Recent debates in academic circles have questioned the relevance of human dignity in bioethics. Some scholars argue that the concept is useful as it helps in explaining a number of bioethical issues.
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The areas addressed by the concept include embryo research, biomedical enhancements, as well as care for the disabled and the dying. Others argue that it is a useless and irrelevant concept given that it is just a means of justifying unconvincing arguments and un-articulated biases.
The current paper is a critical analysis of the controversy surrounding the issue of human dignity and bioethics. In the paper, the author analyses the history and meaning of human dignity as perceived from different sources. In addition, the author outlines some traditional guidelines with regard to bioethics.
The author analyses the various alternative approaches to bioethics and the principles on which bioethics are based. Finally, the author discusses possible solutions to address the controversy surrounding human dignity and bioethics.
History of Human Dignity and Bioethics
There are various sources of human dignity in contemporary society. Each of these sources contributes significantly to bioethics. However, the diverse nature of these sources brings with it some difficulties with regard to the application of the human dignity concept to bioethics (Ainslie2001, 110). Some of the various sources of human dignity are discussed in the section below:
Kantian Moral Philosophy
Immanuel Kant is among some of the philosophers who attempted to set human dignity on a rational foundation. According to Kant, the concept of human dignity has two major components. The two are humanity and dignity. According to Gregor (2006, 99), dignity denotes a ‘form of value’ that cannot be equated to anything else in the world. In other words, it is not possible to put a price tag on dignity.
The concept derives its moral foundation from its ability to limit and regulate the exchange between humans. It is not the ‘price’ of the individual or the amount that is paid to use his power and other resources.
Kant views humanity as an ‘objective end’ (Gregor 2006, 99). What this means is that the concept regulates the ‘other ends’ of humans. The regulation is in terms of the activities prompted by the ends. Humanity is not a goal that is to be achieved. On the contrary, it is the ability of the individual and the society in general to set objectives. It also refers to the ability of the individuals to reason systematically.
According to Kant, respect for humanity, among other things, involves avoiding using others in ways aimed at meeting ends that they cannot formally share in (Pluhar 2007, 42).
What this means is that acting on people without their consent is disrespectful to humanity. Making false promises, giving inaccurate and misleading information, as well as assault on the freedom and morals of others, are all regarded as disrespecting human dignity.
Human consciousness is an important aspect of human dignity. It involves freedom, justice and injustice, as well as ‘good’ and ‘bad’. Human values are homogenous and hierarchical. For instance, pleasure and esteem are homogenous. The implication of this is that individuals viewed as just, according to human judgment, deserve to be happy (Pluhar 2007, 40).
In extension, the implication means that there are three distinctions of human aptitudes. The three are animal, rational, and moral distinctions. According to Gregor (2006, 91), the original disposition or Anlage to the good involves three issues.
The first is animality, which is evident given that humans are living beings. The second is humanity, which is evident in as long as humans are living and rational beings. The last is personality, which addresses the rational and responsible nature of humans.
Kant argues that individual human beings must respect themselves ‘as animal beings. For instance, the individual should desist from killing or defiling themselves out of lust or anger. The argument made by Kant is a valid and significant issue in bioethics.
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Life cannot be reduced to mechanical operations. As such, when humanity is confronted with opportunities for genetic and other enhancements to the human organism, cautions should be taken (Pluhar 2007, 44). In addition, the argument that duties and rights are legally enforceable is a very important issue in bioethics.
However, it is important to note at this juncture that, in some cases, human dignity may pose problems to a bioethical discourse. The reason for this is that it is often invoked by opposing sides arguing about the same issue of bioethics. For instance, is it right for an elderly patient suffering from Alzheimer’s disease to stop taking his cardiac medication in hopes of a quick death?
These are some of the questions that divide scholars and other professionals in the field of bioethics (Fletcher 2009, 87). Some may argue that it is alright to stop taking the medication and allow the disease to progress naturally, affording the patient a dignified and humane death.
If such a patient continues taking the cardiac drugs and other life supporting medications, he may end up becoming a burden to his family and the society at large. They will also become humiliated by their condition, especially when they start suffering from dementia. Others may argue that assisting another person to die is contrary to the dignity and respect equally owed to all forms of human life.
Another possible argument is that the dignity and autonomy of individuals dictates that the patient should be granted the freedom to make the decision without interference. The decision made by the patient should be respected by all, regardless of whether or not we agree with it (Beyleveld 2001, 97).
The relationship between human dignity and technology is another source of problem in bioethics. For instance, many people wonder whether or not it is right for an athlete to use drugs that enhance their performance (Kass 2003, 89).
Some may argue that the use of new forms of technology is permissible since it enhances the characters and traits that uphold the esteem of human beings. Others might disagree with this position by arguing that the use of new forms of technology leads to over-dependency on such technology (Ainslie2005, 29).
According to the Bible, man was created against the image of his maker, God. The belief is another foundation on which the concept of human dignity is based. According to the scriptures, human beings are to some extent similar to God. As such, they possess an inherent and inalienable ‘dignity’. A major aspect of this dignity is the special place occupied by man in the natural world.
Compared to the other animals, it is man alone who can comprehend the world. Man is engaged in efforts to perfect nature in order to complete and complement God’s creation. Such interpretations of human dignity are significant to bioethics. For example, they inform such activities as medical support and cloning, among others. Such efforts are understood as endeavours to perfect nature, a God given responsibility (Kass 2003, 88).
But others may interpret the biblical concept differently. The dissents argue that it may be true man was created in God’s image. However, this fact does not make man a creator, but a creature. It means that all human beings, regardless of whether they are healthy or sick, have a share in the God given dignity.
The position gives ethical guidance to professionals, advising them to treat their fellow creatures with respect and dignity. It means seeing dignity where others may find disability and finding human life in places where others regard it as only a clump of cells (Engelhardt 2006, 54).
The various interpretations of the biblical account of human dignity conflict with each other. As such, their effects on bioethics are not clear. For instance, does human dignity mean that human life is sacred, regardless of its stage of development?
In other words, is destroying an embryo equivalent to destroying a life and, therefore, forbidden? Some argue that the biblical account of human dignity is unreliable. They are of the view that it is merely a camouflage for religious dogmas that have no legitimate place in secular bioethics (Beyleveld 2001, 89).
Constitutions and International Declarations
Most constitutions and international declarations enacted after the Second World War address the concept of human dignity. Such constitutions and declarations are regarded as sources of this concept in contemporary bioethical discussions.
For instance, according to the President’s Council on Bioethics (2005, 37), all individuals enjoy the inherent and inalienable dignity accorded all humanity. The declaration by this council is seen as the foundation on which freedom, justice, and peace in the world is built on.
But it is important to note that the meanings, content, and foundations of human dignity are not explicitly defined in these constitutions and international declarations.
The view of human dignity expressed in these articles reflects a political consensus among groups that have varying understandings of what the concept entails. Human dignity is interpreted as anything that entitles human beings to basic human rights and freedoms (Ainslie2001, 110).
As a concept, human dignity is formal and vague in nature. The vague nature of the concept extends to its representation in the various constitutions and international declarations. As a result of this, the concept fails to adequately address the controversy surrounding contemporary bioethical practices.
Addressing the concept in these articles should, however, form a basis for exploring the nature of the ground on which human dignity is built. It will also help in exploring the idea of universal human dignity aimed at establishing a baseline for human rights that should never be violated (Fletcher 2009, 93).
Euthanasia is the practice where a person takes the life of another person, intentionally and painlessly. It is practiced by act of omission or commission for compassionate reasons. Euthanasia comes from a Greek word, which loosely translates to ‘good death’. The act may be achieved by either administering a lethal drug to the patient, or withdrawing basic health care, which normally sustains life (Fletcher 2008, 77).
According to Ainslie (2001, 111), the practice may be voluntary or non-voluntary. Voluntary euthanasia refers to taking of human life on request of that person, for example, when a patient requests his family and the doctor to switch off life-supporting machines. On the other hand, non-voluntary euthanasia is taking of human life without the person’s request or consent.
The question of whether this practice is right or wrong is highly controversial. Some argue that it is permissible and dignified to take a person’s life by act or omission. The permissibility is especially significant if the act saves the patient from prolonged agony. Others argue that human dignity does not permit the taking of a person’s life. As such, euthanasia is wrong, regardless of the conditions under which it is carried out (Ainslie2005, 29).
The doctrine of double effect governs the permissibility of actions with two possible outcomes. The possible outcomes are good and bad. The principle provides that an action of this kind may be permissible provided the bad outcome is only foreseen, not intended. It is also permissible if the bad outcome is proportionate to the action, meaning that the bad effects do not outweigh the good intended effects (Beyleveld 2001, 99).
However, the principle does not permit for an action with two outcomes that are both intended. If, for instance, a doctor administers a high dose of pain relief drugs to a patient with the intention of relieving pain and distress, but with the awareness of the possibility of death, the action is permitted under this principle. It is permitted provided the foreseen possibility of death is determined as proportionate to the action.
The doctrine is fiercely criticised on the basis of whether or not there is a moral difference between intending and foreseeing an outcome. The critics argue that the difference should be made clear, such that the agent excused is capable of showing the permissibility of the act (Engelhardt 2006, 50).
Problems touching on formal and material cooperation will always arise when research is carried out on human genes. There are different forms of cooperation, which can take place in different areas of human life. Not all forms of cooperation in immoral procedures are morally wrong.
Wrongful cooperation occurs where a person knowingly cooperates with a researcher intending to do something that is wrong. For instance, when a bus driver stops at an abortion clinic knowing that some of his passengers are getting off at the station, he contributes to the practice, even if at a small capacity (Fletcher 2009, 87).
The principle of autonomy basically complements the principle of respect for humans. The principle emphasises that human beings have the right to make their own choices and decide how to lead their life (Ainslie2005, 24). In healthcare settings, it is equivalent to the principle of informed consent.
It basically states that a patient should not be treated without their consent or that of their lawful surrogate, except under defined circumstances. However, to affirm autonomy, the patient or surrogate must be fully informed about treatment and all the alternatives to make a free and intelligent choice.
Furthermore, the patient or surrogate must be competent and capable of comprehending the outcomes of the choice. They should also be capable of making a free choice without coercion or undue influence (Fletcher 2008, 18).
Beneficence and Non-Malfeasance
The two principles primarily address professional conduct. They emphasise on the fundamental importance of the patient’s interests. As a principle, beneficence requires people, other things remaining equal, to do good, or that which will advance the interests of the patient.
The principle of non-malfeasance, on the other hand, requires individuals, other things remaining equal, to avoid doing harm to the patient, or something that will be contrary to the patient’s interests (Kass 2003, 89). The difference between the two principles is observed on their stand on the avoidance of harm to the patient and the requirement for positive benefits.
The principle of non-malfeasance requires that a person should not kill, cause needless pain, or incapacitate others. On the other hand, the principle of beneficence requires the person to prevent the infliction of needless pain, prevent killing, and prevent incapacitation of others (Fletcher 2008, 78).
The principle requires the fair distribution of goods and services. It includes fair distribution of medical goods and services. The principle requires equal treatment of all cases. It requires a human need, which is defined as any claim to a basic need, to be regarded as important (President’s Council on Bioethics 2005, 33).
The failure to do so will amount to neglect. A medical need is determined in terms of likely benefits to the patient, urgency of need, change in quality of life, and the duration of benefit (Ainslie 2005, 29).
Solution to the Controversy
The first step to tackling the controversy between human dignity and bioethics involves recognising the fact that most of the traditional approaches to this debate have no place in contemporary society (Lynne 2000, 59. In this day and age, a lot has taken place and traditional sacred values that depend on widespread and acceptable myths have no place in the society.
Humans need to encourage values that can withstand the scrutiny and criticism directed towards their own creation. However, in doing so, human beings have to be self-conscious about their reliance on such policies without destroying their faith (Fletcher 2009, 78).
According to Ainslie (2005, 23), there is always some form of disagreement between what the author refers to as the ‘whistle-blower’ and the authorities. The disagreement is present, regardless of the fact that the authorities may be fully aware of the fact that they have conferred, albeit by mistake, scientific recognition on findings made fraudulently.
Finally, humans should rely on both laws and traditions in addressing the controversy between human dignity and bioethics. The laws that prohibit unjust practices should be encouraged. Codes of ethics and legal liability should be encouraged and enhanced. Individuals who practice in the field of medicine should be held accountable, whether or not they have a valid claim of ignorant innocence (Fletcher 2009, 29).
Traditions that discourage unfair treatment should be encouraged. In addition, local traditions, which can withstand scrutiny and defend the values that humans try to protect, should be encouraged. Only those traditions that respect all should be preserved (Kass 2003, 88).
In this paper, the author analysed the controversial issue of human dignity and bioethics. The author discussed the history and meaning of human dignity as explained in various sources, including the Bible. The author outlined some traditional guidelines that inform bioethics.
An analysis of alternative approaches to bioethics, as well as the founding principles of bioethics, was also provided. Finally, the author discussed possible solutions to the controversy surrounding human dignity and bioethics.
Ainslie, George. Breakdown of Will. Cambridge: Cambridge University Press, 2001.
Ainslie, George. Breakdown of Will: Behavioural and Brain Sciences. Cambridge: Cambridge University Press, 2005.
Beyleveld, Deryck. Human Dignity in Bioethics and Biolaw. Oxford: Oxford University Press, 2001.
Engelhardt, Tristram. The Foundations of Bioethics. Oxford: Oxford University Press, 2006.
Fletcher, Joseph. Humanhood: Essays in Biomedical Ethics. Buffalo, New York: Prometheus Books, 2008.
Fletcher, Joseph. Morals and Medicine. Princeton, New Jersey: Princeton University Press, 2009.
Gregor, Mary. Groundwork of the Metaphysics of Morals. Cambridge: Cambridge University Press, 2006.
Kass, Leon. The Beginning of Wisdom: Reading Genesis. New York: The Free Press, 2003.
Lynne, Rebecca. Persons and Bodies: A Constitution View. Cambridge: Cambridge University Press, 2000.
Pluhar, Werner. Critique of Judgment. Indianapolis, Indiana: Hackett, 2007.
President’s Council on Bioethics, The. Taking Care: Ethical Caregiving in Our Aging Society. Washington, D.C.: Government Printing Office, 2005.