This book is nothing if not ambitious. It presents human dignity as a ‘Theory of Everything’ (pp. 19–21) to make sense of bioethics and law. What is more, the author offers his own account of human dignity to rival those of Augustine, Aquinas, Kant and many contemporary writers on human dignity, from those who dismiss the concept (such as John Harris) to those who argue that it is fundamental (such as Leon Kass).
The book is of significance for its defence of the importance of the concept of human dignity and for demonstrating, by diverse examples, that recognition of human dignity is a ubiquitous feature of human moral experience, notwithstanding the failure of theorists to do justice to it. This reviewer found the two most useful chapters of the book to be the collection of statements reflecting patients’ use of the term dignity (in chapter 5) and the collection of international instruments and court decisions invoking dignity (chapter 7).
The summary of various contemporary accounts of dignity (chapters 3 and 4) is useful primarily for identifying some of the main protagonists in the current debate, and secondarily for whom it treats in which chapter. Foster perceptively categorises Deryck Beyleveld and Roger Brownsword, and indeed Martha Nussbaum, as ‘conflaters of dignity and autonomy’ (p. 65). Such conflation subverts the concept of human dignity and reduces to the stance that ‘dignity is useless’ (the title of chapter 4). However, Foster's discussion of each of these authors is uneven (notwithstanding that some of his criticisms are valid). In general, the reader is best utilising these chapters as a bibliography for further reading but not relying on the analysis they provide.
The weakest points of the book are its forays into philosophy and theology. The following passage in relation to the history of philosophy is characteristic: ‘There has been little real philosophical progress [in understanding human dignity] since the Stoics. The contribution of the philosophical professionals has been to provide different taxonomic schemes. They have simply diced dignity in slightly different ways, and stuck pieces in their albums under new or rediscovered labels’ (p. 80).
How can such an extraordinary generalisation of the whole history of philosophy be maintained, one might wonder? The answer seems to be: by the simple expedient of not reading very much philosophy. This is more evident in the case of theology, as is shown by the continuation of the paragraph: ‘Sometimes they have sprinkled some theological stardust over the album, and said they had finally seen what dignity was all about. And sometimes they have blown away all the theological stardust, and said precisely the same thing’ (p. 80).
This dismissal of moral theology and theological anthropology as epiphenomenal ‘stardust’ (which is used to say ‘precisely the same thing’ as philosophy) becomes visceral when Foster discusses Augustine: ‘Their [early Christians’] intrinsic Gnosticism was crystallised in body‐hating doctrines such as sacerdotal celibacy and the perpetual virginity of Mary. So when Augustine burst into the North African Christian world, he found a ready audience for his soul‐is‐all pastiche of historic Christianity. He had been a practicing Manichean, and never really stopped… Augustine's dead hand has strangled most well‐meaning Christian attempts to persuade dignity to get its hands medically dirty’ (pp. 32–33). Later Foster makes clear that he identifies this Augustinian influence as the chief flaw in contemporary Catholic bioethics: ‘Unlike many Catholic commentators, she [Mette Lebech] expressly and resonantly acknowledges how important it is to see humans as embodied creatures: she eschews the pathologically fastidious Gnostic Augustinianism that has often emasculated Catholic bioethics’ (p. 51). Foster does not give evidence of which secondary sources provide the basis for such scattergun labelling of the most sophisticated Christian critic of Neo‐Platonism in the ancient world, for it is clearly not from reading Augustine himself that he arrives at this position. For those who wish to compare these assertions with the historical Augustine they might start with reading the City of God or the Literal commentary of Genesis or even look at the discussion of Augustine in D.A. Jones, Approaching the End (OUP, 2007).
Foster charges the Catholic tradition with inconsistency because Thomas Aquinas says at one point that dignity can be lost, while John Paul II states that it cannot be lost (p. 29, citing as the source a website giving ‘quotations from Catholic social teaching’!). However, more attention to the thought of Thomas Aquinas, for example, by reading him directly, would have shown that language in general, and theological language in particular, makes much use of analogical terms (see Herbert McCabe Appendix 4 to Volume 3 of the Blackfriars edition of the Summa Theologiae). Terms such as human dignity are used not just in one sense but in several related senses, just as the terms goodness, love, honour, unity, and indeed, being, are used in different senses. Many of the writers discussed by Foster allude to different meanings of the term ‘human dignity’, and seek to give an account of the relationship between these uses. In contrast Foster argues for a single univocal meaning of human dignity to provide a ‘single philosophical currency’ (p. 16) to evaluate moral and legal claims. The univocal definition he gives is as follows.
‘What is dignity then? It is objective human flourishing’ (p. 6).
‘[O]ne should conduct an audit of the net amount of dignity left at the end of the proposed transaction, taking into account, suitably weighted, the dignity interests of all the relevant stakeholders’ (p. 8).
‘I propose a version of the consequentialist approach. The consequence to which one should look is the net amount of dignity – the net amount of objective human thriving – left by the proposed action or inaction… One should then ask: ‘How can this transaction be managed so as to maximise the amount of dignity in it?’’ (p. 15).
It is clear from Foster's discussion of examples that this ‘audit’ of dignity ‘interests’ can sometimes lead to the sacrifice of one life (whether aggressor or innocent, whether indirectly or directly sacrificed) if the consequences ‘maximise’ the overall quantity of dignity. Foster is explicit that his approach is ‘consequentialist’, though he does not seem aware of the Anscombian origin of this term. In sum, Foster's approach is a variant on utilitarian thinking, a ‘dignity’ that can be ‘audited’, ‘weighted’, and ‘maximised’. Such a currency is no more than a price on human life and implicitly expresses a belief that everything and everyone has their price. From a classical perspective this is the antithesis of dignity.
Given Foster's approach it is unsurprising that he does not comprehend the reaction of pro‐life critics of the A, B and C v Ireland case, a case which urged the Republic to introduce legislation to clarify when women would have a legal right to abortion (following a contradiction opened up in Irish law by the X case).
‘And if that required abortion so be it. The dignity analysis that I have been urging has no difficulty at all with this conclusion, and the Catholic pro‐life lobby's disquiet with the [A, B and C v Ireland] decision is (in the light of the Catholic Church's ancient reliance on the principle of double effect to justify abortion when the mother's life is threatened), incomprehensible’ (pp.163–164).
In dismissing this ‘disquiet’ Foster does not acknowledge the force of slippery slope considerations which are surely relevant in a context where those taking the A, B and C case were seeking to introduce, by degrees, a general right of access to abortion in Ireland. Still more significantly, Foster also fails to acknowledge the importance of distinctions between direct and indirect abortion, intentional and unintentional killing, that are essential to traditional Catholic moral analysis of these kinds of cases.
Foster is aware of the challenge facing anyone seeking to give an account of so fundamental an ethical concept as human dignity. He states at the beginning of the book, ‘It is easy to say what the answer to something is not… It is much harder to do what I have tried to do here: to say what the answer is. And of course I have failed’. Regretfully, this reviewer is inclined to agree.
