Human Dignity and Bioethics

Dignity and Bioethics | 489
adult and of a philosophy professor at an Ivy League university. No
matter how severe the disability, there are no gradations in intrinsic
dignity. It is the value one has by virtue of being the kind of thing
that one is—a member of the human natural kind.
Second, respect for intrinsic dignity would prohibit, as described
above, euthanizing disabled human beings of any age on the basis of
their disability. As discussed, in violation of P-VI, this practice would
undermine the most fundamental basis of any human morality.
Third, as discussed above, the duty to build up the inflorescent
dignity of human beings—a duty based on respect for intrinsic dignity—carries
with it a notion of the radical equality of the intrinsic dignity
of all human beings. Just as skin color, income, education, and
social worth ought not be the basis for differential access to health
care, likewise disability ought not be invoked as a basis for justifying
unequal access to health care.
Yet, as a duty of imperfect obligation based on P-IV, the duty
to provide health care to the disabled will have limits even in the
wealthiest society. A disabled person cannot be euthanized, but there
will be limits to how far one goes in sustaining the life of a disabled
person, just as there will be limits to how far one must go in sustaining
the life of any person. These limits include the physical, psychological,
social, spiritual, and economic resources of the individual in
his or her particular circumstances as well as the limits of a society’s
resources. It is critically important to add, however, that any criterion
for deciding upon limits must not be based on the disability in
itself, since this would constitute a judgment regarding the worth
of the person and violate the principle of equal respect for intrinsic
dignity. Rather, such judgments must be based on the same criteria
one would use for deciding on the limits of care for any individual,
whether disabled or not. That is, based on the inefficacy of the intervention,
on absolute scarcity, or on the individual’s own judgments
about burdens and benefits. Limits based on judgments of social
worth, whether made by physicians or third parties, are inconsistent
with the meaning of respect for intrinsic dignity.
Thus, the conception of dignity presented here is in full harmony
with the traditional distinction between killing and allowing to die,
converging on that distinction by noting differences in the types of
dignity and the moral duties associated with each. The conception of