A central concept in the ethics of many end-of-life

A central concept in the ethics of many end-of-life issues is the dignity and value afforded to each and every human being. It has been a fundamental theme of this text that, according to the Christian worldview, every human being is made in the image of God and possesses innate dignity and worth regardless of race, ethnicity, socioeconomic status, stage of development, or mental/physical functional capacity. This dignity and value are given by God and are therefore inviolable.

The term human dignity has become an important and powerful rhetorical instrument that is thrown about carelessly in many of the debates surrounding end-of-life issues such as euthanasia, physician-assisted suicide, and the treatment of individuals in so-called permanent or  persistent vegetative state . The term itself is not foundational because it can mean different things to different people depending on how it is used and how it is defined. Because human dignity is not always clearly defined in contemporary medical ethics discussions, it can be used by both sides of many discussions to support different positions. This lack of definition and subsequent confusion contributes to much of the polarization surrounding many bioethics issues. A clear understanding of how this term is defined and used to support varying positions is vital to mapping the contours of many of the current debates on end-of-life issues, especially within a secular culture.

In his 1996 encyclical letter, Evangelium vitae, Pope John Paul II affirmed, explained, and defended the Catholic Church’s pro-life stance against abortion, physician-assisted suicide, and euthanasia. In this pronouncement, he maintained the core belief that “society as a whole must respect, defend, and promote the dignity of every human person, at every moment and in every condition of that person’s life” (John Paul II, 1995, n. 81). During the same decade that Evangelium vitae was published, the Swiss organization Dignitas was established. Dignitas was founded to promote euthanasia and the right of persons to choose the manner and timing of their own death as well as provide individuals with the means to do so. Their motto was “to live with dignity, to die with dignity.”

How can the Catholic Church and the organization Dignitas, both with completely different beliefs and practices, appeal to the same concept of human dignity to support their positions? It is obvious that the term human dignity is being used differently and to represent very different ideas. When John Paul II used the term, he was referring to a specific theological concept, namely, the image of God that all human beings possess. On the other hand, Dignitas’s motto was meant to convey the idea that the rational autonomy of every individual was central to their dignity as a human being. Autonomy, in this case, is understood as individual self-rule, without any controlling interference or limitations.

Autonomy

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