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Friday, March 7, 2008

Session 5: Human Dignity and Bioethics: Essays Commissioned by the President's Council on Bioethics

A Panel Discussion

Jean Bethke Elshtain , Ph.D. University of Chicago

Steven Pinker , Ph.D. Harvard University

Eva Brann , Ph.D. St. John's College

CHAIRMAN PELLEGRINO :   Welcome back.  We're ready for the last session of the current meeting, which will be devoted to the subject of human dignity.  And as many of you know and perhaps you have already seen, the Council has just published or put out a volume, an anthology on this very, very important subject.  The Council chose it, I think just briefly to say, because it has used the term "human dignity" in a number of its reports in a variety of ways, and many requests for a definition of what does the Council mean. 

I do not find a significant single or singular definition in the report, but you will see an anthology which covers the spectrum of opinions.  Dignity is, however, an inescapable concept in any discussion on bioethics, whatever you may think of it.  And I think this morning we have asked three people who we would very much like to hear on the topic with reference to the anthology or in whatever way they want to comment on its use in bioethics or generally, culturally, philosophically, or otherwise.

We will proceed as follows:  We will ask each of the panelists to present their response, the first being Dr. Jean Bethke Elshtain , followed by Steven Pinker , and lastly, Eva Brann .  The order is accidental and without any premeditation of number one, two, or three, and I think you'll appreciate that quickly when they speak.  I have asked them to present their comments, and then we'll have a general discussion by the Council members.  Without further ado, I'd like to ask Dr. Jean Bethke Elshtain of the University of Chicago to open the discussion.

PROF. ELSHTAIN :   Well, thank you very much, Dr. Pellegrino. 

Reading the fascinating material from the volume on human dignity, I was surprised to discover that a suggestion had been made, not by members of this Council—a suggestion they were responding to, or a number did, that human dignity is such a vague and porous notion we would do well to dispense with it altogether.

Now, many members of the Council, as well as authors commissioned to write essays for the volume, countered this suggestion, and I want to add my voice to this chorus by noting a simple fact:  we could not do away with the notion if we wanted to.  Only someone with his or her heads in the clouds of vaporous abstraction could argue that a potent evaluative notion that has been a central feature of discourse about human beings and human possibilities for centuries, ever more so in the last 60 years, might be removed by a person or commission or group that watches over our vocabularies.

A locution like "human dignity" troubles many because there is no knock-down definition to the term.  It generates debates; it doesn't settle them.  But that is true of what philosophers call essentially contested concepts, concepts that are powerfully descriptive and evaluative and that generate debates about how we are to understand and to apply them.  "Freedom" is such a word.  "Justice" is such a word.  The notion of human dignity is one of those contested concepts.  We cannot do without them, and it is pointless to make such an attempt.  This is also an argument that was advanced in the volume by Mr. Sulmasy.

Now, human dignity has entered our political and ethical vocabularies with increasing urgency over the past 60 years, and I think we know why that is:  two murderous wars in the twentieth century embroiling the West and beyond; gulags and death camps; the radical misuse of both genetics as eugenics and technology in the twentieth century totalitarian systems.

All of these horrific events remind us of what can happen when human dignity is negated or forsworn.  And I should tell you these events have been much on my mind the last few months because I'm teaching a graduate course this term at the University of Chicago called "Politics, Ethics, and Terror," in which we read the writings of three great Europeans,   Hannah Arendt, the anti-Nazi German theologian Dietrich Bonhoeffer, and Albert Camus, and their responses to twentieth century totalitarianism.  And each of them advances the notion of human dignity and talks about its violation in recalling those events or discussing or engaging those issues.

Now, let me offer a few other reminders of that era.  The great theologian, Paul Tillich , made 100 broadcasts into Nazi Germany during World War II over Radio Free Europe.  The theme of human dignity surfaced repeatedly in these messages.  These were essentially sermons to those who claimed to be German Christians. 

In a radio broadcast from May 11, 1942 , Tillich proclaimed:  "Whoever has been deprived of rights has become a thing with which one can do what one desires.  He has lost his dignity.  He has become an instrument for strange ends, a slave of tyrants, a tool of arbitrariness, an object of violation.  Your rights are the acknowledgement that you are a person, that you have a dignity that is inviolable, that you are a uniquely irreplaceable self."

Then came the moment a year after the war ended when a young French writer, then 33 years of age, addressed a packed audience of college students at Columbia University .  Albert Camus , himself an unbeliever, told the American young people that he wanted to convey to them the horror and shame his generation of Europeans had just passed through.  He wanted to characterize as precisely and as accurately as he could the crisis of world dimensions then at hand. 

In order to do this, he offered four brief vignettes.  Now, there's no time, obviously, to read all four, but let me repeat just one in Camus ' words:  "In Greece , after an action by underground forces, a German officer is preparing to shoot three brothers he has taken as hostages.  The old mother of the three begs for mercy, and he consents to spare one of her sons but on the condition that she herself designate which one.  When she is unable to decide, the soldiers get ready to fire.  At last she chooses the eldest because he has a family dependent on him, but by the same token she condemns her other two sons, as the German officer intended."

Now, what matters now, Camus concludes, is not, it seems, whether one spares a mother suffering or upholds human dignity, but whether one helps an ideology to triumph.  Now, one of the symptoms of the crisis that Camus goes on to describe in light of these vignettes is, in his terms, the perversion of values that judges a person or a historical force "not in terms"—these are his words—"of human dignity but in terms of efficiency and success." 

And then he continues, "If nothing is true or false, good or bad, if the only value is that of efficiency, that is to say, the strongest, the world is then no longer divided into just and unjust but into masters and slaves, and he is right is he who dominates."  And in such a world the term, he continues, "human dignity" no longer figures.  It has been cast out.

Now, in his brilliant philosophical essay The Rebel , Camus plies this theme further.  His essay, he tells us, is the story of European, we might say, Western pride, and it is pride, superbia, that invites nihilism and the will to power. 

Human dignity, by contrast, is all about limits—the articulation of limits to what one does or should do even if one can do it.  Can we articulate such limits, Camus asked, in a world—this was his haunting dilemma—in a world stripped of God or any transcendent reference point. 

If we can't, he says, we're really doomed.  He believes that that belief in God is fading and, indeed, that the possibility of people agreeing that there is some transcendent point of value is also diminishing, so we've got to find another basis, argues Camus.  That was his challenge.  And he says if we cannot respect and articulate "a dignity common to all men," we are, indeed, on the downward slope.

Now, with these searing reminders of the twentieth century in mind, let me throw down the gauntlet, so to speak, cast in the form of a query.  Has anything good ever come from denying or constricting human dignity?  I can think of one horror after another in recent history— you'll forgive me for bringing up one more example from this era.  As I said, it's much on my mind—including the National Socialist euthanasia program that murdered children and adults with disabilities, mental and physical, by the tens of thousands, that flowed directly from constricting human dignity, from reading whole categories of persons out of the moral community. 

Now, the definitive study of this program raises questions about how and why such a thing could come about, and the author, historian Michael Burleigh , attributes it to a post- and anti-Christian and illiberal ideology that entered into and dominated the thoughts of a sufficient number of people that the National Socialists thought they could move forward. 

And they were, as many of you know, aided and abetted in this effort, given the prior publication of an essay by two doctors, Karl Binding and Alfred Hoche , on life unworthy of life.  And the argument in that essay was that some lives have a negative value.  The argument relied on a positivistic theory of law, that is, one does away altogether with any notion of a higher law or a natural law that might check human ambition, if you will, and embraces law as the will of a particular community, the Volksgemeinschaft in this case, or, more properly, in this regime, the inner will of the Fuhrer that was itself the expression of the will of the German people. 

Those who could not be striving, sovereign selves, which was the ideal, are a threat to those sovereign selves for a number of reasons:  they allegedly weaken the gene pool, and they create a burden on the strong.  And if and when the weak burden the strong, the weak in this ideology must die. 

So we see here a fusion of crude materialistic arguments, both economistic and Darwinian, with Darwin 's theory turned into a social ideology.  And then utilitarianism is thrown in for good measure—the greatest good for the greatest number.  And that contributed to this Weltanschauung that led to the deaths through planned starvation, which was mostly used against the infants and children, and lethal injection of minimally 200,000 upwards, maybe 400,000 persons with disabilities. 

Now, everyone recognizes in these sorts of things that we hope are safely ensconced in the past a massive crude violation of something, and that something we tend to call human dignity.  Is it possible that attacks on human dignity can also creep up on cats' paws in the name of eliminating suffering?  Although that was one of the arguments, interestingly enough, that was made in Nationalist Socialist propaganda, too:  "We're kind people.  We're eliminating suffering."

Fast-forward to March 2005.   The New England Journal of Medicine published an essay on euthanasia for newborns, printing up the Groningen —I'm not saying it quite the way the doctors say it, but a city in—it's impossible to pronounce it the way they pronounce it—Groningen Protocol for such procedures.  The New York Times Magazine , July 10, 2005 , reprinted those protocols under the heading, "Euthanasia for Babies:  Is this humane or barbaric?" 

Now, I suspect that all of us know that the average reader of The New York Times prefers the humane alternative, and the humane course, it perhaps will not surprise you, favors infanticide if the correct procedures are followed.  Euthanasia of newborns, under such circumstances, we are told, is the way of reason.  And those who say we shouldn't cross that line advance the way of "sentiment," a.k.a. unreason. 

Now, the essayist Jim Holt asks his readers to imagine a heated dining room table argument about this issue.  The way of reason requires unflinching honesty.  By contrast, moral sentiments are inertial, resisting the force of moral reasons.  And the essay concludes in this way:  "Just quote Verhagen"—Verhagen is the Dutch doctor who worked up the protocols.  Just quote his "description of the medically induced deaths"—and you'll notice the sort of euphemistic way of putting it—"over which he has presided."  And these are the words of Dr. Verhagen :  "It's beautiful, in a way.  It is after they die that you see them relaxed for the first time."

Now, Holt claims that at this point even the most spirited dining room table conversation about moral progress will fall silent.  He imagines the hushed atmosphere as one in which the diners are overwhelmed by the vision of peace at last for deformed or handicapped infants.  But I suspect that many would fall silent from the claim—the shocking claim—that we must give these perturbed spirits some peace at least by killing them.

Now, Holt insists that brutal candor—"I'm killing them, and it's the right thing to do"—is the ethically preferred route rather than the much more complex approach that might say, "Permit multipli-handicapped infants to die rather than using sustained heroic measures to keep them alive if that's what's required."  This latter course is presented as "casuistic confusion."  So any course that reflects moral uneasiness is confused and dishonest, and any course that makes it easier for medical personnel to kill is honest and reasoned.

Now, what does all this have to do with the Council and its work and the volume that we were given to read?  Very interesting volume, too.   If I haven't said that already, I should say that now.  So let me go over some possibilities with the assistance of C.S. Lewis ' prescient essay, "The Abolition of Man."  I bring it forward in part because a number of the essayists refer to it. 

Now, from the human dignity volume I read from the essay by Daniel C. Dennett the following:  "The psychologist Philip Tetlock identifies values as sacred when they are so important to those who hold them that the very act of considering them is offensive."  Now, you'll notice there's nothing about—no consideration of the truth claims of such a statement.  It's a statement about the emotional state of the speaker. 

Now, this is sheer emotivism.  What is emotivism?  It's the insistence that all statements of value, all normative claims, reduce to subjective feelings.  That is, there's no truth warrant, no cognitive basis for these arguments.  It's the sentiments as opposed to reason of which The New York Times article speaks.  And Lewis sums up emotivism in this way:  First—firstly, in his language, that all sentences containing a predicate of values are statements about the emotional state of the speaker and secondly, that all such statements are unimportant.

Now, for Lewis , when powerful ordinary human feelings and responses are set up as contrary to reason, we are on dangerous ground, indeed.  For a botched treatment, he tells us, of some basic fundamental human emotion is not only bad literature, which is one of his major concerns, but is moral treachery to boot. 

And he goes on to argue that one must not traffic in a false distinction between reason and emotion, rationality and sentiment.  That's the sort of positivistic emotivist approach to these things.  And in the regnant positivism and emotivism—in that epistemology, "the world of facts without one trace of value and the world of feelings without one trace of truth or falsehood, justice or injustice, confront one another and no rapprochement is possible.  It is all a ghastly simplicity."  That's the end of the quote.

And in such a universe, unsurprisingly, everything has a price rather than an intrinsic value or dignity, and those who promulgate such views, Lewis tells us, who debunk what they consider these traditional or sentimental values "often have in the background values of their own which they believe to be immune from the debunking process."

So with that in mind I would ask us to consider the claim in the volume by Ms. Churchland with Lewis ' argument in mind.  And at one point in her essay she says the following:  "I predict that those who today are morally opposed to embryonic stem cell research will fall silent once the clear medical benefits begin to emerge." 

Now, this is a surprising statement for many reasons.  It suggests first that principled moral opposition can be erased by cumulative instrumental benefits, now entirely hypothetical, and, second, that good itself is located in a future state of affairs and that this hypothetical future state of affairs trumps any harms in the present. 

Now, this is the stance, interestingly enough, that Albert Camus condemned in The Rebel :  those who believe anything goes in the present because of some alleged future state or benefit that will eventuate if only certain pesky groups are removed or certain voices of opposition are silenced.  And Ms. Churchland clearly finds voices of opposition an unpleasant vexation, even to the point of accusing moral opponents of, in one example she brings forward, favoring misery and death over the salutary benefits of—her example is mass vaccinations against human papilloma virus, which she equates to the smallpox virus.

Now, her example—I'm not an expert on the human papilloma virus and inoculations against it, but the example implicates her in a set of background values, obviously, that she doesn't bring to the surface for a debate, a set of assumptions about human beings and human behavior, the behavior of young women, including adolescent girls.  The assumption is they're going to have multiple sexual partners—I do mean multiple—before marriage and possibly after. 

To the best of my knowledge—she compares it to the smallpox vaccination—there were no behavior correlates to smallpox as there are to the spread of the human papilloma virus.  But the assumption is we can do nothing about human behavior.  In fact, we simply have to assume certain things about it, but that's not brought forward for examination. 

So what's interesting here is that often those that decry the moral certitude of their opponents who are strong moral evaluators, in the philosopher Charles Taylor 's terms, themselves are guilty of unyielding certitude that manifests itself often in not taking seriously the arguments of those they oppose or in diminishing the views of those they oppose.  Those folks favor misery or death, for example.  Another example I found in the volume of this was from Prof. Nussbaum 's essay where she claims that embryonic stem cell research involves nothing more than an indiscriminate "clump of cells."  And this has nothing to do with human dignity and its violation.  Now, I think I'm right that no serious fetologist or scientist would describe an embryo as just an indiscriminate clump of cells.  That would be a misdescription of what's going on there, but if you describe it in that way, again, it's easier to diminish any possible counterargument.

Now, as I move to the concluding section, let me turn to how we articulate limits to violations of human dignity and bring forward three essays in the volume.  Leon Kass , whom I respect enormously and with whom I'm usually in agreement or often in agreement, makes a move in his essay in the volume that I cannot take with him.  Namely, he distinguishes between the basic dignity of all human beings and the full dignity of being actively human or human flourishing.  Now, why do I find this a potentially troubling move?  Because it doesn't take much imagination, those of us who are familiar with the history of the twentieth century, to conjure up scenarios in which those possessing full dignity pass judgment on those of basic dignity as having a lesser dignity and go on to act accordingly. 

Now, Dr. Kass resists this strenuously, of course.  In medicine he says the ethical focus has to be on equal worth and dignity.  No life is worthier than any other, and under no circumstances should we look upon a fellow human being as if he had a life unworthy of life.  So all human beings should be treated as if they had full and equal dignity, and the burden is on those who think otherwise, which leads me to wonder why—create a situation rhetorically, if you will, where such possibilities might more likely emerge. 

What is one to do if one has been declared unequal?  According to Kass, I must then assert my human dignity.  And this he calls rhetorically effective but not metaphysically based.  And I wondered if this was altogether reassuring.  It's certainly not reassuring to those who cannot rhetorically assert their dignity, and I was thinking as I read this also of Hannah Arendt's discussion in On Totalitarianism about what happens to those are first stripped of their civic standing and identity and then the fact that they can assert their basic human rights until they're blue in the face and it means very, very little unless there is a political regime or government that will acknowledge that and enforce it.

Where else to turn?  Very briefly, to the essays by Father Neuhaus and Prof. Meilaender .   Neuhaus argues in a very augustinian vein that our focus on human dignity should be on those most subject to having their dignity violated, that our focus should be there under the "do no harm" norm.  Too often nowadays, he avers, bioethics is an industry for "the production of rationalized permission slips" as scientific and technological imperatives are joined to wealth. 

As an alternative, Neuhaus lifts up politics, amazingly enough, people debating how we are to order our life together.  And, inescapably, the question of limit as to what we are permitted to do is a political question, and we cannot remove fraught moral matters, as Ms. Churchland seems to want to do, from political debate.  That is, a small group of experts alone can't make these decisions.  The dignity of the human person is not primarily, Neuhaus concludes, about asserting the rights of the autonomous will but as an obligation to protect those whose autonomy is very limited.

And Professor Meilaender, who's here and can certainly speak for himself, seems to me correct in arguing that once you introduce distinctions of merit and excellence as affording the full measure of human dignity, you begin to sort of subtly undermine the egalitarian ideal of human dignity, and it is, of course, this idea that has underwritten and been absorbed into universal claims of human rights in the post-World War II era.  All you have to do is go to the UDHR, the Universal Declaration of Human Rights, and you'll see that immediately. 

So this raises a very serious question, it seems to me, as to whether those who do not share this account can sustain a robust regime of human rights, most critically of the negative variety—you can't do these kinds of things to people.  This is what you're not permitted to do.

Now, I want to conclude with a claim from Prof. Nussbaum's essay—and I hesitated about bringing this forward, but what Dr. Hurlbut had to say in the last session helped me to screw my courage to the sticking point, so I'm going to do it—about a child with disabilities.  So I want to bring this forward because I think it's illustrative.  It's a personal story, but it's illustrative of a more general set of concerns.

It's a claim from Prof. Nussbaum 's essay.  It's not argued; it's just stated, that we should not accord "equal dignity to a person in a persistent vegetative state or to an anencephalic child, since it would appear there is no striving there, no reaching out for functioning." 

Now, I confess I really don't know what "reaching out for functioning" means, exactly, but I do know the following, and this is the story:  In 2003 the 18-year-old son of one of my cousins died.  This young man was supposed to have died much before that.  He was born anencephalic.  He could never speak, couldn't feed himself, couldn't crawl, couldn't walk, couldn't do any of the things that normal human beings generally do or learn to do.  So I suppose there was no striving there, in a sense.  Prof. Nussbaum says we should not accord him dignity, full human status.  And for Peter Singer , certainly, Aaron would have been—for that was his name—would have been a prime candidate for euthanizing.

But to anyone who met him, Aaron was a beautiful child with the biggest blue eyes and the most striking dark eyelashes imaginable.  He stared out at the world, making no apparent distinctions, until his mother, my cousin, came into view.  And then—and I don't know any other way to describe this—something would happen.  His face would beam.  It would light up.  I don't know how else to put it.  Something was going on there, some type of recognition.  I would defy anyone to claim otherwise.  And certainly her love and care and devotion kept him going for 18 years.  And when he died, an entire family, his parents, sibling, grandparents, aunts, uncles, cousins, an entire community mourned their loss.

Now, the story of Aaron and Paula Jean is a story of human endurance, and I think it's also a story within my frame of reference of the receipt of the gift of grace.  But I would ask you to contrast it to the vision of peace promulgated by the euthanasia doctor who extols how beautiful are handicapped newborns who have been killed intentionally.

And I think this helps to set out in bold relief some contrasting possibilities, contrasting visions of our human future, because it's one in which human beings are certainly going to write some decisive chapters in whether we will abolish man in the sense of obliterating that dignity which is truly human and intrinsically ours or, by contrast, remember how to respect and to cherish our humanity, however weak and broken the forms in which it may appear among us.

Thank you.

CHAIRMAN PELLEGRINO :   Thank you very much, Prof. Elshtain .  Now I'll ask Dr. Steven Pinker of Harvard University to present his observation.

PROF. PINKER :   Thank you very much.  I'd like to begin by thanking the Council for inviting me to comment on this report.  I consider it a great honor, and I thank you for giving me the opportunity.

There's much to admire in the report on bioethics and dignity.  The essayists have clearly approached their tasks with great seriousness, as the topic deserves.  The papers show deep analysis of numerous issues and impressive philosophical and historical erudition.  Also, they are written in an admirably clear manner, something that coming from academia, I don't take for granted.

I'd also like to call attention to Adam Schulman 's superb introductory overview and to Dan Davis ' extremely useful historical perspective.  I think that anyone reading the volume will learn an enormous amount and be enlightened on many issues.

Nonetheless, the thrust of my remarks will be mainly critical.  I'll argue that the volume has not successfully fulfilled its mandate of "undertaking fundamental inquiry" or providing a forum for national discussion of bioethical issues.  Instead, I think the volume has been steered in particular directions by a steep over-representation of certain viewpoints and methods and outright exclusion of important contrary viewpoints.  And for that reason, I will argue that the volume has failed to offer an analysis of the concept of dignity that is useful in resolving debates on bioethics or in advising policy.

I will begin with a composition, and no one looking at the list of contributors can fail to notice that a majority of the contributors, 12 out of the 23, were selected from institutions with an explicitly Christian and, indeed, almost entirely Catholic mission statement, and that of the remaining 11 contributors, four are known for their advocacy of a greater role of religion in public life.

It's also conspicuous that the essayists did not include a single scientist, this on a topic inspired by scientific advances.  The essayists did not include any empirical scholar who studies the facts of human life—no psychologist, no social scientist, no historian, and hence, no one who could enlighten us on the psychological basis of ascriptions of dignity or how standards of dignity vary across cultures and historical periods.

Now, I think part of the motivation of the report was made admirably clear by Dr. Davis when he said on page 32 that the President's Council on Bioethics has a "critical view of contemporary academic bioethics and of the way bioethical questions are debated in the public square."  Well, that's okay, yet no mainstream academic bioethicist was invited to reply to this criticism or to defend the way bioethical questions are debated in the public square.  And, most importantly, most of the essays have as their foil—and we heard this this morning— Ruth Macklin and her essay, "Dignity is a Useless Concept." 

I noted in the index that there are 15 page references to Dr. Macklin , more than anyone else except Kant with 35, the Bible with 34, and Aristotle with 21.  Yet the volume does not have an essay by Dr. Macklin or anyone else who would defend her obviously important viewpoint.  Everyone else is replying to it.

Now, despite these exclusions of important viewpoints, the volume does manage to find room for seven essays that base their arguments on Judeo-Christian doctrines.  And we read in the volume of arguments that assume the existence of an immaterial soul separate from the brain, the divine authorship of the Bible, the literal truth of miraculous events narrated in Genesis such as a man living 900 years, the claim that the Old Testament is the only grounds for morality, that divine revelation is a source of truth. 

Now, to put it mildly, such claims are highly tendentious.  They would be extraordinary in just about any other government forum.  If they ever served as the basis of legislation, they would almost certainly violate the establishment clause of the First Amendment to the Constitution.  Yet aside from two paragraphs from Dennett there is no critical examination of these claims in the volume.

Now, I want to register my disquiet with the imbalance of the volume, but that is not the main point of my comments, which is to diagnose what I see as the failure of the volume to advance our collective understanding of the concept of dignity in bioethics.  And I will try to present an alternative conception that I think is defensible.

Let me begin at the beginning.  I think there is a backstory to the volume that is alluded to by Dr. Davis and by several of the other papers, which is as follows:  We in the democratic West are the beneficiaries of a fantastic success story in moral progress.  Beginning in the Enlightenment and accelerating since the end of the Second World War, a near consensus has developed on the centrality of human rights in the way we run our societies.  This concept goes by many names.  Human rights, respect for persons, and autonomy are three of the most prominent that are repeatedly mentioned in the volume.  And the idea roughly is that because all humans have an equivalent minimum capacity to suffer, to prosper, to reason, and to choose, no human may impinge on the life, the interests, or the freedom of another. 

I think it was well captured in a quote from John Stuart Mill that Dr. Davis reproduces, mainly, that liberty consists in framing the plan of our life to suit our own character, doing as we like subject to such consequences as may follow without impediment from our fellow creatures, so long as what we do does not harm them, even though they should think our conduct foolish, perverse, or wrong.

Now, I call this a fantastic success story because, among other things, it justifies most of our laws, like those against murder, assault, and rape.  It rules out the horrors that Dr. Elshtain alluded to, such as slavery, genocide, totalitarianism, and conquest.  It's the basis for the liberal democracy that we all enjoy.  And, most important, in the current context it rules out the obvious bioethical abuses that the late twentieth century's concern with bioethics tried to address.  It rules out the Mengele experiments.  It's rules out the Tuskegee syphilis study.  It rules out harmful experiments done on people without their consent.  And it justifies our most important bioethical practices, such as the demand for informed consent before experimental and medical procedures.

Now, crucially, these principles are not controversial.  There isn't anyone right now who will debate the justification of the Tuskegee syphilis experiment.  There is no one today who is going to say that it's all right to inject people with diseases to study how the disease progresses.  It shows that consensus in bioethics is possible, despite the fact that there are, indeed, some essentially contested concepts.  Enormous amount of consensus and progress is possible, and I believe that that is a standard that is appropriate to aim for.

Now, here's where the plot thickens.  A number of biomedical advances raise the possibility of opportunities that can reduce suffering, promote human flourishing, harm no sentient being, are freely and knowingly chosen, yet they elicit disquiet in third parties.  There are numerous examples brought up in the volume:  drugs that enhance cognitive functioning, anti-aging research that promises to extend the human lifespan, pre-implantation genetic diagnosis, somatic cell nuclear transfer, surrogacy, in vitro fertilization and other reproductive technologies, cloning, a market in organs for donation, and many others.

And it's no secret that many members of the Council are viscerally repelled by these prospects but realize that they can't rule them out with the consensus ethics of autonomy, human rights, or respect for persons.  Hence, we have the appeal to dignity.  The problem, of course, is that, for one thing, dignity is, as just about all the essays acknowledge, a squishy concept.  It has much of its basis in religious doctrine.  And for these two reasons, it has not provided the kind of consensus definition of the kind that would be necessary in a democracy.

I see the current volume as designed to put dignity on a firmer conceptual basis and therefore provide the grounds for regulating or banning these disquieting practices.  This, I believe, is the ultimate goal of the President's Council, and it's why I think there was a thumb on the scale in choosing the authorship of the reports. 

Nonetheless, despite this attempt, I think, as I said, that the volume does not succeed in providing a sound basis for dignity, and indeed, almost every essay notes that the concept remains ambiguous, slippery, and vague.  Indeed, it's a source of obvious contradictions, such as that—take the case of euthanasia.  Proponents of physician-assisted suicide and euthanasia say that it's okay because it promotes death with dignity.  Opponents say it's not okay because the deliberate termination of life violates dignity.  Dignity is invoked on both sides of the issue.

We read that slavery and other forms of degradation are morally wrong because they take someone's dignity away, but we also read that nothing you can do to a person can take his dignity away.  We read that dignity reflects excellence, striving, and nobility so that only some people achieve it by dint of effort and conscience, but we also read that everyone, no matter how lazy, evil, or mentally impaired, has dignity in full measure.  We read that disease and disability are tragic because they reduce dignity, but we also read that disease and disability are incapable of eliminating dignity.

So I think that the concept of dignity remains a conceptual mess, and a number of the essayists do make distinctions trying to clarify the concept, but I don't think any of them solves the problem.  Indeed, I'm going to argue that the situation is even worse than that because none of the essayists note three troubling features of dignity as the concept is ordinarily understood as the word "dignity" is used in conversation and writing, problems that make it a deeply unsatisfying basis for bioethics.

And the three troubling features are that dignity is relative, that dignity is fungible, and that dignity can be undesirable.  And, indeed, an undue emphasis on it can be immoral.  And let me go through those in turn.

First of all, dignity is relative.  Now, I want to emphasize that I am not a relativist.  I'm not a moral relativist.  I'm not a scientific relativist.  I'm not a psychological relativist.  I believe in a universal human nature.  But the brute fact is that ascriptions of dignity can radically vary.  They can vary across history.  As the song points out, "In olden days, a glimpse of stocking was looked on as something shocking." 

We laugh at the photographs of the Victorians and their starch collars and wool suits going for a walk in the woods on a sweltering day.  We smile at our grandparents who address even their best friends as Mr. and Mrs. So-and-So all out of a concern for dignity that we no longer share.  We know that dignity can vary across cultures, and we laugh at the aristocrats and brahmans of various societies who consider it beneath their dignity to pick up a dish or to diaper a baby.  We know that ascriptions of dignity can vary radically across individuals.

Dr. Kass , the former director of this Council, wrote an extended and eloquent discussion on how licking an ice-cream cone in public was deeply undignified.  Now, before reading this, it never occurred to me that anyone would find eating an ice-cream cone undignified.  Clearly, Prof. Kass and I have very different descriptions of dignity.  I just have no problem with it.

Secondly, dignity is fungible.  The President's Council treats dignity as an absolute sacred value.  The fact is that every one of us voluntarily, repeatedly, and happily relinquishes dignity all the time for other goods in life.  Getting out of a car is undignified.  Having sex is undignified.  Eating on the run, which all of us have to do as opposed to sitting down at a dining table in dignity, is undignified.  Any of us who got here from another city have suffered the indignity of having to take off our shoes and belts and have a wand put up our inseam to pass through airport security. 

And, most pointedly, medical procedures necessarily subjects us to all kinds of indignities.  Everyone in this room has—or I assume—undergone a rectal examination.  Many people have undergone pelvic examinations.  Those of us over 50 have undergone colonoscopies.  Needless to say, these are deeply undignified, and that's fine because we sacrifice dignity for other goods in life.

The third point is that dignity can be a bad thing, and Prof. Elshtain asked can any good ever come from denying or constricting human dignity, and the answer is an unambiguous yes.  For example, any third-world tinhorn dictator, bemedaled, sashed, epauletted, strutting on his reviewing platform solemnly reviewing the goose-stepping soldiers parading in front of him, is an epitome of human dignity.  That is not necessarily a good thing.

Political repression works by preserving a kind of dignity.  Those who ridicule or satirize or even criticize their political leaders are subject to imprison, torture, or death, justified in many cases by their assault on the dignity of the state or the leader.  Religious fanaticism is driven by an attempt to safeguard dignity, most appallingly in the recent story in Sudan where a British schoolteacher was imprisoned and threatened with death by an angry mob because she allowed her first-grade class to name a teddy bear Mohammed .  Likewise, the fatwah against Salman Rushdie , the death threats against the publishers of the Danish cartoons on Mohammed , were all justified by their assault on the dignity of religion.

An emphasis on dignity is the basis for cultures of honor for the practices of dueling, for example, that led to the demise of Alexander Hamilton where it was considered essential to defend your dignity by challenging to a duel anyone who would compromise it by criticizing your conduct.  The mafia code of Omerta is based on dignity.  The urban gang leader who kills someone who disses him is motivated by a concern for dignity.  And totalitarian societies are obsessed with dignity.  The identical uniforms in Maoist China, the cladding of women from head to toe in Afghanistan under the Taliban, the practice of female genital mutilation explicitly designed to eliminate the indignity of sexual desire in women—all of them are justified by an attempt to safeguard dignity.

Indeed, I would say that a foundation of democracies is that the right to dignity is extremely limited.  We enshrine a right to make fun of our political leaders.  You can turn on the TV set any night at 11:35 and watch Leno and Letterman and Jon Stewart reduce the dignity of our political candidates and leaders, and that is a good thing.

We allow people to be undignified in their own or others' eyes, and we don't allow the government to play a role in deciding "the vision of the good life" or "how to use freedom wisely," two quotes from the volume that were meant to be good things but which I've got to say send a chill down my spine.

Now, the price of allowing indignity is that we live in a society that has many things that many of us would rather not see.  I would be very happy if Britney Spears would go away.  I'd be very happy if “American Idol” were to go away.  But I tolerate these assaults on dignity because I believe that this kind of toleration is what makes this country great and what leads to the enormous benefits of Western democracy in general.  "My country, 'tis of thee, sweet land of liberty."

So does this mean that Ruth Macklin was right?  Is dignity a useless concept?  I would argue not quite.  The problem that I think she correctly identifies is that dignity is a feel-good word.  People invoke it to ennoble or exalt or, dare I say it, dignify whatever concept the speaker favors.  And this was a point made eloquently by Prof. Schaub .  And I think that's why it has so many contradictory meanings. 

In particular, it's used many times in this volume as a kind of warm and fuzzy synonym for the concept of personhood, autonomy, or bearer of rights that is the foundation for the moral consensus that I alluded to at the beginning.  And my recommendation is to stop it, that using the word dignity as a synonym for human rights adds nothing.  It confuses the issue. 

And, again, as Prof. Schaub points out, the Founders had no need to invoke the concept of dignity to justify the principles of American democracy.  Lincoln did not need to allude to it to oppose slavery.  Churchill did not need it to oppose Hitler .  We don't need the concept of dignity to argue that slavery or genocide are wrong.  And I think it's the casual invocation of dignity for anything that we favor that leads to obvious absurdities such as that slaves both do have dignity and don't have dignity. 

So does dignity have some precise meaning?  And I think the answer is yes.  A number of splitters among the essayists in this volume try to distinguish different kinds of dignity.  I think they get at the distinction obliquely.  None of them hits the nail on the head, that is, that dignity, as it is commonly understood, as people actually use the word dignity, is a perceptual phenomenon, namely, certain signals in the world trigger an attribution in a perceiver.  That's what I mean by a perceptual phenomenon.

So just as converging lines in perspective are a trigger for the perception of depth, just as differences in sound volume between the ears is a trigger for the perception of position, certain features in another human being are a trigger for ascriptions of worthiness.  These include signs of self-control, of control over the immediate physical environment, of composure, of cleanliness, of competence, of maturity, and of a certain physical but nonsexual attractiveness. 

Moreover, dignity is a stimulus that elicits certain emotional and behavioral responses in perceivers.  It's what psychologists call an affordance.  Just as the smell of baking bread triggers a desire to eat it, just as the sight of a child's face triggers a desire to protect it and cherish it, just as the sound of an infectious rhythm triggers a desire to move to it, so the appearance of dignity triggers a desire to esteem and respect the person.

I think this account explains why dignity, in fact, is morally significant, that we should not take lightly a phenomenon that causes one person to respect the rights and interests of another.  But it also explains why dignity is relative, why it's fungible, and why it's often undesirable, namely, dignity is the sizzle, not the steak.  It's the cover, not the book.  It is skin deep.  What matters is respect for the person, not the superficial signs that trigger it.  And, hence, there is the possibility of dignity illusions, signs of dignity without the actual merit, as in the tinhorn dictator, and merit without the signs that ordinarily trigger it, as in the degraded slave.

So what is it that makes dignity morally useful?  I think there are two considerations which we can call first-person dignity and third-person dignity.  First-person dignity consists in the fact that, all things being equal, people like dignity.  They like to be dignified.  It's among the interests of a person that we are obligated to respect.  I don't like someone stomping on my toe.  I also don't like someone throwing a pie in my face or pulling my pants down. 

The desire for dignity, hence, is among the interests that, all things being equal, we respect in other people.  This has an obvious application to biomedicine in considerations about the dignity of patients.  I think the excellent discussions by Drs. Dresser and Pellegrino on how the dignity of patients is often needlessly compromised is an excellent example of that, and I wholeheartedly applaud that concern for dignity. 

Note, though, that this use of dignity is not controversial.  No one makes a moral argument saying that it's okay to subject patients to unnecessary, humiliating treatment.  The battle that Profs. Dresser and Pellegrino are fighting are battles against thoughtlessness, against callousness, against inertia.  They don't represent a clash of moral systems, and that's another reminder that despite the essentially contested nature of certain concepts, consensus in bioethics is possible and worth striving for.  And I suspect that if Prof. Macklin were given the opportunity to comment, she would agree fully that dignity is useful in that particular context.

Then there's third-person dignity, namely, do certain cases of reduced dignity produce in perceivers a contraction in empathy, a hardening of their hearts that leads to a reduction in their respect for persons?  I think that is worth taking seriously.  It conforms with the famous quote from Macaulay that the Puritan hated bear-baiting, not because it gave pain to the bear but because it gave pleasure to the spectators.

Now, can this happen?  And the answer is   a clear yes.  I think history teaches us that when certain people are degraded and humiliated against their will, it can elicit callousness and mistreatment on the part of onlookers:  the yellow armbands the Jews were forced to wear in Nazi Europe, the dunce caps and awkward clothing and ugly haircuts that political prisoners in Maoist China and other countries were forced to endure, which elicited throwing of stones and mistreatment.  Keeping people in squalid conditions we know can reduce dignity and elicit mistreatment.  In fact, we know it from a laboratory study. 

The famous Stanford prison experiment consisted of subjecting some of the participants to degrading situations.  They were forced to wear nylon stockings on their head, to walk around in awkward robes barefoot, and the other subjects in the experiment very quickly subjected them to humiliating mistreatment. 

Note, however, that all of these cases involve coercion.  And, indeed, all of them are ruled out by the principle of autonomy, human rights, and respect for persons.  So even in a case where dignity is part of a causal process, it actually is not necessary to rule out that kind of mistreatment given that we have autonomy and rights.

Now, that having been said, there may conceivably be cases where voluntary reductions in dignity have some negative externality in terms of increased callousness.  It's possible, for example, that desiccation of corpses can be ruled out on that basis, and one can make an argument that, say, humiliating practices like dwarf tossing, even if they are mutually agreed upon, perhaps could be harmful if they had the effect that people were more callous or cruel to other dwarfs.

Crucially, this is an empirical claim about human psychology.  It's a prediction about what will happen to people placed in particular circumstances, and, as such, it must be informed by facts.  It cannot be stipulated from the armchair with personal hunches, given the dangers of totalitarianism and the dogmatic rejection of human betterment.

And I think Prof. Churchland 's essay reminds us that in the history of biomedicine there were many practices that were condemned in their time as affronts on human dignity, based on what we now know to be incorrect intuitions that they would lead to callousness and a hardening of hearts, practices such as blood transfusion, vaccination, in vitro fertilization.  These predictions about human psychology turned out to be incorrect.  If they had been acted upon and those great improvements in human well-being had been ruled out, grave harm would have been done.

So to sum up, I think dignity, if precisely defined, according to the way the word is used as opposed to being co-opted as a feel-good term, has some degree of usefulness in bioethics.  It's one of the interests of a person that merits protection, all things being equal, and it can, in theory, have effets on third parties that ought to be considered in the light of evidence. 

But, as a superficial signal of worth rather than worth itself, dignity should not be fetishized.  It should not be treated as an absolute value.  It should not be used to ratify vague feelings of unease and new developments.  It should not be used as a justification for the exercise of arbitrary power, and it should not be used to stifle advances in human well-being.

Thank you very much.

CHAIRMAN PELLEGRINO :   Thank you very much, Dr. Pinker .  Our third speaker is Dr. Eva Brann of St. John's College , Annapolis .

PROF. BRANN:   I have to begin with an excuse. When I had read my very interested way through a small portion of the pages of proof of the work being unveiled today, I called my friend and colleague Tom Merrill, who had conveyed the Council's kind invitation to me, and began by saying: "You know, even a partial reading of Dignity and Bioethics makes me wonder how I could add anything of consequence." And he, courteous man that he is, was quick to say, "We understand perfectly." "No, no," I said, "I want to come, if I am allowed to dwell on an aspect of dignity not quite in sync with the concerns of the book." And I told him what I had in my mind, which he thought would not be unacceptable.

This is the view of dignity which is perforce neglected, though not unmentioned, by the contributors: It is possible to argue that the dignity which belongs peculiarly to persons is subject neither to bestowal nor withdrawal by any agent or condition.

I'll expand on that in a minute. But first I want to concede that the meaning or an aspect of the meaning of dignity accepted by writers for this volume is the oldest and most common use: Our dignity depends largely on the valuation and correspondent treatment accorded us by others. The very Indo-European root of the word, d-e-k, dek, has the basic meaning of acceptability; the word "decent," what is fitting, and "dogma," what is cause for acceptance, from the Latin and Greek derivatives respectively, are testimony, and above all, the Latin dignus, worthy, what is valued.

Then Hobbes , whose deflationary glossaries of terms in the Leviathan tells bald truths in elegant language, says of dignity: "The public worth of a man, which is the value set on him by the commonwealth, is that which men commonly call dignity." And "the value or worth of a man," he says further, "is as of all other things, his price; that is to say, so much as would be given for the use of his power, and therefore not absolute."

Let me cite right here another view of the matter that I will come to later, namely Kant 's, who occurs how many times?  Twenty-three.   It was a lot.  For it is the relevant opposite of Hobbes '. Kant also equates worth and price, but he thinks that human dignity—and the German word is Würde—has precisely no price that shifts with the market, for dignity has no tangible value. It is what "has no mere relative worth, that is a price, but an inner worth, that is dignity."  It says that in Foundation of the Metaphysics of Morals.

But this is not the ordinary usage. There is, for instance, Giovanni Pico della Mirandola 's Oration on the Dignity of Man of the late fifteenth century—which is worth citing and is, in fact, quoted in Nick Bostrom 's article—because Pico's text is an early one in the attempt to come to grips with the question, how can human dignity be preserved when human essence is being exploded? Pico's answer is that man was invested with his chameleon nature, his infinite mutability, his limitless self-creation by God himself, for God had given away all his archetypes to the rest of creation and had none left for the last creature, the one that was to comprehend all creation.

So he gave man just that: original indeterminacy and the power to make himself. What could be more relevant to our present condition with respect to our biological and psychological selves? But my point here is that, although Pico establishes a novel kind of dignity, the dignity of a purely potential being, a nothing-in-himself and everything-through-himself, he credits this creation to God. We are invested with our dignity by God. That is, to be sure, a safer and grander thing than being accorded our dignity by other people, but it is still a worth from elsewhere.

There are, on the other end of the spectrum, dignities that are indignities, undignified. In my favorite Jane Austen novel Persuasion (that is, it's the favorite while I'm reading that particular one), there is a local squire, Sir William Elliot, a man we, though of course, not she, would call a pompous ass, "a man who, for his own amusement," she says, "never took up any book but the Baronetage," a man who has to be persuaded that "the true dignity of Sir William Elliot will be very far from lessened in the eyes of sensible people by his acting like a man of principle." For to straighten out his finances he must, which appears to him impossible, "alter materially his style of living in a house that had such a character of hospitality and ancient dignity to support."

Well, I won't belabor what people suppose anyhow, that dignity insofar as it means imputed worth or "respect"—and recall that that very word means "being looked at"—that that  involves others as they regard and consequently treat us.  That was a point that Pinker made.

I want to take a moment here to point out that to most of us, even to those of us who are pretty well off, the matter of dignity is often centered on medicine, the more so, the older we get. Now it seems to me—and I may have got this wrong— that there is a difference between bioethics and medical ethics. The former has to do with technical advances in the treatment of living creatures and involves large ethico-political policy questions. Medical ethics I think of as being concerned with our treatment as individual patients. But, of course, they overlap.

Now, treatment implies having something done to us, even if at our behest and for our own good, and a patient is the one whom it is done to, not only the sufferer from the illness but the passive object of the treatment. A friend of mine in the Southwest, about my age, writes to me, and I am omitting particulars: "I went to see a specialist who was perhaps the most arrogant dismissive doctor I have ever encountered." He gives her a lot of unhelpful diagnoses. She goes on, "I saw him for less than five minutes. The most discouraging part of the event was that I failed to express proper outrage, but walked meekly away to have the treatment he ordered." This is indignity with a vengeance, and probably far more acute to most of us than the long-term policy questions with which the present book is concerned.

However, this little but often-heard tale is, to my mind, in fact an argument for the importance of Dignity and Bioethics as a book and as a concern, for there is obviously a close parallelism between broad-gauged bioethics and smaller-scale physician's conduct. As the character of human life is more and more consigned to technical intervention, the role of the expert becomes more and more dominant. And if headless barging-ahead is the rule of the epoch in the one realm, causeless arrogance does then follow in the other.

That is precisely why I think that we should consider a view of our dignity which does not consign it to the conduct of others. This view might begin with an experience, that of humiliation. I can think of a type of humiliation, as an example, which seems to be a favorite of inhuman humans, from sadistic sergeants in army barracks to SS men in ghettos, namely, being made to go on your knees and scrub the floor with a toothbrush, which combines every kind of indignity: being forced from our naturally erect position, doing pointless work, being given inadequate tools or materials. Indeed a grand example of the last factor is Israel in Egypt . The Egyptians wanted to make "their lives bitter," and one way the Pharaoh thought of was to give this order: "Ye shall no more give the people straw to make brick, as heretofore," which was certainly counterproductive and thus intended as an imposition and an indignity.

But who has lost their dignity here? Not ever the subjects of humiliation. The authors of it are the ones who have lost their dignity and are therefore rightly the objects of indignation, the sense that something unworthy has been done, that indignities have been perpetrated.

So I'm far from thinking that individuals can't impose indignities on people as that doctor did to my friend and that Pharaoh did to my people, and that policy decisions couldn't lead to a devaluation of human dignity on a super-individual scale, as thoughtless users of biotechnology surely will. Yet it ought to be a source of puzzlement and wonder that we, by and large, are willing to talk in a way that colludes with the humiliation.  We want to be given our dignity and are indignant at having it taken away. We not only talk that way, we feel that way. I want to inject here the caveat that I'm not much for the "we" talk when it comes to sentiments. My usual reaction is "Who 'we'? Not me." But in this case I do want emphatically to include myself: I have a live sense, on certain occasions, of having suffered an indignity.

There is something puzzling about that feeling, which is identical, I think, with the one sense of the Janus-faced word "shame." Sometimes we feel shamed not by something we did, actively, but by something we suffered, passively. How is it that shame which is our sense of our value in our own eyes, the affective side of self-respect, is so sensitive to our value in others' eyes that we can feel degraded by the opinion not of competent impartial spectators—that would make perfect sense—but of people who have diminished their own worth by trying to take away that of others?

By and large, our natural feelings have their own soundness, and it seems to me likely to waste time and to call for trouble to mess with reactions that seem to come about naturally. For instance, it leads to no good to try to keep little boys from being motoric, as they usually are, or, for that matter, to push other little boys who are by nature esthetically contemplative, into athletic action. It isn't even necessary to settle the question whether our affective modes are genetic or learned or gotten in some other way, to decide not to tinker with what is given. That seems true for the most part.

But there might be feelings that internal reflection—note well, not external pressure—might beneficially change, especially the kind of feeling that is directly amenable to self-admonishment, as not all passions are. Thinking out what we are, such that we need not always be shamed by what is done to us, by people and even by nature, would be the condition of such self-control. I say "not always" because now and again being a victim is indeed shameful. For sometimes we owe it to ourselves to resist, even forcefully. I say "forcefully" rather than "violently" because resisting wrong in due proportion is not violent.

This view, I would point out, is the opposite of one recently proposed by both practicing psychologists and political philosophers. They say that shame must be marked as socially unacceptable and forthwith eradicated, for it is essentially a victimization of the deviant by a normalizing society. For my part, I am thinking not of what that occult agency called society does to us but of what we permit ourselves to do to ourselves. Social engineering has nothing to do towards curing this harm, but individual thinking has everything to contribute.

Here I want to call Kant to aid. He is the right philosopher, because in matters moral his teaching is not, to be sure, unnatural, but rather non-natural. That is to say, moral and natural phenomena are for him mutually irreducible, and that is final. For nature is subject to natural law and is thus deterministic. Any moment in time consists of natural states that have necessary next moments as a consequence.  No part of nature can initiate, that is, act on its own, to change its future. When anything is thus subjected to law Kant calls its state heteronomous, a Greek word meaning "subject to law given by another." For then it will follow that if anything in nature has dignity it is accorded to it by us, insofar as these laws of nature arouse our wondering admiration—for Kant largely because they are in their fundamental features the product of our minds.

But then, in the starkest possible opposition to law-driven, heteronomous nature, there are persons, human beings in their personhood. A human being is indeed part of nature; it has a body subject to the laws of physics and biology. It also has a soul, whose affects make it subject to another set of laws, those of psychology, less well known but equally deterministic. We too are, in part, heteronomous; we belong to nature.

But one part of us is indefeasibly autonomous, meaning that it, and thus the human being with it, is, to be sure, subjected to law, but subject to law it gives to itself. To be subject only to ourselves is what makes us persons; what makes us free is precisely that we do not do what we want, for desire, too, is subject to natural law, but that we have put ourselves under the rule of reason, for we as persons also obey a law, albeit our own.

Now this seems offputtingly strange at first. We are subject to law, and this is called our freedom, and this law is our own choice but not something we desire. The resolution lies in the character of law. A law is a rule of reason. As law it must be universal in its realm of application; as rational, it must be free of self-contradiction. Thus the law I give myself must be the one that is applicable to all human beings without exception—of course, first of all, to me. That is one version of that famous "Categorical Imperative" (which means an unqualifiable command): "Act in accordance with that rule through which you can at the same time will that it become a universal law."

This is a thumbnail sketch of Kant 's moral philosophy, a philosophy as throughgoingly systematic as any I know of. And usually it won't do to rip some piece of a carefully constructed system out for a specially dedicated use. But I've always had the sense that Kant's morality, which seems to me too severely non-natural for daily use, has its moments, Kantian moments, as it were, in which it works as nothing else will.

It seems to me that the time when our dignity is at stake is such a moment. Kant says that our moral action follows "from the idea of the dignity of a rational being that obeys no laws except that which it gives at the same time to itself."  Sometimes an idea, a reflection, can and should revise our moral feelings, and teach us that, whatever our sense of being offended in our dignity might tell us, we must instruct our feelings that this is not possible. Our dignity is our own to uphold or to diminish.

It seems to me that people quite unacquainted with the abstruse though wonderful system of Kant's two Critiques, the one devoted to our knowledge of nature and the other to our actions in the moral realm, could find protection from all the attempted assaults on their dignity in what I might call somewhat loosely Kantian-type thinking.

For those assaults come in two varieties, an inimical one that attempts to destroy our dignity and a friendly one that works hard to save it for us. Both are, from this perspective, indignities though in very unequal degrees. The Kantian thought is that we are double beings, as physical bodies and passionate souls subject to inexorable and sometimes cruel laws of nature, and as thinking beings free, ourselves the law-givers and hence the harsh judges of our own deserving. Thus no one can shame us but we ourselves in our sovereignty.

There are situations—and for us who live in a by and large prosperous land they are very often medical ones—when it helps to think that out, and what helps most is to have thought it out before the event.  So much the more should this view of dignity be considered in the face of the momentous current policy discussion affecting our very nature as persons.

Thank you.

CHAIRMAN PELLEGRINO :   Thank you very much, Dr. Brann .  I will now open the discussion for the members of the Council, and I will do that after Dr. Meilaender himself opens the discussion, as has been characteristic, one person of the Council beginning the general Council discussion.  Gilbert ?

PROF. MEILAENDER:   Well, thank you to all three of you.  To the cacophony of voices in the volume we have now added three more rather different voices.  I mean, obviously, there's no point to my trying to review or deal with everything all of you said.  I'm going to try mostly just to say a word about one issue that seems to me important—three different issues, one for each of you, that seems to me to be especially important in what you say.  You may want to comment on them yourselves.  Council members may just want to get in however that happens.  But I guess, actually, in the case of Prof. Pinker I will indulge myself with a couple of extra comments, but mainly one for each.

With respect to Prof. Elshtain , the thing that it seems to me I'd like greater clarity on or that it would help to be clearer on is the relation between the language of rights and the language of dignity.  You made connections between them in the talk, but I'm not sure what the connection is, what, if anything, dignity adds to rights language.  There are contributors to the volume who think that if rights language, or at least good rights language, is in place, you could use dignity language, but in a sense, nothing is gained by it, and I'm not sure what your view on that is from the way you used it.  And since several of the contributors make the point, as I think is incontestable, that rights language has been more common in our political tradition, though maybe dignity language has risen to the fore in the last 50 years, but it would seem to me that that's an issue that would be worth thinking about, and it would be useful to clarify a little bit more.

I do want to indulge myself just briefly.  I teach at Valparaiso University with a Lutheran connection, though exactly what that means always is a little difficult to say, I think.  But before I came there I taught for 18 years at Oberlin College , which in recent decades no one has confused with a religious institution.  And whatever the relevant merits and demerits of the two places , there's absolutely no doubt in my mind that Valparaiso is an intellectually more diverse institution.  Though we did a lot of talk about diversity at Oberlin, there's very little diversity of ideas.

I thought of that in connection with your comment on the contributors because you need to add that the religious or at least religiously connected thinkers in the volume disagree at various points.  I mean, it's just worth noting.  Simply noting institutional identifications doesn't tell anybody much of anything.  That's just an aside. 

The other aside I'd make is that—I mean, I appreciate your deep commitment to our political tradition, but democracy does not, in fact, make public decisions by consensus.  We take votes, and it's a quite different thing, and taking votes is designed precisely to allow a variety of voices into the conversation.  And that's worth noting.

But the thing that it seems to me the issue that kind of systematically pervades your comments, actually, but came to the fore for me, especially when you turned to offering your own understanding of what the most useful way of talking about dignity would be, you began with a perceptual phenomenon, as you called it, which elicits certain kinds of responses and so forth, but which turned out to be only skin deep and that what matters is respect for the person, you said, which you said very shortly after having said that people have used dignity language as a synonym for personhood, autonomy, and so forth and they should just stop it. 

But the truth of the matter is that the distinction between the normative and the descriptive needs clarification here.  In your own useful comment you begin with something that I guess we'd take to be fundamentally descriptive.  We end up with a normative concept, respect for persons, and, indeed, a normative concept that you appeared to have ruled out briefly before.  And so I think that that relation between or distinction between the descriptive and the normative needs work.   I mean, I think the same thing that I could work it through with respect to your three troubling functions of dignity and so forth, but that will suffice to make the point, I think.

And Prof. Brann , just a thought about sort of your being drawn to Kant here, which if somebody had just asked me to predict in advance, I wouldn't have expected, but I don't know.  I think it was Iris Murdoch who wrote once that Kant 's man had received a marvelous incarnation a century earlier; it was Milton 's Lucifer.

And the thing that struck me is that yours is a very solitary vision, in a way, or at least it seems to me to be that.  Maybe you'll correct me:  "We're subject only to ourselves.  We should not be sensitive to our value in the eyes of others."  And particularly in connection with bioethics, which has to do with the body, with a body which sort of locates us in relation to others, I wasn't sure about that move. 

You think of Susan Shell 's essay in the volume where she goes to some lengths to try to find the Kant who hasn't embodied humanity, and you seem to want the solitary vision.  And, I mean, I just wasn't sure about that vision, and I wasn't sure, then, whether it was or was not a plus for bioethical reflection. 

So those would be issues that I highlight.

CHAIRMAN PELLEGRINO :   Thank you, Gil .  I will ask the speakers to withhold their comments until we've heard a few from the Council, and then you can respond.  Each of you will have an opportunity to choose those of the responses you wish to give your own answer to.

Prof. Gómez-Lobo , I have you next.

PROF. GÓMEZ-LOBO :   Thank you.  I'm going to concentrate on Prof. Pinker 's exposition.  First of all, I must say that I greatly appreciate the sharp criticism.  I think there's nothing more important in human interactions than to argue very clearly, very sharply when you see a disagreement, et cetera.  I value that very highly.

Now, that said, I want to ask, I would say, for you to say a little bit more about dignity in the following sense:  I think that your exposition, at least, made very clear to me that here we have a phenomenon that is quite common in our thinking, namely, that we have one word, quote, unquote, dignity, with multiple meanings.  It's really the case, as Aristotle says, that it's a word said in many ways—said in many ways—and that therefore stands for sharply different concepts.

And this happens with many of our central words, and not just with this one.  I mean, I can think of about a dozen of those.  So a part of what we're always doing is trying to be clear in our minds when we're using the word in one sense and when we're using it in a different sense, when we're using it in a descriptive sense, when we're using it in a normative sense.

Now, that for me immediately tells me that if I sat down with your text and I could read it I could resolve a number of the contradictions that you mention because, of course, to say that a slave contains dignity and a slave has his dignity taken away—it could be resolved by showing that we're talking about different concepts.  And with regard to the first concept, the appropriate thing to say would be that the slave retains the dignity but that the dignity has been violated, which is not the same as to say that the dignity has been taken away. 

Then there's something I was trying to do, and you'll forgive me for this.  I was trying to think in Spanish for a moment, and one of the interesting things I noticed—I'm not 100 percent sure of this—is that in Spanish we hardly use the term "dignified," which is a term in English that is used very often for the description of certain, say, demeanors, procedures, et cetera.  We probably would use different words for that.  

And also in ancient Greek, I cannot think of something corresponding to "dignified."  The ancient Greek word for "dignity" is clear.  It's "axioma," which has a different connotation.  But what's the important point in my mind?  And this is where I come to try to get further comments from you.  And it's this, and I'm going to Prof. Elshtain 's point.  Isn't there something very basic, something that we invoke in our moral thinking, to stop the treatment of other human beings as happened in, say, Nazi concentration camps?  Shouldn't we grant all of these varieties of meanings but still retain this notion that there's something there—that there's something there that goes very deeply into what we are and into what we normatively want for ourselves, namely, that no human being be intentionally killed? 

And, you know, maybe we can find a different word, but the last 40 years or since Kant , we do have a notion of dignity which is deeply connected with human nature, and that that serves a purpose in that that's neither relative—I cannot say that because you're a gypsy you don't have dignity—it's not fungible—you cannot sacrifice it.  You cannot say, "I'll give it up"—nor is it a bad thing.  I would insist that the meaning of the word dignity points to something that is basically good, basically because it's a normative attempt to protect a basic human good as a good of life.

CHAIRMAN PELLEGRINO :   Thank you very much.  Other members of the Council?

DR. ROWLEY :   Relative to—well, two things.  I was as a member of the Council asked to or encouraged to provide an essay, and it didn't seem to me that I had anything special to add, and so I did not provide an essay.  We've talked a lot about the Nazis and their actions, which we think violate human dignity.  I think we could talk about an episode much closer to home, namely, the American treatment in Iraq of, quote, terrorists, and as soon as you call somebody a terrorist, you have really said that person doesn't have any dignity or doesn't have any worth or his aims or her aims are such that whatever we do to them is really not torture but we're just trying to get information.

So I think that here is an action that we as Americans have committed to others that, at least in the minds of some people, would violate what some individuals would call human dignity.  So I think we shouldn't go back to the last century and point to others.  We have to consider these things as relative to us.  And so I'm very concerned that we can discuss the term in some abstractions and yet not really realize its current moral implications.

CHAIRMAN PELLEGRINO :   Thank you, Janet .  Alfonso ?

PROF. GÓMEZ-LOBO :   Let me say briefly I fully agree with that.  I fully agree.

CHAIRMAN PELLEGRINO :   Further?  Peter ?

PROF. LAWLER :   This was in many ways a great panel because you represent three Western possibilities.  Jean is in some sense Judeo-Christian, and Prof. Pinker is hardcore nature, and then we had Kant , hardcore anti-nature, in a way, but still not Christian.

And so the question I had—the Kant thing I understand.  I just disagree with it, but I get it.  For Jean and Prof. Pinker, Jean, how do you know—is your understanding of human dignity dependent on a Judeo-Christian revelation, or could it stand on its own two legs apart from anything we learned from the Bible?  Or there's a third possibility, is what we learned from the Bible gives us a new insight on what we can see with our own eyes.

And, Prof. Pinker , how do you know people have rights?

CHAIRMAN PELLEGRINO :   Thank you, Peter .  I'm watching the time, and I can allow for one or two more comments and then give our speakers an opportunity to respond with brevity and conciseness, hopefully.  One or two Council members.   If not, then I will ask each of you to select one or two.  I know that we're doing an injustice to your presentation, but I know, also, you can come to the point quickly.

Dr. Elshtain ?

PROF. ELSHTAIN :   With that warning in mind about coming to the point quickly, I will indeed be brief.  I want to respond first to Prof. Meilaender about what the language of dignity brings to the discussion of human rights.  And here, Gil , I think it would be a matter of, again, the weight of the last 60 years, which I mentioned in my discussion, that it's not surprising that the concept of human dignity was brought forward. 

When the drafters of the Universal Declaration of Human Rights were working on their document as a necessary underpinning, given what they had seen in the recent past and the massive violations and they could think—and this was a diverse group of people, not representing just one tradition.  They could think of no stronger way to cast their concerns than, "Given massive violations of human dignity, how do we sustain a regime of rights that assumes this human dignity and that tries to forestall the worst violations?" 

Now, it seems to me that what the language of dignity especially adds to rights language—and that's why I mentioned briefly, but a longer discussion would be warranted—is what I call the negative rights.  These are the things you don't do to people.  They have a right not to be the victims of genocide and so forth.  Whether it would add much to the so-called positive table of rights because, you know, those can be extensive.  You can have everything but the kitchen sink thrown in—a right to a college education, right to this, right to that—which may or may not be within the capacities that societies do provide and so forth. 

I don't think it brings as much to the table there, but I think it does when you're articulating limits to what can or should be done to people.  And that's where I would start to sort of respond more fully in greater length to your concern.

One of the other documents that I might have brought forward in my paper was Primo Levi's sort of searing account of being a prisoner in Auschwitz and the systematic ways in which one's very humanity was stripped away, one's dignity was slowly sort of removed.  And I think it's those kind of examples that were so much in people's minds when the human dignity theme began to be such a central feature of the discussions of human rights.

Could I have one other —

CHAIRMAN PELLEGRINO :  Yes, absolutely.

PROF. ELSHTAIN :   Very quickly, Dr. Rowley , your comment about terrorists and terrorism, it seems to me—I have two kinds of comments to make.  One is that it seems to me that accurately characterizing someone as a terrorist—and we have a received definition of that that's pretty well settled in international law and in thinking about these issues, namely, someone who explicitly targets—knowingly and explicitly targets noncombatants or civilians for harm, for death.  It's not a term that is just applied willy-nilly.

How do we respect the dignity of terrorists?  Well, by one thing, we hold them responsible for their deeds.  It would be disrespectful of them to see them simply as victims of circumstance who cannot be held morally responsible.  Now, on the issue of how such people are to be treated when they're captured, there I think you're quite right that, if I understood you correctly, issues of human dignity are going to enter in to think about the limits to what one can or should do, even to those who are terrorists who have knowingly killed civilians or planning to do that, in one's interrogation of them.

And it's just interesting that in the most recent issue of Foreign Policy , the question of dignity—the dignity of those being interrogated—is explicitly mentioned.  Questioning detainees is perfectly legal; it simply must be done in a manner that respects human dignity.  So you can see how much that debate has entered in.

And then one final, very, very quick comment, and that is I think in Prof. Pinker's comments in fully engaging those, which I know I can't do and I know we can't do today, but it just strikes me we'd be once again on the ground of whether there are strong truth warrants for certain kinds of normative claims or not or whether it really is a matter, as you said at one point, of personal hunches or vague feelings of unease, and I think that would really be the ground on which the issue would have to be engaged. 

And it does strike me, finally, with Peter Lawler's comments that the whole question of whether some notion of human dignity can stand alone, it's the very reason I brought Albert Camus into the picture, because he's explicitly not a theist, is himself an unbeliever, although is very clear that he's indebted to the background sets of beliefs afforded in what we call loosely the Judeo-Christian tradition, and then seeks to build some notion of human dignity that isn't entirely dependent on that tradition.  Now, whether that's entirely successful or not is another issue, but that's one reason I specifically brought him into the discussion.


PROF. PINKER :   I'll begin by commenting that I think that Dr. Rowley 's comments on Iraq are entirely apposite and that they correspond to what I called the third-person importance of dignity in terms of the potential negative externality of what happens when someone's dignity is reduced in the eyes of those that have power over them. 

And perhaps the most vivid example are the abuses at Abu Ghraib, which are very typical of abuses in prisons in police states where there is a vicious circle where someone's dignity is reduced by having them parade naked or have them cower in front of barking dogs or crouch on the ground, which does increase the callous treatment by their tormentors.  That is, I think, a sense of dignity that we ought to take seriously in moral considerations. 

Second, to respond to Prof. Meilaender , let me make it very clear, I had no intent whatsoever of disparaging any university that has a Christian or Catholic mission statement.  I was just making a statistical claim that the very unusual composition of the committee says something about the way that the views were assembled and just gives us information, not that there is anything whatsoever to be disparaged about the particular distinguished universities that all of the panelists come from.

Third, Prof. Gómez-Lobo , I do appreciate that language is rife with terms of multiple meanings, with polysemy, if I can put in a plug for my most recent book, The Stuff of Thought .  It has a whole chapter on polysemy.  Nonetheless, I think in discussions of a kind that we're having where we attempt to formulate policy to clarify concepts, our task is to try to reduce or eliminate polysemy because polysemy is a source of fallacies, as in the proof that a horse has six legs.  Well, it has four legs in front, and it has two legs in back.  Four plus two equals six. 

If you shift between two meanings of a word, you open yourself up to fallacy, and I think that there's a very real danger of that happening in the case of dignity, where there is one sense—the one that I think everyone can agree upon, mainly, the perceptual cues that elicit respect, such as composure, self-control, and so on, which is exactly what is violated, say, in the Abu Ghraib case—and there there's widespread agreement—versus it being a vague umbrella term that is either applied, I think, inadvisably as a synonym for rights and personhood or, in general, is used as a way to ennoble whatever beliefs the writer is advocating.

And I think, indeed, the case of the Nazi Holocaust illustrates this quite clearly.  I don't think you need to invoke the concept of dignity to say why it's wrong to murder six million Jews.  I think we've got lots of moral resources that can specify why that's a bad thing without ever using the word "dignity."  As Dr. Schaub pointed out, Churchill did not have to invoke dignity.  You don't need dignity to explain why murder is wrong. 

And, indeed, as you point out, you don't want to say that whatever moral concept we invoke to condemn the Holocaust is relative or fungible or undesirable, but I think the concept of dignity is all three of those, and that's exactly why it isn't dignity that we should turn to in order to condemn genocide.

I have one more point—I'm happy to have an exchange, or I could make the last point, and then we could have it then, but I'm very happy to engage you.  Should I—


PROF. PINKER :   Okay.  One more point, and this speaks both to Dr. Meilaender 's question about how one distinguishes the normative from descriptive and to Dr. Lawler 's challenge, how do you know that people have rights.  Because I do distinguish the normative and descriptive.   I think that much of my discussion is that dignity makes much more sense as a descriptive concept than as a normative one, with the two provisos that one ought to respect someone's first-person interest and dignity and the third-person concern with negative externalities, whereas I do think that rights is a normative concept and one that I would defend in a nutshell as follows.

And this is an argument that has been made in many forms for thousands of years.  It basically hinges on the interchangeability of perspectives.  How do I know that people have rights?  Because there's certain things that I claim for myself.   I maintain that it's wrong to kill me, to torture me, to imprison me, to degrade me.  It is therefore inconsistent, as long as I am engaged in any kind of discourse with you, to deny the same consideration to you on pain of saying that there is something special about me compared to you.  If I say that, you have no reason to take me seriously.  I think this is the kernel of an idea that's behind the Golden Rule, behind the first formulation of the categorical imperative, behind Rawls' veil of ignorance, behind Spinoza's viewpoint from eternity, and a number of other formulations with, of course, differences among these formulations, but all of them hinge on that essential notion of the interchangeability of perspectives, one of the reasons that I think this concept is indeed so robust in the face of all of the disagreement, all of the contested concepts, why this consensus on the centrality of rights really has emerged and is delightfully robust in the Western tradition. 

I'm sorry, Dr. Gómez-Lobo , you had a comment?

CHAIRMAN PELLEGRINO : Alfonso , yes, please respond to Dr. Pinker .

PROF. GÓMEZ-LOBO :   Well, I did not want to take the—


PROF. GÓMEZ-LOBO :   It was a remark to the following effect:  Rather than eliminate polysemy, I think that what we should do is say dignity sub 1, dignity sub 2, dignity sub 3, because I don't think it's easy to rule out certain expressions that are in common use in our communities.  So my pleading was very simple, was what does, say, internally dignity, inner dignity, natural dignity, dignity sub 1, entail as opposed to the other meanings of the term.

PROF. PINKER :   That's a reasonable response.  I would suggest that dignity sub 1 as a psychological phenomenon is extremely useful.  The question is , do we need dignity sub 2 if it is a synonym for rights and personhood.  And is there a dignity sub 3 that has a precise role in these discussions.  But I agree , that's a good way to formulate it.

CHAIRMAN PELLEGRINO :   To protect Dr. Brann 's dignity I'm going to give her her due time on the program.

PROF. BRANN :   I guess I'm just going to respond to Dr. Meilaender 's description of Kant as being isolated.  You used that word or describing an isolated human being.  He wasn't that way personally.  He gave lovely dinner parties and said that he regarded every day not spent in the company of a charming woman as a lost day.  But as far as the categorical imperative is concerned, that is, the notion that dignity might be mine to lose but it's not someone else's to give or to protect, the republic or the kingdom of all those who believe themselves to be autonomous in that way is a kind of sociability which seems to me to have real substance to it.  That's not a matter of personal isolation but, rather, a matter of having real friends, namely, others who take responsibility for their own dignity. 

And Dr. Lawler said that the paper was about Kant .  I didn't think of it that way.  I thought of it as being about me.  And since it was to be delivered in respectable company, I needed a respectable text to support me.

CHAIRMAN PELLEGRINO: Peter , we have a few moments.   Go ahead.

PROF. LAWLER :   So Prof. Pinker , Dr. Brann 's was a wonderful statement concerning her freedom, which everyone has admired for years.  So other people who talk about rights or something like rights—the Christians explain how we're free. Kant explains how we're free.  Locke , who you rightly ripped the guts out in your—explains how we're free from nature with all that blank slate stuff.  So it seems to me every other interpretation of dignity or rights is all about our freedom, but studies show flowing from Mr. Darwin that we're not really free.  So how can you talk about rights without talking about our freedom from brute nature in some way?

PROF. PINKER :   You mean the free will versus determinism issue?  Where do I come down on that?

PROF. LAWLER : Liberty from brute nature in some way.

PROF. PINKER :   Oh, from brute nature?  Oh, well, the way I've put it in The Blank Slate is that I don't think that our—I think that liberty from brute nature is a bit of a misnomer, that we have complex brains, a hundred billion neurons, a hundred trillion synapses.  Part of that brain is a frontal lobe that has the ability to anticipate the future, to execute decisions, to take into account the esteem and condemnation of others.  It is complex enough that it cannot be predicted in its entirety from prior and current conditions, that what we idealize as free will at one level is at another level the activity of an extremely complex brain, especially the frontal cortex. 

So in terms of how do I resolve the idea of freedom, which is, I agree, indispensable in ethical discourse, with a belief that our actions are products of our brains, which are physical organs, it would come from the emergent properties of the brain being extraordinarily complex.

PROF. LAWLER :   So unlike all the other species, we live for ourselves and not for the species.  Would you say that?

PROF. PINKER I think I would deny that other organisms live for the species.  I think that's the fallacy of specie selection, which has long been ruled out within evolutionary biology.  I don't think that humans live for their species, and I don't think humans live for themselves, either.  People live for their families, their friends, their communities, I think, by nature.

People also, thanks to their frontal lobes which can learn lessons of history, which can pursue the logic of the interchangeability of perspectives, which have an expandable circle of empathy, can, in civilized circumstances, stretch their cognitive powers to have a moral concern for others.  And therein lies our hopes for moral progress, in a nutshell.


PROF. DRESSER :   This was a very intellectually rich discussion.  Thank you so much.  I wish we could put your essays into the volume.

I guess I would really press Prof. Pinker about respect for persons and personhood which, in my view, are just as mushy and controversial.  There are many arguments about who is a person, what constitutes a person, respect for persons, what does that mean.  It seems to me they're on a similar plane to dignity in that way.

PROF. PINKER :   I think there are, indeed, debates on what are the entry conditions for personhood in terms of species boundaries, in terms of ontogeny.  It's not clear to me that the concept of dignity in its clear senses sheds light on how we resolve those issues.  My own view is that those issues are—that because biology is inherently continuous contra the very heavy Aristotelian emphasis in this that runs throughout this volume in terms of essences or natural kinds, I think that that's a deeply unbiological way of thinking about ourselves .

I think nature gives us, unfortunately for us, many continuities .  I think that we must impose certain boundaries for action, and my own view, in terms of these boundary conditions, is where can we place a boundary that is not apt to slide.  So I would consider it a matter of policy rather than looking to biology for an answer. 

But the reason I bring that up—and I don't want to get into that particular argument here, which would be suitable for another day.  But the reason I bring it up is that it's not clear to me that dignity adds anything to the very acute problems that, indeed, we face in defining personhood.  They are problems.  They're not problems that dignity will solve, I don't think.

PROF. MEILAENDER :   Just a quick follow-up on two things.  On your last remark it seems to me clear that dignity is not going to resolve the question of which beings are indeed persons and which are not.  I think that what many of us understand is that there's a connection, because dignity has been cashed out in terms of respect for persons, and the connection is there, so the pros are on both sides.

But let me make the following suggestion, going back to this idea that dignity means different things that further differentiate concepts of dignity.  And I would say, well, the Abu Ghraib treatment of prisoners is a violation of dignity—at least I can think two or three of these concepts of dignity, or at least two of them.  And certainly I can see—and I think you're absolutely right—that the undignified position, et cetera, probably exacerbates the callousness.  In other words, at a psychological level, it seems to me, very clear. 

But on the other hand, I would still argue that there's a concept of dignity there which grounds my moral judgment that these people were mistreated, and I would say in very traditional terms it's because they are human persons just like you and me.  I would go that route.

PROF. ELSHTAIN:   I just wanted to sort of second your motion, although I would have to think more about, you know, dignity 1, 2, 3, and so on.  But I think it's really—some fundamental something that over time we have learned to call human dignity was violated when we saw the pictures from Abu Ghraib and that the strongest possible way we could condemn that was to talk about violations of human dignity.  The language of violation of rights doesn't quite seem as powerful in some rather interesting way.  So it seems to me that, of course, there are all kinds of systematic ways we might explore the relationship between human dignity and human rights and the question of personhood, but I think we start to get on rather dangerous terrain if we think personhood is something that an external party attributes to someone or not, as the case may be.  And that attribution, then, becomes the basis of dignity. 

I think that's a dangerous move, and it's one, obviously, that has been made by a number of philosophers and others who argue that certain kinds of human beings simply lack dignity by definition because they aren't persons in the way he has chosen to make that attribution. 

And let me while I—this is probably the last time I'll have the floor so I want to get this in.  And that is that I think when we're talking about these matters in social and political life that we can never—as important as the kinds of discussions that we're having are, we can never forget that these ideas always flow into a world of politics, which is to say a world not just of dialogue but of power, and that we must always be wary about what permission slips we give to the powerful to do things to the weak and the vulnerable. 

And that, it seems to me, is where human dignity emerged, especially, as I said, in the last 60 years as a kind of cry from being on the grave, if you will, of all of those who had their dignity violated and as an ongoing reminder for us in the present.  I think it's in part because of that background that we can identify—we're alert to and can identify violations of human dignity in the present and then think of ways that we can build in barriers to those kinds of violations.

CHAIRMAN PELLEGRINO :   Thank you very much.  I want to thank our participants for being very, very, direct, critical, effective, productive .  I really, really do appreciate your comments.  I want to thank the Council members for their involvement, as well.  The volume is, of course, completed.  Rebecca, we can't add these, but, like you, I wish we could have added them in addition, but that would be an infinite series that would never end.  So I think we will have to call an end to the discussion.

Thank you all very much for coming.  We do not have any persons requesting to make a public comment.  At the end of our meetings customarily we ask for those who sign up to make any comments they wish, but we do not have them, and it's for that reason that I've been less than relenting in my insistence on time, but forgive me.  Thank you all very much.

Oh, excuse me, Janet .

DR. ROWLEY :   Well, we have a number of students in the audience, and I think that—I hope that at least some of the discussions have been illuminating for you.  I certainly appreciate the fact that you have had the interest to come, and I hope that some of our attempts to deal with important matters will encourage you to continue in your own efforts to do the same.

CHAIRMAN PELLEGRINO :   I want to add we also have representatives of the bioethics library at Georgetown University and National Reference Center .  And I put a pitch in for that because if you're looking, students, for assistance in how to find out where to go next with all of this information you've received, that's a good place to start, but I'm afraid they're going to be overloaded if you really take my invitation seriously.  But we're glad to have you with us.  Thank you.

  - The President's Council on Bioethics -  
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