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Friday, February 16, 2007

Session 6: Human Dignity and Bioethics - A Preview of Council's Upcoming Dignity Volume

A Council Discussion of Gilbert Meilaender's "Human Dignity: Exploring and Explicating the Council's Vision," and Daniel C. Dennett's "How to Protect Human Dignity from Science"


DR. PELLEGRINO:  Council members, welcome back.  Council members, are we all here?  It doesn't look like it.  I know some are gone.  Very good.  Thank you very much.

This last session is devoted to the upcoming volume or anthology being put together on the subject of human dignity.  Those of you who have followed the publications of the Council over the years I'm sure have seen the concept of dignity in a sense hovering over a lot of the discussion, what it is to be human, how do we preserve human dignity in the face of a variety of assaults on it today.

Council members have received papers that have been elicited from a variety of authors, some on the Council, others not on the Council.  And the subject of today's discussion is to get comments from the Council members on the volume, which is being edited by Adam Schulman and is coming close to completion and ready for publication.

We have asked two of the Council members to open the discussion:  Dr. Floyd Bloom and Dr. Peter Lawler.  And while they're making their comments and throughout the rest of the discussion, I want to urge other Council members if they wish to take the invitations being extended to write a comment on one of the existing papers, which you have read, or submit a paper of your own.  We would like as much as possible to have Council participation as well as the participation of invited authors.

Let's begin, if I may.  Dr. Floyd Bloom, would you lead us forward?

DR. BLOOM:  I hadn't been appointed to the Council when you decided to do this compilation of essays on dignity.  So when Dan asked me to start the discussion of the essays by Gil and by Dan Dennett, I looked at it as a great learning experience.

Reading Gil's essay gave me the chance — in fact it required — that I go back and read parts of Human Cloning and Human Dignity, Being Human, and Beyond Therapy.

A skeptical Council member might wonder whether getting new Council members to read old Council reports is not a major part of how you get picked to lead discussions.


DR. BLOOM:  If that were the case, thank you because I learned a lot.  And I thought these were both thought-provoking essays.

When I moved from the NIH to the Salk Institute in 1975, I was given the study of Jacob Bronowski, who had just died.  And it's Bronowski's writings that come to mind, especially The Sense of Human Dignity, when I ponder the phrase "human dignity."

But the Council's early report, as Gil so clearly notes in his essay, Bronowski used the term "human dignity," but, as far as I can tell, he never defined it except by examples of respect within the community of scientists for each other's findings and interpretations, whether or not one agreed with them, and the scientific spirit to dissent and explore while searching for truth as human values, which in his phrase he said were "ratified by the great religions of the world."

He said the outcomes of science and technology are mere tools and artifacts, it's the spirit and creative energy behind them that form the basis for human values and ideals, which is as close as I think I could find that he came to talking about human dignity explicitly.  And it's that spirit that I think of when I ponder the meaning of dignity in the sense of this volume and these two particular essays.

Gil's essay refers to the three definitions of dignity described by Beyleveld and Brownsword and more recently by Caulfield and Brownsword in their considerations of policy-making for the era of biotechnology.  Those three definitions are:  number one, empowerment, which is very similar to what Mike said yesterday, the right of individuals to make autonomous choices; secondly, as a means of constraint; and, thirdly, as dignified conduct.

So since Gil is here and I can pose the query to him, it seems to me that you use dignity as constraint in a fashion somewhat differently than do Beyleveld and Brownsword.  You used it in the sense of constraint in a legal or ethical issue to control activity to which one freely consents and which seems to harm no one.  But Beyleveld and Brownsword used the sense of scientific constraint in the terms of barring activities, such as cloning humans or selling organs for transplant, as a social position that these forms of scientific activity are against human dignity because they are contrary to the public good.  And that seems to me much closer to the way I read Leon's essays to have defined or used the phrase "human dignity."

Dr. Dennett's essay that we already engaged in a little bit of discussion earlier this morning is much closer to neuroscience.  And so I feel more akin to it.  And it uses the recent findings with non-invasive imaging on which to build the case that human dignity arises — and this is his list — from the capacities of the human brain that allow for language, art, music, religion, humor, recording and reviewing history, and planning projects that go well into the future, and that humans are the only animals that can conceive of the project of leading a good life.

Studies that begin to disclose the parts of the brain that work together when we make decisions that attribute trust and emotional status to others ground for me in real substance these brain-based human abilities that lie at the heart of human dignity.

One might also expand on his concepts of dolphins and great apes as having a protomorality, a capacity to cooperate and express altruistic behaviors.  Elephants, for example, have recently been shown to be capable of mirror self-recognition and altruism, not only for their own species but for other species.  And recent news stories again substantiate the idea that dogs will willingly rescue human beings, even if they don't know who those human beings are.

For the most part these two essays, both very thoughtful, taking their own levels of resolution do not directly contradict each other except for the one exception that Robbie pointed out in his questions to Francis Collins.

On page 6 of his essay, Dennett asks whether the very meaning of our lives depends on the reality of our immortal soul.  And he answers no.  Well, Gil on page 11 takes the view that society's commitment to equal dignity is best and most safely grounded in religious belief.

So if Dr. Dennett had been here this morning, what I would have liked to have asked him is this.  I know or I can imagine how the human brain does language and music, remembering and planning.  And when I queried PubMed about brain imaging and religion, much to my surprise, there were more than two dozen papers that use positron emission tomography, functional MRI, EEG, even SPECT., to look at phenomena from the mystical experiences of Carmelite nuns to buddhists contemplating a remembered meditation.

So, not surprisingly for those who understand that interpretation, there are certain parts of the brain, particularly on the right side of right-handed people, that show enhanced activity during religious experiences, but what Dr. Dennett doesn't tell us is what brain systems or networks he thinks underlie religious contemplation and what in our evolutionary history has given rise to a system that would mediate such functions.

That's mostly what I have to say, but I would like to offer this for the Council's amusement after this lengthy discussion.  This is the final version of Bob Dylan's song "Dignity" from 1991, "So many roads, so much at stake, so many dead ends, I'm at the edge of the lake.  Sometimes I wonder what it's gonna take to find dignity," 1991.

DR. PELLEGRINO:  Thank you very much, Floyd.

For the benefit of those who have not seen these papers, we asked our discussants to look at two of the papers, particularly that will be appearing in the volume.  One is Dr. Gil Meilaender's "Human Dignity:  Exploring and Explicating the Council's Vision" and another by Daniel C. Dennett, "How to Protect Human Dignity From Science."

Now for our second discussant.

DR. LAWLER:  Well, thank you.  And I will try to be brief, given the lateness of the hour.

So my job is to introduce these two papers by Meilaender and Dennett.  And I will use the last names because I don't know Dennett.

From one point of view, they defend two extreme and incompatible positions.  They're both extremists.


DR. LAWLER:  As was pointed out in the last session, Dennett is surely an extreme atheist.  And Meilaender we might say is an extreme theist; that is, an Augustinian.  But extremism in defense of dignity is surely no vice.


DR. LAWLER:  And they are both, as they say, nice guy extremists, although you can find a sentence or two in both articles like the one Robbie quoted last session, which are overly assertive and a little bit mean.

In general, these dignity extremists lack the self-righteousness that often accompanies dignity extremism.  So they agree.  And they agree.  As extremists often do, they agree on many things, more things that it appears at first.  They both agree that dignity is not a useless concept.  And this is not a small point of agreement.

And they both agree that dignity has to be saved from modern science or at least misunderstandings of what modern science actually teaches. Not only that.  They seem to agree that our understanding of dignity, at least our traditional understanding of dignity, is Christian.

So Meilaender says that the dignity of each unique and irreplaceable human person is real.  And the only explanation for that observed phenomenon of human dignity that makes sense is the Christian one.  So our belief in the equal dignity of all human persons is part of our Christian inheritance.

Dennett agrees that our understanding of dignity or at least the traditional understanding of dignity, the given understanding of dignity is Christian.  But he adds that the Christian claims about the soul or some immaterial dimension of personal existence have been refuted by modern science.

So dignity has now the same status as the mermaid, although I would add: sensible people never believed in mermaids, although sensible people in the past I think believed in the soul.

Dennett adds — and this is very important — that our need to believe in dignity is real and characteristic of the type of social being human beings alone are.

We social beings, who conceive a project for the good life to live good purposeful lives, good lives, can't live together well without believing in some useful illusions, like free will, love, and dignity, but free will, love, and dignity, strictly speaking, have no real basis in what we can actually know about our accidental evolutionary and wholly material existences.

So Dennett's ingenious solution that solves the problem of the incompatibility perhaps of dignity and modern science is to say today we should candidly admit our need to believe, that we're hard-wired to need to believe. And then our allegiance to the belief in human dignity will be supported by the good life it makes possible for us.

We can see that if we give our allegiance to dignity, our lives will be better.  So we can suppress the thought about whether our belief in dignity actually makes any natural sense because we can't see.  According to nature, we do believe.  And when we do believe, we're better off as a certain singular kind of social animal.

So a difference, a major difference, between the two great thinkers we're talking about is that for Gil Meilaender, it would make all the difference in the world.  We really are unique and irreplaceable beings.  Dennis suggests we can suppress that thought about the reality of the situation and regard that thought as a useful one.

So for Meilaender, our dignity is mysteriously given to us by a personal god.  And the human situation is fundamentally mysterious in certain respects without a religious explanation at least.

For Dennett, nothing human is mysterious.  Everything can or will be explained in a wholly material way.  That's good, though, because then we can understand scientifically why we have to attribute dignity to ourselves.  Insofar as we believe our dignity is mysterious, we can't consciously and rationally employ it for the purposes of flourishing social life.  So modern science, properly understood, makes dignity more effective.

There are other points of agreement between these two extremes.  Meilaender and Dennett don't agree with those who connect dignity with autonomy, with our freedom from our natural limitations for laws or choices we impose on ourselves.

Autonomy is based on the denial of the truth about our embodied existence.  And dignity, properly understood, should be compatible with what we really know about our limited social and temporal lives.

Even Dennett's fictional dignity depends on our understanding of our real material situation.  So for both Meilaender and Dennett, dignity is a characteristic of embodied beings who know the truth about their situation. Not only that.

These two extremists both have an egalitarian view of dignity, separating themselves from, say, certain members of this Council, who have a more aristocratic understanding of dignity.

They deny that our dignity is dependent on the excellence or virtue we display in social context.  It's easy for Dennett to do that because there's nothing I can do that will really make me more dignified given that I am not really dignified anyway.  And Meilaender says there is nothing I can do that can really make me undignified.  So Meilaender says it's true, and Dennett says it's useful to regard all human beings as equally dignified.

We have to wonder whether either Meilaender or Dennett really disconnect dignity from real human achievements in thought and action.  Meilaender criticizes Leon Kass for saying patients because they lack agency lack the capacity to be dignified.  And to support his case, he gives us the example of a dignified patient who acts with patience in light of the truth about his dependent human condition.

So in a very Christian way, he explains how patients can be more dignified and more truthful than great leaders or manly or magnanimous men who have forgotten about the limitations of their embodiment.

But Kass responds that in describing the patient, the dignity he displays depends upon action and thought appropriate to a situation.  So the patient, Meilaender describes, is not really a patient.  He's just part patient and part not because a pure patient would be perfectly passive.

So a pure patient would be someone with advanced stage Alzheimer's, lacking any capacity for thought and action.  But an advantage of Meilaender's and Dennett's position over, say, the position of Kass is they can explain quite clearly why patients with advanced stage Alzheimer's, late stage Alzheimer's, have dignity.

Meilaender says they have dignity because of the type of being they are and cannot change.  Dennett might say, at least, it's just socially useful to regard people with late stage Alzheimer's as having equal dignity; we'll have a better life as a result.  Kass actually has to think about this.  And it's hard because he doesn't regard dignity as given in either of those two ways.

Now, I would make one more point.  Meilaender and Dennett connect dignity with degradation, Dennett almost in spite of himself.  Indignant behavior is or anti-dignity behavior is reducing human beings to less than they really are.

So Meilaender has told us that a human being who alienates his body or alienates himself from his body through the sale of his kidneys is acting in an undignified way.  And even Dennett worries that a misinterpretation of modern science will erode our indispensable faith in human dignity.

So they both really want to preserve the qualities that really distinguish human beings from their attack by modern science in some way or another.  So surely even Dennett wants to preserve the real existence of human beings capable of acting in a dignified way from, say, biotechnology that would suppress those parts of the brain that make dignity indispensable.

So they both show us why we should use the word "dignity" because that's not self-evident because Americans in most of our history have spoken not so much of dignity but of rights.  Because we can speak so clearly of rights, why go down the murky road toward dignity, which is controversial and causes us to be self-righteous.  Here's why.

The Twentieth Century and the Twenty-First Century.  The word "dignity" made a comeback in the Twentieth Century because what the totalitarian regimes did in the war against the reality of human nature was a lot worse than a violation of rights.  So you can't say Hitler just violated rights.  You can't say Stalin just violated rights because they were at war against the being capable of experiencing dignity, human individuality.

So the great dissident opponents of totalitarian regimes, like Solzhenitsyn and Havel and Pope John Paul II, were big on bringing back the word "dignity" because the word "rights" just wasn't enough.

And in the Twentieth-First Century, great men like Leon Kass bring back the word "dignity."  By replacing "life, liberty, and the pursuit of happiness" in a crafty way with life, liberty, and the defense of dignity because what biotechnology could conceivably do to us, misapplied, would be at war with the very aspects of our nature that allow us to be dignified beings because biotechnology opens the opportunity of actually changing our natures in an undignified way.

So I think even Dennett in his own way agrees with that.  We have to have the use of the fiction of dignity to fend off biotechnology that might do that.  But I would add to everything these great experts say another piece of evidence of our dignity is that both totalitarian efforts and biotechnological efforts to eradicate those aspects of our nature that make us dignified beings will inevitably fail.

Thank you.

DR. PELLEGRINO:  Thank you very much, Peter.

Gil, would you like to respond?

PROF. MEILAENDER:  Let me just say a couple of things.  Judy Crawford was already nailing me at breakfast with some questions about my essay.  And I told her I was just going to refer all questions to her.  That would be my preferred strategy, actually.

And also I don't myself think it would be a fruitful discussion for sort of me just to respond to questions.  I think the Council should have its own discussion.

Let me say a couple of things.  Floyd directed a specific question.  But I wasn't sure I understood it, Floyd.  Let me say a word.  And you'll just have to see whether I got you or not.

I took the second notion of dignity from B&B, as I like to call them since their names are not easy, the side constraint notion, to be at least somewhat similar to the notion I had developed in the last part of my paper about dignity as a kind of anthropological position or dignity as serving as a placeholder, as I called it, for a richer anthropological view but only somewhat similar to that in the sense that theirs is largely a negative notion.

The language you quoted I thought was less mine than their view in a way, just autonomous action that harms no one and so forth; whereas, it seems to me that the anthropological vision that I had tried to show the Council at least attempts to develop, though it will have some of those negative functions that serving as a side constraint is an attempt, actually, to say something more positive about what really makes human beings human beings.  So that would be sort of what I would say to that.

Then just a word, drawing on Peter's various comments.  If I had this to do over again, I think I would reverse the parts of the paper in a way because I think it might make more sense.

See, I tried to sort out what I think are several different things the Council does with the language of dignity in those reports.  And then I worry about certain issues that they raise.

The second general thing that I sort out, what I was just referring to, what I call sort of a placeholder for a richer understanding that comes out at certain places; in Beyond Therapy in one way; certain places in the cloning report in another way; certain places, actually, in the little introductory comments in Being Human, the reader, as I noticed.

I wouldn't have said — now, I'm subject to being corrected.  I wouldn't have said there was anything necessarily Christian about that claim of mine.  I would think there might be various ways to get to that anthropological view.  I probably get to it in certain theological ways, although there certainly have been Christians over the centuries who have sort of fallen short of that view, at least by my lights.

So I don't know.  You know, if you had reason to prove to me that it was necessarily Christian, that would be okay with me.  That wouldn't bother me, actually.  But I don't think it is.  And I don't think I developed it that way.

The first kind of issue I worry about, which is where the equality issue really comes out, that is where I argue that I think, in fact, we have been dependent on the religious tradition in a certain way to be able to affirm the equal dignity.

So I think that the development of those two aspects, the second one is more kind of the dignity of human nature, the nature that we all share.  The first is the dignity of the person, the individual person, who, though belonging to the species, may have some of the characteristics of our nature and not others of them.  And I think if I had it to do over again, I might have reversed the order of them in order to try to make that clearer.

But that much I would say at least by way of trying to clarify the sense in which there are or are not specifically religious or theological claims at work.  And I think I'll stop there.

DR. PELLEGRINO:  Thank you very much, Gil.

I'll open the subject to general discussion now.  It need not be limited to these two papers, any of the papers that you have read in the anthology that Adam has put together for you up to this point.  Dr. Schaub?

PROF. SCHAUB:  Yes.  I do have questions for Gil, even though he doesn't want questions.  It will take a while before the questions emerge, and I want to ask your forbearance.  I started jotting down some notes on Gil's essay, and I got a little carried away.

Since I am usually pretty brief, I hope that I have some accumulated minutes and that you will bear with me as I sort of deliver myself of this.  Well, I don't know how to characterize it.  I'll just launch into it.

Gil tells us in his fine essay that there are some realms in which comparative judgments of excellence are permissible, indeed required.  Assuming that our consideration of these two papers is one such venue, I feel at liberty to direct my remarks to the more worthy of these papers and to ignore the other.

Gil argues that Christianity has transformed the Greek emphasis on comparative dignity.  Christianity, he says, marks 'a great rupture in Western culture.' He further argues that this Christian egalitarianism is the inspiration behind the American assertion of man's equality in the Declaration of Independence.  He suggests that one needs belief in the fatherhood of God for the brotherhood of men to be seen as self-evident.

And he worries that with the decline in religious belief and maybe even more especially the unwillingness to acknowledge the connection between religion and politics, we're increasingly in a situation where our commitment to equal human dignity is ungrounded and, hence, unsustainable.

So Gil wants us back on firm ground.  And, in particular, he argues that there are two places where differences in excellence or dignity must not matter.  The first is at the threshold of death when the continuance of life itself is at stake.  And the other that he mentions is the opportunity to live within human society and participate in its common life.

Now, while Gil makes plain his discomfort with the Hellenistic, aristocratic take on dignity— he even calls it a temptation that ought to be resisted — I felt that there were many instances in which Gil was more of a Hellenizer than he admits.  And let me cite just one of those.

Early in the paper Gil presents us with a character from a Galsworthy novel.  I think Gil is probably the only person in the nation still reading Galsworthy.


PROF. SCHAUB:  I mentioned this to a literary critic friend of mine.  And she said, "Galsworthy.  How stodgy."


PROF. MEILAENDER:  I read it many years ago.


PROF. SCHAUB:  In the Galsworthy novel, Gil offers us Old Betty Purdy as an individual who confounds our aristocratic assumptions about greatness and dignity.  And the passage that he cites does indeed show the falsity of status and wealth as markers of human dignity, but I think it does not at all argue for equal human dignity.

The greatness of this little old lady came from the moral virtue she displayed in the midst of the ordinariness of her life.  Her greatness depended on her comparative excellence, not her equal human dignity.

We're told of the meagerness of her material existence and her limited range of action, but her back had been straight, her ways straight, her eyes quiet, and her manners gentle.

I take it that we're to admire her fortitude and her probity and her kindness.  Those are not qualities equally possessed.  If the woman had, instead, lived in Buckingham Palace and had the world as her stage, real greatness would still have depended on her moral virtues.

I think that's one of the points made by the wonderful movie The Queen starring Helen Mirren.  Of The Queen also, it could be said that her back had been straight, her ways straight, her eyes quiet, and her manners gentle.

Now, although Gil reiterates that he finds something offensive about the aristocratic view of human dignity, it seems to me that he himself regularly recurs to a version of it and that he can't help but do so.  After all, in Christianity, the message to respect basic humanity came from the fullest humanity.  The bearer of the message was not just a godly man but God become man.  We are to imitate his perfection.  Christian virtues may be different from classical virtues, but the standard is — if anything — higher.

Gil appeals to Lincoln for evidence of what he calls the problem we have with an inegalitarian concept of dignity.  I, too, accept Lincoln as an authority.  However, I don't think that Gil reads him quite right.

Lincoln is not at all offended by the aristocratic view.  In fact, Lincoln always starts his explications of the meaning of the Declaration by acknowledging the fact of human inequality.  Men are not equal in all sorts of features and capacities.  And Lincoln lists a number of them.

But for Lincoln, admitting the existence of those various politically and socially significant inequalities should not in any way imperil the real truth of the Declaration, namely that men are equal in their natural rights to life and liberty.

And note, as I think others have already mentioned, Lincoln speaks of equal rights, not equal dignity.  I suspect that we may have gone awry when we confounded the language of dignity with the language of equality.

Dignity was not a word that either the founders or Lincoln employed much.  And when they did, it was in a, frankly, meritocratic sense.

Moreover, in the passage that Gil cites, I think it is worth noting that Lincoln illustrates the equality of rights by saying that human beings are equal in their right to eat the bread that their own hands have earned.

In other words, even this equal right hinges on earning.  Labor is the title to property.  And men will labor unequally.  Now, Lincoln doesn't tell us here what those who are unable to labor are entitled to.

And I surely don't mean to suggest that Lincoln would have denied sustenance to the young or the elderly or the sick.  Lincoln was attacking the injustice of slave labor.  And his arguments are marshaled accordingly.

And we certainly have evidence of Lincoln's capacious humanity in the closing lines of the Second Inaugural, when he calls on Americans to care for him who shall have borne the battle and for his widow and for his orphan.

But the example of Lincoln leads me to think that we have a model for how to combine and celebrate both the respects in which human beings are equal and the respects in which they are unequal.  And one need not imperil the other.

Indeed, the life of Lincoln, a superior man, who devotes and sacrifices his life to the teaching of equality, reminds us that we can't have one without the other.  So we shouldn't lose sight of the success of the American founders, among whom I include Lincoln, in combining the egalitarian and the inegalitarian.  They just didn't seem to struggle with it as we are.

I was a bit taken aback by Gil's assertion that there are two places where comparative judgment should not be given any scope:  at the threshold of death and participation in human society.  Gil seems to say that these are absolutes, but I wonder whether he really means it.

The quote from Kierkegaard says, "If you save a person's life in the dark thinking that it's a friend but it was the neighbor, this is no mistake."  Well, it seems to me it might have been a very big mistake if your neighbor also happened to be your enemy and you happen to have been on a nighttime reconnaissance mission.  In other words, Kierkegaard's statement is radically apolitical.  It abstracts entirely from the distinction between friend and foe.

Gil, do you mean that one is never justified in taking human life, not even the life of an enemy in combat?  If comparative judgments have no place at the threshold of death, does that commit you to not only oppose the death penalty, which I take it that you do, but commit you also to a thorough-going passivism?

If, on the other hand, you allow for individual and societal self-defense, then it seems to me that you have admitted the validity of comparative judgments of worth, even at the threshold of death.  So in this case, it seems to me that the language of equal rights is preferable to the language of equal dignity.

Rights are inalienable, but they also imply reciprocity and responsibility.  Those who violate the rights of others have rendered some of their own rights forfeited.  So that a rights-based approach protects the innocent and the weak, about whom Gil and all of us are concerned.  But it doesn't require us to abandon human judgments about virtue and vice.

As to Gil's claim that our founding doctrine is grounded in Christianity, it's true that the Declaration refers to man is created equal and endowed by their creator with certain inalienable rights.

It's also true that Jefferson shared Gil's worry that once religious belief falters, the commitment to equality will be hard to sustain.  Here's how Jefferson put it, "And can the liberties of a nation be thought secure when we have removed their only firm basis, a conviction in the minds of the people that these liberties are of the gift of God, that they are not to be violated but with His wrath?"

Having granted that much, I would just point out that the Declaration refers to the Laws of Nature and Nature's God.  And I suspect that nature's God is not quite the same as the biblical God.

Gil says that the truth of human equality is a theological proposition or theological assertion, but how strong a theology is required?  Is natural theology sufficient?  Jefferson I think thought that it was.

And in other writings, Jefferson argued that it was not religion at all but, rather, reason and science that will reveal the truth of the Declaration.  In a letter written just days before his death, Jefferson said, "All eyes are opened or opening to the rights of men.  The general spread of the light of science has already laid open to every view the palpable true that the mass of mankind has not been born with saddles on their backs, nor a favored few booted and spurred, ready to ride them legitimately by the grace of God."

Now, as we know, even if equal rights are self-evident, they're not self-establishing.  The paradox of rights is that you have to hazard your life and liberty in order to vindicate your right to life and liberty.

As Frederick Douglass never tired of telling his enslaved brothers, "Hereditary bondmen, know ye not who would be free themselves must strike the blow."

This was a heartening message for blacks and for women, who had the wherewithal to strike the blow and secure the dignified treatment to which they were by nature entitled.

It may not be such a tearing message for the young or the drastically impaired, although perhaps the answer that Locke gives about the young is sufficient.  He says, "Children I confess are not born in this full state of equality, though they are born to it.  Consequently, our handling of them must always be aware of their directedness toward rational liberty." Children are rights bearers, too.  Accordingly, the power of parents and guardians is limited."

Locke insists it does not extend to life and death.  Immature human beings, embryos included arguably, have the same bodily immunity as adults.  There's a fundamental human right not to have one's body captured or controlled by others for their ends and purposes.

In the case of the weak and immature, respect for this basic right to life will continue to depend on the deference of the strong.  In his speeches, Lincoln deployed his relentless logic to get those who had the upper hand to realize the momentary and fragile character of their strength.  He stressed that the only guarantee of one's one rights lies in the recognition of the rights of others:"As I would not be a slave, so I would not be a master."

And, again, in giving freedom to the slave, we ensure freedom to the free, honorable alike in what we give and what we preserve.  This is a version of neighbor love and brotherhood that is reasonable and republican in character.  It doesn't deny the fatherhood of God, but it doesn't draw attention to it either.

And, in closing, at the risk of impiety, I will suggest that brothers can get along pretty well when the father, whether human or divine, remains further in the background.  After all, the first story of brothers in the Bible is a story of fratricide in response to God's favoring the gift of one brother over the other.  I'm not so certain that it helps our sense of human equality to view matters under the aspect of eternity.

As I read the Bible, some of us will be eternally damned and others saved.  We are not equidistant from God, either here on Earth or later.  I'm quite certain that Gil is nearer my God to Thee than I am, but I think that we can still be equal citizens, mutually acknowledging our individual rights and brotherly responsibilities.

DR. PELLEGRINO:  Thank you very much, Dr. Schaub.

Gil, do you want to comment?

PROF. MEILAENDER:  Sure.  I'll comment on a few things, not by any means everything that Diana has taken up.  Just a comment on what I drew from my stodgy reading habits, I read all nine volumes at one time in my life.

Although, Diana, you are always a very careful reader, I didn't think you did quite justice to the way I used the Galsworthy passage there.  That paragraph where I used it begins, "Suppose, however, that our understanding of comparative excellence were reshaped somewhat by a sense of equal human dignity."

And having quoted, I say, "And suddenly what seems almost a given in the Council's discussion who are the great and who are the ordinary human beings may be far less obvious." I wasn't trying to rest the entire argument for equal human dignity on that but simply to begin to reflect on the significance of a kind of democratizing of that concept that takes place.

I mean, the argument moves on from there.  It doesn't stop there.  So that I think you, careful reader though you are, abstracted that a bit from the flow of the argument and just let it stand on its own.

A second point, I don't know if you really want to argue theology or not, but if you would like a discussion of the concept of incarnation, we can have it.

Jesus is not thought to have the fullest humanity in any sense, whatever that might mean.  He's thought simply to have assumed our nature into God's own nature, the nature that we all share but not a fuller sense of it in any way.  So that, I mean, I don't think that's right.

The Kierkegaard stuff, the neighbor for Kierkegaard is anyone whom you may encounter.  And, therefore, if you rush into the burning house next door thinking to save someone whom you really like who is, of course, your neighbor most fundamentally because the most fundamental category is neither friend nor foe but neighbor, you rush in, save someone whom you really like, drag the person out to safety, only to discover that it's someone you have never met or someone you hate, Kierkegaard says in the most basic sense you have made no mistake.  You ran in there to save your neighbor.  You saved him.  And I think that's true.

That doesn't mean that friend or foe distinctions make no difference at all in life.  It doesn't mean — I mean, you raised the issue of combat, for instance.  We may, alas, find ourselves in circumstances where the needs and the claims of several neighbors seem to stand in conflict with each other and we have to decide whether there is any way to serve the needs of any of those neighbors at all there.

Many people, myself included, have been drawn to some form of just war thinking in those circumstances.  I mean, even the neighbor against whom you turn has certain claims on you.  There are certain things you can't do at that point.  But it's an attempt to find a way through that sort of conflict between the claims of neighbors.

There have been some people, of course, who have thought that you just shouldn't do anything.  I don't myself think that, but I think that what one seeks there is — I mean, when the claims of several neighbors conflict, justice is what one tries as best one can to do in sort of defending not oneself but some other neighbor who is in need.

And then, finally, on the kind of, really, I think larger — the issue that is really at the heart of what you say, well, you know, I like to honor the founders, too, but I do not bend the knee before them.

The American tradition is larger than what the founders alone had to say.  There was a tradition here before 1776.  And that larger tradition, which has continued to be mined, as you surely know, by political theorists since then — I mean, think of Cary McWilliams' idea for eternity in America, for instance — would suggest that there's a whole lot more to our tradition than simply that language of rights that in the context of struggle for independence came to the fore.

But the larger issue here for me would be that, I mean, I'm not sure what the thrust of your appeal to confine ourselves to the language of rights is.  For better or worse, we happen to have used dignity, as I think — I mean, whatever you think of my particular claims, I mean, I tried to sort through the material we used in order to say things we wanted to say about the nature of human action and how it relates to enhancement and about human procreation and so forth.  We didn't find the language of rights sufficient to do that.

I point to some examples of this along the way.  And I guess before I took that back, I would need to see an argument that suggested that the language of rights could accomplish what we tried to accomplish and what I would still think is important to accomplish.

So that, you know, as I say, the things that we did in Beyond Therapy and The Cloning Report seemed to me to at certain places make use of that language in important ways that probably can't just be duplicated by rights language.  And it's, therefore, language we need to say if we want to say everything that we need to say.  That would be what I would say.

PROF. SCHAUB:  Yes.  Just very quickly to that, I don't think I was arguing for a return exclusively to rights language but, rather, a combination of equal rights and earned dignity so that when it comes to these issues sort of at the beginning of life and at the end of life, I really do think that the rights language may be sufficient.

And it was revealing to me that where the dignity language really becomes more appropriate is in the Beyond Therapy report and especially in the section on performance when you're talking about, you know, the essential dignity of human action.  That's why I had no quarrel with the section of the paper that dealt with the anthropology.  That all seemed to me very fine.

PROF. MEILAENDER:  I would just note that it is not the only place where we — I mean, the Taking Care volume uses it also.  And it's not that kind of anthropological principle at work there.

PROF. SCHAUB:  I am just saying I think it is more appropriate in that one context than in the other context.

DR. PELLEGRINO:  Thank you both.

We will now open the discussion to other members of the Council, not necessarily on these papers, on any of the papers in the anthology.  Dr. George, I saw your hand first.

PROF. GEORGE:Thank you, Dr. Pellegrino.

Gil, I think that there are two beliefs that are the glories of our civilization and central to our political self-understanding, our national political self-understanding:  the belief in the inherent dignity of the human person and the belief in the equal dignity of all human beings.

Now, as I say, those are glories of our civilization, but they are also problematic and puzzling and difficult to explain because we know of the profound differences between persons.  And we know that there are some persons who are in severely debilitated conditions with respect to those very features of our humanity, which seem so central to its dignity and its specialness.  And so we struggle to make the argument in defense of inherent and equal dignity.

Now, it seems to me that there are two ways of making the argument.  I don't think they are incompatible.  And at the end of this, I'm going to ask you the question whether they're incompatible and we have to choose.

One way is to make it the way I think you are making it, drawing on the great moral theologian Oliver O'Donovan, among others, where one is arguing from the theological proposition that there is a God and that man is made in his image and likeness to the conclusion that man, therefore, bears an inherent dignity and all men have an equal dignity, equal share.

The other way goes in the opposite direction.  It is to observe that human beings as possessors of the God-like powers of reason and freedom, literally awesome powers, that are traditionally associated with divinity have a basic dignity, an inherent dignity, and that since all human beings possess, in at least radical root form from the beginning to the end, this basic natural capacity, — it may be blocked in the case of a severely debilitated, congenitally debilitated, person or something like that, it might be locked, but, nevertheless, at least in radical form, it's there — we acknowledge that people have inherent dignity, we're all equal.  And then we raise the question, well, how can it be that we material creatures possess these powers that are not even reducible to material causes or so it's supposed?

Dennett would disagree with this, but many of us would think that they're not reducible and a complete account can't be given in purely materialistic, reductive terms.  How can that be?

And then we ask whether it might be in virtue of a more than merely human ground or source of these realities in the whole of the intelligible order, which has given us some share, limited to be sure, and fallible, but some share, in those powers of reason and freedom, those divine, awesome powers, the powers that are at the heart of our dignity.

And so in the second way of arguing, the argument is not from God but, rather, to God.  You might put it this way.  And I'll conclude.  What does it mean to say, as the Bible says, that man is made in the image and likeness of God?  It obviously doesn't mean that God has two hands and five fingers on each hand and so forth.  Doesn't it mean that man possesses in limited form but, nevertheless, really these God-like powers, that God has made man in his image and likeness by giving him a sharing in these divine powers of reason and freedom, so that you can say it in theological terms and quote Genesis or say the same thing in philosophical terms that don't divert to the theological question but are not incompatible with it or are they?

PROF. MEILAENDER:  I'm moved to reflect again what an unusual government body this is.


PROF. MEILAENDER:  And I apologize for whatever responsibility I bear for that fact.


PROF. MEILAENDER:  Let me ask you one question before I try to answer.  Would I be right in assuming that you are more drawn to the second of those two styles of argument?

PROF. GEORGE:Only by temperament.


PROF. GEORGE:So that I would say I'm not saying that one is more legitimate than the other or more compelling than the other.  Floyd is a scientist.  Janet is a scientist.  I do legal philosophy.  I am more inclined toward philosophical things.

I think theologians are wonderful people and so forth and so on.  And I am happy to see them do business their way the way I am happy to see Floyd and Janet practice their crafts.  But by temperament, I do it the other way.

What I am really interested in asserting unless I'm wrong, in which case I want to be corrected, is that they're not incompatible.

PROF. MEILAENDER:  Okay.  No.  That's fine.  Well, you know me.  I let 1,000 flowers bloom.  And I have no objection to working in either direction.  And I do think that they are in principle compatible, though I probably have less confidence in how well the second route will work than you may have.

And I think, just as a matter of fact, that the concept of the image of God is a really muddy concept, both biblically and in the sort of history of theological reflection on it.  I mean, it's just not clear anybody knows for sure what it means.  So that in terms of the steps by which you have proceeded there, I mean, I think they would be complicated.

I probably in this paper proceed a little bit in the other way because there is a certain point where it seems to me it's useful, rather than thinking of religious folk as always on the defensive and having to make the case for saying anything about what they believe in public discussions about matters like biotechnological concerns, it seemed to me useful to say, "Well, for better or worse, these religious folk have got a reason to affirm something that most of us claim we want to affirm, the equal dignity of human beings.  And, you know, if you want to affirm that and you don't share that reason, well, then, you know, come up with another one."

It's not that I object to somebody coming up with other ones, though I'm inclined to doubt that there are just a lot of them floating around that will be successful.

But, I mean, I was concerned to make the point that this has functioned as a kind of ground for that view and has a certain kind of legitimacy to function that way in our discussions.

But certainly I don't expect everybody to want to start with theological premises.  I understand that.  And if one can provide a kind of reasoned argument that gets to the same place, I am happy.

You know, I take my friends wherever I can find them in life.  It's not easy.  And, you know, I am happy to get support from wherever it comes.

DR. PELLEGRINO:  Thank you, Gil.


DR. KASS:  Thank you.

I am really in a way reluctant to enter after these really very eloquent and carefully prepared responses, you know, two by assignment and then this stunning and I think very powerful critique, Gil.  But let me say something about your paper.

I think it has done an enormous service by going through the work of the Council's previous reports and shining your bright light on acknowledging the conceptual difficulties and even confusions that sometimes emerge if you sort of took the various places where these placeholders sit for certain notions and to call attention to the central difficulties of the concepts and the not always fully clear use that we have made of them in those reports while at the same time defending the necessity of using such notions in those particular places where nothing else would seem to do.

Second, I think it's a great contribution to call attention to the insufficiency of simply laying down along side by side some notion of the dignity of full flourishing and some notion of the equal dignity independent of flourishing.

You can say you were in favor of both, but if you simply are doing that, you haven't really articulated their relation.  And it is I think an ongoing challenge for those of us who I think without self-contradiction — and Diana has given a wonderful example in the person of Lincoln and the kind of sympathies that we can have for that.  It's not a contradiction.

And, nevertheless, I think that it's incumbent upon us to try to give an account of how the first and the second are related, the second is related to the first.  And I took that to be, really, my assignment in struggling with this for the paper, which belatedly came to all of you only recently.

I can't resist.  This is as an aside and not for comment.  The title of the paper is "Explicating the Council's Vision."  And, for the record, I would simply say it's one man's explication of the vision insofar as it's there.

And to the extent to which my own personal views are analyzed in this particular paper, every author complains that he or she has been misunderstood.  And I concede that one contributes to such misunderstanding.  I'll simply say on the personal side let my own essay be an attempt to deal with what I take to be the not quite accurate presentation.

On the substance, you talk about in a certain mood we feel a certain inclination to think this way, that there are certain temptations that we might feel to make judgments about the lives that people live or whether they are degrading themselves or are somehow demonstrating certain qualities that we admire.

I don't think that you would want to say of Thomas Aquinas that his argument about dignity was based upon his being in a certain mood or he yielded to a temptation to which he should not have yielded when he made that comment that you quote.

There are philosophical reasons.  Diana has done a really nice job.  Peter has done a nice job, I think, for talking about the virtue component.  And that leads me to the second argument, and I have done something of this in my current paper.

I think you're mistaken to say the essence of the notion of the dignity of a virtue, let us say, or of good deeds — and they are good deeds in the small — is that they are comparative.  It's only accidentally that these are comparative.

If every single human being behaved courageously, it would still be dignified, even if there were no inequalities.  And I think that you do not have to embrace inequality in order to recognize the excellence.  What you're measuring are the deeds of human beings against the standard of worthiness, not compared to one another.

The sports example is comparative necessarily because there are winners and losers.  The virtue example is only accidentally comparative, would that there were less grounds for making that comparisons and people lived up to the standard, but I don't think that you have to somehow fear that because unavoidably we will wind up saying certain people are vicious, that the judgment of virtue depends upon one person being better than another.

I guess I don't want to go on much longer.  Well, two more comments.  I do think that there is a real fear that if you begin down the road of acknowledging the dignity of a virtue of flourishing, that you might be put in a position of making invidious judgments at the edges of life, when nobody wants to do them or at least decent people shouldn't do them.  And if your concern is about the death and dispatching question, then the equality principle is absolutely crucial.

On the other hand, if your major worry is about degradation, dehumanization of the sort that several people have spoken about, it will not do simply to make a plug for the principle of equality because one could be equally debased and not know it.

So I think depending upon which part of this bioethical discussion you're most worried about or which is most on the table, these two different notions deserve a place.

And then, finally, — and I don't endorse either of the two alternatives that Robby has given us.  It seems to me that I don't think there's a word that has been written in any of the documents that this Council has produced that depend for their arguments on human dignity on any particular theological view.

It might be that as individuals, that we come to these things, but we have tried to have these discussions in terms of arguments and persuade one another on the basis of a kind of public reason, nor do I think that there is any notion about the dignity that has been discussed here that rests upon a metaphysics of the immortal human soul.

You might want to suspect some people of believing that.  For the record, I am not one of them.  So I don't think that — we have tried to sort of start with human phenomena.  We don't necessarily care whether it reaches to metaphysics or theology.

We're trying to appeal on the plane of the moral concerns that we now face in our practical decisions and as our life is unfolding under the new developments in biotechnology.

And it seems to me it's very important.  I mean, I don't mind.  In fact, I welcome the fact that the Christian thinkers don't hide their lights under a bushel.  I think that's very important.

On the other hand, if you want to say, "Look, the arguments for the equal dignity of human beings depends upon that teaching," we're, in effect, saying to other kinds of people, "Either you join the church or you can't defend yourself on this point."  And that it seems to me is not either the wise or sensible or I would say even the true way.

Part of the reasons we have rights language, there is a much older tradition in the West, but certain schisms in that tradition led the Thirty Years' War, in which people bloodied one another over who had the better account of the immortality of the soul.

DR. PELLEGRINO:  Thank you.

We have time for one or two more comments.  Janet?

DR. ROWLEY:  Well, I generally sit these discussions out because I feel so ill-prepared and then so shallow in any kind of comments that I might make or so.  "Untutored," I suppose, is a better word.

And following up on what Leon just said, I have always been impressed with what I consider the violations of human dignity that are committed in the name of religion.  So, you know, I think that religion, Christian, Muslim, Buddhist, whatever, has a lot to answer for in terms of violations of human dignity.

I think also that this Council has done — I'm not sure whether we have done some damage to what I would consider human dignity.  And I come back, and it's really too bad that Mike isn't here because I think his book The Ethical Brain and the discussion of ethics or altruism, as I can recall, — and it's a while since I read the book — being somewhat near to some of the aspects toward the end that Peter was getting at, that we really found as a society that we're a lot better if we behaved ethically and morally toward one another, however that is defined, than if we don't.

And the things that Floyd was talking about as to understanding where in the brain some of these impulses might actually be located makes it, if you will, a scientific, rather than a philosophical or a religious, question.

And so I'm concerned that we have often overridden reason and freedom in the name of dignity and said that my reason and freedom are defective or you have a right as an individual based on what you think human dignity requires to overrule what I might think because you're more right and my reason leads me in the wrong direction.

And I think that there is a certain hubris in your saying that your view of dignity requires certain action and my view of dignity leads to trampling some of these.  Your view of dignity can't trample my rights, my reason, my freedom, my autonomy because you're right and I'm wrong.  And I think that this is a real concern that this view can in itself lead to a trampling of human dignity.

DR. PELLEGRINO:  Thank you very much, Janet.

Just one more.  Paul?

DR. MCHUGH:  Well, I, like Janet, often find myself overwhelmed by my ignorance in these areas, but I do think that it's important to say some things from that interesting interface between science and art, namely medicine and its practice and what it means.

I'm going to turn back, actually, to Dr. Rowley in a minute to make my point.  And that point comes in a number of different ways.  But one of the things that I found great about our Council which has happened over this time has been this combination of our interest in what is basic and then what is expressed.

It's unique, I think, in Council work, that we both talked about the science and then published this book on what fundamentally were the expressions of the poets.

Our Council has worked in both of those arenas remarkably effectively and had very interesting conversations.  Leon's recent article on this speaks to that as he talks about the distinctions that he wants to draw between human beings and being human and then ingeniously brings them together in this wonderful circle of the circle of being, as it were and, therefore, evokes for me that wonderful phrase from a great poet, the Irish poet, William Butler Yeats, in that poem "Among the Schoolchildren," where he ends up with saying, "How do we know the dancer from the dance?"  And that speaks to what the dignity really is.

We hear about the material, and then we hear about what happens.  We don't find inspiration of Cal Ripken in the orthopedic clinic.  We find it on the field.  But we can help him if he gets into trouble.

Now, I want to come back to this issue that Professor Meilaender wants to dismiss, namely this image and likeness of God, because, in point of fact, I find that both as an Augustinian and as a contemporary person, a very important issue for us and for me.

I want to come back to Janet in this way because, first of all, Janet, although I agree with you that in religion we have caused lots of trouble, I wish it were only religious people that had caused a lot of trouble.

The real problems we get are what we believe.  Okay?  And in the Twentieth Century, did we stop believing in God and we caused 100 million deaths?  And we couldn't come close to that when we believed in God.  So it's what we believe and how we use our belief.

Now, I just want to tell you what I believe about what gives human beings their dignity because it's in their image and likeness to God.  And where do I get that?  How do I find it?  I find it in the Trinitarian conception of God.  I guess that's Christian.  I guess it's Christian.


DR. MCHUGH:  And how do I see it expressed, especially expressed, on a day I spent in a lecture hall at Hopkins listening to Janet?  Janet came and talked about her work and showed us what came of it and inspired our lecturer this morning.

The Trinitarian idea is that there are three things about human beings and three things that are in God.  One is the capacity, the executive capacity, for conceiving of something, conceiving something could be the father, if you will; the work of working it through and articulating one thing after another, the word, the Son, if you would; and, finally, the inspiration given to others and inspiring us by seeing it.  All of these were done by Janet.


DR. MCHUGH:  She conceived of this problem of the leukemia of these children.  She worked not just from finding the chromosome but then worked out the molecular details.  And it was a hell of a lot of work.  And she showed us all the various people that had contributed to it.

But then at the end, we realized together what this journey meant for us, what it did in dignity to give us cures for these children but not simply that practical and, as our friend showed us today, the loss of death, but simply the sense that this experience, this expression of a human being in action, you know, for me, it just filled my heart and filled the room in my opinion with everything.

So I am interested in expressing what I mean by human dignity in this Trinitarian expression, where we can see it, where we can see it in action, where we can — I don't want to say worship it at this level but certainly celebrate it.  I mean, I celebrated that day.  And I still remember it, of course.  And I could tell the dancer from the dance.

And it's in that arena that our Council has spoken about dignity in action.  Leon speaks about it today.  We have heard about it from Gil and everything.  And I come down to thinking it's Christian.

DR. PELLEGRINO:  Thank you very much, Paul.

Let me again say to Council members I hope relative to this discussion and looking at the papers, that you will be inspired to write your own comments.  I know that Adam Schulman will welcome them.

Indeed, Adam, would you like to say a word or two about where the volume is?  And I think that that will bring us to the conclusion of our meeting.

DR. SCHULMAN:  Yes.  I would just like to reiterate what Dr. Pellegrino said, that we still would welcome any submissions you would like to give in the form of comments to the essays that you have received.

We haven't received too many to date, but I do think that as the volume gets closer to completion and publication, it will be a much stronger and much more interesting product if it's not just a stand-alone collection of essays but includes as well your considered reactions and comments on these papers.  I think it will be a much more interesting thing for the public to read when it shows what the Council members made of these essays.

So as we are working on editing these essays and we're really fairly flexible about when you can submit these things; that is to say, even until fairly late in the editing process, there would be room for member comments on these essays.

So I encourage you if you haven't done so to think over the essays that you have ready.  And if there is one that particularly interests you, we would be delighted to receive commentary on it.

DR. PELLEGRINO:  Thank you very much, Adam.  Thank you for undertaking the task of putting the papers together into an anthology.


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