The Western concept of dignity has six very different interpretations, if one includes dignity as slogan .

  • Dignity as virtue : showing resilience, acceptance, poise, patience and endurance in the face of hardship, for instance.

  • Dignity as rank and position: the dignity of a senior politician or a senior cleric, for instance.

  • Dignity as comportment : not shouting and smoking in maternity wards, for instance.

  • Dignity as understood by Kant and expressed through his formula of humanity : those who have dignity can expect (or command as Kant would say) respect for their reasonable sense of purpose and self-worth.

  • God-given dignity: dignity equated with a sanctity of life as, for instance, in Catholicism.

  • Dignity as slogan: this cannot be defined precisely, but can be found in highly charged debates, for instance against new technologies,Footnote 1 which are seen as an affront against human dignity.

The two main philosophical streams of Western dignity are dignity as virtue and dignity realised through the formula of humanity. We have extracted from them a common core, namely a sense of self-worth . Could this extension be applied to the Middle Eastern concept? Yes. Dignity as respect for and the protection of the self-worth of human beings is the core that could harmonise the main Western approaches to dignity with the Koranic interpretation.

The Koran , as interpreted in this book, encourages its readers to replace humiliation with dignity, leading to a deviolentisation of life. Dignity leads to peace , according to the Koran. In humiliating others, the Koran argues, one loses one’s own dignity. It also asks followers to develop their own dignity first, as a basis for recognising the dignity of others and acting upon this recognition. No one can revoke one’s own dignity, the Koran argues, but oneself. Recognising and developing one’s abilities, talents and senses belongs to the search for dignity. At the same time, one can help others develop and assist in their self-improvement and quest for dignity. Finally, striving towards dignity, according to the Koran, means that people need to be aware of their spiritual dimension and develop their related abilities in a constant effort to improve themselves. For instance, the inferiority of the social standing of women is an indication of social decadence and a sign that men’s dignity is not developed.

From the above, one can see a strong similarity between dignity in the Koran and dignity as virtue , and in particular a strong emphasis on developing self-worth and assisting others in doing so. Human dignity is contingent upon the recognition of one’s own nobility (self-worth ) and others’ nobility. Neglect of other people’s dignity is a result of the neglect of one’s own, according to the Koran . For instance, corruption is an example of neglect for one’s own dignity.

At the outset of the book we quoted Fukuyama’s (2012) editorial commenting on the Arab Spring. He wrote: ‘The basic issue was one of dignity, or the lack thereof, the feeling of worth or self-esteem that all of us seek.’

It thus seems that one can find an inner kernel in dignity discussions that unites major Western and Middle Eastern streams: dignity as a sense of self-worth, which we have a duty to develop and respect in ourselves and a duty to protect in others.

At the same time, this book identified a range of diverse interpretations of dignity. For meaningful dialogue on the subject, it is therefore necessary to listen carefully and ascertain whether conversation partners are using the same or at least a similar concept of dignity. If not, fundamental disagreements can remain hidden to the detriment of constructive consensus.

We would like to end with a fictional dialogue.

4.1 Dignity—A Fictional Dialogue

Doris Schroeder talking to a friend, a psychiatrist.

  • Friend: Did you ever write that book on dignity you told me about?

  • Doris: Yes.

  • With Bani-Sadr?

  • Yes.

  • How was it?

  • I am glad I didn’t write the book on my own.

  • Why?

  • I now have a stronger belief in the value of being precise, commonsensical and analytical in applied ethics and a stronger view on the limitations of this approach.

  • Why?

  • People often seem to make moral decisions based on unquestioned assumptions. And they mostly see their own situation and outlook. If one combines this attitude with a lack of empathy for others, some serious misjudgements can result.

  • Do you have an example?

  • There was one case I used for the book that I found profoundly sad and worrying. It was discussed using the term ‘dignity’. A 28-year old woman went to court to have her feeding tubes removed because she wanted to die.

  • Why?

  • She was suffering from a painful illness and was also quadriplegic.

  • What did the court decide?

  • They granted her request and allowed the removal of the tubes. She died.

  • Did you think this was wrong?

  • No. On the contrary, I do believe it is wrong to force artificial nutrition on somebody against their will.

  • So what was wrong?

  • The way the court approached the decision. And the obvious hidden assumptions the judges must have had.

  • What do you mean?

  • The judges showed no empathy with the young womanwho was called Elizabeth. They simply imagined what they would feel like if they were to go from presiding over a court to being quadriplegic and in pain.

  • And?

  • Their written judgement said that Elizabeth was ‘imprisoned and must lie physically helpless subject to the ignominy, embarrassment, humiliation and dehumanizing aspects created by her helplessness’.

  • I see what you mean.

  • To focus almost exclusively on Elizabeth’s helplessness and toileting needs under the topic of dignity is just wrong.

  • And what does this have to do with your belief in the value of analytical precision?

  • An applied ethicist who tries to be precise and starts from everyday occurrences or literature can bring out various dimensions in a concept, for instance in dignity.

  • Hmmm.

  • Dignity is often mentioned in the context of the dependency of severely ill or disabled people …

  • And?

  • And, I wish there was another word in this context. It seems wrongto meto use the word dignity both for Nelson’s Mandela’s comportment on Robben Island and in the context of incontinence.

  • I see.

  • It becomes dangerous when a concept that is imbued with almost mystical powers, such as the constitutional right to the inviolability of dignity, is suddenly used by judges who are pronouncing their views on the alleged humiliation of incontinence.

  • Don’t you understand the judges?

  • Yes, I do. But I believe that this is not right.

  • Let me read you something. It is about an old man talking to a middle-aged man over a chess game. The old man had been involved in the resistance against Salazar in Portugal. [She produces a paperback and then reads the excerpt given in this book’s introduction about the old man in a nursing home and his Swiss visitor (Mercier 2009: 364–365)].

  • You aren’t saying anything… It is moving, isn’t it?

  • Yes.

  • This man who had risen above his torturers despite unbearable agony could not cope with incontinence. The other man, Gregorius, analyses what dignity means for him and concludes: ‘And then you get worked up about a dirtied bed?’

  • Who is the author?

  • He is Peter Bieri, a Swiss professor of moral philosophy, but he writes novels under the pseudonym Pascale Mercier . What counts, though, is not the author but his main character. What Gregorius does show, in my view, is the value of precision and analysing concepts in applied ethics.

  • Yes?

  • Gregorius showed Eça that his intuitions about dignity and comportment and incontinence were incompatible with other understandings of dignity that he himself had adopted in an extreme situation.

  • And is that what your book is about? Showing the difference between these two concepts of dignity? The one about incontinence … well, you know what I mean, and the one about resisting torture?

  • Yes, that’s part of what I tried to do in my sections of the book. I termed one ‘comportment dignity’ and the other ‘dignity as virtue ’, but …

  • Wait a second… [She opens the paperback again.] Let me read something else to you. This time Gregorius is listening to a medical doctor:

The day before, I had informed a patient in the presence of his wife that he didn’t have long to live. You have to, I had persuaded myself before I called the two of them into the consulting room, they have to plan for themselves and the five children—and anyway: part of human dignity consists of the strength to look your fate, even a hard one, in the eye. … I took off my glasses and pinched the bridge of my nose between thumb and forefinger before I spoke. The two must have recognized the gesture as a harbinger of an awful truth, for when I looked up, they had grasped each other’s hands, which looked as if they hadn’t sought each other for decades. (Mercier 2009: 79–80)

  • Yes?

  • That’s a form of dignity as virtue, dignity in the face of hardship.

  • So are these the variations of dignity you came up with?

  • No, there are five, plus one outlier.

  • Five??!!

  • Yes. But don’t let me bore you with the details. What I hope to have shown is that these five concepts are strong and meaningful for many people and that they can contradict each other. It is therefore important to define them properly and make sure that discussants are talking about the same thing. And then there is a sixth one, dignity as slogan , which is indeed not meaningful.

  • How do you mean, ‘discussants’?

  • I mean people who are arguing about specific moral dilemmas, for instance, end-of-life decisions. If one is talking about comportment dignity and the other about a concept inspired by Catholic belief, which implies the sanctity of life , they will talk past each other.

  • Talk past each other?

  • One more. [Doris opens the paperback again.] Here is Gregorius once more.

I sat down in the lecture hall next to the Irish man. … It was unbelievable. The lecturer. … sketched in a creaky voice a casuistic of lying that couldn’t have been more nitpicking or farther from reality. … Can God create a stone He couldn’t lift? If not, then He isn’t almighty, if yes, then He isn’t either, for now there is a stone He cannot lift. That was the kind of scholasticism that poured forth into the room. … But that wasn’t what was really unbelievable. What was really incomprehensible was the discussion, as it was called. Cast into and enclosed in the gray lead frame of polite empty … phrases, the people spoke perfectly past one another. Constantly they said they understood each other, answered each other. But it wasn’t so. Not one, not a single one of the discussants, showed the slightest indication of a change of mind in view of the reasons presented. (Mercier 2009: 136–137)

  • If it goes well, analysing in applied ethics can illuminate concepts and help people avoid talking past each other. If that happens, people will change their minds, at least some of them. There will be some movement.

  • Does that work?

  • Not if people’s attitudes and opinions are narcistically cemented in stone and they are unwilling to listen to others.

  • So?

  • In addition to the analysis, there has to be a willingness to open one’s mind to others.

  • Is that where the limitations are?

  • Pardon?

  • You talked about the limitations of analytical philosophy before.

  • Yes.

  • That’s interesting.

  • I don’t know how one can instil a sense of empathy and imaginative caring in human beings, for instance in the judges who presided over Elizabeth’s fate. But I know that a sole focus on rational analysis will not suffice for fully rounded, well-balanced human interactions. But then, you are the psychiatrist.

  • And how does this relate to the book?

  • Do you remember something else I said earlier on?

  • What?

  • That I would like to co-author with an eminent scholar from an ancient culture, a highly respected politician known around the world?

  • Yes?

  • An excellent counterbalance against over-rationalising is input from a source that provides reflective scholarship rooted in a different culture, don’t you think?

  • Hmmm.

  • I have been lucky that Abol-Hassan Bani-Sadr co-authored this book.

  • Why?

  • Don’t you think so?

  • I just want to understand better what you mean.

  • But I already told you that wisdom and scholarship balance against over-rationalising. They make you think. Especially if you don’t understand everything immediately.

  • Hmmm. Perhaps you need to tell me more about the limitations of the analytical approach.

  • I believe there are three. The first is that one still needs judgement.

  • How do you mean?

  • Analytical philosophy cannot easily justify a preference between two equally coherent thought systemsfor instance, to decide between dignity as virtue and dignity according to Kant if they were applied in specific cases.

  • Yes, I see what you mean. And the second limitation?

  • Perhaps that’s not really a limitation of analytical philosophy, more a limitation of analytical people who fail to show any empathy or common sense.

  • Empathy? Common sense? Are you thinking about changing careers and moving into my domain?

  • [Doris smiles.] Let me read something to you, written by a colleague of yours but for an applied ethics journal.

One case of mental disorder was encountered by a friend of mine, in an interview with a woman who had killed her infant. When asked why she had done it she gave the following explanation.

  1. 1.

    All human beings die and are judged

  2. 2.

    They are judged according to their sins

  3. 3.

    If they are found innocent, they live with God in heaven

  4. 4.

    Living with God in heaven is better than life on earth

  5. 5.

    My baby has committed no sins

  6. 6.

    If he dies, he will be innocent and go to heaven

  7. 7.

    Therefore, I killed my baby.

While it is clear that there is irrationality of a very profound kind here, it is not clear just how to categorise it. Premises 1, 2, and 3 are believed by a great many people and therefore each belief is ‘one ordinarily accepted by other members of the person’s culture or subculture.’ Premise 4 is found in some of the great religious works of Western Culture (e.g. Paul, Philippians 1:21). Premise 5 is a plausible premise on most readings by people who think in those terms, and 6 is merely a logical entailment of 2, 3, and 5. The practical conclusion comes as a surprise but, given the argument, the surprise is not explicable on purely rational grounds because the conclusion follows from premises that are widely believed by rational people. Nevertheless, we are not surprised that the argument was produced in justification by a woman accused of child murder and thought, by a psychiatrist examining her, to be suffering from psychosis. (Gillett 2003)

  • Do you see what I mean?

  • Yes.

  • I believe an over-emphasis on rationality and logic alone is detrimental in applied ethics, even if the degree is obviously different from the above disorder. But, for instance, it is not clear to me why philosophers do not work more often with psychologists and psychiatrists. On the topic of dignity that might be very fruitful.

  • Why?

  • Bani-Sadr and I came to the conclusion that there is an inner kernel that binds together the two main Western conceptions of dignity (dignity as virtue and the Kantian understanding of not instrumentalising other people) and dignity as seen in the Koran . It is dignity as a sense of self-worth , which we have a duty to develop and respect in ourselves and a duty to protect in others.

  • How could psychologists or psychiatrists help?

  • You know that, don’t you?

  • I do, but I am interested to hear what you think.

  • I found an interesting analysis of human dignity in a psychology book. What the psychologists did was to name the four scourges that harm dignity (Fig. 4.1). The first scourge is violence. Those humans who can defend themselves against violence can protect their dignity, but if you are a child, for instance, or a person who cannot escape for some reason, constant violence will make you feel smaller and smaller and ever more helpless, until, in the end, you have lost your sense of self-worth . Let me read something from the book:

Somebody who is regularly unable to defend themselves tends towards losing all hope of a solution or exit and starts to accept the loss of self-worth and the sense of dignity. How are you meant to feel when you are beaten all the time and when your personal boundaries are not respected? Losing your sense of self-worth can become natural, and helplessness becomes the terrible normality. (Baer and Frick-Baer 2009: 12, DS translation)

  • The second scourge is humiliation . That is something philosophers have worked on in relation to dignity, especially an Israeli philosopher called Margalit. But it was still good to see it in the psychology book. The authors say that humiliation begins where people are made smaller through words or behaviour. They give the example of a boy who hears all the time: ‘You’ll be nobody, you’ll end up as a bin man,’ and loses all sense of self-worth over the years (Baer and Frick-Baer 2009: 13). They write:

Humiliations are part of everyday life for many people. If they happen only occasionally, people can normally defend themselves successfully and can find a way to cope with the denigration. The main danger occurs in the repetition and in the continuity. Where people are continuously subjected to humiliation, this experience trickles into their image of themselves and the sense of one’s own dignity can get lost. (Baer and Frick-Baer 2009: 15, DS translation)

  • The third scourge is disregard. Do you agree with this one? It doesn’t seem as obvious to me as the others:

From a psychological perspective, it is obvious. Humans are very social beings; to be ignored and disregarded systematically is very difficult for the human psyche. (Baer and Frick-Baer 2009: 15, DS translation)

  • That’s what the psychologists in the book say. They give a case example where parents ignored their child for a week after some wrongdoing or after a low grade at school. And the child said ‘I was treated like thin air for a week. That was terrible. I yearned to be shouted at.’ (Baer and Frick-Baer 2009: 16, DS translation). The psychologists write:

To be ignored and not to receive answers or comments to what one says – these are heavy punishments and they can make people suffer a lot. (Baer and Frick-Baer 2009: 16, DS translation)

  • The fourth scourge is embarrassment. To me that sounded a lot like the second one, humiliation , but the examples given made the difference clear. What do you think?

  • What were the examples?

  • One case recalled how a child was constantly embarrassed and on edge because the father regularly got drunk in public. She said, ‘When my father had one of his binges, I was so incredibly ashamed. I found this so undignified. … Later I despised him. And I had terrible stomach pains. … A little bit of my dignity died in my stomach.’ (Baer and Frick-Baer 2009: 18, DS translation)

  • Yes, that’s a good example. Humiliation is usually meant when a particular person is targeted, but you can feel serious embarrassment unrelated to yourself, or at least not directly related to yourself, as in this case.

    Fig. 4.1
    figure 1

    Harming dignity: the four scourges

  • The other reason I liked the analysis from the psychologists was the obvious link to Bani-Sadr’s thoughts on dignity. They spoke about power, as he did. There is one section in particular, where Bani-Sadr writes that freedom and human rights will become casualties if human relationships are built on power.

  • And the psychologists?

  • They write that many people who feel defenceless and vulnerable do so because other people’s power has wounded them permanently through humiliation and violations of dignity.

  • So, yes, I can see how this is all coming together: dignity according to the Koran , dignity as virtue , dignity as not instrumentalising others. So what next?

  • This is probably the place where one should ask, ‘Which book next?’

  • And?

  • I think my answer to ‘What next?’ is ‘Do something practical, don’t just write about it.’