Dignity's 'wooly uplift'

I have been sufficiently concerned for awhile about the more or less random deployment of terms such as 'human dignity' for and against any and all kinds of normative positions that I have done a bit of research on it while I was a Distinguished Visiting Fellow at Queen Mary, University of London's Graduate School last term. Here's a pre-print of an Editorial I jointly wrote with Anna Pacholczyk, a graduate student at Manchester University for the journal BIOETHICS (2010; 24(2): ii. There's also a longer article forthcoming in the first issue of the JOURNAL OF BIOETHICAL INQUIRY in 2010 that I wrote on my own. Check it out and let me know what you think about it.

DIGNITY'S WOOLY UPLIFT

A. J. Ayer was famously and predictably dismissive of terms such as 'human dignity', referring to them as a kind of 'wooly uplift'.¹ Despite the pervasive presence of appeals to dignity in medical ethics and the common use of this term in professional codes, constitutional texts and various human rights instruments², both the moral basis as well as the meaning of this term continue to remain nebulous at best. Ruth Macklin suggested that we can do without dignity.³ Christian anti-choice campaigners, worried that a term as hegemonic as 'dignity' might be used by their opponents in the context of arguments about assisted dying, are staking their claims as to the true meanings of the term.⁴

Recent empirical research focuses on the importance and meaning of dignity to terminally ill patients. Dignity here, however is little other than an umbrella term for various patient needs being satisfied.⁵ This place-holder function offers us nothing by way of addressing the crucial normative questions that usually give rise to the deployment of 'dignity' in bioethics and biopolicy, such as for instance the moral permissibility or otherwise of assisted dying.

Given that the concept of dignity is not a primitive term of ethics, despite vague noises to the contrary⁶, invoking dignity without clarifying its basis and reach is mere sloganism – an ethical conversation stopper of a kind.⁷

Ethics is commonly and quite rightly so understood as having two primary functions: to guide our actions as moral agents and to provide us with justifications for the guidance provided. Can a hydra-like notion of dignity serve this purpose? In the context of assisted dying, appeals to dignity are used on the both sides of the fence. For instance, the Roman Catholic Church considers euthanasia to be a 'violation of the divine law, an offence against the dignity of the human person.’⁸ On the other hand, organizations campaigning in favour of the decriminalization of assisted dying in its varying forms do not hesitate to campaign in the name of 'human dignity', too.⁹ The situation in the legal context is not much better. When in September 1993 the Canadian Supreme Court issued a ruling on the terminally ill Sue Rodriguez's petition to declare invalid s 241 (b) of the Criminal Code¹⁰ - which criminalizes assisting people to commit suicide – both the majority and minority opinions employed the argument from ‘human dignity’ to support their views. ¹¹

Some scholars accept that we cannot reasonably 'expect dignity to have only one, clearly delineated meaning.'¹² Doris Schroeder argues that this is no reason to get rid of the concept altogether. She maintains that 'dignity is a slippery idea, but also a very powerful one and the demand to purge it from ethical discourse amounts to whispering in the wind.'¹³ A recent defense of the UNESCO Declaration on Bioethics and Human Rights against its critics, asserts that 'human dignity' and other such principles could 'function as guidelines for reviewing or reorganising research practices'.¹⁴ That is a troubling proposition.

The current state of affairs seems to be that, notwithstanding the dubious normative merits of 'human dignity', the fact that it is commonly used is sufficient reason to continue using it. This proposition is evidently flawed. We surely can do better than this.

1 A. J. Ayer. (1947) Language, Truth and Logic. London: Victor Gollancz.

2 C. McCrudden. Human dignity and judicial interpretation of human rights. European Journal of International Law 2008; 19: 655-724.

3 R. Macklin. Dignity is a useless concept. BMJ 2003; 327: 1419-1420.

4M. Somerville, “Defining human dignity”, 22 November 2009, The Gazette (Montreal), online: . Accessed 29 November 2009.

5 H.M. Chochinov. Dignity and the essence of medicine: the A, B, C, and D of dignity conserving care. BMJ 2007; 335: 184-187.

6R. Goddin, “The political theories of choice and dignity” (1981) 18:2 American Philosophical Quarterly 96.

7 R. Van Der Graaf & J.J.M. van Delden, “Clarifying Appeals to Dignity in Medical Ethics from an Historical Perspective” (2009) 23:3 Bioethics 151.

8 F. Cardinal Seper. Declaration on Euthanasia. Acta Apostolicae Sedis 1980; 72: 542. Available at: Congregation for the Doctrine of the Faith http://www.vatican.va/roman_curia/congregations/cfaith/documents/rc_con_cfaith_doc_19800505_euthanasia_en.html [Accessed 29 Nov 2009].

9 D. Hillyard & J. Dombrink. 2001. Dying Right: The Death With Dignity Movement. New York: Routledge.

10 R.S.C., 1985, c. C-46.

11 Rodriguez v. British Columbia (Attorney General), [1993] 3 S.C.R. 519.

12 D. Schroeder. Dignity: Two riddles and four concepts. Camb Q Healthc Ethics 2008; 17: 230-238: 237.

13Ibid: 237.

14 M. Levitt & H. Zwart. Bioethics: An export product? Reflections on hands-on involvement in exploring the “external” validity of international bioethical declarations. J Bioeth Inq 2009; 6: 367–377:370.