Where does Human Dignity Come From??

Dr. Daniel Daly

This is a continuation of reflections on Dr. Daniel Daly's IBPCA lectures. He spoke about the source of human dignity.

As a high school volunteer in my local children's hospital, I remember standing in front of a plaque emblazoned with the patients' bill of rights. It began with:

______ Medical Center affirms each patient's right to receive care delivered in a considerate, respectful, dignified and comforting manner.

Why? I wondered, as I stood there in my candy-striper polo. Why dignity? Where does dignity come from? Where do documents like the Universal Declaration of Human Rights base their claims on dignity?

That was the beginning of a many-year period of frustration with secularized healthcare that insisted on human dignity. I was glad, of course, that they maintained human dignity. However, I could not discover a source of that dignity, consistent with an agnostic or pluralistic worldview.

And, in fact, it is not to be found. Dignity without God is a relic of a post-Christian society. (A good relic, but an inconsistency.) Dr. Daniel Daly discussed the source of human dignity very lucidly. We are made in the image of God (“imago Dei”): we have intellects, imaging his omniscience; we are social, imaging his Trinity; we have free wills, imaging his will; we have inherent value, imaging his essential goodness. Because we image God, men have transcendent value which cannot be taken away. Moreover, we are all equally valuable, because we all share equally in human nature.

This value is different in kind from the value of the rest of enmattered creation. Non-rational animals, plants, and non-living creatures have intrinsic value--that is, they are good in themselves and should be loved as creatures of God and means to him. Men have this, and more. Men are persons. What is a person?

Principlism is a House of Cards

Dr. Daniel Daly

This post is less about an IBPCA lecture as the previous ones have been. In fact, it is actually original content (i.e. a real post) which sprung from the content of one of our lectures.

Dr. Daniel Daly, an assistant professor of theology at St. Anselm College in Manchester, NH, lectured on healthcare ethics (especially benefit/burden analysis), globalization, and resource allocation. As he introduced himself and explained that he was a Catholic and would be using Catholic ethics in his presentation, he threw out a few startling, refreshing statements: “The roots of medical ethics are found in Catholic theological ethics,” he said unapologetically. He added that 15% of hospital beds in this country are Catholic; that number rises to 25% world-wide.

He then began his presentation by reminding us of the predominant system of ethics taught in medical schools today. This system, developed by Thomas Beauchamp and James Childress, was articulated in Principles of Biomedical Ethics (1994). Beauchamp and Childress sought to find basic ethical principles that all could agree upon. They found four and listed them in this order, though they maintained that there was no hierarchy:

1. [Patient] autonomy
2. Beneficence
3. Nonmaleficence
4. Justice

Obviously, this is a principlist system (built out of principles to be respected), unlike the system that people like Aristotle, Christ, and the teachers of the Church propose (i.e. virtue ethics, built from a goal--the happiness of being a good or holy person).

Principlism has become the favorite of medical schools and I was up to my ears in it last year. Frankly (we are now leaving Dr. Daly), it makes me tired and angry, for several reasons.

• Principlism is a philosophical house of cards
• Principlism makes good-hearted ethics professors (who lack understanding of what they're teaching) inconsistent: insofar as they really want to make us good people, are teaching virtue ethics anyway!
• Principlism is a sign of the destruction of the profession of medicine (a loss of the end...)

Deadly Medicine: Creating the Master Race

On the final day of the IBPCA week of lectures and research, my fellow externs and I visited the U.S. Holocaust Museum. While there, we saw the “State of Deception: The Power of Nazi Propaganda” exhibit and spent a little time in the Wexner Center on the Nuremberg Trials. Unfortunately, there was not enough time on our schedule to see the entire exhibit. I hope to return some day and complete my tour.

We also had a special presentation on medical ethics by Dr. Patricia Heberer (some audio clips of her here). As is well known, The Nazis carried out experiments on eight to ten thousand involuntary human subjects. According to Dr. Heberer, these studies were often not soundly conducted and frequently were testing racist hypotheses (she gave an example of an attempt to prove that Aryan immune systems were better than French ones, which were better than Slavic ones, and so on down the supposed racial hierarchy).

Maternity Homes: Reverse Morbidity with Hope

This is the presentation I gave at the Research Summit of the International Institute for Bioethics and Patient Care Advancement, modified slightly for this venue.

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I am currently involved in the preliminary efforts to open a maternity home in my community and I would like to explain that I am taking that particular step because maternity homes are among the best remedies to the profound needs of special pockets of the female patient population—namely, racial minorities, adolescents, and the urban poor. (For the sake of brevity, I will only speak about a smaller group made up of adolescent women who are impoverished and among the country's larger racial minorities: non-Hispanic black and Hispanic.)

First, some numbers from 2009, the most recent year that the CDC provides birth and pregnancy rates. Of every 1000 women between ages 15 and 19 in this country, 39 give birth to a child. This number is not evenly distributed among the various racial groups in the US. Of 1000 Hispanic teens, 70 give birth; of blacks, 59 do; of whites, only 25.

Birth rates are not the same as pregnancy rates, since some pregnancies end in abortion or miscarriage. Pregnancy rates are not available for 2009, but if rates have remained relatively stable since 2005 (the latest year the CDC provides), then we can estimate even more distressing statistics: the differences between racial groups are even more pronounced, and the abortion ratios are probably also skewed, as high as 50% among black adolescents compared to maximums of 43% in whites and 36.5% among Hispanics.

International Patient Care and Bioethics Externship

This week I have been at a series of lectures in bioethics as the first part of an externship with the International Institue for Bioethics and Patient Care Advancement (IBPCA). This series of lectures will be followed by five weeks of working with Dr. D, a local GYN (she gave up OB some years ago, sad face).

The preceptorship begins with five days of lectures and research, culminating in a presentation of the results of our research and a plan for project over the next five weeks.

International Institute for Bioethics and Patient Care Advancement (whew)

This week I have been at a series of lectures in bioethics as the first part of an externship with the International Institue for Bioethics and Patient Care Advancement (IBPCA). This series of lectures will be followed by five weeks of working with Dr. D, a local GYN (she gave up OB some years ago, sad face). The ethics have been surprisingly (refreshingly) good. Everything labelled with IBPCA is from that week. Enjoy!

Edit 7/19/12: Please note that some of the content I had posted about the IBPCA preceptorship has been removed because of the terms the lecturers had with the Institute (about publication of their research, etc).