The recognition of a right to life, liberty, and the autonomy of the individual and the mandate of government to secure these rights is being threatened by an increasingly illiberal notion of “human dignity”, says evolutionary psychologist Stephen Pinker.
His 2008 broadside in The New Republic took to task a now defunct body, the US President’s Council on Bioethics whose publication Human Dignity and Bioethics is shot through with disquiet about advances in biotechnology. It could not be more different from the enlightened report issued earlier this year by the Council’s successor calling on the current administration not to stifle biomedical research with over-restrictive regulation (see my post). Does the contrast between the present advisory body’s recommendations and the report put before the previous President signal a fundamental change in the way we approach progress in this field? Probably not. Only two weeks ago, Sir John Gurdon (the Nobel physiologist whom schoolteachers had written off as a scientist) bemoaned the regulatory restrictions that make important therapies too costly to pursue. Pinker’s dismay at the “scientific illiteracy” of society rings true today:
Ever since the cloning of Dolly the sheep a decade ago, the panic sown by conservative bioethicists, amplified by a sensationalist press, has turned the public discussion of bioethics into a miasma of scientific illiteracy. Brave New World, a work of fiction, is treated as inerrant prophesy. Cloning is confused with resurrecting the dead or mass-producing babies. Longevity becomes “immortality,” improvement becomes “perfection,” the screening for disease genes becomes “designer babies” or even “reshaping the species.” The reality is that biomedical research is a Sisyphean struggle to eke small increments in health from a staggeringly complex, entropy-beset human body. It is not, and probably never will be, a runaway train.
The heated debate about science in the current run up to the election reflects the deep divisions in American society vis a vis the ethics of biomedical innovation, genetic manipulation of animals or humans, embryonic stem cells and so-called “therapeutic cloning” that could furnish replacements for diseased tissue and organs. And the concept of “human dignity” has become, in Pinker’s view, a stalking horse for anti-science prejudice (see my post “Defining dignity – nailing jelly to the wall?“). The general feeling is that, even if a new technology would improve life and health and decrease suffering and waste, it might have to be rejected, or even outlawed, if it affronted human dignity. This is not a development to be encouraged. Dignity is a “squishy, subjective notion”, intended to “squelch research and therapy”.
The report which is the object of Pinker’s jeremiad is obviously old hat now but the concept of “human dignity” is still very much at the centre of bioethics (along with related expressions like “fundamental aspects of human existence” and “the central core of our humanity”.) And the concept of dignity is natural ground on which to build an obstructionist code:
An alleged breach of dignity provides a way for third parties to pass judgment on actions that are knowingly and willingly chosen by the affected individuals. It thus offers a moralistic justification for expanded government regulation of science, medicine, and private life.
Pinker argues that there are three features of “dignity” undermine any possibility of using it as a foundation for bioethics.
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.
As I noted in my post on Michael Rosen’s book Dignity – its History and Meaning the notion began as a concept denoting high social status and the honours and respect due to rank. Pinker cites the case of the French king who found it beneath his dignity to move his throne back from the fireplace. One night he simply roasted to death when his attendant failed to show up. Dignity has come a long way since then, but the fact that it has transmogrified into something quite opposite – an inner value enjoyed by all irrespective of societal status – shows how amorphous the idea is.
Second, dignity is fungible. It is not a sacred value; here is Pinker at his Rabelaisian best, worth quoting in full:
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.
The third point is that dignity, in its original form, is positively harmful. Preserving the dignity of certain religious figures has led to riots and murder. On an even larger scale, “totalitarianism is often the imposition of a leader’s conception of dignity on a population”. It is the mark of a free society that disempowers the state from enforcing a conception of dignity on its citizens.
But wait – isn’t there something good to say about dignity? After all, it is at the heart of the line of “right to die” cases, running from Pretty to Nicklinson and no doubt on into the distant future when Parliament finally responds to the pressure to change the law and allow us to choose our own way of going. But Pinker’s reflections raise a fascinating question here. We are primed to respond to certain features in another human being which trigger ascriptions of worth. “These features include signs of composure, cleanliness, maturity, attractiveness” – a dignified person, in other words. In what way can a patient suffering from locked-in syndrome or some other physically disabling condition elicit the same reaction from those about him? This sort of “dignity”, warns Pinker, is skin-deep:
it’s the sizzle, not the steak; the cover, not the book. What ultimately matters is respect for the person, not the perceptual signals that typically trigger it. Indeed, the gap between perception and reality makes us vulnerable to dignity illusions. We may be impressed by signs of dignity without underlying merit, as in the tin-pot dictator, and fail to recognize merit in a person who has been stripped of the signs of dignity, such as a pauper or refugee.
… or, as Pinker might have added, the mute body in the bed, unable to enforce his or her wishes to have the tubes removed, or the fatal draught administered.
So it’s the autonomy version of dignity that we must hang on to, not just in these cases, but generally. Dignity is not a “contentious moral conundrum”. It should be more precisely specified as a matter of thoughtfulness, pushing against callousness and bureaucratic inertia
And, because it amounts to treating people in the way that they wish to be treated, ultimately it’s just another application of the principle of autonomy.
Dignity in the sense of an inner value eliciting respect should be acknowledged. Maybe Mr Wackenheim the dwarf was correctly denied his lucrative soar through the French air (remember Michael Rosen’s example) because it is possible that the sport of dwarf-tossing encourages people to mistreat all dwarves. But, for such a hypothesis – and others like it – to justify restrictive laws, it needs empirical support.
In a free society, one cannot empower the government to outlaw any behavior that offends someone just because the offendee can pull a hypothetical future injury out of the air.
In short, we must guard against the tendency to use “dignity” to condemn anything that gives someone the creeps.
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