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Unpublished Paper
Human Dignity as a Normative Standard or as a Value in Global Health Care Decisionmaking?
ExpressO (2015)
  • George P Smith
Abstract

Abstract

Dignity is seen commonly as an ethical obligation owed to human persons. The dimensions of this obligation, in today’s post secular society, are—however—subject to wide discussion and debate; for, the term, human dignity, and its preservation, defies universal agreement. Yet its preservation, together with the prevention of indignity, is a guiding principle or at least a vector of force in a wide range of issues ranging from embryo research and assisted reproduction to biomedical enhancement, and the care of the disable and to the dying. In clinical medicine, safeguarding the dignity of the patient is a core responsibility of all physicians to respect patient autonomy and to act with beneficence and non-malficence in health care decisions.

While foundational instruments such as The Universal Declaration of Human Rights, the International Covenant on Economic, Social and Cultural Rights and The Covenant on Civil and Political Rights, as well as The Universal Declaration on the Human Genome and Human Rights together with The Convention on Human Rights and Biomedicine, all codify a mandate to ensure human dignity within various contexts of international conduct, the notion—itself—is stated normally in grandiloquent terminology without more and always subject to progressive realization rather than absolute recognition.

This Article focuses on an investigation of a specific application of human dignity at the end-stage of life. Arguing that beneficence and compassion are integral to the preservation of dignity and the management of refractory pain and suffering, the conclusion drawn is that when conditions of medical futility present situationally and patient values and life experiences comport with sound medical judgment or best patient interests, palliative sedation should be endorsed more widely and accepted as an efficacious course action which protects the essential human right of every person to die with at least a semblance of dignity.

Ongoing international efforts must continue to be taken in order to guide the actions of states in seeking to set and to maintain levels of cultural and social conduct which serve to safeguard human dignity throughout life and especially at its end-stage. Without issues of justiciability being resolved, and the absence of a central enforcement, however, dignity will likely remain an elusive value—but certainly not, in and of itself, a cognizable normative standard.

Human dignity, and its implementation, can nonetheless serve as a valuable catalyst for informing and shaping ongoing debates on this vital issue of concern; and, furthermore, testing the extent to which International Equity can serve as a template for securing dignity and well-being in health care decision making at the end-stage of life.

Keywords
  • dignity,
  • human dignity,
  • global healthcare,
  • end-stage of life,
  • beneficence,
  • compassion,
  • refractory,
  • pain and suffering,
  • medical futility,
  • palliative sedation
Publication Date
March 17, 2015
Citation Information
George P Smith. "Human Dignity as a Normative Standard or as a Value in Global Health Care Decisionmaking?" ExpressO (2015)
Available at: http://works.bepress.com/george_smith/102/