A Defense of Dignity: Creating Life, Destroying Life, and Protecting the Rights of Conscience

Chapter One: Introduction

One introduction the subject of human dignity has received a fair bit of attention. Both the report of the President’s council on Bioethics, Human Dignity and Bioethics, and the Vatican declaration Dignitas Personae have highlighted the idea of human dignity in the public eye while they have also raised important and difficult questions.1 “What exactly is “dignity”? What is “human dignity”? Do human beings have it innately, or only conditionally? Should human dignity matter to us? in these introductory remarks, i will suggest answers to these questions. the collection of essays that constitute this book examine ethical issues related to human dignity. the chapters fall into four groupings. chapters 1–2 treat the dignity of the human person and consider arguments from advocates of animal rights that it is unjust to accord dignity to all human beings while declining to extend the same rights to nonhuman animals. chapters 3–8 address the procreation of human life (including issues such as “procreative beneficence”) and the immediate beginning of life (including issues such as ectopic pregnancy and fetal surgery). chapters 9–11 focus on the end of life (including the issues of 1 D 2 A Defense of Dignity treatment of PVS patients, physician-assisted suicide, and organ donation after cardiac death). the last two chapters attempt to defend the dignity of health care professionals who seek to serve others by following the dictates of their consciences. As a presupposition to treating all of these issues, it is important to ask whether the very concept of “dignity” has a useful place in contemporary ethical debates. A number of recent works have analyzed human dignity.2 Perhaps the most polemical contribution is the article “the Stupidity of Dignity” by Steven Pinker, who argues against the usefulness of dignity as a central principle in bioethics.3 in addition to criticizing the ambiguity of the term “dignity,” Pinker sees three problems with making use of dignity as a principle of bioethics, namely its relativity, its fungibility, and its potential for harm. he therefore rejects the concept of “human dignity” in arguments about bioethics and proposes to rely solely on the notion of “autonomy.” Pinker first illustrates the problematic relativity of the concept of dignity: First, dignity is relative. one doesn’t have to be a scientific or moral relativist to notice that ascriptions of dignity vary radically with the time, place, and beholder. in olden days, a glimpse of stocking was looked on as something shocking. We chuckle at the photographs of Victorians in starched collars and wool suits hiking in the woods on a sweltering day, or at the Brahmins and patriarchs of countless societies who consider it beneath their dignity to pick up a dish or play with a child.4 Pinker fails, however, to note that the concept of autonomy is also relative . the importance of autonomy in contemporary discourse can be traced historically to the philosophy of immanuel Kant, who described it as the self-given law of practical reason shared universally by all rational beings. Kant himself considered it always contrary to autonomy to commit suicide for any reason, to lie with any intention in any circumstance, or to have sexual intercourse outside of marriage. many contemporary philosophers, however, enlist autonomy as a justification for conclusions contrary to those drawn by Kant. if dignity cannot work as a central prin- introduction 3 ciple in bioethics because it is relative historically, autonomy cannot work as a central principle in bioethics for the same reason. Pinker offers the fungibility of dignity as his second rationale for dropping dignity from the vocabulary of bioethics. he writes: Second, dignity is fungible. the [President’s] council and [the] Vatican treat dignity as a sacred value, never to be compromised. in fact, every one of us voluntarily and repeatedly relinquishes dignity for other goods in life. Getting out of a small car is undignified. having sex is undignified. Doffing your belt and spread-eagling to allow a security guard to slide a wand up your crotch is undignified. most pointedly, modern medicine is a gantlet of indignities. most readers of this article have undergone a pelvic or rectal examination, and many have had the pleasure of a colonoscopy as well. We repeatedly vote with our feet (and other body parts) that dignity is a trivial value, well worth trading off for life, health, and safety.5 here again, Pinker fails to notice...