Vulnerable Dignity, Dignified Vulnerability: Intertwining of Ethical Principles in End-of-Life Care.

José María Muñoz Terrón

doi:10.3390/ijerph18020482

Abstract

The aim of this article is to analyze how dignity and vulnerability, as declared principles of bioethics, both can be seen in a new light when they are thought of together, in their intertwining, in order to outline a proposal for an analytical framework for end-of-life care. It is thus shown, on the one hand, that the demand for respect for the equal dignity of every person, linked by the different anthropological and ethical theories to their autonomy as a rational agent, also refers to their fragile, vulnerable, and interdependent character, as an embodied subjectivity, sustained by a complex web of care. On the other hand, the vulnerability of these selves as others, constituted by the radical appeal of everything that affects them socially, emotionally, sensitively, and by their need for recognition and attention, would be pathological if it did not include the impulse towards autonomy, which, although precarious and connotative, requires dignified and equitable treatment. This intertwining of both principles points to a phenomenological conception of the person as a corporeal social existence, from which a number of studies on the attention to dignity and vulnerability at the end of life are analyzed.

Highlights

The aim of this study is to present dignity and vulnerability as two fundamental ethical principles of care at the end of life, which acquire full meaning when they are thought of together, showing their intertwining
On one hand, the study proposes that the recognition of vulnerability is already implicit in the demand for respect for dignity, linked by the philosophical tradition to the rational autonomy of the person since it does not deal with a sovereign or autarkic subject but rather fragile, vulnerable, and interdependent beings who are in need of care
Dignity, which Pico della Mirandola associated with the capacity of a being, susceptible of becoming by choice one of the most negligible or one of the most sublime creatures, and linked by Immanuel Kant with value without equivalence, but equal to every rationalsensible being that takes for itself the norm of its action, can only be understood as human dignity when it is linked to the possibility of being denied, damaged or not recognized

Summary

Introduction

The aim of this study is to present dignity and vulnerability as two fundamental ethical principles of care at the end of life, which acquire full meaning when they are thought of together, showing their intertwining. On one hand, the study proposes that the recognition of vulnerability is already implicit in the demand for respect for dignity, linked by the philosophical tradition to the rational autonomy of the person (from stoicism, passing through the humanism of Pico della Mirandola, to the enlightened ethics of Immanuel Kant) since it does not deal with a sovereign or autarkic subject but rather fragile, vulnerable, and interdependent beings who are in need of care. From this double perspective, of a vulnerable dignity and dignified vulnerability, the study points to a responsive phenomenological conception of the person as an intercorporeally situated social and corporeal existence

Dignity and Vulnerability in the Declarations of the Principles of Bioethics

Dignified and Autonomous in Vulnerability

Conclusions