Essay on Arie F

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Multicultural dialogue on dignity from a Japanese perspective Nursing Ethics
2015, Vol. 22(2) 273–275
ª The Author(s) 2015
Reprints and permission: sagepub.co.uk/journalsPermissions.nav 10.1177/0969733015569841 nej.sagepub.com Fumie Arie
Sophia University Institute of Bioethics, Japan

The fundamental importance of preserving dignity of life and human dignity has been reemphasized in conjunction with the increasing complexity of the ethical argument that has occurred with the development of biomedical technology, in particular regenerative medicine, and the onset of debate about respect for individuals’ wishes at the beginning and end of life.1 There remains an insufficient understanding of the meaning of the word “dignity” when we speak of preserving dignity of life and human dignity or the dignity of individuals; yet, we use the term widely in various medical and educational contexts as a noble-minded sense of values, as a self-evident fact. It can be considered that in the current situation, there is a tendency to treat the word indifferently and inconsiderately as a convenient expression, without regard for its diversity and complexity of meaning.2,3
Naturally, all words have meaning, and such meaning is the product of a mutual understanding reached after being continuously interpreted by people based on history, religion, and individual values. However, people often assume conceptual words to be self-evident and overuse or use them simplistically without a deep understanding of their meaning.2,3 “Dignity” is one such word. In the medical field, during the practice of care in particular, or within education, nobody would argue against the fact that dignity is an important concept. However, ironically, the word “dignity” appears to be treated as if it possesses dignity itself. For example, when well-known scholars and nursing instructors say “This is what dignity is. Let’s value the dignity of the patients,” everybody is satisfied, thinking “I see, dignity is important.” Alternatively, when a certain scholar asserts that “Dignity is a sentimental and useless concept,” this is regarded as an inhumane idea. Yet, are we really able to explain our grounds for criticizing such claims or thinking them justifiable?
When specialists define “dignity” in a particular way, we should not disregard the danger of accepting such definitions uncritically.
A question arises here. When we speak of dignity with others, or are conscious of dignity, does this “dignity” possess the same meaning? In particular, do people with different histories, cultures, and religions talk about the same “dignity” with each other? I first began to question this when I participated in a certain international study course on bioethics, and I discussed “dignity” with doctors, nurses, and other medical professionals from Europe, the United States, and other places. Some participants asserted that dignity was something that could be taken away by other people, whereas some claimed that dignity could never be removed by others no matter what the situation, as long as the person did not renounce it themselves. In the case of the former, dignity can be perceived as something fragile that can be damaged by other people regardless of the subjectivity of the person; in the case of the latter, dignity can be understood to be something independent that cannot easily be violated by external forces and can be protected by one’s own free will.
Furthermore, there were others who took the position that dignity is possessed equally by all humans in the same way as rights, and that it can be damaged or protected by others, and also those who asserted that dignity exists as a thing of value, something akin to the human spirit that cannot be tarnished by external forces, or that dignity is similar to self-affirmation or self-respect. What were these diverse interpretations of dignity,

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Nursing Ethics 22(2)

held by the course participants, each based on? Perhaps,
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