Abstract
In a recent issue of Neuroethics, I considered whether the notion of human dignity could help us in solving the moral problems the advent of the diagnostic category of minimally conscious state (MCS) has brought forth. I argued that there is no adequate account of what justifies bestowing all MCS patients with the special worth referred to as human dignity. Therefore, I concluded, unless that difficulty can be solved we should resort to other values than human dignity in addressing the moral problems MCS poses. In his new book Christopher Kaczor criticizes the argument I put forward. Below, I respond to Kaczor’s criticism. I maintain that the considerations he presents do not undermine my argument nor succeed in providing adequate justification for the view that all MCS patients possess the worth referred to as human dignity.
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Notes
For a more detailed account of MCS see, e.g., [3].
Kaczor thus addresses my argument in connection with discussing the moral justifiability of abortion.
Here Kaczor also refers to “God the Father, the Son, the Holy Spirit,” and angels [2, p. 92]. As I continue to approach the topic from the viewpoint of secular moral philosophy, I now put these kinds of beings aside.
Kaczor thus uses the term ‘person’ to refer to beings that possess dignity. That I do not use the term ‘person’ in the same way does not affect the argument of this article, see also [1, p. 45].
If only living humans have human dignity, the doctrine of human dignity should be complemented with plausible answers to the questions of why only living humans have human dignity and when human life in the relevant sense ends.
I acknowledge that there are difficulties in assessing whether or not a MCS patient will recover. Yet the existence of such problems would seem to be compatible with there being some MCS patients with very low level of consciousness who can be known never to recover.
An anonymous reviewer objected that now I am ignoring the obvious relevance of the act-omission distinction. Unfortunately it is not clear what the relevance of the act-omission distinction is supposed to be here. The reviewer’s idea assumedly is that a proponent of the doctrine of human dignity can maintain that saving the healthy person is more justifiable than saving the MCS patient because omitting to save the MCS patient would not be as wrong as doing something resulting in the patient’s death. But this does not help proponents of the doctrine of human dignity. Consider the case of a person who is faced with the choice depicted above twice. Her first choice is to save the healthy person. Her second choice is to save the MCS patient. If the healthy person and the MCS patient have the same moral status, the two choices are morally equal. Yet it is intuitively plausible that the second choice is less justifiable than the first. Furthermore, like the doctrine of human dignity, the act-omission distinction is deeply problematic [cf., e.g., 9–11]. Accordingly, that it would be justified to refer to the act-omission distinction here presupposes that its problems are shown to be merely apparent.
According to an anonymous reviewer, this is the correct interpretation of Kaczor’s view.
This interpretation is suggested by an anonymous reviewer. Here the reviewer also objected that the fact that a MCS patient is not able to flourish does not entail that the patient does not have any rights. For reasons I have already explained above, I am in total agreement with the view that the fact that a MCS patient is not capable of flourishing does not entail that the patient does not have any rights. And nothing I maintain here or in the previous article [1] is in conflict with that view. I thus accept that the MCS patient can have moral rights, what I am concerned with here is the justification of those rights.
Kaczor also defends his position by arguing that accounts that make the moral status of a being dependent on its ability to actually act rationally are unable to give the same moral status to all humans [2, pp. 94–95]. That of course is not a problem for those who think, say, that permanently comatose humans do not have the same moral status as normally healthy humans. And, to respond to a possible objection to such a view, someone can maintain that such humans as, for example, small babies who are incapable of rational action have higher moral status than permanently comatose persons because, or when, the former have the potential to develop into beings capable of rational action.
The reviewer also says that a broken watch is still a watch. As it is more relevant in this connection, I now focus only on the heart example, but the considerations I present in its connection pertain, mutatis mutandis, in connection with the watch example too.
These criticisms were presented already in the version of this article the reviewer now in question assessed.
In the article Kaczor criticizes [1] I however argued against several of the reasons for the doctrine of human dignity presented within that tradition. Kaczor did not object to those arguments.
Someone might now object that people have rights—such as the right to bodily integrity—that would be violated by permanently stopping a person’s heart from pumping blood. However, the primary problem with permanently stopping a person’s heart from beating surely is rather that it kills her than that it violates her bodily integrity. Indeed, certain cases of medical emergency demonstrate that it can be morally permissible to violate a person’s right to bodily integrity in order to ensure that her heart does not permanently stop beating.
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Acknowledgments
I thank an anonymous reviewer of this journal for helpful comments on an earlier version of this article. The writing of this article was financially supported by the Academy of Finland for which thanks are also due.
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Varelius, J. Minimally Conscious State, Human Dignity, and the Significance of Species: A Reply to Kaczor. Neuroethics 6, 85–95 (2013). https://doi.org/10.1007/s12152-011-9147-z
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DOI: https://doi.org/10.1007/s12152-011-9147-z