How many things have been justified in the name of dignity! Brandished by the defenders of euthanasia as well as by its opponents, the argument forces itself in and too often puts an end to the discussion. This being said, what does dignity really mean? Marianne Durano is a philosopher and gives us keys to understanding and putting in perspective the rogue sense of a notion that is too often trivialised.
“Autonomy is the basis of the dignity of human nature and of every rational nature.” This definition, given by Kant in Groundwork of the metaphysics of morals, looked forward to a promising future. It was the cornerstone of many ways of thinking concerning medical ethics. Dignity would thus be dependent on autonomy, i.e., on the capacity of defining the rules of one’s actions oneself. Even better, Kant assimilates rational nature and human nature, reason itself being recognisable through autonomy… Human dignity, as the human being, would thus depend on this principle of autonomy, which requires for everyone to be able to make choices independently of any exterior influence, may it be one’s own body, one’s own emotions, or one’s own inclinations. Because can someone ravaged by passion or disease, truly be called autonomous? In order to be truly autonomous, i.e., truly free, one would indeed need to be determined by nothing else than by one’s own reason, after having put aside any interest of determinism. Only a truly selfless person would be absolutely free. When some associations demand “the right to die in dignity”, they imply that a person who has lost all autonomy, made dependent and vulnerable through suffering, has also lost all dignity along with his freedom. Chosing one’s death would thus represent the “ultimate freedom”, the last autonomous act that would give back the dying person his endangered dignity.
Can autonomy alone define dignity?
This reasoning is flawed. If the patient’s dignity is threatened by a lack of autonomy, then how could he regain that autonomy by showing a last proof of autonomy? If I am weakened by pain to the point of losing my dignity, how could I be considered autonomous when asking for euthanasia? If one’s dignity depends on one’s autonomy, then the right conclusion must be made: he who no longer has dignity is no longer autonomous, and he who no longer is autonomous no longer has any dignity. Things need to be clarified. Either a person who asks to die does it in an autonomous way, and therefore still has dignity, i.e., enough to carry on living; either the person is no longer autonomous, and his choice is not truly a choice. In both cases, one can see how dangerous it is to connect autonomy and dignity. Where does alienation really start? Are we truly autonomous in our daily decisions? Who can be truly certain of receiving no exterior influence, no unconscious desires, no uncontrolled impulse? To define a priori criterias of autonomy, and therefore dignity, would represent an intolerable form of violence towards the patients. But to suppose that he who has lost his autonomy is the best placed to diagnose his own situation, is forgetting that, precisely, his alienation itself prevents him from seeing clearly.
Misdirected dignity closes like a trap
How can one overcome this stalemate? By giving up forever the vocabulary of autonomy, which seems to me to be a fantasy that creates more issues than it actually solves. Dignity means the unconditional respect due to a person: on the contrary, the fact of making dignity dependant on autonomy conditions this respect. To define a person through his autonomy and reason, to grant man dignity only if he is considered to be a reasonable being, would imply that all dependant and vulnerable beings are no longer considered as human beings whose lives should be respected for themselves. By legalising euthanasia for underage people, and soon, why not, for mentally disabled people, Belgium clearly demonstrates the inherent contradictions of the arguments of the supporters of the right to die “in dignity”. Euthanasia comes out less as a last proof of autonomy (for what autonomy could there be for underage and disabled people?) than as the consequence of a lack of autonomy, sanctioned by an outside decision. Before, one had to be autonomous to be able to benefit from euthanasia, now one simply needs to be vulnerable to endure it. Dignity is becoming a mask ripped off by suffering, which another can take off us… in the name of freedom!
Who has dignity?
By acting in this way, dignity goes back to being what it was during antiquity: a role that society temporarily assigns to us, and that it can take back anytime. The old dignitary was an important person, and dignitas was a rank and social prestige. It is, in this respect, quite telling that the Swiss association for assisted suicide is called this. This dignitas implies that the value of a person depends on his usefulness to society, of the importance that the latter attaches to him. It is indeed towards this concept of dignity that we are moving. Euthanasia presented as a social progress is, in reality, a regression on a conceptual point of view. Each person, until now recognised worthy of dignity for their own sake, once more see their value depend on their place in the social hierarchy. At the top, the strong, the free, the autonomous, the notorious, the dignitaries. Down in the catacombs, the old, the sick, the alienated, the vulnerable, the proletarians. For is a person overwhelmed by hunger truly autonomous and filled with dignity? It was that kind of reasoning that led the antiques to grant citizenship only to free men, rich enough to have the leisure of being involved in politics. Exit then, children, women, slaves, and strangers! This kind of discourse can be found… in Kant’s work itself, which, at least, was thorough and disciplined enough to draw the consequences of these principles. If autonomy is the principle of dignity, then dependant beings are certainly not capable of taking the responsibility for a political speech. He who cannot be a law for himself, cannot by deduction be the judge of the laws of the community. Kant, having said this, believes that only a person who owns a property, i.e., who only depends on himself, is worthy to be a citizen. This enables him to write, undisturbed, in Theory and practice: “The housekeeper, the shopkeeper, the journalist, the barber even (…) have not the necessary qualities to be citizens”. That is how far one needs to go, if one decides to define dignity through autonomy.
Find dignity in humanity
What alternative against this can one suggest? None other than what presides over the rights of men, the rights of citizens, our very concept of humanity; that which binds a person to dignity, unconditionally, with all its weaknesses, its defaults, its diseases and alienations. Society, in this perspective is not an aggregation of autonomous individuals. On the contrary, it finds its reason to be in our unavoidable dependences, i.e., in our need of others. He who wishes to be autonomous until the end, is alone until the very end. He who knows himself as a dependant being, agrees to be so in an extreme way. But both have equal dignity, worthy of living, worthy of being loved. The question is not: “Who is the freest?”, but: “With whom can we and do we want to live?”