Autonomy, human dignity, and death with dignity: Advancing a relational view of human dignity in end-of-life bioethics.

摘要

This dissertation aims to clarify the relationship between autonomy and human dignity, to describe how inherent human dignity requires a relational response, and to explore how this relational response to inherent human dignity can be incorporated into end-of-life care. The approach of the dissertation is to justify a specific understanding of human dignity based on a comparative analysis of the meaning and function of human dignity in the literature.; To support this more relational concept of human dignity, one must endorse the idea that human dignity has both universalist and particularist dimensions. Universalist human dignity promotes the view that humans have inherent dignity simply by virtue of being human. Particularist human dignity expresses the notion that particular views of what brings meaning, value, and purpose to life shape one's understanding of human dignity. In a relational understanding of human dignity, both concepts are important, for they work together in a dynamic fashion. End-of-life bioethics often focuses on particularist human dignity, but this can create conceptual and practical problems. Conceptually, the particularist view tends to hinge human dignity on the possession of certain properties like autonomy and rationality, capacities that many dying people lose. Practically, those without such capacities may be devalued as humans, which can also contribute to a sense of alienation or isolation for individuals near death. These practical developments run counter to the importance that interpersonal relationality has in affirming the worth of people near death.; This dissertation has six chapters. Chapter one offers a summary of the problem, its significance, and the argument and outline of this dissertation. Chapter two examines the historical roots and conceptual understanding of autonomy in bioethics. Chapter three addresses the historical roots and conceptual understanding of human dignity in bioethics. Chapter four integrates the elements of chapter three into the meaning and significance of death with dignity. Chapter five analyzes how arguments for and against physician-assisted suicide are most helpful when they incorporate both universalist and particularist notions of human dignity. Chapter six concludes the project by examining the salient points of this dissertation.