Protecting Human Dignity in Research Involving Humans

J Acad Ethics (2009) 7:17–25 DOI 10.1007/s10805-009-9086-z Protecting Human Dignity in Research Involving Humans Thomas De Koninck Published online: 4 August 2009 # Springer Science + Business Media B.V. 2009 Abstract Human dignity is the supreme criterion for protecting research participants, and likewise for numerous ethical matters of ultimate importance. But what is meant by “human dignity”? Isn’t this some vague criterion, some sort of lip service of questionable relevance and application? We shall see that it is nothing of the sort, that to the contrary, it is a very definite and very accessible criterion. However, how is this criterion applied in protecting research participants? These are the matters that we will examine now. My presentation is divided into four parts. 1/Recognizing Human Dignity; 2/Practical Definition of Human Dignity; 3/The Human Being in a Weakened State; 4/ Conclusion. Keywords Human . Person . Dignity . Unity . Individual . Indivisible . End . Means . Sense . Meaning . Mind . Body . Freedom . Responsibility . Recognition Recognizing Human Dignity In fact, in every culture, in every era, a fragment of tragedy, an epigram, a legislative text, a proverb, an inscription on a tomb, a short story, a song, a work of art, a work of wisdom, have all testified to “a requirement that is older than any philosophical formulation”, which in Paul Ricoeur’s terms has always been “something that is due human beings simply because they are human”.1 Recognition of this requirement becomes more explicit as civilizations assert themselves, the most remarkable being the recognition that is immediately given to the weakest and poorest—the importance of goodwill and respect toward the poor. Chinese wisdom ranks the “ability to comfort others” as most important. Ren (or jen) cites that one does not “become human except in one’s relationship with others” and that “the moral tie is most important in that it is the basis of, and constitutes the nature of, all human beings.”2 1 Ricoeur 1988. 2 Cheng 1997, p. 68 sq. According to Marcel Granet, all Confucian doctrine of “the supreme virtue”, ren (or jen) is defined as [translation] ”an active feeling of human dignity”, based on respect for oneself and respect for others, from which the golden rule is derived. Cf. La pensée chinoise [trad.: Chinese thought], Paris, Albin Michel, 1968, p. 395–398. See Confucius, Discourses (trans. Anne Cheng, coll. “Points Sagesse”, Paris, Seuil, 1981), XII, 22; cf. VI, 23; IV, 15. For the Laws of Manu and other parallel texts from various traditions, see C. S. Lewis, L’abolition de l’homme [original title: The Abolition of Man], trans. Irène Fernandez, Paris, Critérion, 1986, p. 179–201. T. De Koninck (*) Philosophy Faculty, Université Laval, Quebec, QC, Canada GIK7P4 e-mail: thomas.dekoninck@fp.ulaval.ca 18 T. De Koninck Respect for the poor and suffering in every sense of the term, is at the core of the Jewish and Christian traditions. The Koran states duties to orphans, the poor, travellers without lodging, the needy, and those who have been put into slavery.3 Compassion is one of the two main ideals of Buddhism.4 Everywhere we seem to have the sense that a state of destitution is that which reveals the quality of being human most clearly and commands awareness of its own particular nobility—the nobility of being, not of something that is possessed. Thus in India, the Laws of Manu, of ancient origin, go so far as to recognize in the weakest particular nobility: “Children, the old, the poor and the sick should be regarded as lords of the atmosphere”.5 Among the Greeks, Sophocles helps us see something similar in the person of old Oedipus, blind and in tatters, practically abandoned, declaring, “So, when I am nothing—then am I a man?”.6 Respect even for the dead has been universal, as burial practices illustrate. Why should one, to this day, be moved to common understanding or assent before the action of the young girl Antigone in Sophocles’ great play when she refuses to let the body of her brother, denounced as a traitor, to be left to rot in the sun and be eaten by vultures, at the cost of breaking the law and sacrificing her own life? Her ethical commitment, and the universal echo it provokes, implies that even the dead body of a condemned person deserves sacred rites. These will restore it to the humanity to which it belongs by right. If this be true with regard to the dead, if even the remains of a condemned man deserve such respect, what should one think of a living human body, destitute or defenceless as it may be?7 Antigone’s decision is ethical in nature as it has the form of a commitment. Saying, in such a case, “This is a human being,” is a moral judgment precisely because it commits. “I declare,” she says, “that my brother’s body deserves all honours due to a human being and it is my duty because I am his sister and our parents are no longer alive, to act accordingly, even if it costs me my life.” Today, Emmanuel Levinas has drawn our attention once more to the fact that the human face, bare and vulnerable, essentially poor, demands no less respect. Access to the face is immediately ethical. An assassin cannot look his victim in the eyes, as if he senses the presence of something sacred.8 But Antigone immediately goes even further, because her brother no longer even had a face—like in Isaiah (52, 14), “his appearance was no longer that of a man.”9 That which Antigone demonstrates so clearly is that regardless of our condition, we all share the same humanity, and therefore the same dignity. 3 Cf. I Kings 21; Isaiah, 58, 6–10; Deuteronomy 15, 1–15; 24, 10–15; 26, 12; Proverbs 14, 21; 17, 5; 22, 22– 23; 23, 10–11; Matthew 5, 3–12; Luke 6, 20–26; 10, 29–37; Mark 12, 41–44; Luke 16, 19–25; Matthew 25, 31–46; and Azim Nanji, Islamic Ethics, in A Companion to Ethics, ed. Peter Singer, Oxford, Basil Blackwell, 1991, p. 108 sq. 4 On wisdom and compassion in Buddhism, see Florida 1991. 5 Quoted by Lewis 1947. 6 Oedipus at Colonus, 430, translated by Robert Fagles, in Sophocles, The Theban Plays¸ New York, The Viking Press, 1982, p. 286. 7 For detailed references, cf. T. De Koninck, De la dignité humaine, Paris, PUF, 1995 (2e edition, «Quadrige», 2002), p. 7–10; C. S. Lewis 1947. 8 Cf. Emmanuel Levinas, Totalité et infini, La Haye, Martinus Nijhoff, 1971; Humanisme de l’autre homme, Paris, Fata Morgana, 1972; and the particularly clear presentations in Éthique et Infini, Paris, Fayard, 1982, p. 89–132. 9 Dominique Folscheid points out that the human embryo which he does not hesitate to call “notre plus-queprochain” [our more-than-neighbour], does not have a face, either: cf. “L’embryon, ou notre plus-queprochain”, in Ethique, no. 4, 1992, pp. 20–43, especially 25. Furthermore, see Philosophie, éthique et droit de la médecine, edited by Dominique Folscheid, Brigitte Feuillet-Le Mintier and Jean-François Mattéi, Paris, Presses Universitaires de France, 1997, p. 195–208. Protecting Human Dignity in Research Involving Humans 19 This recognition of every human being’s unique dignity, about which civilizations are so remarkably in agreement, is of the utmost importance, because this means that the universal recognition of human dignity is not derived from some abstract definition of man; that it is not based on some particular so-called “philosophical system.” Not long ago, moreover, UNESCO created an anthology under the direction of philosopher Jeanne Hersch, entitled Birthright of a Man, which brings together over one thousand fragments from every continent, from the most diverse cultures and every era from the third millennium BC to 1948, when the General Assembly of the United Nations adopted the Universal Declaration of Human Rights.10 This anthology bears eloquent witness to the universality of this honour given to the human being by the fact alone of being human. At the centre of it all, the chief enigma, or better still, mystery is surely each one of us, every single human being, different, unique, from the beginning till “the last syllable” of time. We can all share Saint Augustine’s wonder when he writes: “And yet the natural phenomena known to all men are no less wonderful, and would be a source of astonishment to all who observe them, if it were not man’s habit to restrict his wonder at miracles to the rarities. For example, could anyone fail to see, on rational consideration, how marvellous it is that, despite the countless numbers of mankind, and despite the great similarity among men through their possession of a common nature, each individual has his unique individual appearance?”.11 Indeed, one of the many great themes in Augustine is that marvels, “miracles” (from miror, mirari: to wonder) abound before our very eyes, so dulled by custom that we no longer see those marvels. Changing water into wine is fine, but what about water, what about nature? The power of a mere seed is for Augustine “a great thing” (magna quaedam res est) which ought to fill us with awe. One is reminded of the surprisingly similar wonder expressed by Hegel in his reflections on development (Entwicklung): one cannot see in the simple germ its provision for the entire tree, growth and all: branches, leaves, flowers, their colour, odour, taste, and so forth. Or, more recently, of the observations of biologists who speak of cells as “miraculous” in quite the same sense as Augustine here: “Cells are the basic unity of life. They are the true miracle of evolution. Miracle in the figurative sense, since although we do not know how cells evolved, quite plausible scenarios have been proposed; miraculous, none the less, in the sense that they are so remarkable”.12 But the wonder of wonders must be the birth of humans. Augustine writes: “Someone rises from the dead, people are astonished; there are so many births every day, and no one 10 Cf. Jeanne Hersch (dir.), Le Droit d’être un Homme. Anthologie mondiale de la liberté, Recueil de textes, Paris, UNESCO and Robert Laffont, 1968; reprinted J. C. Lattès/ Unesco, Paris, 1984 and 1990. 11 De Civitate Dei, XXI, 8, op. cit., translation, p. 981.The uniqueness of each individual is corroborated by neuroscience; cf. Gerald Edelman, Bright Air, Brilliant Fire. On the Matter of the Mind (1992), London, Penguin Books, 1994. 12 See Tractatus in Iohannis Evangelium, VIII,1; Augustine speaks of the “admirable and stupendous works of God in each grain of seed” (Tractatus..., XXIV, 1); the “infinite power of seeds” (De utilitate credendi, 16, 34); cf. Tractatus..., I, 9; Epistulae, 102, 5; P. L., 33, 372; Sermo 247, 2; P. L., 38, 700. For the Tractatus in Johannis Evangelium we use the edition provided in Bibliothèque Augustinienne,71, printed with French translation and excellent notes by M.-F. Berrouard, Paris, Desclée De Brouwer 1969; for the De utilitate credendi, the text provided in Bibliothèque Augustinienne, 8, with French translation and notes by J. Pegon, 1951; second revised edition by G. Madec, Paris, Desclée De Brouwer, 1982; for the Epistulae and the Sermones, we use Patrologie latine (P. L.), ed. J.-P. Migne, Paris, 1841 sq., indicating each time the volume and the page; translations into English are our own. See also G. W. F. Hegel, Vorlesungen über die Geschichte der Philosophie, I, Werke 18, Frankfurt am Main, Suhrkamp Verlag, 1986, pp. 39–47. Finally, we quote from Wolpert 1991. 20 T. De Koninck wonders. Yet if we look at this with more discernment, it takes a greater miracle to give being to someone who was not, than to revive someone who was”.13 Again: “The births of so many humans who did not exist are each day greater miracles than the resurrections of humans who existed”.14 Finally: “(...) Although the miracles of the visible world of nature have lost their value for us because we see them continually, still, if we observe them wisely they will be found to be greater miracles than the most extraordinary and unusual events. For man is a greater miracle than any miracle achieved by man’s agency”.15 This is the chief wonder, then: the everyday miracle of human persons, unique, indivisible—which is the original meaning, of course, of “individuals”—yet composed of mind and body. We should never tire of attempting to understand the implications of mind and body as they are so wonderfully united in each one of us. There are immense implications which time does not allow us to enter into much now, but to which all of you are doubtless sensitive. I shall have to confine myself to some practical implications, in what follows. To begin with, we are able to recognize a dual practical implication. First: all human beings, regardless of their condition, have equal dignity that everyone is called upon to honour. But at the same time there is the other implication also, namely, the duties that this leads to: “something is owed…” My own humanity obligates me, in a word, to tangibly respect this dignity that is specific to every human being without exception, but I must furthermore prove myself to be equal to the human condition. Pindare’s adage: “Become what you are”, could in this sense serve to underscore all ethics. Practical Definition of Human Dignity Yet, how can human dignity be defined in a way that is, in fact, practical at the same time? When applied to the human being, the word “dignity” must be understood unsentimentally, rigorously. It means nothing less than this: the human being is infinitely above any price. In his Groundwork for the Metaphysics of Morals, Immanuel Kant provides an excellent description of this fundamental distinction between dignity and price: “Where ends are concerned, everything has a PRICE or DIGNITY. That which has a price can also be replaced by something else, as equivalent; to the contrary, that which is greater than any price, and accordingly, has no equivalent, is that which has dignity. That which relates to man’s general inclination and needs has a market price; that which corresponds to a certain taste, even without assuming a need, in other words, to the satisfaction in the mere purposeless play of our faculties, has a… sentimental value; but that which constitutes the condition under which a thing can alone be an end in itself does not have a relative value, i.e., a price, but an intrinsic value, that is, dignity”.16 Kant now rightly adds that the human being “exists as an end per se, and not simply as a means which this or that will might use as desired. In all his actions, both those that involve himself and those that involve other rational beings, the human being must always be 13 14 Tractatus.., loc. cit. (VIII, 1). Sermo 242, 1; P. L. 38, 1139; cf. Tractatus..., IX, 1; XLIX, 1. De Civitate Dei, X, 12, op. cit., translation, p. 390. 16 Immanuel Kant, Fondements de la métaphysique des moeurs [Groundwork for the Metaphysics of Morals], second section, tran. Victor Delbos reviewed and annotated by Ferdinand Alquié, in Kant, Oeuvres philosophiques II, Paris, Gallimard, coll. Pléiade, 1985, p. 301–302 (AK IV, 434–435). In this quotation from Kant, as in those which follow, the words underlined are underlined in the text. 15 Protecting Human Dignity in Research Involving Humans 21 considered at the same time as an end…” Rational beings are called persons, because their nature already designates them as ends in themselves, in other words, something which cannot simply be used as a means, something which therefore accordingly limits our faculty to act as we like (and which is an object of respect ). Therefore, these are not simply subjective ends that exist as an effect of our action and subsequently have value for us; these are objective ends, that is, things whose existence is an end in itself, and even an end such that it cannot be replaced by something else…”. It might as well be said, as he moreover puts forward explicitly, that persons have an absolute value, not a relative value.17 Human dignity, expressed in various ways, has always been associated with our rational nature and the resulting free will, as expressed by Kant, by all those of the Enlightenment, and again today in the 1948 Universal Declaration of Human Rights which I just mentioned. Thus, in the Middle Ages, St. Bernard said, “I call human dignity free will, which makes man worthy not only to be placed above other living creatures, but also gives him the right to power over them. I call knowledge the power he has to distinguish this eminent dignity, power whose origin is not in himself.” For Thomas Aquinas, the human being’s nobility comes from that which is intelligent and at the origin of his actions, in other words, free and this is how he is in God’s image.18 According to Dante, “The greatest gift God gave in his generosity was the creation of free will; it most resembles God’s goodness and God accords it the highest value. It was given to all intelligent creatures and to them alone”.19 Freedom, in short, sums up everything, its two essential components being intelligence and will, both immense, as is revealed to us by our inner experience of thought and desire. It is these that we find once more in the expression which “dominates all of history with the concept of the individual” (Paul Ladrière ), that of Boethius (circa 480 to 525 AD): “individual substance of the rational nature”.20 The simplest and most accessible way to see this connection between the concepts of person and freedom is the concept of causality as first reflected in ordinary language. The Greek word aitia, cause, first of all means “responsibility”, as in “accountability” in the sense of a “charge”; the Latin word “causa” evolved in a similar fashion and means first of all, a legal cause or action or trial. The words “accuse”, “excuse”, “recuse” still bear the indication of this origin. 17 Kant, ibid., p. 293–294 (AK IV, 428). This idea of the human being as an end in itself dates back to the time of ancient Greece in the conception of freedom as the opposite of servitude: “[translation] we call free he who is his own end and exists for no other” (Aristotle, Metaphysics, A, 2, 982 b 25–26). For a developed discussion of this point and connections with Kant, see Emerich Coreth, Vom Sinn der Freiheit, InnsbruckWien, Tyrolia -Verlag, 1985, especially p. 22–34; cf. in addition Jacqueline de Romilly, La Grèce antique à la découverte de la liberté, Paris, Editions de Fallois, 1989 (repeated in the collection «Biblio Essais» by Livre de Poche). See also in the records of the Second Ecumenical Council of the Vatican “Gaudium et Spes”, paragr. 24: “[translation] man, the only creature on the earth that God wanted for itself…”. 18 Cf. saint Bernard, treatise On the Love of God, chapter II, in Oeuvres mystiques, trad. Albert Béguin, Paris, Seuil, p. 31–32. As for St. Thomas, see Summa theologiae, Ia-IIae, Prologus, and the discussion thereof proposed by Otto Hermann Pesch, in Thomas d’Aquin. Grandeur et limites de la théologie médiévale [grandeur and limits of medieval theology], tran. Joseph Hoffmann, Paris, Cerf, 1994, p. 489 sq.; cf. also Ia Pars, q. 93. For more nuances and references than we can provide here, and good introductory presentation, see Servais Pinckaers, «La dignité de l’homme selon Saint Thomas d’Aquin», in De dignitate hominis, Mélanges offerts à Carlos-Josaphat Pinto de Oliveira, Freiburg Schweiz, Universitätsverlag, 1987, p. 89–106. 19 Dante, The Divine Comedy, Paradise, Canto V, 19–24 (tran. Alexandre Masseron, Paris, Albin Michel, 1950). 20 Naturae rationabilis individua substantia (Contra Eutychen and Nestorium, c. III, PL 64, 1343). Cf. Ladrière 1991; cf. 47–51. 22 T. De Koninck If I take you to court for legal action, it is because I feel you are responsible (having to answer for, or respond) for something; I recognize you ipso facto as a person. You cannot try a being that can in no way answer for its actions. “[translation]…Treating an individual like a person is to consider him responsible, in the literal and figurative sense, for his actions before the courts of the law or ethics—or for some, even before the courts of divine judgement” (Alan Montefiore). John Locke would not be wrong in this regard, to see a “term of the courts” (forensic) in the term “person”.21 It is therefore with good reason that there is currently emphasis placed on the voluntariness of consent in matters pertaining to the protection of human participants involved in research. The Human Being in a Weakened State I would now like to show that the absolute principle of the inviolability of psycho-physical integrity and human life that is invoked with regard to experimentation on human beings is entirely founded and demonstrate why. It is because we must never lose sight of this supremely important and, moreover, obvious determination—previously explained as we have just seen, by Boethius: The person is an individual (from the Latin individuum—“that which is indivisible”). This is what has the utmost importance from the perspective that concerns us here. That this intelligent being, henceforth called upon to answer for his actions, is an individual, means first and foremost that he is an indivisible being, and moreover, he is indivisible from his rights (which the 1948 Declaration furthermore points out in an exemplary manner). As Paul Ladrière wrote, “[translation]If it is not anchored in the concreteness of each individual, dignity and unconditional respect of the person degenerate into moralism and all sorts of sexist, racist, nationalist, corporatist, classist, elitist, etc. ideologies. Moralisms and ideologies which have in common that they do not grant dignity or respect except to those that seem, to them, deserving of it. The individual as a unique being and as a rational being, expresses the ontic and ontological aspects of the person. When these aspects are forgotten, the individual can be reduced to his biological, psychological and economic-political aspects”.22 So long as we refer to our ordinary living experience, despite the difficulty in conceiving of “indivisibility”, we normally feel like “one” of “everyone” (“every” “one”) ,“I”, a separate “individual”. Socrates’ body can be divided but Socrates himself can never be divided. This indivisible uniqueness of the human person is moreover, more clearly than ever corroborated by science.23 So, this is what helps us understand the recognition by all 21 Cf., sub verbis, respectivement, aitia et causa, Liddell and Scott, and Ernout and Meillet, quoted above note 4; Alan Montefiore, loc. cit., p. 691 a, referring to Amelia Rorty 1976; John Locke, Essay Concerning Human Understanding, II, XXVII, 26. We also owe the following definition of person to Locke: “…a thinking intelligent being, that has reason and reflection, and can consider itself as itself, the same thinking thing, in different times and places” (Essay II, XXVII), which was subject to devastatingly just criticism by Charles Taylor in his book Sources of the Self, Cambridge University Press, 1989, c. 9, pp. 159–176 (cf. the corresponding notes also, 542–544), The first part of the definition, concerning intelligence and reflection repeat, of course, classical, obvious concepts; the second part, concerning intellectual awareness of selfidentity through time, is problematic, however, and has trapped more than one follower of a certain “bioethics” (for more details, see our book, De la dignité humaine, op. cit., p. 6; p. 47–50; 54–56). 22 Paul Ladrière, loc. cit., p. 54. 23 Science teaches us specifically that the neural structure of the brain of every human being, even an identical twin, is different from that of every other brain. See Gerald M. Edelman, Bright Air, Brilliant Fire. On the Matter of the Mind (1992), London, Penguin Books, 1994, especially Chapter 9 and the afterword; and Jean-Pierre Changeux, L’homme neuronal, Paris, Fayard, 1983, p. 277–284. Protecting Human Dignity in Research Involving Humans 23 types of wisdom of the inalienable dignity of the world’s weak, as we have been able to observe from the start. This is particularly important when taking into consideration the protection of all the vulnerable populations participating in research. The invalid’s soul is neither altered nor less united with the body by the fact that this body is, for example, in a deep coma or deficient in some other way. Its face, hands, entire body, have exactly the same dignity as before because, once again, human dignity is the issue. It is enough to understand by the word “soul”, for instance, simply the primary source of life; this soul is what differentiates this body from a cadaver. All frankly dualistic visions (making the soul and body two distinct substances) take away the body’s dignity. It is tempting to insist, of course, that human dignity—intelligence, will, freedom—is rather the human soul’s doing. But the human soul does not exist as a separate entity; it is indivisibly one with the body, witness the body’s dissolution at death. Whether the living person it animates is asleep or awake, comatose, severely handicapped or totally fit, it is just as present. It is the soul that makes possible any exercising of the various potentialities it unites—walking, seeing, thinking, loving and all the rest; because it is obviously not their exercise alone that constitutes the soul; otherwise I would have to maintain that every time I began to walk, a new soul appeared and that “the same beings will be blind numerous times per day, and the same for the deaf.”24 A text of Chinese wisdom renders this reality of the soul well, even if its presence is less evident: “The nature of man can be compared to the eyes. During sleep, they are closed and it is dark. They must wait to see until awakening. Prior to awakening, it can be said that they have the basic ability to see but it cannot be said that they are seeing. Now, everyone’s nature possesses this basic ability but it is not yet awake. It is like people who are asleep waiting to be awakened.”25 How intimately linked are the soul and body? Regardless of the state the living human body is in, the body and soul are one and one only, regardless of the apparent condition of the body, which may be greatly diminished, because the soul is one and indivisible, as we recognized above, by saying that Socrates, or any other human being, is indivisible. (Common sense recognizes this; claiming someone is “schizophrenic” is to state that his spirit is “split in two”, and thus to recognize its fundamental unity. Division is impossible in the absence of something to divide: this attribute is meaningless, otherwise; who is “schizo”?) This is the way it is from the first to the last moment of the human body’s life; otherwise it wouldn’t be the human body. Every human individual is, at every moment, regardless of condition, a person and possesses full dignity.26 It follows from what we have just seen that every human body, regardless—with profound dementia, Einstein, comatose, three-time Olympic champion—merits the same 24 Aristote, Métaphysique [Aristotle, Metaphysics], 1, 3, 1047 a 9–10, trans. Tricot, in his famous refutation of the Megarians who are unable to see the reality of potential. The philosopher to whom we owe the most enlightening determinations regarding the union of the soul remains Aristotle, particularly in his treatise, De anima, as we are reminded by Hegel in the last century and Hilary Putnam today. For a more detailed preliminary approach to this matter of the soul and body, see our book, De la dignité humaine, op. cit., chapter III, p. 81–114. 25 Tung Chung-shu (circa 179–104 BC), Cg’un-ch’iu fan-lu (Luxuriant Gems of the Spring and Autumn Annals), ch. 35; in A Source Book in Chinese Philosophy, translated and compiled by Wing-tsit Chan, Princeton University Press, 1963, p. 275. 26 On the attempt by some to create a new classification, that of human beings who would not be persons, see our criticism in De la dignité humaine (especially p. 6, 48–49, 54–56, 83–84, 114). Cf., on the other hand, the very thorough study by Roberto Andorno, La distinction juridique entre les personnes et les choses, Paris, L. C. D. J., Bibliothèque de droit privé, 1996 and by the same author, the small work, La bioéthique et la dignité de la personne, Paris, Presses Universitaires de France, coll. «Médecine et société», 1997. 24 T. De Koninck respect. The absolute dignity of every human being is the same in each phase of life, from conception to the extreme frailty of old age because it is still the same human being, the same person. One should have to have a heart of stone—or be “a man of resentment” (Nietzsche)—not to see it, or more likely, not to want to see it. This is even clearer since science discovered the “organic (and spiritual) uniqueness of every person, which is felt by some to be the most significant discovery of this century.”27 Conclusion Human dignity is, therefore, the objective, transcendent, intangible and thus normative, and thus always valid value in the realm of experimentation. No human being, regardless of whoever he or she is or whatever his or her condition, can ever be reduced to the status of means. This is what is meant by human dignity from the practical perspective. The human being is an end, never simply a means, as Kant rightly saw. It is easy to get an inkling of how enlightening this criterion is with regard to protecting human participants in research. Most of you are better placed than I am to illustrate this through the examples you are familiar with in participating in research. Before closing, however, allow me one final remark of the utmost importance, which is: Everything I have said to this point assumes that we have gone beyond the technician mindset, as it is a matter of raising reason above the simple determination of the means (where technology rules), to determination of the ends, which is far more difficult and crucial. So, to go back to Adorno’s example, we can compare the speed of the trains travelling to the Nazi concentration camps, to the speed of medical information allowing human lives to be saved. There is speed in both cases but how different it is due to the diametrically opposed ends speed is serving. Piaget demonstrated very well that “sensory motor intelligence seeks only practical adaptation, that is, its aim is simply for success or use, whereas conceptual thought aims for knowledge” A purely technical perspective as such does not allow access to the reflective level, but keeps the subject in the infant’s sensory motor stage, in the darkness that covers technical activity, so long as it has not been enlightened by reflection.28 This point is of the utmost importance and I would not know how to conclude this lecture without impressing it on you. The benefits of technology are too obvious to dwell on. Nonetheless, at its lowest, the technician mindset joins forces with the spirit of power and proves to be incapable of seeing that there is a matter of meaning or sense in what is done. Recognition and respect for human dignity are on a plane with meaning and sense. Technological actions, however, have short-term objectives (the manufacture of weapons of mass destruction, for example); they do not have ends in the true sense of the word. To the contrary, technical effort becomes its own end and finds justification in the simple accomplishment of that which is technically possible. To take an example that is unfortunately all too current, there is no technical reason not to manufacture as many weapons as possible. At this level, the implicit nihilism in the technological mindset no longer even recognizes its inherent distress. This mentality furthermore leads to the 27 28 Philippe P. Meyer 1993; cf. p. 74 et 214. Piaget 1963; cf. Alain, “Entendre”, in Les passions et la sagesse, Paris, Gallimard, Pléiade, 1960, p. 144: “l’activité technique et cette nuit de pensée, impénétrable, qui la recouvre” [translation: technical activity and this impenetrable night-time of thought that covers it]. See also Hottois 1984. Protecting Human Dignity in Research Involving Humans 25 disappearance of the sacred because transcendence and religion escape technological language entirely; and this mentality leads to the devaluation of the symbol or sign because these reflect something else, something invisible. This mentality radically contradicts culture and ethics themselves. Dostoyevsky’s statements must therefore be taken seriously: “Beauty is most important, beauty is more beneficial than bread!” (We can well see, in fact, that a life devoid of meaning is not worth being lived, even if you have all the bread you want; and, on the other hand, beauty immediately gives meaning.) And Dostoyevsky adds, “Beauty alone is man’s purpose for living and the young generation will perish if its only error is with regard to the forms of beauty.”29 The unique dignity of every human being whatsoever, is rightly counted among the highest forms of beauty. References Cheng, A. (1997). 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Oxford University Press. 29 Dostoïevski, Carnets des Démons [trans.—notebooks for The Possessed (Demons)], tran. Boris de Schloezer, Paris, Gallimard, Pléiade, 1955, p. 974.