Friday, May 23, 2008

The Stupidity of Dignity

It has been a week now since we were visited by PC 601B at the porch we sleep in at night and told to leave – it was 1.50am – due to police “cleaning” the City of London of rough sleepers. We stayed in the porch though because she told us we wouldn’t be arrested if we did so. When PC 698B visited us on 9 May he wasn’t so accommodating and informed us he would arrest us if we didn’t pack up and leave right away – it was 2.20am – despite Declan having been diagnosed in the Royal London Hospital with a sprained ankle only hours before. Pursuant to Article 34 of the European Convention on Human Rights (ECHR), Declan has written to Prime Minister Gordon Brown (see blog of 17 May “Letter to the British Prime Minister”) and the Registrar of the European Court of Human Rights (see blog of 13 May “Letter to the European Court under Article 34”).

Article 34 of the ECHR establishes a duty on Convention states not to subject applicants to any improper indirect acts or contacts designed to dissuade or discourage applicants from pursuing a Convention remedy. Between one thing and another, in particular the homeless on Declan’s case, especially in the Sisters of Mercy Dellow Centre and the Manna Centre (whose building is provided rent-free by the Catholic Archdiocese of Southwark), we are now more convinced than ever that the European Court has invited the Government to set out its observations on the merits and admissibility of Declan’s case – in December Declan received a letter from the Court turning down his request of 8 September for priority, but informing him that his application, also of 8 September, would be examined possibly before the end of January.

Human Dignity and Bioethics

On 1 March, President George W Bush’s Council on Bioethics released a 555-page report, entitled “Human Dignity and Bioethics: Essays Commissioned by the President’s Council on Bioethics”, a volume of 28 essays and commentaries by Council members and invited contributors. The Council, created in 2001 by President Bush, is a panel of scholars charged with advising the president and exploring policy issues related to the ethics of biomedical innovation, including drugs that would enhance cognition, genetic manipulation of animals or humans, therapies that could extend the lifespan and embryonic stem cells and therapeutic cloning that could furnish replacements for diseased tissue and organs.

Steven Pinker, world-renowned thinker and Johnstone Family Professor in the Department of Psychology at Harvard University (and an honorary associate of NAC and early signatory of Declan’s petition to the UN on therapeutic cloning), was one of three people invited by the Council to a panel discussion on 7 March devoted to the subject of human dignity. In a subsequent article for The New Republic, entitled “The Stupidity of Dignity”, Pinker writes that the Dignity report “reveals a great deal about the approach to bioethics represented by the Council”, adding: “And what it reveals should alarm anyone concerned with American biomedicine and its promise to improve human welfare. For this government-sponsored bioethics does not want medical practice to maximize health and flourishing; it considers that quest to be a bad thing, not a good thing.”

According to Pinker, a majority of the contributors, 12 out of the 23, were selected from institutions with an explicitly Christian and almost entirely Catholic mission statement, and that of the remaining 11 contributors four are known for their advocacy of a greater role of religion in public life. “Conspicuous by their absence are several fields of expertise that one might have thought would have something to offer any discussion of dignity and biomedicine,” Pinker writes. “None of the contributors is a life scientist - or a psychologist, an anthropologist, a sociologist, or a historian.”

The volume finds room for seven essays that “align their arguments with Judeo-Christian doctrine”, writes Pinker. “We read passages that assume the divine authorship of the Bible, that accept the literal truth of the miracles narrated in Genesis (such as the notion that the biblical patriarchs lived up to 900 years), that claim that divine revelation is a source of truth, that argue for the existence of an immaterial soul separate from the physiology of the brain, and that assert that the Old Testament is the only grounds for morality (for example, the article by Leon Kass [the Council’s founding director] claims that respect for human life is rooted in Genesis 9:6, in which God instructs the survivors of his Flood in the code of vendetta: ‘Whoso sheddeth man’s blood, by man shall his blood be shed, for in the image of God was man made’).”

Pinker argues that the concept of dignity is natural ground on which to build an obstructionist bioethics. “An alleged breach of dignity provides a way for third parties to pass judgment on actions that are knowingly and willingly chosen by the affected individuals,” he writes. “It thus offers a moralistic justification for expanded government regulation of science, medicine, and private life. And the Church’s franchise to guide people in the most profound events of their lives - birth, death, and reproduction - is in danger of being undermined when biomedicine scrambles the rules. It’s not surprising, then, that ‘dignity’ is a recurring theme in Catholic doctrine: The word appears more than 100 times in the 1997 edition of the Catechism and is a leitmotif in the Vatican’s recent pronouncements on biomedicine.”

According to Pinker, many members of the President’s Council are repelled by a number of biomedical advances – examples brought up in the volume: drugs that enhance cognitive functioning, anti-aging research that promises to extend the human lifespan, pre-implantation genetic diagnosis, somatic cell nuclear transfer, surrogacy, in vitro fertilization and other reproductive technologies, cloning, a market in organs for donation, and many others – but realise that they can’t rule them out with the consensus ethics of autonomy, human rights, or respect for persons. Hence, the appeal to dignity. The problem, Pinker argues, is that, for one thing, dignity is, as just about all the essays acknowledge, a “squishy” concept (ambiguous, slippery, and vague). It has much of its basis in religious doctrine. And for these two reasons, it has not provided the kind of consensus definition of the kind that would be necessary in a democracy.

The concept, writes Pinker, is a source of obvious contradictions: “We read that slavery and degradation are morally wrong because they take someone’s dignity away. But we also read that nothing you can do to a person, including enslaving or degrading him, can take his dignity away. We read that dignity reflects excellence, striving, and conscience, so that only some people achieve it by dint of effort and character. We also read that everyone, no matter how lazy, evil, or mentally impaired, has dignity in full measure. Several essayists play the genocide card and claim that the horrors of the twentieth century are what you get when you fail to hold dignity sacrosanct. But one hardly needs the notion of ‘dignity’ to say why it’s wrong to gas six million Jews or to send Russian dissidents to the gulag.”

Pinker explains that dignity has three features that undermine any possibility of using it as a foundation for bioethics: dignity is relative (we chuckle at the photographs of Victorians in starched collars and wool suits hiking in the woods on a sweltering day); dignity is fungible (modern medicine is a gauntlet of indignities); and dignity is often harmful (think of the Salman Rushdie fatwa). In his article, Pinker mentions the bioethicist Ruth Macklin who, fed up with loose talk about dignity intended to squelch research and therapy, argued in a 2003 editorial “Dignity Is a Useless Concept” that bioethics has done just fine with the principle of personal autonomy - the idea that, because all humans have the same minimum capacity to suffer, prosper, reason, and choose, no human has the right to impinge on the life, body, or freedom of another. Once you recognise the principle of autonomy, Macklin argued, “dignity” adds nothing. (In his presentation to the Council on 7 March, Pinker pointed out that in the index to the Dignity report there are 15 page references to Macklin, more than anyone else except Kant with 35, the Bible with 34, and Aristotle with 21, and yet the volume does not have an essay by her or anyone else who would defend her obviously important viewpoint. Everyone else is replying to it.)

Pinker concludes: “Worst of all, theocon bioethics flaunts a callousness toward the billions of non-geriatric people, born and unborn, whose lives or health could be saved by biomedical advances. Even if progress were delayed a mere decade by moratoria, red tape, and funding taboos (to say nothing of the threat of criminal prosecution), millions of people with degenerative diseases and failing organs would needlessly suffer and die. And that would be the biggest affront to human dignity of all.”