Dignity and the Body: Reclaiming What Autonomy Ignores
Brian Volck, MD, Cincinnati Children's Hospital Medical
Center
Joel Shuman, STD, PhD, Kings College
“Dignity” is a contested concept, advanced by medical ethicists such as Leon Kass, et al, (President’s Council on Bioethics, 2008) and derided by others, especially Ruth Macklin (British Medical Journal, 2003), who calls dignity a “useless” concept and Steven Pinker (The New Republic, 2009) who attacks it as “stupid.” Macklin and Pinker claim that any advantage in using the word “dignity” is already found in respect for the autonomy of persons. They further agree that “dignity” smuggles religious reasoning into a strictly secular conversation and suggest that “dignity” is a Trojan horse for religious – and specifically Catholic – “dogma.” Pinker, moreover, offers several examples of why and how bodies are inherently undignified, betraying a squeamish distaste for human embodiment.
In explicitly dismissing the body and locating agency in the ostensibly autonomous, choosing self, Macklin and Pinker implicitly marginalize – if not dismiss outright – the elderly, children up to an age when autonomous reason might be acquired, the physically disabled, and especially the intellectually disabled. Both, finally, suggest that assertions of human dignity threaten to limit the development and application of new biotechnologies that promise to relieve human suffering.
We agree with Macklin and Pinker insofar as they claim religious roots for the concept of human dignity – the locus of which is the body, rather than the choosing will – but we argue that these are reasons for rather than arguments against employing the concept in ethical discourse. We will show how human embodiment necessarily limits the exercise and practical extent of autonomy, using Wendell Berry’s observation that “There is, in practice, no such thing as autonomy. Practically, there is only a distinction between responsible and irresponsible dependence.”
We will also argue that Macklin’s and Pinker’s terms of insult (“useless” and “stupid”) are often used to demean precisely those made vulnerable by autonomy defined as the exercise of independent rational choice, i.e. the marginalized, elderly, pre-rational, and disabled.
We briefly describe the Christian theological account of the physical body as a created, though limited, good, marked with the image of the Divine and necessarily interdependent. We also explore the Pauline image of the church as a gathered body and propose this as an important corrective to the effects of hyperindividualization and commodification arising from an overemphasis on autonomy as rational choice.
We explore how dignity is inherently embodied and how it better accounts for human interdependence than even highly modified forms of neo-Kantian autonomy, especially when applied to those marginalized persons implicitly dismissed by Macklin and Pinker. We will also explore how dignity, inherent in the body rather than exclusively in the intellect, respects limits of natural life and need not prolong natural death nor require “heroic measures.” Dignity, we conclude, provides important correctives to the disembodied principle of autonomy.
Joel Shuman, STD, PhD, Kings College
“Dignity” is a contested concept, advanced by medical ethicists such as Leon Kass, et al, (President’s Council on Bioethics, 2008) and derided by others, especially Ruth Macklin (British Medical Journal, 2003), who calls dignity a “useless” concept and Steven Pinker (The New Republic, 2009) who attacks it as “stupid.” Macklin and Pinker claim that any advantage in using the word “dignity” is already found in respect for the autonomy of persons. They further agree that “dignity” smuggles religious reasoning into a strictly secular conversation and suggest that “dignity” is a Trojan horse for religious – and specifically Catholic – “dogma.” Pinker, moreover, offers several examples of why and how bodies are inherently undignified, betraying a squeamish distaste for human embodiment.
In explicitly dismissing the body and locating agency in the ostensibly autonomous, choosing self, Macklin and Pinker implicitly marginalize – if not dismiss outright – the elderly, children up to an age when autonomous reason might be acquired, the physically disabled, and especially the intellectually disabled. Both, finally, suggest that assertions of human dignity threaten to limit the development and application of new biotechnologies that promise to relieve human suffering.
We agree with Macklin and Pinker insofar as they claim religious roots for the concept of human dignity – the locus of which is the body, rather than the choosing will – but we argue that these are reasons for rather than arguments against employing the concept in ethical discourse. We will show how human embodiment necessarily limits the exercise and practical extent of autonomy, using Wendell Berry’s observation that “There is, in practice, no such thing as autonomy. Practically, there is only a distinction between responsible and irresponsible dependence.”
We will also argue that Macklin’s and Pinker’s terms of insult (“useless” and “stupid”) are often used to demean precisely those made vulnerable by autonomy defined as the exercise of independent rational choice, i.e. the marginalized, elderly, pre-rational, and disabled.
We briefly describe the Christian theological account of the physical body as a created, though limited, good, marked with the image of the Divine and necessarily interdependent. We also explore the Pauline image of the church as a gathered body and propose this as an important corrective to the effects of hyperindividualization and commodification arising from an overemphasis on autonomy as rational choice.
We explore how dignity is inherently embodied and how it better accounts for human interdependence than even highly modified forms of neo-Kantian autonomy, especially when applied to those marginalized persons implicitly dismissed by Macklin and Pinker. We will also explore how dignity, inherent in the body rather than exclusively in the intellect, respects limits of natural life and need not prolong natural death nor require “heroic measures.” Dignity, we conclude, provides important correctives to the disembodied principle of autonomy.