Читать книгу This Is Bioethics - Udo Schüklenk, Ruth F. Chadwick - Страница 37

3.33 A ubiquitous phrase used liberally in many a bioethical analysis and argument is that of human dignity. Unfortunately, while the language of human dignity is universal, there is no consensus on the moral basis or on the precise meaning of human dignity. Religious as well as secular accounts of human dignity exist, and yet, it remains unclear whether it should best be understood as a basic, or primitive, term of moral language or whether it might reasonably be derived from a moral theory of mainstream appeal. The Australian philosopher Robert Goodin thinks that it is impossible to ground human dignity in a moral theory. He suggests that we should accept ‘human dignity’ as a logical primitive, ‘a fundamental axiom in our individualistic ethical system’, as he calls it (Goodin 1981, 97). This, of course, does not resolve the problem at hand. Goodin concedes that dignity cannot be derived from an ethical framework, so, instead, he suggests without further justification, that we should accept it as a primitive term of moral language. The problem is, unfortunately, that the meaning of the term is not self‐evident to begin with and so we have no reason to accept this invitation.

3.34 Among others this was lamented by Adam Schulman, a contributor to an anthology on bioethics and human dignity produced by former US President George W. Bush’s Council on Bioethics. In his chapter Schulman analyses promising existing normative foundations for the concept of human dignity, and concludes that they all fail. Schulman takes this challenge as a kind of a conceptual call to arms: ‘In short, the march of scientific progress that now promises to give us manipulative power over human nature itself … will eventually compel us to take a stand on the meaning of human dignity, understood as the essential and inviolable core of our humanity’ (Schulman 2008, 17). Ruth Macklin has taken a different approach. She argues in a much‐discussed article in the British Medical Journal that ‘a close inspection […] shows that appeals to dignity are either vague restatements of other, more precise, notions or mere slogans that add nothing to an understanding of the topic’ (Macklin 2003). In her view, in secular bioethics at least, talk of human dignity merely means respect for personal autonomy.

3.35 David A. Hyman agrees, he writes:

… in every generation, philosophers, ethicists, religious figures, politicians, and professional worrywarts have cited human dignity as a reason to restrict innovation or prohibit it outright. Consider a few examples. Galileo was forced to recant his heliocentric views because the Roman Catholic Church had already embraced the Ptolemaic system as more consistent with Biblical revelation and with man's dignity as God's creation. Indoor plumbing, the printing press, skyscrapers, the suburbs, automobiles, television, the Sony Walkman™, and the franchise for women were all met with the objection that they were inconsistent with human dignity. The Industrial Revolution, which laid the foundation for the modern world, was criticized because machines were expected to destroy human dignity.

(Hyman 2003)

3.36 In the medical context, human dignity continues to hold a prominent place. The World Medical Association's Declaration of Geneva⁵³ demands that doctors treat their patients with ‘compassion and respect for human dignity’. Oliver Sensen points out that human dignity, today forms the moral ground of human rights in UN documents. For instance, in the 1948 Universal Declaration of Human Rights, human rights are grounded in ‘the recognition of the inherent dignity […] of all members of the human family.’ Sensen sees a problem in the UN approach on this issue. He writes:

[i]n documents like these [UN declarations, covenants] key terms are deliberately kept vague, since one can only secure an agreement among so many parties at the price of a certain ambiguity. If one were to specify the meaning and grounding force of human dignity, it might be at odds with some parties' deeply entrenched opinions and beliefs. In this case the whole project might fail. Accordingly, there is no explicit attempt to clarify or justify human dignity in these documents.

(Sensen 2011)

3.37 Another example of this phenomenon, in the field of bioethics, is the UNESCO Declaration on Bioethics and Human Rights⁵⁴. It uses human dignity to ground the substantive policy guidance contained in the Declaration. David Benatar, a South African philosopher, agrees with Sensen's argument on the popularity of vague language in this dignity‐centered declaration. He is suspicious that it is being used by the drafters of this document ‘to gloss over disagreement’, which is achieved by them choosing words ‘that are sufficiently vague that each person can interpret them consistently with his or her own views’ (Benatar 2005). Unfortunately, just as is the case more generally, there is no consensus among experts on what the moral basis of human dignity is, if any, and what its specific meaning in the health care context should be taken to be.

3.38 In bioethical discourse dignity often means one thing and its opposite. Unsurprisingly, given its vagueness, human dignity is deployed in ethical, political, and even legal contexts in support of diametrically opposing points of view. For instance, both proponents as well as opponents of assisted dying deploy the human dignity trope for their respective ends. The rhetorical tool of human dignity pervades many public policy debates and it is present in many other spheres of social life. Authors often use it to cloak potentially controversial moral considerations in the language of dignity.

3.39 When you come across dignity arguments in bioethics, always investigate whether there is anything substantive to it, or whether it is no more than a pleasant‐sounding word deployed to shame you into agreeing with a particular point of view. We are not suggesting here that it is impossible to create a coherent theory of human dignity, but today it is fair to say that there is no consensus on either the moral basis of human dignity, or its meaning, or its scope.