I have long argued that by creating health, we create the opportunity for people to live, not the other way around. But this definition misses something important. I see our role not simply as using health to help people live, but as helping people live lives with dignity. This is consistent with the emphasis on health as a human right that has emerged as a strong current in the health literature over the past few decades. But I also argue that we should champion dignity as the ultimate role of health. Toward this aspiration, I would like to spend a few moments thinking about what dignity is and why it should be the central goal of the pursuit of health.
Let us start with the question of what dignity means. The Cambridge Dictionary defines dignity as “the importance and worth that a person has, which commands the respect of others and the esteem of oneself.” This seems like a good working definition of dignity because it emphasizes the fundamental and intrinsic worth of all people, and dignity is a reflection and recognition of that worth. It is important to remember that this concept, which is central to the modern human rights framework, is fairly new in human history. For most of the human past, life was considered cheap and the course of human events was one of conquest, with the strong dominating the weak. This reflects a slow emergence of recognition that dignity is an inherent human quality that must be respected.
This evolution of thought has intersected with various religious and philosophical traditions, from the Christian concept of dignity, rooted in the fundamental sanctity of human life created in the image of God, to the Confucian concept of dignity, based on the moral potential of all human beings to be good. Such traditions have influenced modern concepts of dignity, which are rooted in a worldview in which the fundamental worth of all human beings is celebrated and protected. Because dignity is a human universal, it transcends the forces that divide us and empowers us to engage equally in the work of creating a better present and future.
Why dignity should be the ultimate goal of health
These notions of dignity reflect why we want to pursue dignity as a general good. But why should we especially value supporting human dignity as the ultimate goal of health? Essentially, a life with dignity means that people can live as they wish, even if this requires tolerating disagreements about how some people want to live. But to live as we wish, it is most beneficial not to be plagued by ill-health. Our work on health is therefore about creating the right pathways for people to live with dignity, in line with their wishes, that enable them to do so. Enabling everyone to be as healthy as possible for as long as possible is an inevitable path there.
To build a world where everyone can live a dignified life, we must constantly ask ourselves, “What are we trying to achieve with health, and what is the world like for those who cannot achieve all that others can because of unimprovable health problems?” This means that health plays a front-and-center role in creating a path to self-actualization for everyone, regardless of physical or other abilities. This means creating a different kind of society than, for example, one that promotes a path to achievement only for those who can do almost everything they want to do. Rather, it is our responsibility to create a world with different paths that acknowledge different abilities.
Creating these pathways starts with knowing where we fall short: really looking at others. We live in an increasingly fragmented world, where it may be easier than ever to see only what we want to see, ignore the dignity of others, and isolate ourselves from those whose lives are entirely different. Forces like technology, partisanship, and even geography can all encourage us to willfully close our eyes to the wider world. But we can choose in this moment to use the tools available to us to connect with others, really see them, and in so doing, create a world that centers dignity. Instead of letting the distractions of the world blind us to the lives of people different from our own, we should see them, understand that they are not adequately supported in the status quo, and commit to creating a world where difference does not mean contempt.
How to value dignity in the pursuit of health
So what does it mean in practice to value dignity in the pursuit of health? What should a concern for dignity prompt in our work? First, a focus on dignity demands that we evaluate our efforts not just by how well we prevent disease but by whether we remain focused on the unique needs and perspectives of the communities with which we engage. Our efforts should reflect an ongoing dialogue with these communities, so that we never do anything that does not take into account the full humanity of the people we are trying to help.
Second, caring for dignity means focusing on dignity in everything we do, recognizing that just as dignity is a universal human characteristic, it should be universally applicable in our work as well. This means constantly asking ourselves whether what we are doing truly supports the dignity of all people, and being honest with ourselves when our efforts fall short.
Third, focusing on dignity necessarily means pursuing health as a human right. This means everything about how we think about health and how we work to build a healthier world. It means maintaining a radical vision of a healthier future while pursuing this vision practically and incrementally. Such a vision recognizes that we are not healthy until we are all healthy, and that our efforts are incomplete if anyone is denied the dignity that health makes possible.
A version of this post also appears on Substack.
