Human Dignity and Bioethics

506 | Rebecca Dresser
dignity, when contemporary science and theory seem to undercut the
traditional religious justifications for this idea?
My question is different. If human dignity applies to anyone, it
applies to people experiencing serious illness. Every author in this
volume would agree that human patients should be treated with
human dignity.* But what does this mean today? What constitutes
dignified treatment for patients receiving care in the context of contemporary
medicine?
In this essay, I examine dignity from the bottom up. I consider
how the concept of dignity bears on the treatment of patients with
serious illness. I argue that dignity merits more scholarly attention in
bioethics, that it is no less problematic than other bioethics concepts,
and that it is a central concern for patients and caregivers in the clinical
setting. My analysis draws on scholarly work and on my personal
experience as a cancer patient.
The Bioethics Critique
For many years, certain bioethics scholars, medical professionals, and
policy officials have embraced preservation of human dignity as a
clinical and policy goal. Securing a “Death with Dignity” for patients
was an early preoccupation of the bioethics field. 2 The need to preserve
human dignity has also been recognized in work on the new
reproductive technologies, genetics, medical training, and research
on human subjects. 3
Yet the concept of dignity has recently come under attack. The
sharpest critique comes from philosopher and bioethicist Ruth Macklin,
who claims that “appeals to dignity are either vague restatements
of other, more precise, notions or mere slogans that add nothing to
an understanding of the topic.” In the worst case, she argues, dignity
acts as a slogan to substitute for substantive argument favoring a
particular position. In other cases, Macklin sees appeals to dignity as
redundant, adding nothing to the analysis. For example, in the end-
* As the contributions by Gelernter, Meilaender, and Sulmasy suggest, however,
there may be disagreement over what constitutes dignified treatment for permanently
unconscious individuals like Theresa Schiavo or for advanced dementia patients.