Human Dignity and Bioethics

470 | Daniel P. Sulmasy, O.F.M.
that the word in question adds nothing to the concept one already
endorses. While shrouded in rhetoric, this is precisely the structure
of Macklin’s argument. Premise: dignity means nothing more than
respect for autonomy. Conclusion: therefore dignity means nothing
more than respect for autonomy and (Corollary) therefore dignity
adds nothing to bioethical discourse.
A more careful treatment of the topic is in order. In this essay I
will, first, describe three ways the word “dignity” has been used in
moral discourse, both in the history of Western thought and in contemporary
bioethics. I call these the attributed, the intrinsic, and the
inflorescent uses of the word.
Second, I will argue that, while all three senses have moral relevance,
the intrinsic sense of dignity is the most fundamental from
a moral perspective. I will advance this argument in two ways. I will
call the first the Axiological Argument and the second the Argument
from Consistency.
Third, I will outline some of the general norms that follow
from accepting the moral primacy of the intrinsic sense of human
dignity.
Finally, I will show how this vigorous understanding of dignity
helps to give shape to arguments in bioethics. As examples, I will
show (briefly) how it applies to questions about justice and access to
health care resources, the care of the disabled, embryonic stem cell
research, cloning, euthanasia, and the care of patients in the so-called
permanent vegetative state.
I will conclude that a notion robust enough to supply answers to
all of these questions is not useless.
Three Senses of Dignity
Throughout Western history and in contemporary debates, the word
dignity has played a prominent role in ethical discussions. It may
be surprising to both religious and non-religious persons to know,
however, that dignity is not a word that entered the Western moral
vocabulary through the Judeo-Christian heritage. Dignity is not an
important word in either the Hebrew or Christian scriptures. For almost
two millennia, it was not an important theological term. Until