Author: Dr. Kunihiko Ishitani
President of The International Research Society of the Sapporo Conference for Palliative and Supportive Care in Cancer
President, Higashi Sapporo Hospital, Japan
As the saying goes, “time flies like an arrow,” and before we know it the 5th Sapporo Conference for Palliative and Supportive Care in Cancer (SCPSC) will be upon us (July of next year). In the previous issue of our Newsletter, we introduced its theme under the title “Toward a New Era in Palliative Care in Cancer.” The program has already been published on the SCPSC website and has received numerous positive responses from readers worldwide.
In this issue, we would once again like to share the details of the program for those who may not have had the chance to view it yet. Additionally, starting this February, participant registration and abstract submissions for general presentations will open. We look forward to receiving many applications.
The SCPSC has addressed the issue of “euthanasia,” which is considered to encompass many of the challenges facing palliative care. As part of our exploration of the underlying philosophy, we are examining Kant’s concept of “human dignity.”
Chapter 4: The Circular Structure Surrounding “Human Dignity”
-On the Dignity of the Deceased –
In October of last year, a public lecture on body donation, titled “A Gift That Connects Lives: The Future of Medicine Opened by Body Donation,” was held at my alma mater, Sapporo Medical University. It was organized by Professor Kanna Nagaishi of the Department of Anatomy. As one of the speakers, I delivered a talk titled “The Significance of Body Donation: Exploring the Concept of Human Dignity.” The motivation for this event stemmed from a growing concern that, following the COVID-19 pandemic, there has been a decline in the number of individuals willing to donate their bodies. This trend raises potential challenges for future medical education, research, and surgical training. Having personally participated in anatomical dissection practice using body donations during my time as a medical student at my alma mater, I felt deep gratitude and a strong sense of obligation to accept the invitation to speak at this meaningful event.
I have been contemplating the issue of “euthanasia,” one of the critical challenges in palliative care, for many years. As a result, I have come to believe that Immanuel Kant’s concept of “human dignity” is central to the discussion of euthanasia and that the act of willingly donating one’s body symbolizes this profound significance. To conclude my lecture, I stated: “Kant teaches that ‘humans have dignity because they possess the freedom to live self-disciplined lives and act morally not only for their own happiness but also for the happiness of others.”
In Japan, there is a deeply ingrained cultural practice of solemnly respecting the remains following body donation. This is an accepted notion, observed not only within Buddhism but more broadly through all religious rituals broadly. The reverence for the deceased body and its symbolic power is a universally shared phenomenon.
This universal belief—that “the deceased must be treated with respect”—raises profound and complex questions in moral philosophy, encapsulated in the concept of “the dignity of the deceased.” This discussion extends to various contexts, such as the dignity of fetuses, the ethics of organ trade, end-of-life care during the COVID-19 pandemic, and even to deaths caused by war and famine.
In his 2012 work, “Dignity: Its History and Meaning,” 1)2) Professor Michael Rosen of Harvard University offers a positive account of Kant’s interpretation concerning “the dignity of the deceased.” His exploration provides a significant contribution to the discourse on the concept of dignity.
The concept of dignity, as previously mentioned, is a complex amalgamation of various diverse elements.3) After World War II, the concept of dignity expanded beyond the realm of everyday life to occupy a fundamental role in political and legal spheres. For example, the preamble to Article 1 of the Universal Declaration of Human Rights (1948) by the United Nations states, “All human beings are born free and equal in dignity and rights.” Similarly, Article 1 of the Basic Law for the Federal Republic of Germany (1949) begins with the declaration, “Human dignity shall be inviolable.” Nevertheless, it goes without saying that Kant’s ideas lie at the core of this discussion. In Grundlegung zur Metaphysik der Sitten(1785)4), Kant explicitly states that “the basis of human dignity lies in autonomy, and only morality, which possesses an unconditional and incomparable value, guarantees human dignity.” Furthermore, he argues that because human beings have a moral law that embodies autonomy (human beings themselves are the source of law), dignity is always “human dignity.” Law entails obligations, and Kant holds that we have obligations to ourselves and to others, and that we have an obligation to demonstrate respect for “human dignity.” As we have seen, this is quite different from the modern understanding of autonomy as the individual’s ability to choose whatever way of life suits them.5)
Professor Michael Rosen, in Chapter 3, “Duty to Humanity (Human Dignity),” revisits the question, “Why do we have a duty to treat the deceased with dignity?” He highlights Kant’s assertion that “the duty to respect human dignity is fundamentally a duty directed towards oneself.” Based on this view, Rosen argues that one cannot truly be human without fulfilling this duty. He concludes that the preservation of dignity for the living—those left behind—becomes possible only by paying respect to the deceased. This creates a circular structure surrounding “human dignity” (the pursuit of the highest ideal, only to return to the point of origin). A recent report depicted the victims in Gaza burying the dead, piling rubble stones over the graves, and offering prayers. This act of showing respect to the deceased—fulfilling the duty to uphold the “dignity of the deceased”—also demonstrated how the dignity of the living is preserved through such actions.
The debate over “body donation” prompted me to look into Professor Michael Rosen’s book “Dignity: Its History and Meaning,” in which he brilliantly expounds on the “dignity of the dead” based on Kant’s “inviolable sanctity of human dignity.” Professor Michael Rosen’s philosophical thinking on “human dignity” is a great blessing for us, as he is also an outstanding scholar of Immanuel Kant.
Read the full Newsletter here, including information on the 2026 conference.
References
1. Michael E. Rosen: Dignity: Its History and Meaning. Harvard University Press. 2012
2. Michael Rosen: Dignity: Its History and Meaning. (Translated by Taichi Uchio and Yoichi Mine) Iwanami Shinsho, 2021
3. Yukie Ishitani: IRS-SCPSC Newsletter New Year Special Issue (BMJSPCare Blog Feb.15.2024)
4. Immanuel Kant: Grundlegung zur Metaphysik der Sitten.1785. (The Fundamental Principles of the Metaphysic of Ethics. Translated by Yoshiyuki Mikoshiba, 2022)
5. Kunihiko Ishitani: Human dignity and Autonomy-The fallacy of Autonomy・Self-determination, and Right to Self-determination –
IRS-SCPSC/ News Letter January. 2024
