Human Dignity and Bioethics

336 | Susan M. Shell
activities they prompt. An “end in itself” is not “an object that we of
ourselves actually make our end”; it is, rather, in Kant’s words, the
“objective” end that serves as a “supreme [limiting] condition” upon
whatever ends we have. 6
The most clear-cut cases of Kantian “respect” for humanity involve
not using others in ways whose ends they cannot formally
share—i.e., by not acting on them without their own consent. The
moral impermissibility of false promising (along with “assaults on
the freedom and property of others”) follows directly and unproblematically,
in Kant’s view, from this formula. 7 It is easy to see the
attractiveness of Kant, from a liberal political perspective, given the
congruence between his moral thought and traditional liberal insistence
on the right to life, liberty, and the pursuit of property and/or
happiness. The peculiar force and influence of Kantian principles in
contemporary arguments for patient choice and informed consent is
especially apparent. 8
If matters rested here, it would be easy to conclude, with Macklin,
that appeals to “human dignity” as such could be abandoned
without much loss. Autonomy, in the sense of choice, and the deference
that in her view it commands, would indeed suffice. Whatever
adults consent to (with a somewhat hazier provision for children and
other “dependents”) would set the bioethical standard.
But Kant indeed has more to say. Duties toward oneself (and
toward others in matters where consent is impossible or otherwise
has no immediate bearing) are more complicated but no less essential
to a full understanding of what the claims of “human dignity,”
in his view, require of us. One is obliged on Kant’s account to treat
humanity in oneself, no less than in others, as an “end in itself.” 9 But
to fully appreciate this point, one must turn from the second term in
“human dignity” back to the first.
What, then, does Kant mean by “humanity”? Scholars, it must
be said, differ on this point. For Christine Korsgaard, it is the sheer
capacity to set ends; 10 for Allen Wood, it is that capacity joined with
an ability to think systematically. 11 Kant himself seems to speak of it
in two ways. On the one hand, humanity is the “subjective” side of
rational nature—the way in which rational nature in us immediately
and unmistakably impinges on our consciousness. Every human being
“necessarily represents his own existence” as an end that needs no