I was convinced of one thing, after studying the United States Conference of Catholic Bishops’ ERDs, namely, that the idea of human dignity can be terribly misapplied and misused. I was struck by how fragile human dignity really is. Some people think that the idea of dignity cannot demarcate a genuine priority in moral discourse. Udo Shuklenk, for example, borrowing from A.J. Ayer, speaks of dignity, in a eponymously named paper, as a matter of woolly uplift, a mere matter of emotional gesturing.
In this short paper (or editorial), he says this:
Recent empirical research focuses on the importance and meaning of dignity to terminally ill patients. Dignity here, however is little other than an umbrella term for various patient needs being satisfied. This place-holder function offers us nothing by way of addressing the crucial normative questions that usually give rise to the deployment of ‘dignity’ in bioethics and biopolicy, such as for instance the moral permissibility or otherwise of assisted dying.
My own experience is quite different. Dignity was of profound concern to Elizabeth as MS took a more and more firm grip on her life. And dying with dignity became one of her central, critical concerns. Was she merely emoting, gesturing vaguely to something that could be accounted for in other terms? I don’t think so. Her concern for dignity was her concern for a number of things, including autonomy, respectful self-regard, and equality in her encounters with medical professionals. It had nothing to do with her needs being satisfied. It had to do with the way others regarded her, and how she regarded herself. This was completely independent of her various needs being satisfied. Indeed, in having some of her needs satisfied she felt a definite degradation of dignity, because increasing dependence for some of her needs became humiliating and existentially threatening. The boundaries between herself and others were breaking down.
But this indicates what is so very wrong with the Roman Catholic idea of the dignity of the human person. This has nothing at all to do with personal self-regard, for it applies, indifferently, to persons and to protoplasm. In a paper about Hannah Arendt’s conception of human dignity, and how modern political arrangements tend to diminish human dignity, or expunge it altogether, we are told that
… what distinguishes humans is the capacity for membership and participation that is grounded in their autonomy and intersubjectivity. … when humans are stripped of such membership and participation, they are naked and shivering creatures, undignified, unfree, vulnerable, less than fully human. [Isaac, American Political Science Review (1966), 64]
This is terrifically important, and it shows precisely what is wrong with the Roman Catholic idea of dignity. Used in the Roman Catholic way, the idea of dignity isn’t even woolly uplift. It’s a way of taking possession of an important moral word for nefarious purposes. In fact, what it does is precisely to strip the human of “membership and participation, … [so that they become nothing more than] naked and shivering creatures, undignified, unfree, vulnerable, less than fully human.” This comes out very clearly when the ERDs come to stipulate what can and cannot be done to a woman who has been raped. Suddenly, she becomes less than human, treated as a mere creature who might have conceived as a result of an act of violence. She has no choice. She is no longer considered to be an adult human being with any choices of her own. Her capacity for choice has been preempted by the man who raped her, and by the church that respects that act by imagining that God might have worked through it.
Precisely the same thing happens when a person is dying. The ERDs pretend to be treating patients as adults who are capable of choice, but, according to the ERDs the patient cannot choose something with the intent of dying. But it is a mere pretence that one can separate intentions in the way proposed. To stop treatment, or nutrition and hydration, because these would no longer be of benefit to the patient, is to intend to bring that person’s life to an end, because, in that situation, death is the only possible benefit that can be provided. We can look at the principle of double effect another time, but it is clear that where this kind of casuistic game is being played the patient as a person is being disregarded, for her choice or capacity for choice are not being respected. And if the intention is to cause death — and ceasing to provide nourishment can have no other intention — then what is wrong with permitting the patient to choose whether the period of her dying should be long or short? After all, if food is no longer a benefit, then death is, and it is ridiculous to pretend otherwise.
The problem is that the Roman Catholic Church puts the person on the same level of moral significance as protoplasm. That term may no longer be used in cell biology, but it puts the point with the kind of punch that is needed here. For if the church dehumanises the person at life’s beginnings, as if it has nothing to do with human choice or decision, making a conceptus or an embryo or a foetus as significant as an adult human being, then it also dehumanises at the end of life, for in neither case is the person’s capacity for decision and choice considered of any importance. The person is not conceived of as contributing shape to a life. This comes almost entirely from outside, through an intrusion parachuted into the midst of life, and immune to our power of choice, because imagined, without any basis in demonstrable fact, to be the act of a god. In fact, choice in these areas is thought of as irregular and immoral, because conflicting with the will of the imagined divine agent. This, however, is not to ascribe dignity to the person; it is simply to deny it.
Human dignity is very fragile, and can be easily destroyed. Religion, which thinks of human beings as in some sense reflective of the divine nature, tends to destroy it, because it refuses to human beings at crucial points in their lives the exercise of precisely those features that (in the religious imagination) makes us divine: the capacity for choice, decision and creation. Here is where the old trope about “playing God” comes into play, because, ultimately, the religions say, we are dependent creatures, and not free. But this just means that, at those points, human dignity is being denied, and persons are treated like things. The poison of that failure to respect human dignity has a tendency to spread itself liberally over everything else that religion touches, because, as Hitchens’ points out time after time, it means that we must, ultimately, abject ourselves before our Maker. But our Maker, thus understood, is always mediated by human beings, and it is before them we bow, all dignity shorn away.