Steven Pinker has an article in The New Republic on the recently released Human Dignity and Bioethics report by the President’s Council on Bioethics on the role of dignity in medicine.

The report does not, the editors admit, settle the question of what dignity is or how it should guide our policies. It does, however, reveal a great deal about the approach to bioethics represented by the Council. And what it reveals should alarm anyone concerned with American biomedicine and its promise to improve human welfare. For this government-sponsored bioethics does not want medical practice to maximize health and flourishing; it considers that quest to be a bad thing, not a good thing.

The problem, Pinker says, is the strong and obvious religious slant in many of the report’s essayists.

Of course, institutional affiliation does not entail partiality, but, with three-quarters of the invited contributors having religious entanglements, one gets a sense that the fix is in. A deeper look confirms it.

The fix is indeed in. A number of the chapters openly address Judeo-Christian beliefs or literature, at times explicitly referencing biblical arguments. Most unfortunate is that these arguments go unexamined. Nowhere, except for a small commentary by Daniel Dennett, are any religious claims criticized.

Pinker admits most of the chapters in the report do not address Catholicism, but the scene does not become sunnier as his gaze is cast more broadly to the entire report. For a 555-page report written to elucidate the role of dignity in bioethics, the Council does a piss-poor job.

How well do the essayists clarify the concept of dignity? By their own admission, not very well. … In fact, it spawns outright contradictions at every turn. … We read that dignity reflects excellence, striving, and conscience, so that only some people achieve it by dint of effort and character. We also read that everyone, no matter how lazy, evil, or mentally impaired, has dignity in full measure.

Given the slipperiness of “dignity” as a concept, it is difficult to pin it down in a useful way. Pinker grants it a modicum of moral significance, but I think Ruth Macklin’s 2003 editorial “Dignity is a Useless Concept” provides a straightforward argument against ever worrying about dignity.

Macklin argued that bioethics has done just fine with the principle of personal autonomy–the idea that, because all humans have the same minimum capacity to suffer, prosper, reason, and choose, no human has the right to impinge on the life, body, or freedom of another. This is why informed consent serves as the bedrock of ethical research and practice, and it clearly rules out the kinds of abuses that led to the birth of bioethics in the first place, such as Mengele’s sadistic pseudoexperiments in Nazi Germany and the withholding of treatment to indigent black patients in the infamous Tuskegee syphilis study. Once you recognize the principle of autonomy, Macklin argued, “dignity” adds nothing.

Review boards already exist to ensure no study imposes undue emotional or physical strain on its participants. Beyond that, all we can reasonably ask for is that every participant acts of their own volition. Informing a participant of the risks and benefits of their participation allows them to choose for themselves whether the study will rob them of their dignity. This system gives an appropriate amount of scientific freedom while protecting all involved. Any further restrictions by the government would be constricting and antithetical to scientific progress.

Even if progress were delayed a mere decade by moratoria, red tape, and funding taboos (to say nothing of the threat of criminal prosecution), millions of people with degenerative diseases and failing organs would needlessly suffer and die. And that would be the biggest affront to human dignity of all.

(P.S. This report is even more disquieting after having just seen the Jesus Camp documentary.)

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