Human Dignity and Bioethics

Human Dignity and Respect for Persons | 27
“liberty” consists in “framing the plan of our life to suit our own
character;…doing as we like, subject to such consequences as may
follow: without impediment from our fellow creatures, so long as
what we do does not harm them, even though they should think our
conduct foolish, perverse or wrong.” 29
The concept of respect has undergone a similar process of evolution,
with a tapering of its meaning over time. For Ramsey, respect
is a duty, the fulfillment of which demands multiple interrelated
modes of responsiveness to the unique, irreducible worth of the
person, a worth affirmed not only in honoring the individual and
deferring to his wishes, but also in tending to his needs and caring
for him. Today, however, respect is often understood more narrowly,
as a duty strictly correlative to the individual’s rights to privacy and
self-determination—a duty to refrain from interfering with the free,
unfettered choice of the autonomous individual, a duty that can be
set aside only in the interest of protecting another from harm. It is
this sense of respect that seemingly animates the principle of respect
for autonomy that Macklin champions as central to contemporary
medical ethics. And as a description of medical ethics today, her assertion
is reasonably accurate.
The critical question, which Macklin never fully explores in her
essay, is whether this centrality of respect for autonomy as a bioethical
principle should be embraced as an unqualified good for theory
and practice in human subjects research, clinical medicine, and beyond.
Nor does she note that interest in human dignity as a bioethical
concept has been prompted, in part, by the growing sense that
the prevalence of autonomy in bioethics and beyond, in American
culture and society, reflects an incomplete and inadequate—even a
distorted—grasp of humanity and thus of what is at stake in many
of the controversies provoked by the advance of biomedicine and
biotechnology. 30
Human Dignity, This Volume, and the President’s
Council
One such controversy was on the mind of President Bush when, on
August 9, 2001, he addressed the nation in a televised speech devoted