Dignity is a useless concept
BMJ 2003; 327 doi: https://doi.org/10.1136/bmj.327.7429.1419 (Published 18 December 2003) Cite this as: BMJ 2003;327:1419
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Ruth Macklin’s recent British Medical Journal editorial, “Dignity is
a useless concept,”(1) has touched off a lively debate in bioethics.
Simply put, she argues that this oft-invoked term is like the emperor’s
new clothes: there’s nothing there—or, more precisely, nothing that isn’t
more clearly conveyed by the widely accepted principle of respect for
persons. Prof. Macklin is surely correct that in most cases, such as in
the protections afforded for individuals to make their own choices about
medical care or participation in research, dignity is simply a term to
recognize that “one is a person whose actions, thoughts and concerns are
worthy of intrinsic respect,” as the Nuffield Council on Bioethics has put
it.(2)
The vehemence with which Macklin’s argument has been rejected by many
of those who wrote “rapid responses” to the on-line BMJ demonstrates that,
especially for persons working in health care, dismissing dignity risks
disregarding a basic tenet of the respect owed to patients as human
beings. I think it is possible to agree with them and still think Macklin
is right because they are talking about different things: the former are
concerned with dignity in the particular sense of treating individuals in
a dignified fashion, while Macklin is criticizing the use of the term in a
general fashion, as is conveyed by calls to safeguard human dignity from
scientific changes.
In the particular sense, dignity is invoked to enjoin people in power
from subjecting others to humiliating or degrading acts. For example, it
is right for hospitals, nursing homes, and similar facilities to ensure
that patients are not wheeled about in flimsy and revealing hospital
gowns, treated demeaningly, gossiped about by staff, or the like. That
such behavior is usually proscribed by more specific rules does not make
it wrong to sum them up as protections of patients’ dignity. Moreover,
comparable strictures also apply to dead bodies, not because they would
suffer directly but because treating individual—particularly, recently
deceased—cadavers with respect provides security for all of us (as the
future dead) and reduces the risks of a slide toward undignified conduct
toward the demented (“they won’t notice”), the infirm (“they can’t
object”), the poor (“they have no power”), and so forth.
Thinking about how individuals’ rights to respectful treatment are
violated makes clear the difference from the general sense of dignity
criticized by Macklin. Examples of the types of uses to which she objects
include assertions that human cloning or the patenting of human genes
violates human dignity. Such claims are not based on any showing of harm
to particular persons but to humanity in general, although, as she shows,
once the august but ill-defined concept of human dignity has been invoked,
no further justification for the claim is typically provided.
This vagueness contrasts with the reality that is conveyed by
Macklin’s argument that what lies behind dignity is simply the principle
of respect for persons. As spelled out in The Belmont Report, an early and
still highly regarded elaboration of bioethics principles, respect for
persons encompasses “two basic ethical convictions: first, that
individuals should be treated as autonomous agents, and second, that
persons with diminished autonomy are entitled to protection.”(3)
Attending to the latter facet helps to round out the picture painted by
Prof. Macklin.
While it is difficult to know what violating human dignity might
mean, it is not difficult to specify conduct that would fail to treat
persons as autonomous agents. Indeed, over the past thirty years,
bioethics has been greatly concerned with helping to show why (and how)
healthcare professionals should have clear and candid conversations with
patients that will enable them to be informed decisionmakers and, having
done so, respect the decisions these patients make. Saying that the
failure to respect autonomy violates human dignity may not provide any
added illumination, as Macklin points out, but at least equating dignity
with autonomy clarifies the contours of the former.
Likewise, specifying the ways in which persons with diminished
autonomy should be respected—in sum, not treated as objects or
unconsenting means to others’ ends, but rather as persons whose own well-
being must be enhanced—is a fairly straightforward task.
But if the term “human dignity” is cut free of being a less precise
way of expressing these two facets of respect for persons, how then could
one tell when it is violated? The answer provided in Arthur L. Caplan’s
response to Prof. Macklin that dignity “reflects a moral status that moral
agents assign to others”(4) tells us nothing about which acts amount to
indignities or why, much less why it is important that the imputation of
status be made by “moral agents” or itself be labelled “moral.” Most of
the human rights now associated with the broad concept of human dignity
have been set forth in treaties negotiated by sovereign states, not moral
agents. Indeed, Caplan’s response seems to mirror the prevailing use of
the term human dignity in bioethics documents: it is violated whenever
someone finds something troubling or offensive, without the need to
specify what the harm is.
Let me provide an example: I think the world will be a better place
if human reproductive cloning is never developed, but I feel obligated to
explain that conclusion by trying to weigh the possible benefits and harms
of the procedure. Suppose that a talented but unscrupulous fertility
specialist secretly developed a safe method of reproductive cloning and
used it on an unwitting couple. Certainly their rights to be informed
decisionmakers about their own reproductive healthcare would thus have
been violated, but would the existence of a cloned child violate human
dignity? Assuming that neither the parents nor the child ever knew her
origins, I can imagine some practical risks, but no assault on human
dignity. Those who invoke that concept against reproductive cloning seem
to be bundling in it our sense that many reasons given by people wanting
to use cloning rather than sexual reproduction (such as a desire to
replicate a dead child, to create copies of themselves, or to have a
duplicate of an admired person) involve substantial risks of unhappiness
or worse for the child (as well as disappointed expectations for the
parents), and that allowing such individual uses would push forward a
process in which children (and people in general) are measured by the
extent to which they possess particular genetic features. Whether
particular harms of this sort, which would be inconsistent with human
flourishing and which tend to treat human beings as objects, would
actually follow from reproductive cloning is a matter of speculation;
making such predictions in a reliable would plainly depend on getting
quite specific about the harms, a task that is not advanced by invoking
the concept of human dignity, without more.
Therefore, let’s continue to ensure that patients are treated “with
dignity” and protected against humiliations and thoughtless treatment that
undermine the respect they are owed as persons, while at the same time
insisting that those who would invoke “human dignity” as a fundamental
principle in bioethics and as a guide to public policy must clarify the
content of the concept beyond respect for persons.
1. Macklin R. Dignity is a useless concept. BMJ 2003;327:1419-1420.
2. Genetics and human behavior (2002),
www.nuffieldbioethics.org/publications/pp_0000000015.asp (accessed 29 Dec.
2003).
3. National Commission for the Protection of Human Subjects of
Biomedical and Behavioral Research (U.S.), The Belmont Report (30 Sept.
1978), U.S. Govt Printing Office, p.4.
4. Caplan, AL Dignity is a social construct. 24 Dec. 2003
http://bmj.bmjjournals.com/cgi/eletters/327/7429/1419#44646 (accessed 29
Dec. 2003).
Competing interests:
None declared
Competing interests: No competing interests
Ruth Macklin argues that pruning a multivalenced term from the
ethical lexicon, namely ‘dignity’, will result in no loss of content or
substance ethically or, ultimately, culturally: perhaps clarity will be
gained thereby. One may instead equate dignity with "respect for persons
or their autonomy" [1]. However, is ‘person’ for which one is to have
respect less rich or conflicted a concept, or less excisable for example
when equated with autonomous moral agent (excluding those who not yet, no
longer, or may never fully actualize this human potential)? Autonomy is a
good that is a precondition for engaging in a broad range of human actions
(healing or injurious), but it is not the only good – and as a concept it
may be that it is called upon to do too much work in ethical
consideration. (In particular this applies where ethics is limited to the
articulation of the implications of autonomy - the potentials and powers
and interests of autonomous agents, defined in terms of a capacity to
conceptualize, articulate and pursue explicit goals – in extremis denying
all else.)
With greatly limited autonomy, a person (say with mental retardation)
can live a life ‘of dignity.’ Yet does such a one have a claim upon us in
this regard whether or not they can articulate it (that is without
autonomy and before cultural ‘concessions’)? A recognition (rather than
mere assigning [2]) of dignity in the absence of autonomy is requisite to
call culture to account towards providing conditions for such a life ‘of
dignity’. Recognition implies that there is something present that a
culture may acknowledge, be blind to, see but ignore for reasons of
immediate utility, or perhaps have come into focus and gain force through
a process of reflection. One with mental retardation may not be able to
articulate a personal let alone generic vision of dignity or defend their
‘interest’ in it, yet culture is wrong not to respond to it or infirm not
to see it. Moreover, dignity’s interests (inhering in particulars) apply
to the dead as well as to the living (as painfully clear in the Georgia
undertaking scandal of 2002) [3].
Certainly any recognition of dignity takes place in cultural context
and has constructive elements in expression which may vary widely. But
dignity reduced to social construct (performatively assigned) cannot do
the work of challenging ‘culture’ to provide conditions supportive of a
‘life of dignity’ when such conditions are or become seriously
inconvenient. If assignable, dignity may be rescinded when it does not
serve the interest of ‘culture.’ (This is quite different from a culture -
a shorthand for individuals and institutions - unable to fulfill
recognized duties to either the living or the dead, say in the event of
famine or epidemic. One would say it is possible they did not receive
their due given a tragedy of circumstance, but without culpability.)
In recognition dignity is responded to duly or perhaps ignored, but
is not assigned. In the ‘performative model’ (where dignity exists if
assigned, or evaporates if rescinded), there can be no ‘truth of dignity’
from which to ‘speak truth to power’. Here, flexible to changing fiat (or
calculus), ‘dignity’ may tend to serve a very specific interest of culture
– namely the prevailing powers in culture (perhaps the elite of culture),
or of a local prevailing power where the interests of power are not
limited by a compelling reason not to actualize all potentials and goals
(admitting here goals pursued for seeming majority interest may be for woe
as well as weal). Without ascribing ill motives, denying dignity or making
it contingent may serve the interests of the powerful contra the
vulnerable. (But where ill motives are obvious, extreme but instructive
examples, such as in the rhetorical history of ethnic cleansing, reveal
the psychological advantages of unassigning dignity for endeavors
considered justified or useful yet outside the previous cultural norm.)
In curcumstances of increasing burden, the vulnerable are unlikely to gain
purchase on utilitarian grounds where the effective powers that assign or
rescind dignity also define the implicit utility function and unit of
utility.
An ‘only social construct’ account of dignity finally hobbles under
the same 'scope problem' found in behaviorist reductions (all human
activity as 'only behavior'): While describing an aspect, the reduction
cannot engage distinctions that are most vital [4]. An alternative to
deleting or reducing dignity to contingent cultural assignment, without
denying context, is understandng dignity as recognizable in human life
because it names something tacitly present – also when its bearer is not
autonomous.[5] If tacit it may be “implied or indicated yet not actually
expressed” by its bearer[6].
The intuition of a dignity present and implicit in human life
underlies coherence in the claim of human rights beyond local convention,
and to right treatment - continuing even after death. Statutes follow (or
may not follow) recognition. Its violation can be sensed in experience -
whether articulable or not - most acutely by those exploited, but also in
observer and even violator - at least until numbed by repetition.
Kirk Allison, Ph.D.
Associate Director,
Program in Human Rights and Medicine,
University of Minnesota
[1] Macklin R. Dignity is a useless concept. BMJ 2003; 327: 1419-
1420.
bmj.bmjjournals.com/cgi/content/full/327/7429/1419 (accessed
12/30/03; simul sub.).
[2] Specifically, “Dignity reflects a moral status that moral agents
assign to others. It is conferred on a human being by other human beings.”
Caplan AL. Dignity is a social construct. BMJ 2003; 327 re. [1] (24
December 2003)
http://bmj.bmjjournals.com/cgi/eletters/327/7429/1419#44646
[3] Cole, TR. We have a sacred covenant with the dead. Los Angeles
Times; Mar 8, 2002; B.17
[4] It should be clear that a person pursuing behavioristly focused
research is not necessarily a reductionist.
[5] Recognition of dignity may extend beyond what is human – more
than one species of dignity may be recognized.
[6] “Tacit.” Webster’s Ninth New Collegiate Dictionary (1985): 1200.
The Oxford English Dictionary (2nd, 1989; online edition) includes the
senses ‘unspoken,’ ‘unvoiced,’ ‘still,’ as well as “Not openly expressed
or stated, but implied; understood, inferred."
Competing interests:
None declared
Competing interests: No competing interests
Editor,
Dr Notcutt in his rapid response correctly points out that a person
has dignity because he has been the object of dignification by others.
But I do not think that this means that a person must have something done
directly to them in order to be dignified. Part of what it is to be human
is that we are, inherently, in relation to each other. Although dignity
is not strictly intrinsic, we are characterised by a dignity conferred on
us by our common humanity - even when moribund or when on Notcutt's desert
island. Respecting dignity, seeking to enhance rather than diminish it,
reflects this.
This does not of course justify the common use of the word dignity to
mask invalid arguments or claims, and it does not excuse us from the
requirement clearly to show what we mean when we refer to people's
dignity. But we should recognise that some form and degree of dignity is
a universal (if not intrinsic) human characteristic.
Competing interests:
None declared
Competing interests: No competing interests
Ruth Macklin's paper, 'Dignity: A Useless Concept' deserves little
comment. 'Dignity' cannot be eliminated and replaced with 'autonomy'
without semantic residue.
The dignity from within is a calm and serious manner. This dignity can
not always be ascribed to patients, but its facilitation during
hospitalisation should be fostered and is not the same thing as
respecting autonomy.
The dignity from without is the honour and esteem held for a person.
This dignity must include a respect for autonomy. On the other hand,
respect for a person's autonomy does not entail honouring or well
esteeming him or her.
Macklin's paper provides an example of impatiently rushed thinking,
exactly the kind of error of which patients too often complain when they
say they aren't treated with dignity. The concept of dignity names
something human. If it were to be eliminated, something human could
become commonly overlooked.
Ruth Macklin has confused dignity for autonomy just as a busy hospital
consultant might confuse Mrs. White for Ms. Smith. I suggest Dr. Macklin
get on better first name terms with her concepts before she operates on
them.
Competing interests:
None declared
Competing interests: No competing interests
In my opinion, Ruth Macklin in his intriguing editorial (1) fails to
remember a paramount paradigm of lack of dignity and respect for persons
or for their autonomy, regarding really both doctor’s and patient’s
dignity, although in opposite sense. What I mean is that now-a-days, in
this technologized world, at least apparently, all HNS provide people
with primary prevention – on more or less large scale – against the most
common human diseases, such as malignancy, diabetes, arterial
hypertension, rheumatic disorders, osteoporosis, a.s.o., which represent
accordingly today’s epidemics, so that a large amount of (people’s) money
is spent on preventive measures every year. According to the concept, all
physicians agree with, that prevention is surely better than treatment,
such as procedure seemingly respects all human rights documents. However,
not “all” individuals can be involved, e.g., by type 2 diabetes (2),
malignancy (3), hypertension (4), osteoporosis (5) a.s.o. (See HONCode
web site 233736, www.semeioticabiofisica.it, Constitutions). As a matter
of fact, although overlooked or ignored by HNS authorities around the
world, for reasons very easy to understand, both Biophisical Semeiotics
and biophysical-semeiotic constitutions do really exists (6). At the bed
side, doctor is now fortunately able to recognize and assess in a
quantitative, and not expensive, way, the diverse constitutions, selecting
rationally people to undergo “real and efficacious” primary prevention,
without creating anxiety, easily avoidable, not causing loss of work
houers, and particularly not spending large amount of financial resources,
which could be more useful if consumed in other fields of the medicine.
1) Macklin R. Dignity is a useless concept. BMJ 2003;327:1419-1420
(20 December), doi:10.1136/bmj.327.7429.1419
2) Stagnaro S., Diet and Risk of Type 2 Diabetes. N Engl J Med. 2002 Jan
24;346(4):297-298. letter [PubMed –indexed for MEDLINE].
3) Stagnaro-Neri M., Stagnaro S. Introduzione alla Semeiotica Biofisica.
Il Terreno Oncologico. Travel Factory, Roma, in stampa.
4) Stagnaro-Neri M., Stagnaro S., Stadio pre-ipertensivo e monitoraggio
terapeutico della ipertensione arteriosa. Omnia Medica Therapeutica.
Archivio, 1-13, 1989-90, 1990
5) Stagnaro-Neri M., Stagnaro S., Diagnosi Clinica Precoce
dell’Osteoporosi con la Percussione Ascoltata. Clin.Ter. 137, 21-27 [Pub-
Med indexed for MEDLINE] 1991
6) Stagnaro S. Primary Prevention based on detecting Biophysical-Semeiotic
Constitution. BMJ.com. Rapid Response. 8 January 2002.
Competing interests:
None declared
Competing interests: No competing interests
I have been very interested in this discussion. However, I believe
that there is a missing element to it.
I am no wordsmith but the way the word dignity is used has troubled
me for a long time. It is much used by various crusaders or aggrieved
relatives (particularly in the media) to reinforce their statements or
arguments and thereby make them unchallengeable.
I go back to the dictionary (Chambers) where I find that dignity is
the state of being dignified. The verb " to dignify" is transitive and
here is the crux of the matter. You are only dignified if I dignify you
(care for you, love you, hold you worthy or in esteem, etc.). Therefore
the use of the word reflects how I treat you. If I clean up your faecal
incontinence, spend time with you, wash your body after your death, then
these are all examples of me dignifying you. Therefore, you are
"dignified".
Dignity is a meaningless concept if you are alone on a desert island
(one for the philosophers).
Dignity is not intrinsic to you, something you own or possess. Yet it
is commonly used in this way and often hijacked to reflect a "lack of
mess", "absence of unpleasant bodily fluids", "being in full control",
"having a stiff-upper-lip", “being smartly dressed”. Hence "he was a
dignified old boy" or “I felt so undignified having a baby/ having my
bottom wiped/ having to be fed etc. etc.”.
Maybe we need to change or expand the definition of the word as
language moves on. Maybe we just need to reflect on the true meaning and
thereby clarify the debate.
Yours sincerely,
Competing interests:
Founder member of local Clinical Ethics Advisory Group (now retired from it)
Competing interests: No competing interests
The term "dignity" may indeed be cliche, but it is a fundamental
necessity in the practice of effective and caring medicine. Dignity, like
religion, does not have to be operationalized or empirically studied. This
construct transcends the hypothetico-deductive analysis of the
experimental method and provides powerful meaning to both the clinician
and the patient.
Dignity is a core value and a core clinical competency; it is a
necessary ethical obligation that provides the foundation for medical
practice, healing and successful palliation. Dignity is more that an
affirmation of one's autonomy. It consists of a psychospiritual connection
with the patient: a connection that involves empathy, presence and
compassion. I submit that this connection can and should remain even after
the patient dies. Cadavers are no less human because they are devoid of
life. On the contrary, cadavers remind us of the finality of life - the
existential reality- that we are mortal creatures temporarily existing and
experiencing the world. The cadaver was the vehicle in which the patient
experienced the awe and wonder of life. Certainly, this vehicle, replete
with a history and identity, should be respected.
The empathic clinician actively appreciates the patient's suffering
and attempts to experience the world from the unique prism of the patient
with sensitivity and compassion. Clinicians provide presence when they are
authentic, deeply aware of the fragility of life and affirm the human
essence of the person they are treating. Moreover, they treat the patient
with regard and respect. Dignity, I believe, is correlated - anecdotally
at the very least - with greater patient comfort and responsiveness to
treatment. The shocking reality is that without dignity, clinicians often
develop a sterile stoicism towards the suffering and a needless aloofness
or alienation from those they serve. Even worse, the absence of dignity as
a core value in medical practice can lead to depersonalization where the
patient's identity and personhood are reduced to an insurance account
number, hospital room number or a diagnosis. For instance, one of the most
shocking examples of this is when I overheard a nurse refer to a patient
as "The urinary tract infection in room 306."
Perhaps, instead of eliminating this construct, the medical
profession can remove the vagueness of the concept by revisiting
palliative care theory and developing universally accepted standards of
dignity-based practices.
Stanley M. Giannet, Ph.D.
Affiliate Assistant Professor of Psychiatry and Behavioral Medicine,
University of South Florida College of Medicine, Florida, USA.
Second Vice President, Board of Directors,
Gulfside Regional Hospice, Florida, USA
Associate Dean of Arts, Letters & Social Sciences,
Pasco-Hernando Community College, Florida, USA
President, Giannet Consulting Services, Inc. Florida, USA
Competing interests:
None declared
Competing interests: No competing interests
Dignity, which derives from the Latin word dignus, meaning worthy, is
not a superfluous concept, in bioethics, or anywhere else. It has a well
defined meaning, which explains many of the uses of the term to which Ruth
Macklin objects in her challenging editorial [1].
Professor Macklin finds the idea of dignity quite problematic, and I
have some difficulty in seeing why. All societies that I know anything
about treat humans, alive or dead, differently from other large dangerous
animals. This is true even for societies which have practiced mass murder,
and those which have practiced cannibalism. The Germans, Russians and
Chinese all developed elaborate systems to demonise and cast out their
enemies, before they slaughtered them. They also had elaborate
bureaucratic systems for the killers [3,4,5]. Even in those societies in
which eating the dead was customary, people did not eat other humans for
food in the same way that they ate chickens, for example.
Dignity is precisely, an inherent moral characteristic of human
beings, or to use Lewis's suggestive term, 'hnau' [6]. It does not depend,
unlike many other characteristics, on the status, actions, capacity, or
position of the human being. It is that characteristic, as a result of
which all humans are deserving of, or due, respect.
Like many other terms in ethics and philosophy, dignity can be used
as an empty slogan, or a cover for intellectual undress, but this does not
invalidate the idea. ‘Rights’ is another useful term, which is often used
sloppily and inadequately, but which remains useful nonetheless. The
Nuffield Council on Bioethics [7], pace Professor Macklin, have in fact
hit at least part of the nail on the head, in defining dignity in terms of
“the presumption that one is a person whose actions, thoughts and concerns
are worthy of intrinsic respect”.
For me, the essential word here is intrinsic. I disagree vehemently
with Professor Macklin’s ideas, but I respect them and her, because she
has an inalienable right to my respect, as a fellow human being (or indeed
as a fellow “hnau”). From this perspective it seems to be vacuous to use
‘dignity’ as a synonym for respect, since respect is a consequence of
dignity, and simply incorrect to use it as a synonym for autonomy.
Finally, in dismissing all documents which do not treat directly of
bioethics and medical research, Professor Macklin has dismissed the whole
conceptual background against which the social meanings of dignity can be
located and understood. I agree, that if one were willing to dismember
ethics from human society in this novel way dignity would mean little, but
autonomy would mean less.
A Happy, Dignified, and Respectful Christmas to you all,
Anthony Staines
[1] Macklin R. Dignity is a useless concept. BMJ 2003;327:1419-1420.
[2] Goldhagen DJ. Hitler’s Willing Executioners. 1997.
[3] Applebaum A. Gulag, A History. 2003.
[4] Laogai Research Foundation. http://www.laogai.org/ (Accessed
25/12/2003)
[5] Lewis CS. Perelandra. (Voyage to Venus). 1943.
[6] Nuffield Council on Bioethics. Genetics and human behaviour.
Chapter 12 Paragraph 2
http://www.nuffieldbioethics.org/publications/geneticsandhb/rep000000104...
(Accessed 25/12/2003)
Competing interests:
None declared
Competing interests: No competing interests
Editor,
Macklin (1) takes too narrow a view. Certainly dignity is often
referred to without clarity or explanation, and in some of these
references it may be redundant. It is misused in driving consideration of
advance directives and active voluntary euthanasia. But Macklin's "close
inspection of leading examples" cannot lead to conclusions about dignity
itself.
Dignity is a characteristic of persons, and one which our actions can
enhance or diminish. It is related to autonomy but it goes further.
Respect for it is a distinct component of what is meant by respect for
persons, and it resonates strongly in the care of the dying, especially
those who no longer retain any autonomy but should still be treated with
respect. When we toilet and wash dying people rather than leaving them
dirty, when we moisten their mouths rather than leaving them dry, when we
lay them out carefully after death, it is their dignity that we are
respecting. Study of nurses' treatment of the dying shows us that social
identity, and dignity, live on in part after death (2).
We should not let the abuses of this concept render it useless. We
should instead use its clarified definition to guide decisions with those
whose dignity is most threatened.
1. Macklin R. Dignity is a useless concept. BMJ 2003;327:1419-1420
2. Waterhouse E (2001). Personal Communication.
Competing interests:
None declared
Competing interests: No competing interests
America's lost dignity
'The holidays' are a traditional time for celebration and the New
Year a time for hope and optimism. It was worrying then to see Ruth
Macklin’s chilling little homily slip in under cover of the BMJ’s festive
and frivolous issue.
America stands on its dignity but has been careless with it.
In a year when America has forcefully confirmed its autonomy and
ditched any respect for persons of other nations, it is a little
unsettling to see an American, a prominent medical ethicist, mount such a
contemptuous assault on the concept of human dignity.
The ‘many’ international human rights instruments and international
conventions do little to address ‘medical treatment or research’ and are
haughtily dismissed by Macklin as of little importance to medical
activity. Americans will wish to ignore it but Article 1 of the United
Nations Universal Declaration of Human Rights states that:
“All human beings are born free and equal in dignity and rights. They
are endowed with reason and conscience and should act towards one another
in a spirit of brotherhood.”
For a country that aspires to be a world leader in human rights, the
death penalty has defined the rogue state and become America’s Achilles’
heel. Article 5 of the Universal Declaration states that:
“No one shall be subjected to torture or to cruel, inhuman or
degrading treatment or punishment.”
American exceptionalism is pre-eminent; it is beneath American
dignity to abide by it. America has also ignored the 1989 United Nations
Convention on the Rights of the Child and continues to execute juvenile
offenders. In 1999 the only country other than America, to execute a child
offender was Iran: an axis of evil indeed.
Ruth Macklin considers dignity a useless concept in medical ethics.
With the medicalisation of judicial killing, I wonder if she might offer
an ethical analysis of this medical activity in America.
Although the aetiology may remain a mystery, the diagnosis is clear.
America exhibits a chronic inability to engage constructively with the
outside world and with international instruments and conventions. When
Americans come to engage with some respect for other nations, the world
may yet dignify, may yet perhaps confer some dignity on America.
Competing interests:
A profound contempt for the human indignity of the American death penalty
Competing interests: No competing interests