Paper
Human Dignity and Medical Ethics
- Authors:
- Thomas De Koninck
- Abstract
- An eloquent example of fallacies exploiting the many-meanings of such keywords or expressions in Medical Ethics as human dignity and individual autonomy, was recently provided by the Royal Society of Canada Expert Panel in its Report entitled End-of-Life Decision Making, published in November 2011. That Report claimed that “while the language of human dignity is seemingly universal, there is currently no consensus on the moral basis or on the precise meaning of human dignity”, concluding that “the concept of human dignity is an unsuitable tool for settling normative questions pertaining to end-of-life decision making”[ ]. This stratagem enabled them to hold that there must be a moral right to assist suicide, in view of what they deem “the paramount status of the value of individual autonomy”[ ]. As we shall see, the Report is gravely mistaken, and misleading, on both counts, beginning with human dignity. There is more still. There is what, on another parallel topic, the Quebec poet Paul Chamberland has incisively summed up in the following terms: “The total alteration of the meaning of words will allow the fabrication of an official version of what shall pass for reality itself”[ ]. One could not better state the fact that, because it is unable to transform reality, ideology alters the meaning of words signifying that reality. Henceforth, as George Orwell put it: “black is white”, “war is peace”, and so forth. The principle is indeed admirably formulated by Orwell in 1984: one must aim to “dislocate the sense of reality”. “In Oldspeak it is called, quite frankly, ‘reality control’. In Newspeak it is called doublethink”. You will recall that “the whole aim of Newspeak is to narrow the range of thought”. Accordingly, “Doublethink means the power of holding two contradictory beliefs in one’s mind simultaneously, and accepting both of them” [ ]. This was aptly illustrated by the Quebec Special Commission on the Question of Dying with Dignity, which transformed the fine expression medical aid in dying into an oxymoron no longer meaning genuine medical aid such as palliative care, but its exact opposite, euthanasia[ ]. What made this possible was the confusion that it was able to maintain in the use of the word dignity, notably within the formula Dying with Dignity, which even served to name both the Commission and its Report. And yet it is easy to notice that the word dignity carries at least one superficial sense, which Gabriel Marcel rightly qualified as “a decorative conception of dignity”, consisting in “impressing oneself outwardly”, to quote André Gide [ ]. Whereas human dignity has, in fact, three strong universal meanings whose relevance to end-of-life care is soon evident: 1) ontological dignity, 2) dignity-decency, 3) dignity-liberty [ ]. This paper will center on those three meanings and their practical consequences, before a brief conclusion. Discussion of “individual autonomy” will find its natural place when we reach the third meaning, “dignity-liberty”.
- Keywords
- Human Dignity; End-of-life care; Bioethics; Medical Ethics; Fallacies
- StartPage
- 193
- EndPage
- 199
- Doi