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Inclusive and relevant language: the use of the concepts of autonomy, dignity and vulnerability in different contexts

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Abstract

The article analyses the three terms autonomy, dignity and vulnerability. The relevance and practical application of the terms is tested in two spheres. First, as guiding principles in the area of ethics of medicines and science. Second, as human rights principles, serving to guide the conduct of public policies for an effective realization of human rights. The article argues that all human beings have the same dignity, but that the autonomy—and therefore vulnerability—differs considerably. Simply said, with reduced autonomy comes increased vulnerability, implying extra attention to the protective dimensions. The article finds that the three terms approach the protection of human beings in different ways and that all are relevant and applicable in both spheres, but that an isolated notion of autonomy and a ‘group-based’ notion of vulnerability are not adequate.

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Notes

  1. Barbosa da Silva (and Sinding Aasen) creates a divide between the ‘humanistic’ and the ‘non-humanistic’ viewpoints or perspectives, where only the former is characterized by universality, applying to all human beings, and emphasizing dignity as the basis of respect for a person’s integrity and autonomy. The ‘non-humanistic’ perspective implies that a person’s dignity is based on the individual’s actual autonomy (Barbosa da Silva 2009, p. 46; see also Sinding Aasen 2009b, p. 107). His use of the terms ‘humanistic’ and ‘non-humanistic’ are problematic, as they entail clear normative ranking. To classify a person as being ‘non-humanistic’ will most likely meet with opposition.

  2. The International Covenant on Civil and Political Rights (ICCPR) Article 23.1; the International Covenant on Economic, Social and Cultural Rights (ICESCR) Article 10.1; and the Convention on the Rights of the Child Article 9.1 and 18.1.

  3. ICCPR Article 27.

  4. ICCPR and ICESCR, Article 1.

  5. Universal Declaration on Bioethics and Human Rights, Article 2(g).

  6. Available in English at: http://www.ub.uio.no/ujur/ulovdata/lov-19990702-063-eng.pdf.

  7. ICCPR Article 10.1 reads: “All persons deprived of their liberty shall be treated with humanity and with respect for the inherent dignity of the human person.” ICESCR Article 13.1 reads (extract): “…education shall be directed to the full development of the human personality and the sense of its dignity…”.

  8. The CIOMS 1993 Guidelines listed in Guidelines 5 through 8 research involving children, persons with mental or behavioural disorders, prisoners and ‘subjects in underdeveloped communities’, respectively.

  9. Paragraph 8 of the 2004 version read (extracts): “Some research populations are vulnerable and need special protection. The particular needs of the economically and medically disadvantaged must be recognized. Special attention is also required for those who cannot give or refuse consent for themselves, for those who may be subject to giving consent under duress, for those who will not benefit personally from the research and for those for whom the research is combined with care.”.

  10. CIOMS 2002b says about vulnerability under ‘respect’: “protection of persons with impaired or diminished autonomy, which requires that those who are dependent or vulnerable be afforded security against harm or abuse” (CIOMS 2002b, p. 17); and under ‘justice’: “‘Vulnerability’ refers to a substantial incapacity to protect one’s own interests owing to such impediments as lack of capability to give informed consent, lack of alternative means of obtaining medical care or other expensive necessities, or being a junior or subordinate member of a hierarchical group. Accordingly, special provision must be made for the protection of the rights and welfare of vulnerable persons” (CIOMS 2002b, p. 17).

  11. Professor of philosophy Glenn Hughes emphasized at a seminar at the Norwegian Academy of Science and Letters 9 December 2008, titled ‘Human Dignity - a Universal Concept?’ that dignity is comprised of four element: liberty, responsibility, uniqueness and vulnerability, and liberty and responsibility must be understood as central elements in autonomy.

  12. UNESCO 2001, Article 4 (extracts). Note that the 2005 Convention on the Protection and Promotion of the Diversity of Cultural Expressions (UNESCO 2005b) does not establish similar links between cultural diversity and human dignity, but introduces the phrase ‘dignity of cultures’ by stating in Article 2.3 (extracts): “The protection and promotion of the diversity of cultural expressions presuppose the recognition of equal dignity of and respect for all cultures…”.

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Acknowledgments

The author wants to thank Jan Helge Solbakk and Kai Ingolf Johannessen for comments on an earlier draft. The usual disclaimers apply.

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  1. Diakonhjemmet University College, P.O. Box 184 Vindern, 0319, Oslo, Norway

    Hans Morten Haugen

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Haugen, H.M. Inclusive and relevant language: the use of the concepts of autonomy, dignity and vulnerability in different contexts. Med Health Care and Philos 13, 203–213 (2010). https://doi.org/10.1007/s11019-010-9242-7

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