Catholic Transcript Online

A regular column last month on the Transcript’s editorial page sought to understand the recent phenomenon of movements, programs and theories literally designed to facilitate death, either in one’s own behalf, or that of others. (See "Faith Perspectives," August issue, p. 26.)

The column probed a narrative by Catherine Pepinster in the London Tablet, about "a purposeful end to life," as discussed in March by a group of thinkers, health care policy-makers and practitioners at Blackfriars, Oxford. The topic is not merely theoretical, as witness the current debate in America concerning health care reform.

According to one of the participants, described as a professor of social work and spirituality, it was suggested that the "medical model" of dying often "gets in the way of humanity." That such a meaningless suggestion could be seriously articulated is an indicator of the shallowness of much of the discussion that followed.

"Outrage" was predicated by another speaker of those who want to control the tragedy of death, but cannot do so as yet. Still another attacked the notion of personhood, by stressing the vulnerability of the person with reference to the philosophy of Alasdair MacIntyre, i.e., "that we should consider ourselves as animals that cannot cast aside vulnerability and dependency so easily." Yet another participant proposed that we search for "a satisfactory argument about our responsibility for the suffering and dying." (Suffice it to say that Mother Teresa of Kolkata would recoil in justifiable horror that after 2,000 years of Christian faith and reasoning, some people are suddenly "discovering" this truth.)

The most disturbing interventions at the Oxford meeting, however, occurred with respect to the concept of human dignity. Attention was called by one participant to (in the Tablet’s phrase) "a highly influential paper" by Professor Ruth Macklin of Albert Einstein College of Medicine in New York City. The problem with this paper is that it attempts to discuss human "dignity" on a bioethical level without any reference to, much less understanding of, the ethical dimensions of the concept. Ethics rests on sound theology and philosophy; one cannot pretend to be a bioethicist without at least wrestling with philosophical principles. Unfortunately, the world today prefers to think and act on the surface of reality, relegating philosophy to a shelf housing fictional accounts of reality. Neither a medical nor a law degree is in itself an adequate credential for engaging in bioethics, yet both academia and medical schools are amply populated by "bioethicists" who possess nothing more.

Professor Macklin in her paper complains that too many articles and reports "appeal to human dignity, as if it means something over and above respect for persons or for their autonomy." For this, she partially blames "religious sources that refer to human dignity," especially "but not exclusively" reflected in Roman Catholic writings. In a sense, she faults the "religious source," which, she alleges, "cannot explain how and why dignity has crept into the secular literature in medical ethics."

The truth is that medical ethics is not its own source. Religion, from which a sound ethics emerges, is its ultimate source. One simply cannot do medical ethics without first granting the fundamental autonomy of ethics; the most basic medical moral norm as expressed by the ancient philosophers, primum non nocere, is rooted not in medical science, but in ethics, a branch of philosophy and theology. And ethics, not medicine, teaches us that every person is unique, precious and unrepeatable. That is what human dignity ultimately signifies.

The dignity of the human person is innate, therefore; it is intrinsic to his being. Which means it is not veneer, not something accidentally attached to personhood. Shakespeare was right on target when he has Hamlet say:

"What a piece of work is a man!... How infinite in faculty!... in apprehension, how like a God!" (IIii)

Bioethicists should begin with this norm.