Dr Paulina Taboada
Profesor Centro de Bioetica
Pontificia Universidad Catolica de Chile
Alameda 340 Correo Central 1
In the April’s Ethics Page, I suggested that the relevance of clarifying the concept and sources of human dignity rests – among other things - in its implications for a proper understanding of the foundations of human rights. This month I shall unfold this idea.
The two terms ‘dignity’ and ‘rights’ are closely related but refer to different things. Dignity is the inherent value of the person as person and not just a claim in relation to other persons. But dignity objectively grounds rights, in the sense of an appropriate way of treating human persons (theiustum). "This iustum is not the dignity itself of the person but a consequence thereof for the sphere of acts directed at persons." (Seifert, 2002, in press). Dignity is then a special case of a ‘morally relevant value’ (Hildebrand, 1978), the violation of which constitutes an immoral act.
According to the different sources of human dignity proposed by Seifert (1987 cf. also my April’s Ethics Page), the author proposes four sources of human rights. His analysis sheds light on the way in which human dignity is at the foundation of specifically personal rights. He recognizes some human rights that can be derived from the very fact of being a person, that is, an individual of the human nature. Among these rights is, for instance, the right to life, to nourishment, to physical integrity, etc. Applied to Palliative Care Ethics, we encounter here the theoretical foundation for the duty to provide so-called "basic care" (hydration, nutrition, basic comfort and symptom relief).
Other rights arise more specifically from the rational and spiritual faculties of the person, such as the rights to education, to truth, to religious freedom, to choose the partner, to get a job, etc. This source of human rights is at the foundation of the moral duty to communicate the truth about diagnosis and prognosis, to offer spiritual support, etc.
Still other rights can be derived from the good use of spiritual faculties. Among these rights are the rights to move, to speak, to act, etc. A "negative" application of this right is, for instance, a situation in which an agitated patient has to be sedated, in order to prevent an eventual harm to others.
Finally, there are also rights that are grounded on special gifts or on a specific vocation, such as the right to educate one’s own children, to unfold special artistic talents, to follow a religious vocation, etc. This source of human rights plays an important role, for instance, when judging the therapeutic proportionality of medical interventions (cf. IAHPC Ethics Page, July 2002). There are cases in which a specific intervention may be judged as disproportionate for an individual patient in the context of other responsibilities related with his unique vocation (e.g., when a father decides to forgo an intervention because it would impose extreme economic burdens to the whole family and deprive them of some basic goods).
We can summarize our previous reasoning, drawing two conclusions:
1. The dignity of the person concedes her certain rights that are different from those rights of non-personal beings.
2. The fact that the human person has some rights implies the existence of the corresponding duties, i.e., some norms that have to be respected by the others.
In other words, the dignity of the person is at the foundation of human rights and of moral duties.
Dr. Paulina Taboada, MD, PhD
Palliative Care and Bioethics