Defining Human Dignity
Both sides of the euthanasia debate claim to be advancing the cause of
human dignity. Whom should we believe?
22 November, 2009
Reproduced with permission
Euthanasia advocates argue respect for human
dignity requires that euthanasia be legalized and
opponents of euthanasia argue exactly the opposite,
that respect for human dignity requires it remain
prohibited. In short, the concept of human dignity
and what is required to respect it is at the centre
of the euthanasia debate, but there is no consensus
on what we mean by human dignity, its proper use, or
American political scientist Diana Schaub says
"we no longer agree about the content of dignity,
because we no longer share ... a 'vision of what it
means to be human'." She's correct. So what are the
various interpretations of dignity and what can they
tell us about "what it means to be human"?
Intrinsic dignity means one has dignity simply
because one is human. This is a status model -
dignity comes simply with being a human being. It's
an example of "recognition respect" - respect is
contingent on what one is, a human being.
Extrinsic dignity means that whether one has
dignity depends on the circumstances in which one
finds oneself and whether others see one as having
dignity. Dignity is conferred and can be taken away.
Dignity depends on what one can or cannot do.
Extrinsic dignity is a functional or achievement
model - dignity comes with being able to perform in
a certain way and not to perform in other ways. It
comes with being a human doing. This is an example
of "appraisal respect" - respect is contingent on
what one does.
These two definitions provide very different
answers as to what respect for human dignity
requires in relation to disabled or dying people,
and that matters in relation to euthanasia.
Under an inherent dignity approach, dying people
are still human beings, therefore they have dignity.
Opponents of euthanasia believe respect for human
dignity requires, above all, respect for human life
and that while suffering must be relieved, life must
not be intentionally ended. Taking life, except
where that is the only way to save life as in
justified self-defence, offends human dignity. That
is why capital punishment is wrong and why
euthanasia is wrong.
In fact, the original primary purpose of the
concept of dignity was to ensure respect for life.
It's ironic that it has been turned on its head by
pro-euthanasia advocates to promote exactly the
Under an extrinsic dignity approach, dying people
are no longer human doings - that is, they are seen
as having lost their dignity - and eliminating them
through euthanasia is perceived as remedying their
Pro-euthanasia advocates argue that below a
certain quality of life a person loses all dignity.
They believe that respect for dignity requires the
absence of suffering, whether from disability or
terminal illness, and, as well, respect for autonomy
and self-determination. Consequently, they argue
that respect for the dignity of suffering people who
request euthanasia requires it to be an option.
Importantly, to respect human dignity we must
have respect for both the human dignity of each
individual and for the worth of humanity as a whole.
That means that even if we accepted that individual
consent could justify taking human life, it is not
necessarily sufficient to ensure human dignity is
not being violated. For instance, a French court
ruled that the "sport" of "dwarf throwing" was in
breach of respect for human dignity and banned it,
even though the dwarfs involved consented.
Even those people who argue for euthanasia should
agree that it must be used only as a last resort.
The work of Canadian psychiatrist Harvey Chochinov,
who specializes in psychiatric care for dying
people, is relevant in this regard. He and his
co-researchers identified the components of dignity
and defined them. They then designed an approach to
enhance terminally-ill people's feelings of dignity
and being treated with respect for their dignity, in
order to address their psycho-social and existential
distress. They call this approach "dignity therapy."
Here are their results: "Ninety-one per cent of
participants reported being satisfied with dignity
therapy; 76 per cent reported a heightened sense of
dignity; 68 per cent reported an increased sense of
purpose; 67 per cent reported a heightened sense of
meaning; 47 per cent reported an increased will to
live; and 81 per cent reported that it had been or
would be of help to their family. Post-intervention
measures of suffering showed significant improvement
and reduced depressive symptoms."
These are truly remarkable results and provide a
stark contrast to a quick-fix solution of a lethal
injection as being the best way to enhance a
person's dignity. But to achieve them takes care,
time, commitment, research and expertise. In
thinking about investing health-care and
medical-research dollars to enhance human dignity,
we should keep in mind such studies.
Some commentators have distinguished different
ways in which the concept of dignity can be used in
bioethics. One they term "human dignity as
empowerment." The central idea here is that one's
dignity is violated if one's autonomy is not
respected, and this concept leads quite naturally to
an emphasis upon informed consent, as we see in
pro-euthanasia arguments. Another concept is "human
dignity as constraint"- that is, constraint on
individual choices to protect human dignity, in
general, as we can see in anti-euthanasia arguments.
The idea of dignity as constraint of autonomy and
self-determination to preserve human dignity, in
general, could be described as "dignity in fetters."
In that case, it is similar to "freedom in fetters."
Sometimes we have to restrict freedom to maintain
the conditions that make freedom possible.
Dignity is like justice, often it's easier to
identify what constitutes a violation of it, than to
define what it is. That probably explains why it is
not uncommon to speak of something being "beneath
human dignity" without defining what dignity is.
That tells us that what is involved - torture, for
example - does not respect human dignity, which
might be a judgment informed in part by moral
intuition or examined emotions, not just logical
cognitive mentation or reason, important as the
Some philosophers see dignity as the marker of
the ethical and moral sense humans have, which they
see as distinguishing humans from animals, which
also have consciousness. They believe humans are
"special" because of this moral sense and,
therefore, deserve special respect. Others reject
any special status for humans and see us as just
another animal in the forest. Arguments that we
euthanize our dogs and cats and so should do the
same for humans reflect this latter view.
Secularists argue that dignity is intimately
connected with religion and reject it on this basis.
It's true that some commentators believe "human
dignity is based on the mystery of the human soul"
and most people regard "soul" as a religious concept
with a theological base. But I'd like to suggest a
broader concept that might allow us to find a wider
consensus about the values we should adopt if we are
to respect human dignity, in particular in the
context of death and dying.
In my book The Ethical Canary, I introduced a
concept I called the "secular sacred" - everyone
disliked it. Secular people thought I was trying to
impose religion on them and that religion had no
place in the public square, and religious people
objected that I was denigrating the concept of the
What I suggested is that the sacred is not only a
concept that applies in a religious or ritualized
context, but also one that operates at a general
societal - or secular - level. Among other outcomes,
it might help us to articulate what respect for
human dignity requires.
I proposed that linking the secular and the
sacred, by adopting a concept of the secular sacred,
can help to unite everyone who accepts that some
things are sacred, whether they see the sacred's
source as religious or purely natural or secular. In
short, the "secular sacred" is a concept we can
endorse whether or not we are religious, and, if we
are religious, no matter which religion we follow.
The sacred requires that we respect the integrity
of the elements that allow us to fully experience
being fully human; in doing so, we protect that
experience. It is a concept that we should use to
protect that which is most precious in human life,
starting with life itself. I propose, as has been
true for millennia, that that requires us, as a
society, to reject euthanasia.
The concept of dignity must be used to maintain
respect for the life of each person, and for human
life and for the essence of our humanness, in
general. The current danger is that in the
euthanasia debate it could be used to realize
precisely the opposite outcomes.