioethics: rethinking the terms of the debate

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Abstract

The discussion of the nature and value of dignity in and for bioethics concerns not only the importance of the concept but also the aims of bioethics itself. Here, I challenge the claim that the concept of dignity is useless by challenging the implicit conception of usefulness involved. I argue that the conception of usefulness that both opponents and proponents of dignity in bioethics adopt is rooted in a narrow understanding of the role of normative theory in practical ethical thinking. I then offer an alternate understanding of the nature and value of dignity. I begin by recognizing that claims that one’s dignity has been violated point to an important difference between “respect for autonomy” and “respect for persons.” I then suggest three different conceptions of how dignity can be normatively guiding for bioethics, and conclude that, ultimately, understanding dignity as the cornerstone of a reflective perspective that frames moral reflection and deliberation is valuable for doing bioethics well.

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Notes

  1. The role of human dignity in grounding human rights has also received a great deal of philosophical attention beyond bioethics in recent years, especially in the context of the foundation of human rights [1–4].

  2. Discussions of dignity are often bound up with debates about moral status, most notably, attempts to distinguish “persons” from “human beings.” Below, I contest one aspect of the tight connection between these two discussions by arguing that the “metaphysical framing” of the dignity debate, which sets out to identify particular status conferring properties, is misguided. In this section, I use the phrase “human being or person” to indicate that my characterization of the dignity debate in bioethics includes those who understand members of either or both categories as at issue.

  3. Although Macklin’s view is arguably the best known in this skeptical camp, many theorists make similar arguments, or maintain aspects of the argument Macklin gives here [10, 11].

  4. Human Dignity and Bioethics: Essays Commissioned by the President’s Council on Bioethics [6] is helpful as an overview of the debate and its history, especially the taxonomy with which the collection begins [17] and those discussions found under the headings “Human Nature and the Future of Man,” “The Source and Meaning of Dignity,” and “Theories of Human Dignity,” which itself focuses on “The Nature and Basis of Human Dignity.”

  5. This metaphysical framing of dignity discussions is in no way unique to bioethics. The foundation of human rights discussion has much the same character, so much so that Joel Feinberg beat me to this observation and characterization of the parties to the discussion by at least 30 years [18].

  6. Recognition of the need for a notion of respect for persons or respect for autonomy that is better able to capture and attend to the value of particular selves (embodied, and historically and socially situated) is not novel. The notion of relational autonomy has been central to the development of such an account, and bioethicists who employ and develop the notion are a valuable source of insight in this area. See Mackenzie and Stoljar’s volume for such contributions [30]. As such, the notion of relational autonomy suggests a similar value to the value of dignity I hope to point to here. At the same time, I believe the discussion of relational autonomy does not exhaust the content of the notion of dignity at play in these examples, as relational autonomy tends to privilege particularity and the construction of selves through relationships and in the context of institutions and practices. Here, appeal to dignity is pointing to how we share particularity. Asserting dignity, or recognizing that dignity has been violated, involves recognition that we are all individuals who lead particular lives and occupy particular social roles (whatever those may be) from the inside.

  7. I have focused my attention on the notion of respect for persons, which departs, in some ways, from the broader dignity debate’s discussion of both human beings and persons. Below, I consider how the view I suggest here may be useful for thinking about moral obligations with respect to non-person human beings.

  8. My discussion here is informed most directly by Robin Dillon and Seyla Benhabib [32, 33].

  9. Gerhold Becker also suggests and begins to develop an account of dignity that takes it as a foundation or cornerstone of a basic moral attitude [35].

  10. See Adrienne Asch’s discussion of revising the current approach to advanced directives in the context of the disability rights critique of end of life movement as a model of this kind of analysis [37].

  11. Jay Rosenberg introduces a distinction between “death” and “loss” in the Preface to the second edition of his Thinking Clearly about Death. It is his notion of loss that I have in mind here [39].

  12. See Erik Parens’s discussion of the value of a “binocular habit of thinking” for a richer defense of the value of being able to occupy potentially conflicting stances, perspectives, or ways of understanding a problem or issue [40].

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Acknowledgments

I had the good fortune to present this work in many different venues. I would like to thank audiences at the Feminist Association of Bioethics 2014 World Congress and the ASBH 2014 Philosophy Affinity Group Meeting. I am especially grateful to Josephine Johnston, Gregory Kaebnick, Erik Parens, Dylan Sabo, Daniel Sulmasy, Kristi Upson-Saia, and the anonymous reviewers for this journal for their insightful and helpful feedback on earlier versions of this argument.

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  1. Department of Philosophy, Occidental College, 1600 Campus Road, Los Angeles, CA, 90041, USA

    Clair Morrissey

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Morrissey, C. The value of dignity in and for bioethics: rethinking the terms of the debate. Theor Med Bioeth 37, 173–192 (2016). https://doi.org/10.1007/s11017-016-9368-6

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