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No view from nowhere: the challenge of grounding dignity without theology
  1. Charles Camosy
  1. Correspondence to Professor Charles Camosy, Fordham University, 441 E. Fordham Rd., New York, NY 10458, USA; ccamosy{at}gmail.com

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Charles Foster's important book—which I use in my graduate courses in theological ethics—goes far beyond the piece to which we are responding here.1 My students appreciate his expertise with respect to the ethical reasoning behind certain kinds of laws and legal decisions. This is an on-the-ground practical reasoning with which academics are often unfamiliar, and a welcome intervention.

The challenge to which he attempts to respond is as big as it gets. How, especially in its post-Christian incarnation, can bioethics (and, perhaps, Western culture more generally) take the concept of dignity seriously? A Christian understanding arrives at heretical conclusions within secular academic/medical discourse, but, as Foster notes, what remains of dignity has been criticised by Ruth Macklin and others as hopelessly vague.

But Foster knows that when we jettison the concept of dignity we become unable to ground even very basic moral judgements—ones shared across several different moral traditions. If we become unable to explain why it is wrong to use a human head for a football, or to sexually exploit a dead body, then something has gone very wrong.

And the problems go even deeper. As Foster suggests, without the concept of dignity it looks difficult to ground the moral standing of a good number of flourishing members of Homo sapiens. Indeed, in a culture that sees full moral standing as depending on something like autonomy, fellow members of the human family who are not autonomous in any meaningful sense don't appear to have the same moral standing. This is true not only for prenatal and neonatal children, but also for those with profound disabilities.

Those with a liberationist approach to ethics not only argue for the full moral standing of these individuals, but that we ought to have something like a ‘preferential option’ for them. Because they are on the margins of our culture—with a moral standing that those with power find inconvenient—they deserve a special level of concern and protection.

The dramatic problem this sets up is what makes the project of Foster (and others like him, like Christopher Kaczor and Daniel Sulmasy) so important. If they are not able to answer Macklin, then it appears the liberationist critique falls flat. Without the solid ground of dignity, their criticisms are akin to criticising modern mining operations as insufficiently aware of the special protection owe ought to afford rocks, given their marginal status.

How does Foster's attempt hold up? Though it is one of the best non-theological attempts out there, I think it has two significant weaknesses. First, there is no scale for making his ‘transactional dignity’ calculation. Second, it just isn't clear ‘objective flourishing’ is a sufficient ground for the dignity of vulnerable populations. Let's take each in turn.

Foster describes his transactional dignity as a ‘utilitarian calculation’ in which all ‘dignity interests’ are considered. But just what kind of calculation it is when one has no scale for weighing and comparing the various impacts on dignity? Take the case of Terri Shaivo: even in a persistently unconscious state, Foster claims she has some thriving interests. How are we to compare them with those of her ex-husband? With her parents and siblings? Not only does no scale for doing this currently exist, it is difficult to imagine how there could be such a scale.

But Foster points out that judges make these decisions all the time. What kind of judgement, then, is being made? It is one that relies on intuition, not a balance sheet calculation. It is grounded in that judge's particular understanding of the good, not an objective norm available to all regardless of normative tradition. There is no view from nowhere.

But here Foster could object and say that humans do have dignity interests related to their thriving that most everyone agrees are objective. He could argue, for instance, that virtually everyone agrees about the thriving interests of humans as animals. The objective difference in thriving between, say, an Olympic athlete, and someone with end-stage cancer, is not socially constructed.

The problem is that not much that's morally significant follows from this. Take Foster's claim—one with which I strongly agree—that the medical students violate their own dignity when they sexually exploit a dead body. That judgement can only be sustained, however, with appeals to a very thick understanding of the good: one that has something detailed and controverted to say about the nature of sexuality, the moral standing of dead bodies, the interests of someone after their death and of the relationship of actions to one's own moral character. The objective flourishing of the medical students as human animals may be completely unaffected by what Foster and I both agree is a seriously immoral act. In other words, the moment you have a thick enough understanding of dignity to claim that these kinds of actions are wrong, you lose any sense that the kind of dignity with which you are operating could be broadly accepted as objective.

But what, then, is left to us? Foster seems aware that there is another route, but he hits us over the head with the fact that he isn't doing anything ‘creepily Judeo-Christian’ or ‘incurably theological’. But it is time for secular Western bioethics to face facts: our moral discourse did not arise out of nowhere. It has a history, and that history comes directly out of centuries of moral reasoning that was grounded in theological first principles. This is true not only of claims about dignity, but about moral discourses ranging from rights-talk to utilitarianism.

But a theological start point not only makes for difficult Oxford common room conversations, it sets off ethical totalitarianism alarms. But who now believes a coherent moral and legal discourse is possible without imposing a particular normative tradition onto those who reject it? What kind of answer would we get from, say, a Muslim physician who refuses to see female patients, or a Jehovah's Witnesses who wants her child to undergo bloodless major surgery, if we said that Western secular culture avoids ethical totalitarianism?

Now, I've been in enough arguments with my secular friends and colleagues to know what comes next: a (often polite) dismissal of theology as being grounded in controverted metaphysical claims for which we do not have arguments. But this is the condition of every normative tradition: from care feminism, to hedonistic utilitarianism, to Foster's transactional dignity. Western bioethics’ focus on autonomy and clinical pragmatism has papered over this inconvenient truth, but it is one we must face squarely if our discipline is to have a genuinely plural approach to normative traditions.

A theological concept of dignity is no more totalitarian than that a utilitarian concept of interests or a liberal concept of autonomy. Good thing, too, because a theological concept of dignity may be necessary to ground some of the West's most significant movements towards inclusivity and social justice.

Reference

Footnotes

  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.

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