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Flourishing is not a conception of dignity
  1. Linda Barclay
  1. Philosophy, Monash University, Clayton, Victoria, Australia
  1. Correspondence to Dr Linda Barclay, Philosophy, Monash University, Clayton, Victoria, Australia; linda.barclay{at}

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Hojjat Soofi develops a modified version of Martha Nussbaum’s capability approach, which he offers as a conception of dignity for people living with dementia.1 He argues that this modified version can address what he identifies as four main criticisms of the concept of dignity. The first and most substantial criticism was developed by Macklin: that appeals to ‘dignity’ add little to moral debates or to the rich field of existing moral values.1 Soofi’s account of dignity does not evade this criticism: to the contrary, it represents another clear example of what Macklin complained about, namely, a moral proposal in which the concept of ‘dignity’ plays no substantive role. We have much to learn from Soofi’s rich account of how to ensure the flourishing or well-being of people living with dementia, but it has little to do with dignity as such.

According to Soofi, Macklin’s argument is that ‘dignity’ is just another word for respect for persons or their autonomy. This is a rather truncated representation of Macklin’s argument, which is in fact broader. Her argument is that the concept of ‘dignity’ adds nothing to the vast array of rich moral values that already populate the field of ethics, mainly because it is a less precise restatement of these existing values.2 She explicitly …

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  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.

  • Macklin R. Dignity is a useless concept. BMJ 2003; 327 (7429): 1419–20.

  • At times, Soofi interprets Macklin to be stating that ‘dignity’ is ambiguous whereas other moral concepts are unambiguous. This is very unhelpful. No philosopher, including Macklin, would claim that any moral concept is unambiguous, as is evidenced by the extensive debates about the meaning of ‘autonomy’ or ‘respect’. Her substantive claim is that the word ‘dignity’ is almost always used as a less precise term for ‘autonomy’ or ‘respect’.

  • Barclay L. Dignitarian medical ethics. J Med Ethics 2018; 44: 62–67. Etinson A. What’s so special about human dignity? Philosophy & Public Affairs 2020; 48(4): 353–381. Killmister S Dignity and shame in Contours of Dignity. Oxford University Press. 2020. Luban D. Human dignity, humiliation and torture. Kennedy Inst. Ethics J 2009; 19(3): 211–213.

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