Human Dignity and Bioethics

342 | Susan M. Shell
from the start by freedom and a related sense of justice and injustice,
right and wrong. Our valuations are not only homogeneous but also
hierarchical. Pleasure and esteem are related (e.g., in our judgment
that those we esteem as just deserve also to be happy) and yet incommensurable.
That observation permits us to make a three-fold distinction
among human aptitudes: animal, rational (in an instrumental
or calculative sense) and moral.* The original disposition (Anlage)
to the good according to Kant, is threefold, consisting in:
1) the Anlage to animality (insofar as we are living beings);
2) the Anlage to humanity (insofar as we are living and also
rational beings); and
3) the Anlage to personality (insofar as we are rational and
also responsible beings). 17
The usefulness for present purposes of this rank-ordering lies in
its relative formality. On the basis of rather minimal assumptions
about the character of human life—assumptions roughly congruent
with the premises of liberalism itself—one can draw, as I will argue,
some significant bioethical conclusions. That one can do so without
appealing to the dogmatic claims of a specific religious tradition—
claims that cannot fail to be politically problematic in a liberal society
like ours—makes Kant’s framework all the more promising.
His explicitly “pragmatic” starting point draws on our ordinary
notions about health and sickness that are inseparably bound up with
our most basic dealings in the world. That such notions have proved
relatively immune to the ideological onslaughts of “value relativism”
is not accidental. We may be willing to sacrifice our health for what
we regard as a greater good; but we cannot regard it with indifference
or as wholly arbitrary in its meaning. Kant analogically extends the
* To be sure, Kant’s formalism here is not theoretically innocuous. In stressing,
as he does, the conditions of experience rather than its particular content, Kant
evades the immediate, concrete claims that may correspond to a specific way of
life. His formalism here thus reflects a more fundamental difference between his
own approach to moral matters and that shared by both classical philosophy and
the Bible.