Human dignity is a
motherhood concept like freedom of speech or the brotherhood of man. It’s great
for padding out politicians’ speeches. But what happens when it conflicts with
another motherhood concept, autonomy, the ability to make free and independent
An oft-quoted example
of this dilemma is the sport of dwarf-tossing. When a town in France banned it
in 2002, one of the dwarfs objected. He was participating freely and being
treated as a basketball was his livelihood. What was the problem? The case went
all the way to the Conseil d’État, the French
counterpart to our High Court. It dismissed the dwarf’s appeal to autonomy.
Allowing himself to be used as a mere projectile compromised his dignity, it
said. The dwarf then appealed to the UN’s Human Rights and Anti-Discriminational Committee. It also upheld the
ban “in order to protect public order and considerations of human
balance between autonomy and human dignity is very tricky. So tricky, in fact,
that quite a number of well-placed bioethicists have taken to denying the
existence of (scare quotes) “human dignity” altogether. A few years ago, for instance, Ruth Macklin was widely applauded by many
of her colleagues when she wrote in the British
Medical Journal that human dignity was a “useless concept”, compared to
She proved her point
by sloshing the idea around in an acid bath of inconsistency and ridicule. “Human
dignity” meant different things to different people. Furthermore, she couldn’t
find a rigorously logical definition. So it should be scrapped.
Granted, autonomy is
important, but there’s something scary about bioethics without human dignity. After
all, it was revulsion at the atrocities committed by Nazi doctors in the death
camps which gave rise to modern bioethics. Surely something more than a
violation of the victims’ autonomy was involved.
For instance, how
should we evaluate the exhibits of plastinated bodies which seem to have taken
the place of Barnum & Bailey freak shows for 21st century crowds?
Plastination is a
technique used by anatomists to preserve specimens for students. Like many
useful technologies, it can be used for dubious purposes. A German anatomist,
Gunther von Hagens, has had the bright idea of turning plastination into a
money-spinner. Since 1995 his flayed and partially dissected corpses have been
touring the world: a man playing chess with his brain
exposed, a man striding a rearing horse, a woman and her baby in the eighth
month of pregnancy and so on. You
can see the muscles, tendons, bones and organs bulge and stretch. A recent
exhibit in Berlin featured a copulating couple.
“These are blockbuster shows,”
according to an American analyst of the museum exhibition business. “We
haven’t seen anything like this since the robotic dinosaurs in the 1980s.”
Why do the crowds like them? It’s a mix of curiosity and disgust. The exhibits
do teach a bit of anatomy, but surely giggling at plastinated genitalia is
amongst their attractions for the millions.
So is there anything
unethical about these exhibits?
Macklin would say No, provided that people had agreed to donate their bodies. Even
on this score, the exhibits might be unethical. Von Hagens and his competitors have
been dogged by allegations that some of the bodies, at least, belong to
executed criminals, from China , Kyrgyzstan or elsewhere. When an exhibit toured England recently, a leading medical journal, The Lancet, harrumphed that its
paperwork was dodgy. “Assurance that all remains on public display were donated
with informed consent of the deceased, is imperative,” it said in an editorial.
But what if all the
“i”s were jotted and the “t”s were crossed? In fact, thousands of people have
agreed to donate their bodies. “It’s something that you want to do instead
of being ashes or worm food, to be some kind of asset instead of being in the
ground,” one woman said. Von Hagens has even claimed that two-thirds of
the males who donated their bodies to his company and one-third of the females
agreed to the use of their bodies for the representation of sexual acts.
But isn’t there
something deeply unsettling about all this which an informed consent form
cannot put to rest? Once these exhibits were living, breathing people. Isn’t undressing
them, treating them as commercial property, and displaying them in poses
designed to elicit ribald smirks a degradation of the very idea of embodied
humanity? If they did consent, did their loved ones consent? Is the human body
just an artefact? What lessons does an exhibit impart to children about the
meaning of human existence and the existence of human dignity?
Even the patron saint of “autonomy”, the 19th
century British philosopher John Stuart Mill, put a limit to autonomy. A
contract to sell oneself into slavery, he said, would be “null and void”. Certainly
our gut feelings about human dignity have to be more rigorously expressed. But it
would be a tragedy for bioethics if the idea were scrapped. The French courts
got it right. There are some things which autonomy cannot justify.
Cook is the editor of MercatorNet