Challenges to Human Dignity in Secular Bioethics 14th AFCMA Congress 2008 Human Dignity in Medicine Catholic Diocese Center, Hong Kong Fr. Joseph Tham, L.C. B.Sc., B. Phil., B.Theo., M.D., M. Bioethics, Ph.D. Outline • Traditions of Human Dignity • Secular approaches to Bioethics – Against Human Dignity – In favor of Human Dignity • Our post-human future? Traditions of Human Dignity • Greeks: Stoics (Aristotle, Plato): acquired – Excellence, aristocratic, elitist? • Christian: intrinsic – – – – Image of God, Redeemed Equality as creatures, not creator co-creators Lower than the gods and higher than the beasts • Modern philosophy (Kant): – Reason, autonomy, freedom – Man not treated as means but as an end. – But too abstract, not existential enough (courage) • Human Nature Human Dignity Human Rights Secular Bioethics • • • • • • No to tradition: Hippocratic Oath, authority No to Metaphysics No to Natural Law No to Human nature vs culture (nurture) No to Religion No to Reason Outline • Traditions of Human Dignity • Secular approaches to Bioethics – Against Human Dignity – In favor of Human Dignity • Our post-human future? Secular Bioethics against Human Dignity • Scientific positivism • Scientific materialism – Darwinism • Against human specificity (exceptionalism) • Human reason (soul) is mechanical, not spiritual – Transhumanism – Neuroscience and neuroethics • • • • • Contractualism Utilitarianism Liberalism Pragmatism Relativism and Nihilism Scientific Positivism • Comte: Scientism, Scientific positivism – Science (empirical data) is the only source of knowledge – Progress is infinite – No limits to research, technological imperative • Stem-Cell Hypocrisy: “The Christian right’s wrongheaded invocation of religion to restrict stem-cell research ranks up there with the medieval sanctioning of Galileo because his scientific views conflicted with church doctrine.”– Newsweek 5/27/2005 Scientific Materialism • Descartes – Dualism: Body and soul two different substances. • Hobbes – Material universe, no human souls – Human behavior is a stimulus-response of “appetites and aversions” – Animals = humans • Skinner, behavioral scientist – ‘animal’ is a pejorative term only because ‘man’ has been made spuriously honorific… – “How like a dog! …like a dog he is within range of scientific analysis.” Scientific Materialism • Joseph Fletcher’s 4 indicators of Humanhood – Minimal intelligence, Self-awareness, capacity to relate to others, neo-cortical function – Not non- or anti-artificial, not essentially parental, not essentially sexual, not a bundle of rights, not a worshipper Scientific Materialism • As far as the scientific enterprise can determine. . . [h]uman capabilities appear to differ in degree, not in kind, from those found among the higher animals. • Humanity's rich repertoire of thoughts, feelings, aspirations, and hopes seems to arise from electrochemical brain processes, not from an immaterial soul that operates in ways no instrument can discover. . . • Views of human nature rooted in humanity's tribal past ought not to be our primary criterion for making moral decisions about cloning. . . . • The potential benefits of cloning may be so immense that it would be a tragedy if ancient theological scruples should lead to a Luddite rejection of cloning. --Francis Crick and E. O. Wilson Darwinism • Human is just a part of nature, no special dignity. • Coll: Animals, plants or nature has dignity. • Animal Rights – Peter Singer: Speciesism (racism) • Chimpanzees and humans share 97% genetic info • Animal culture? Dominance structure and helping behavior • Chimpanzee Justice: “abandon the assumption that ethics is uniquely human.” – Spain’s Great Ape Project: the rights to life, liberty, and freedom from torture to great apes and devolve humans into a "community of equals" with chimpanzees and gorillas. Darwinism • Plant’s rights – Switzerland’s constitution amendment established the intrinsic dignity of individual plants, based on the many similarities they share with us at the molecular and cellular levels. – Vegetation has an inherent value and that it is immoral to arbitrarily harm plants by, say, "decapitation of wildflowers at the roadside without rational reason." – Dr. Keller recently sought government permission to do a field trial of genetically modified wheat that has been bred to resist a fungus. He first had to debate the finer points of plant dignity with university ethicists. Then, in a written application to the government, he tried to explain why the planned trial wouldn't "disturb the vital functions or lifestyle" of the plants. He eventually got the green light. Darwinism • Nature – Ecuador’s constitution, “Nature or Pachamama [the Goddess Earth], where life is reproduced and exists, has the right to exist, persist, maintain and regenerate its vital cycles, structure, functions and its processes in evolution.” Every virus, bacterium, insect, tree & weed has constitutional rights – Paul Taylor: all living beings have moral worth (dignity). “We can think of the good of an individual nonhuman organism as consisting in the full development of its biological powers. Its good is realized to the extent that it is strong and healthy.” – Alan Gregg: “The world has cancer and the cancer is man” Transhumanism • Solutions are to be found in future science and technology. – AI, cybernetics, Nanotechnology, regenerative medicine, stem cells, cloning, hybrids, chimeras… • Self-directed evolution to some better form of life and overcome present limitations. – Why not seize this power? Why not control what has been left to chance in the past? Indeed, we control all other aspects of our children’s lives and identities through powerful social and environmental influences and, in some cases, with the use of powerful drugs like Ritalin and Prozac. On what basis can we reject positive genetic influences on a person’s essence when we accept the rights of parents to benefit their children in every other way? --Lee Silver, geneticist Transhumanism • Joseph Fletcher: Specialize capacities of people – By cloning, constructive genetic engineering, bio-engineer or bio-design para-humans or “modified men”—as chimeras (part animal) or cyborg-androids (part prostheses). – I would vote for cloning top-grade soldiers and scientists, or for supplying them through other genetic means, if they were needed to offset an elitist or tyrannical power plot by other cloners—a truly science-fiction situation, but imaginable. – I suspect I would favor making and using man-machine hybrids rather than genetically designed people for dull, unrewarding or dangerous roles needed nonetheless for the community’s welfare—perhaps the testing of suspected pollution areas or the investigation of threatening volcanoes or snow-slides Transhumanism – Testes and ovaries are social by nature and it would appear ethically that they should be controlled in the social interest – Hybrids could also be designed by sexual reproduction, as between apes and human. If interspecific coitus is too distasteful, then laboratory fertilization and implant could do it. If women are unwilling to gestate hybrids animal females could. Actually, the artificial womb would bypass all such repugnancies. Neuroethics • Steven Pinkers, Harvard psychologist – Morality is biologically based. could be reproduced if complex enough – The brain is a very complex computation machine, but a machine nonetheless. – Morality is simply a function of the brain, and that if one rewired the brain, morality would change. So, for example, people might be rewired to crave incest and to have a taste for eating dirt. Neuroethics • Unfortunately for that theory, brain science has shown that the mind is what the brain does. The supposedly immaterial soul can be bisected with a knife, altered by chemicals, turned on or off by electricity, and extinguished by a sharp blow or a lack of oxygen. Centuries ago it was unwise to ground morality on the dogma that the earth sat at the center of the universe. It is just as unwise today to ground it on dogmas about souls endowed by God. Neuroethics • Richard Dawkins, The Selfish Gene • Evolution of morality – Morality is a product of learning and convention, like toilet training, social justice may be modified—revised, augmented, deepened. – Morality has evolved from animal behaviors to more complex human ones. – Darwin, “A tribe including many members who, from possessing in high degree the spirit of patriotism, obedience, courage and sympathy, were always ready to aid one another and to sacrifice themselves for the common good would be victorious over most other tribes; and this would be natural selection.” – Ethics is rooted in social instincts supplied by our genes • No universal morality, multiculturalism = moral relativism • Determinism, no free will Secular Bioethics against Human Dignity • Scientific materialism – Darwinism • Against human specificity (exceptionalism) • Human reason (soul) is mechanical, not spiritual – Transhumanism – Neuroscience and neuroethics • • • • • Contractualism Utilitarianism Liberalism Pragmatism Relativism and Nihilism Contractualism • Consensus but not truth: – Principlism, Rawls, Nussbalm, etc • Hobbes’ Leviathan: The Value or worth of a man, is, as of other things, his price; that is to say, so much as would be given for the use of his Power; and therefore it is not absolute; but a thing dependent on the need and judgment of another…. The publique worth of a man, which is the Value set on him by the Commonwealth, is that which men commonly call dignity. • Reason unable to find consensus: Engelhardt Utilitarianism • Quality of Life, ends justifies means, $$ • Peter Singer – Australian, Princeton Chair of Human Ethics since 1999 – All and only beings that can (now) experience suffering or enjoyment have interests; and therefore have moral status. • Voluntary euthanasia, Non-voluntary euthanasia of “nonpersons”, Experimentations on brain-damaged humans, Eugenics, Infanticide Utilitarianism: Infanticide • “Since neither the neonate nor the fish is a person, killing these beings is not morally as negative as killing a person.” • “In modern era of liberal abortion laws, most of those not opposed to abortion have drawn a sharp line at birth. If, as I have argued that line does not mark a sudden change in the status of the foetus, then there appear to be only two possibilities: oppose abortion or allow infanticide. In our book Should the Baby Live, we suggested that a period of 28 days after birth might be allowed before an infant is accepted as having the same right to life as others. This is clearly well before the infant could have a sense of its own existence over time, and would allow a couple to decide that it is better not to continue with a life that has begun very badly.” Utilitarianism: Infanticide • Among philosophers and bioethicists, the view that I was to defend is by no means extraordinary; if it has not quite reached the level of orthodoxy, it, or at least something akin to it, is widely held, and by some of the most respected scholars in the fields of both bioethics and applied ethics. • Harvard, Yale, Princeton, Oxford, Tufts, Texas, etc. Utilitarianism: Infanticide • Joseph Fletcher, (1905-1991) Co-Founder, Program in Biology and Society, first professor of medical ethics University of Virginia; Professor of Christian Ethics, Harvard Divinity School • Dan W. Brock, Frances Glessner Lee Professor of Medical Ethics and director of Medical Ethics, Harvard University, and previously director of the Center for Biomedical Ethics, Brown University • Norman Daniels, Mary B. Saltonstall Professor of Population Ethics, Harvard University, and former Goldthwaite Professor of Philosophy and Medical Ethics, Tufts University; • Shelly Kagan, Clark Professor of Philosophy, Yale University and former Henry R. Luce Professor of Social Thought and Ethics; • Michael Sandel, Anne T. and Robert M. Bass Professor of Government, Harvard University. • Ronald Dworkin, Emeritus Professor of Law, Oxford University, Professor of Philosophy and Frank Henry Sommer Professor of Law, New York University. Utilitarianism: Infanticide • Jonathan Glover, director and professor, Centre of Medical Law and Ethics, King’s College, London • R.M. Hare (1919-2002), the late White’s professor of Moral Philosophy at Oxford University. • Julian Savulescu, director of Oxford’s Uehiro Centre for Practical Ethics, head of the Melbourne-Oxford Stem Cell Collaboration, and editor of Journal of Medical Ethics. • James Hughes, Professor of Health Policy, Trinity College, Hartford Conn. • John Harris, Sir David Alliance professor of bioethics, University of Manchester, England • Helga Kuhse, senior research fellow at Centre for Human Bioethics at Monash University, Australia • Tom Beauchamp, Professor of Philosophy and Senior Research Scholar, Kennedy Institute of Ethics, Georgetown University. Utilitarianism: Infanticide • Baruch Brody, Professor of Philosophy, Rice University. • Tristram Engelhardt, Professor of Medicine, Baylor College of Medicine and Professor of Philosophy, Rice University. • John A. Robertson, Vinson and Elkins Chair in Law, University of Texas, and Chair of the Ethics Committee of the American Society for Reproductive Medicine. • Michael Tooley, professor of philosophy, formerly at University of Western Australia and presently at University of Colorado. • Richard Frey, professor of philosophy, Bowling Green State University. • James Rachels (1941-2003), professor of philosophy, University of Alabama, Birmingham • Gregory E. Pence, Professor of Philosophy, Schools of Medicine and Arts/Humanities, University of Alabama Utilitarianism: Infanticide • The Groningen Protocol for Euthanasia in Newborns – 22 cases of severe spina bifida in Holland from 1997-2002 – Newborns with no chance of survival. – Infants who may survive after a period of intensive treatment, but expectations regarding their future condition are very grim. – Babies with an extremely poor prognosis who do not depend on technology for physiologic stability and whose suffering is severe, sustained, and cannot be alleviated. Utilitarianism: Infanticide • ACTIVELY ending a life can sometimes be more humane than waiting for a person to die, and in the desperate cases where death does not come of its own accord to end unendurable suffering, the morally right thing to do is to summon it. Hilde Lindemann - Marian Verkerk, “Ending the Life of a Newborn: The Groningen Protocol”, Hastings Center Report 1 (2008), 42-51. Secular Bioethics against Human Dignity • Scientific materialism – Darwinism • Against human specificity (exceptionalism) • Human reason (soul) is mechanical, not spiritual – Transhumanism – Neuroscience and neuroethics • • • • • Contractualism Utilitarianism Liberalism Pragmatism Relativism and Nihilism Liberalism • Pro Choice, autonomy: abortion, euthanasia • Technological imperative • Human Fertilisation and Embryology Act, UK – – – – – – – – Creation of animal-human embryos, artificial gametes, cloning using two maternal egg sources, germline manipulation, preimplantation diagnosis for eugenic purposes, posthumous conception, removal of the child’s need for a father, use of tissue without proper consent Liberalism • Martha Nussbaum, Professor of Law and Ethics at the University of Chicago. – I think we ought to seek political principles that have a moral content but that avoid contentious metaphysical notions (for example, the notion of the soul)… – Respecting human dignity requires informing people about their choices, restricting dangerous choices for children, but permitting adults to make a full range of choices, including unhealthy ones. – Prostitution, drug use, killing embryos, abortion, cloning, suicide and euthanasia okay, but not research on animals. Pragmatism • Ruth Macklin, “Dignity is a Useless Concept,” BMJ 327 (2003): 1419-1420. – Dignity “is a useless concept in medical ethics and can be eliminated without any loss of content.” – Dignity “means no more than respect for persons and their autonomy.” – Reducible to autonomy or a Trojan horse for religion. • Functional reductionism – Dignity is attributed, not inherent – Can be absent or lost (embryo, fetus, PVS, etc.) – E.g., Dignity in Dying, Dignitas Relativism and Nihilism • My demand upon the philosopher is known, that he take his stand beyond good and evil and leave the illusion of moral judgment beneath himself. This demand follows from an insight which I was the first to formulate: that there are altogether no moral facts. Moral judgments agree with religious ones in believing in realities which are not realities. Morality is merely an interpretation of certain phenomena—more precisely, a misinterpretation. Moral judgments, like religious ones, belong to a stage of ignorance at which the very concept of the real, and the distinction between what is real and imaginary, are still lacking: thus “truth”, at this stage, designates all sorts of things which we today call “imaginings”. Moral judgments are therefore never to be taken literally: so understood, they always contain mere absurdity. -Nietzsche Outline • Traditions of Human Dignity • Secular approaches to Bioethics – Against Human Dignity – In favor of Human Dignity • Our post-human future? Positive secular attempts • Jürgen Habermas – German philosopher, The Future of Human Nature – Not based on intrinsic dignity of human life of the human embryo. – Liberal defense of human dignity based on equality – Dialogue with Benedict XVI. • Joseph Cardinal Ratzinger and Jürgen Habermas, Dialectics of Secularization: On Reason and Religion. Positive secular attempts • Francis Fukuyama, Our Posthuman Future • President’s Council on Bioethics – – – – Leon Kass, Edmund Pellegrino On Being Human Human Cloning and Human Dignity Bioethics and Human Dignity • Virtue ethics (e.g. MacIntyre) • Philosophy of nature (Maritain) Positive secular attempts • Human Rights – Nuremburg trials, slavery – Preamble to the United Nations’ Universal Declaration of Human Rights (1945): “All human beings are born free and equal in dignity and rights.” – Dignity appears in about four constitutions in the period 1900–1945 and in more than thirty-seven from 1945 to 1997. – Charter of Fundamental Rights of the European Union: “Human dignity is inviolable. It must be respected and protected.” – The German Basic Law: “Human dignity shall be inviolable. To respect and protect it shall be the duty of all state authority.” – UNESCO Declaration on Bioethics and Human Rights Human Rights • The meaning, content, and foundations of human dignity are never explicitly defined. • Political consensus, not a philosophical or moral treatise on human nature and the rights and dignities attending human nature • It is difficult to define what human dignity is. It is not an organ to be discovered in our body, it is not an empirical notion, but without it we would be unable to answer the simple question: what is wrong with slavery?—Leszek Kolakowski Human Rights • Via Negativa: when rights are denied – – – – – – – – – Holocaust Slavery Genocide Ethnic cleansings Political murders of dissidents in totalitarian regimes Religious coercion Human trafficking Torture and degradation of prisoners Urban slums Outline • Traditions of Human Dignity • Secular approaches to Bioethics – Against Human Dignity – In favor of Human Dignity • Our posthuman future? Eugenics Hybrids Cloning Embryonic stem cell Prenatal selection IVF Infanticide Euthanasia Abortion Homosexuality Divorce Premarital sex Contraception Masturbation Domino effect Our posthuman future • Growth hormone to make children taller; • Pre-implantation genetic screening to facilitate eugenic choice and enhancement • Ritalin and other stimulants to control behavior or boost performance on exams; • Prozac and other drugs to brighten moods and alter temperaments, increase muscle mass, sexual performance, etc. Our posthuman future • Drugs to erase painful or shameful memories or to simulate falling in love. • Genes to increase the size and strength of muscles. • Nano-mechanical implants to enhance sensation or motor skills. • Techniques to slow biological aging and increase the maximum human lifespan. • Better children, superior performance, ageless bodies, and happy souls. Brave New World • Aldous Huxley – Mastery of human nature and human troubles through technology can issue in a world peopled by creatures of human shape but of shrunken humanity—engaged in trivial pursuits; lacking science, art, religion, and self-government; missing love, friendship, or any true human attachments; and getting their jollies from high-tech amusements and a bottle of soma. --Leon Kass The Abolition of Men We reduce things to mere Nature in order that we may “conquer” them. We are always conquering Nature, because “Nature” is the name for what we have, to some extent, conquered... As long as this process stops short of the final stage we may well hold that the gain outweighs the loss. But as soon as we take the final step of reducing our own species to the level of mere Nature, the whole process is stultified, for this time the being who stood to gain and the being who has been sacrificed are one and the same. C.S. Lewis, The Abolition of Men, 43. Prospects • • • • • • Reconciliation, unity Renewal Education, Formation Religious input Engagement Testimony School of Bioethics Regina Apostolorum, Rome jtham@legionaries.org bioethics@upra.org www.upra.org