Essay
Comment
Justice
5 min read

Dignity: why people matter

How dignity underlies our ethics and law.

Professor Charles Foster is a Fellow of Exeter College, Oxford, and a member of the Oxford Law Faculty.

A pupil in a classroom looks around and into the camera.
Indus Action

You think that you matter: that you are significant. I agree with you. I think the same about myself.

We all think we are significant, and that our significance requires us to behave and to be treated in particular ways. One of the main functions of the law (perhaps the function of the law) is to regulate this sense of significance: to protect my sense of my significance and to stop it interfering with the sense of significance that others have.

A common name given to this sense of significance is dignity. It is a defining characteristic of humans. We see it as soon as we see behaviourally modern humans – who came on the scene about 45,000 years ago. We laid our dead tenderly in the earth, clutching flowers and amulets, rather than leaving them out as food for hyenas. We carved our faces into mammoth ivory because we knew that there was something about our faces which should endure. We believed that we had souls and that other things, human and non-human did too. This made eating other ensouled things a real problem. We evolved solemn liturgies of oblation and satisfaction to solve it. Our walk through life and death was elaborately choreographed, because it wasn’t proper to stomp and blunder. Comportment mattered because we mattered.

These were astonishing assertions – so astonishing that no big society has ever taken them completely seriously.

Jumping from pre-history to history, dignity, like other precious resources, was appropriated by the rulers, who said that they and only they had a right to it. The hoi polloi never truly believed this; they knew their own worth and moral weight. But the rulers told an artful story. The gods had dignity, they said, and the gods gave it to their favoured ones – typically the royals and the heroes. The royals were the gods’ embodiments or regents, and so the thrones of Mesopotamia and Egypt were invested and affirmed by divine dignity. The capricious gods of Olympus gave dignity at particular times and for particular purposes to their particular favourites, who therefore became demi-gods for a while.

In the Hebrew world, however, a radically democratic move was afoot. God was indeed dignified, but since every human was made in his image, all humans were dignified too – and in the same way as God. The idea was picked up by St Paul: ‘There is neither Jew nor Greek’, he declared. ‘There is neither bond nor free, there is neither male nor female: for you are all one in Christ Jesus’.

These were astonishing assertions – so astonishing that no big society has ever taken them completely seriously.

The obscenity of Auschwitz relegated the hyper-spiritualised notion of dignity to the cloister, and Kant’s notion to the Academy. For whatever dignity was, it was outraged there, and the outrage extended to bodies and to the non-rationally-autonomous.

Less ambitious, and so more palatable, was Stoicism’s rather anaemic version of the Imago Dei. All humans were potentially dignified, it said, and each human had a duty to strive to realise their dignified potential. It was much less radical than the Judaeo-Christian conception, but still represented a tectonic break with the royal theocracies of Mesopotamia, Egypt and elsewhere.

This Stoical conception of dignity did useful work. It served to save the notion of dignity from two mortal threats - both, embarrassingly, from the Christian world (though Kant’s relationship with Christian orthodoxy was sometimes uneasy).

There is a strand of Platonised Christianity (drawing on the early Augustine)  that spiritualises the idea of dignity. If it prevailed dignity would have nothing to say in hospitals about bowels or bedpans, in bedrooms about sex, in plantations about slavery, in jungles about the fate of trees or toucans, or in newsrooms about anything at all.

Kant located dignity in rational autonomy, so snatching dignity from children, the demented, the unconscious, the depressed, everyone who has drunk a bottle of red wine, and more or less everyone who doesn’t have a PhD in philosophy.

The obscenity of Auschwitz relegated the hyper-spiritualised notion of dignity to the cloister, and Kant’s notion to the Academy. For whatever dignity was, it was outraged there, and the outrage extended to bodies and to the non-rationally-autonomous.

In the immediate aftermath of the Second World War dignity (almost always undefined) appeared in endless national and international laws and declarations. Fairly recently it has started to have a real legal life of its own, being invoked for many purposes, from prisoners’ rights to reproduce to the right to have your name on your tombstone in the language of your choice.

These specific invocations of dignity sometimes disguise its foundational nature – foundational to human nature itself and to the laws that seek to determine how humans should conduct themselves in society

To say that the Judaeo-Christian account of dignity gives rise to all ethics and law in the western world is a big claim. I make it unapologetically.

To see how foundational it is, ask yourself why you think it is wrong to kick a child, but not a rock. Or why it is wrong to play football with a human head, or do an intimate examination, for the purposes of teaching medical students, on a woman in a permanent vegetative state. In describing the wrongness you will certainly find yourself relying on something that looks suspiciously like human dignity.

The law is often said to be protecting interests other than dignity (such as autonomy, freedom, or bodily integrity), or promoting other values (such as beneficence or non-maleficence). Yet on close inspection, those interests and values will all turn out to be parasitic on dignity. Dignity is the first order principle: the others stem from it.

In the last forty or so years there has been a good deal of academic discussion about just what ‘dignity’ means. There is a growing consensus that it has two complementary parts. First: an inalienable element: the intrinsic dignity possessed simply and solely by reason of being human. This cannot be lost or diminished. It just is. And second, a dignity which is a consequence of the first, but denotes how, in the light of your dignified nature, you should comport yourself. If we say of someone ‘She’s let herself down’, we mean that she has failed to behave with the dignity expected of someone who has the high status of being human.

This account of dignity is derived straight from the notion of the Imago Dei, and from Paul’s gloss. The watered-down Stoical version simply gives encouragement to behave well: it has nothing akin to the inalienable element.

To say that the Judaeo-Christian account of dignity gives rise to all ethics and law in the western world is a big claim. I make it unapologetically. Perhaps you think that it is too extravagant. But it is plain enough that this account, or one of its iterations outside the sphere of Judaeo-Christian influence (there are several), accords as does no other with our intuitions about ourselves and about how we should act, and with the most fundamental axioms of the laws in all tolerable jurisdictions. The most enlightened parts of Enlightenment thinking originate in this account, though they are often embarrassed to admit it.

Whatever we mean by the Rule of Law, part of it is that no one is above or outside it: Jews and Greeks, and bond and free, and male and female are to be treated alike. We’re so used to the idea that we have forgotten its revolutionary roots.

Article
Assisted dying
Care
Comment
Politics
6 min read

Assisted dying’s problems are unsolvable

There’s hollow rhetoric on keeping people safe from coercion.

Jamie Gillies is a commentator on politics and culture.

Members of a parliamentary committee sit at a curving table, in front of which a video screen shows other participants.
A parliamentary committee scrutinises the bill.
Parliament TV.

One in five people given six months to live by an NHS doctor are still alive three years later, data from the Department of Work and Pensions shows. This is good news for these individuals, and bad news for ‘assisted dying’ campaigners. Two ‘assisted dying’ Bills are being considered by UK Parliamentarians at present, one at Westminster and the other at the Scottish Parliament. And both rely on accurate prognosis as a ‘safeguard’ - they seek to cover people with terminal illnesses who are not expected to recover. 

An obvious problem with this approach is the fact, evidenced above, that doctors cannot be sure how a patient’s condition is going to develop. Doctors try their best to gauge how much time a person has left, but they often get prognosis wrong. People can go on to live months and even years longer than estimated. They can even make a complete recovery. This happened to a man I knew who was diagnosed with terminal cancer and told he had six months left but went on to live a further twelve years. Prognosis is far from an exact science. 

All of this raises the disturbing thought that if the UK ‘assisted dying’ Bills become law, people will inevitably end their lives due to well-meaning but incorrect advice from doctors. Patients who believe their condition is going to deteriorate rapidly — that they may soon face very difficult experiences — will choose suicide with the help of a doctor, when in fact they would have gone on to a very different season of life. Perhaps years of invaluable time with loved ones, new births and marriages in their families, and restored relationships. 

Accurate prognosis is far from the only problem inherent to ‘assisted dying’, however, as critics of this practice made clear at the – now concluded – oral evidence sessions held by committees scrutinising UK Bills. Proponents of Kim Leadbeater’s Terminally Ill Adults (End of Life) Bill and Liam McArthur’s Assisted Dying for Terminally Ill Adults (Scotland) Bill have claimed that their proposals will usher in ‘safe’ laws, but statements by experts show this rhetoric to be hollow. These Bills, like others before them, are beset by unsolvable problems. 

Coercion 

Take, for example, the issue of coercion. People who understand coercive control know that it is an insidious crime that’s hard to detect. Consequently, there are few prosecutions. Doctors are not trained to identify foul play and even if they were, these busy professionals with dozens if not hundreds of patients could hardly be counted on to spot every case. People would fall through the cracks. The CEO of Hourglass, a charity that works to prevent the abuse of older people, told MPs on the committee overseeing Kim Leadbeater’s Bill that "coercion is underplayed significantly" in cases, and stressed that it takes place behind closed doors. 

There is also nothing in either UK Bill that would rule out people acting on internal pressure to opt for assisted death. In evidence to the Scottish Parliament’s Health, Social Care and Sport Committee last month, Dr Gordon MacDonald, CEO of Care Not Killing, said: “You also have to consider the autonomy of other people who might feel pressured into assisted dying or feel burdensome. Having the option available would add to that burden and pressure.” 

What legal clause could possibly remove this threat? Some people would feel an obligation to ‘make way’ in order to avoid inheritance money being spent on personal care. Some would die due to the emotional strain they feel they are putting on their loved ones. Should our society really legislate for this situation? As campaigners have noted, it is likely that a ‘right to die’ will be seen as a ‘duty to die’ by some. Paving the way for this would surely be a moral failure. 

Inequality 

Even parliamentarians who support assisted suicide in principle ought to recognise that people will not approach the option of an ‘assisted death’ on an equal footing. This is another unsolvable problem. A middle-class citizen who has a strong family support network and enough savings to pay for care may view assisted death as needless, or a ‘last resort’. A person grappling with poverty, social isolation, and insufficient healthcare or disability support would approach it very differently. This person’s ‘choice’ would be by a dearth of support. 

As Disability Studies Scholar Dr Miro Griffiths told the Scottish Parliament committee last month, “many communities facing injustice will be presented with this as a choice, but it will seem like a path they have to go down due to the inequalities they face”. Assisted suicide will compound existing disparities in the worst way: people will remove themselves from society after losing hope that society will remove the inequalities they face. 

Politicians should also assess the claim that assisted deaths are “compassionate”. The rhetoric of campaigners vying for a change in the law have led many to believe that it is a “good death” — a “gentle goodnight”, compared to the agony of a prolonged natural death from terminal illness. However, senior palliative medics underline the fact that assisted deaths are accompanied by distressing complications. They can also take wildly different amounts of time: one hour; several hours; even days. Many people would not consider a prolonged death by drug overdose as anguished family members watch on to be compassionate. 

Suicide prevention 

 It is very important to consider the moral danger involved with changing our societal approach to suicide. Assisted suicide violates the fundamental principle behind suicide prevention — that every life is inherently valuable, equal in value, and deserving of protection. It creates a two-tier society where some lives are seen as not worth living, and the value of human life is seen as merely extrinsic and conditional. This approach offers a much lower view of human dignity than the one we have ascribed to historically, which has benefited our society so much.  

Professor Allan House, a psychiatrist who appeared before the Westminster Committee that’s considering Kim Leadbeater’s Bill, described the danger of taking this step well: “We’d have to change our national suicide prevention strategy, because at the moment it includes identifying suicidal thoughts in people with severe physical illness as something that merits intervention – and that intervention is not an intervention to help people proceed to suicide.” 

 Professor House expressed concern that this would “change both the medical and societal approach to suicide prevention in general”, adding: “There is no evidence that introducing this sort of legislation reduces what we might call ‘unassisted suicide’.” He also noted that in the last ten years in the State of Oregon – a jurisdiction often held up as a model by ‘assisted dying’ campaigners – “the number of people going through the assisted dying programme has gone up five hundred percent, and the number of suicides have gone up twenty per cent”. 

The evidence of various experts demonstrates that problems associated with assisted suicide are unsolvable. And this practice does not provide a true recognition of human dignity. Instead of changing the law, UK politicians must double down on existing, life-affirming responses to the suffering that accompanies serious illness. The progress we have made in areas like palliative medicine, and the talent and technology available to us in 2025, makes another path forwards available to leaders if they choose to take it. I pray they will. 

Join with us - Behind the Seen

Seen & Unseen is free for everyone and is made possible through the generosity of our amazing community of supporters.

If you’re enjoying Seen & Unseen, would you consider making a gift towards our work?

Alongside other benefits (book discounts etc.), you’ll receive an extra fortnightly email from me sharing what I’m reading and my reflections on the ideas that are shaping our times.

Graham Tomlin

Editor-in-Chief