Dignity is thus no less complex and multifaceted than is human life itself, and one cannot understand one without an understanding of the other. While human dignity may come to the forefront for those of us who find ourselves in situations in which the threat to human dignity is to the fore—in situations of human suffering and distress, pain, debility, or hardship—human dignity is also at the centre of ethical life and so at the centre of our everyday ethical practice. The reason for this is simple: it is precisely the need to be attentive to human worth that is at the centre of ethical thought and action.
Moreover, to be attentive to human worth is to be attentive to the complex relatedness in which all human life consists; a relatedness that encompasses ourselves, the others with whom we live, and the wider world. There is an island there, a mysterious island indeed, and I propose to try to explore this notion or terrain as if one were exploring an island which beckons for exploration: images of childhood here!
How does one get to an island? We have several possible routes, and many options. If we had a lifetime, we could consider many streams of human archaeology: what do the traces of the human tell us—especially about the symbolic life? The resources are too rich: even a fragment is fascinating to a non-professional inquisitive explorer. For example, the ancient Upper Paleolithic images in the Lascaux caves in France are considered to reflect sophisticated shamanic activities,3 and aboriginal rock paintings in Australia may well reflect similar thought worlds4: Parr, a Tasmanian artist, gave attention to these considerations in the Hobart Interdisciplinary Colloquium.
Lickiss and my boots,6 and neither can the concept of human dignity be so contained. The awareness of the social world and symbolic universe immediately appear to be generated within, not outside human consciousness, albeit in response to other realities. There is an interesting connection here with debates concerning the origin of religious practices and ideas, usually based in major traditions on some revelatory event. Gillman discusses this usefully for the modern inquirer7; he notes that for Kaplan, The experience of revelation is very much akin to other forms of human creativity.
When we experience within our social order, or in humanity at large, a striving for ever-growing levels of perfection, when we devise means to reach those levels, and when we are personally impelled to put these means into effect, we have experienced revelation. Relationality or, as we may also refer to it, mutuality must somehow be recognized as primary in any exploration of human dignity. Alternatively, we could engage with philology—and semiotics to try to grasp the notion of the human and human dignity which can be appreciated by an adequate understanding of human language and symbols—over time and space, in diverse cultures.
We quickly recognize that dignity was closely related to status dignitas in the Greco-Roman period, but in more recent times, for example, since the French Revolution, other notions are included: this touches the realm of the historian.
Gruenwald and E. Any such exploration would at least touch on human rituals for recognition of and restoration of respect for dignity, with the actions themselves pointing beyond language. As another option, we could ponder the physical universe, to try to comprehend more of the meaning, place, and possibility of man: we would be within a long tradition if we did so, especially if we can accept that the sacred concepts and writings of most people appear to have been a response to such reflection, as in, in the Hebrew scriptures, for example. The physicists no longer cut us down to size, but in their best moments like the poets they seem to help us cope with the size we are, a speck, but a precious speck, even immortal diamond.
Cultural anthropology obviously cognate with linguistics and semiotics offers another route to this island of the mind. What is understood by human dignity in one culture may be considered indignity in another; or we could examine formally the historical dimensions of the idea of human dignity, even in one culture or place, over time, and in relation to other events, trends, or pressures. Or sociologists could be consulted: what do we know of the social dimensions, origins, implications, or the idea of human dignity, in our time and in past times?
And how do political scientists and legislators view human dignity? There are so many prisms through which the gaze may pass! The situation is like the story of many men feeling part of an elephant and each trying to describe first easy , then interpret harder , what they have felt or experienced. Dilthey, in his introduction to the human sciences as distinct from natural science , stressed the historical dimension in any approach to understanding the human, since man is a historical being, in evolution.
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Ecclesiastes 2: Dilthey, Introduction to the Human Sciences , trans. Betzanos Detroit: Wayne University Press, In the years after World War 2 and in view of widespread cynicism with regard to 14 B. Dilthey, Introduction to the Human Sciences, p. Rhinelander, Is Man Comprehensible to Man? Pannenberg, Anthropology in Theological Perspective, trans.
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Beyleveld and R. See also review by M.
Sokalska, European Journal of Health Law, 9 , — What, do we as clinicians, experience about the human condition—and what, of that which we experience and know, could be a resource for philosophy? But, those same staff do have difficulty in defining any measure of dignity, as was found in a small study which focused on retained not lost capacities in the last three days of life.
Thomasma, D. Weisstub, and C. Street and D. Turner, R. Chye, and G. Aggawal et al. Hack, H. Chochinov, T.uhynofehyjik.cf
CLARIFYING APPEALS TO DIGNITY IN MEDICAL ETHICS FROM AN HISTORICAL PERSPECTIVE
Hassard, L. Kristjanson, S.
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McClement, and M. Doyle, G. Hanks, N. Cherney, and K. Lickiss regard to human dignity. But items on lists are not portraits—just impressions giving teasing glimpses of the underlying reality, worth pondering, and exploring to try to find some coherence in the emerging portrait s of human dignity. What is human dignity? What is that underlying complex reality which seems to clinical staff to be manifest sometimes in observable, even recordable, appearances, or sensed intuitively as something threatened, lost, maintained, or regained in contexts of deep individual or communal distress?
What is the shape of the image, the schema, the symbolic frame, the construct, the idea, the place in the mind, underlying all? Experience in seeking to understand some health aspects of indigenous people in Sydney in the late s led this author to develop a schema, a frame to support the thinking of a clinician. It could be styled as an ecological view of a person, and is, hopefully, in accord with some fundamental contemporary philosophical insights Fig. Initially, the relation is recognized to exist with the current environment, personal and non-personal, in a continuous dialectic.
Taylor29 among others has stressed that personal identity is: [D]efined by the commitments and identifications which provide the frame or horizon. The place of language in all this is critical,—and its presence for cognition, even if not articulation in speech needs to be recognized.
We may have difficulty in expressing the critical importance of retaining language comprehension or expression for human dignity—but it is clear that a capacity for language not necessarily speech must be close to the core of the dignity of being human an immense subject for consideration.
Not only the facts of the past medical, social, psychological but also the manner in which the patient understands, incorporates, and interprets the past, is of immediate importance to the clinician seeking to understand, in order 29 C. Lickiss to restore, rehabilitate, or to continue to care for a patient even in situations of predictable deterioration even approaching death. Neglect of the historicity of the patient, with so many dimensions, inevitably will reduce the possibility of, for example, relieving suffering—a goal which is core business for medicine. Volumes have been written on the former, and there will be no further comment here save to note that in medical circles, an emphasis on eugenics proved a tragic disaster in the early 20th century, and the present emphasis on genetics in medical education, research, and converse needs to be balanced by a regard for persons adequately understood influenced but not determined by genetics ; the humanities are a crucially necessary companion for medical lore, and their relative absence is of grave moment.
Culture is a complex reality and has been variously defined.
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Thus far, the frame in Fig. It has seemed, in my clinical experience, that the person can move out of such a closed system by means of hope. One can call hope a strategy of transcendence, but we need to be aware of the complexity of that term and facile aberrations and some sensitive philosophical literature. Hope has been given attention by countless writers, poets, novelists, playwrights theologians, and philosophers, but also formally by 31 T. Greenhalgh and B. But the hope may be anchored in other domains: the hope may be for immortality, or that I mean something to you, to others, to an Absolute, to God however understood , or have significance in the universe.
Human dignity, the living idea, may be manifest in action, but that action is not, in the last analysis, directed inwards, but outwards, in relationship, even in surrender. Absolute autonomy may the antithesis of dignity, the self-locked in truly no exit. Human dignity, therefore, maybe incorrectly conceived as a static entity, or property, but rather as process, always a becoming and moving to what is not yet… as is life.
Some glimmer of the role of the personal and place relationships, which not only contain, restrain, but also constitute what a particular person is needs to be appreciated by a physician and nurse—however busy. Morse and B.
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