Message on “Human Dignity“ from the President, Dr. Kunihiko IshitaniChapter 2 “Human dignity” and the “Sanctity of life”

Are the “sanctity of life" and "human dignity" discussed in the same context?

More than 30 years ago, my friend and patient, Mr. Satoshi Oide, a religious philosopher, kindly provided a copy of Giovanni Pico della Mirandola's Oration on the Dignity of Man (1496), which he had played a leading role in translating. Pico is said to have lived a good Christian life and was a scholar of philosophy and theology. Considering human beings as transcendent, I remember being quite confused by the passage, "God's Word to Adam - Man determines his own nature based on his free will." Satoshi Oide and others are the disciples of Keisuke Hanada, a famous philosopher and professor emeritus at Hokkaido University.

At that time, in 1988, I first introduced the concept of Quality of Life (QOL), which can be regarded as an attribute of human dignity, to the Japanese medical community. I was also very interested in the Sanctity of Life (SOL), which was generally believed to be an opposing concept. About half a century later, to illustrate these concepts in simplified terms, SOL can be regarded as the basis for life-prolonging medicine while the concept of QOL represents a symbol of a finite life. While efforts were made to try to harmonize the two concepts, QOL has become an important standard in medical care, especially in developed countries.

In the 20th century, the concept of "human dignity", which began with Kant, was emphasized as a counter to help overcome the huge catastrophe of the two world wars and it is clearly stated in terms of the "interrelationship between human dignity and human rights" in documents in the United Nations Charter and the Universal Declaration of Human Rights, etc. From the latter half of the 20th century to the present, along with the development of medical science and technology, the concept of "human dignity" has been vigorously debated based on critical reflection in the context of bioethics. This is true even in the field of palliative care, including genomic medicine and euthanasia.

The Kantian concept of dignity is based on the idea of unconditional respect for individual freedom and the factors that govern it. In other words, the essence of dignity lies in “autonomy.”

Although the term "human dignity" implies respect for dignity, it should not necessarily be concluded that respect for dignity equates to unconditional respect for human life. As examples, the pros and cons of respecting the individual will and actions of those desiring euthanasia, and the ethical debate about triage during the COVID-19 pandemic are well known. The concept in question in such cases is that of SOL. The concept of the “Reverence of Life” as provided by the ‘jungle saint’ Schweitzer, a well-known 20th-century humanitarian, is based on the notion that “life has its own unique (intrinsic) value,'' and this affords the principle axis and starting point for any discussion of the current concept of SOL. Schweitzer was also a close relative of Sartre, who attained his own not insignificant results in the field of philosophy. Respect for the "sanctity of life" does not mean that human life itself should be respected, but that all living things, including living things that are considered to be alive through natural development from the human perspective, should be respected. Therefore, "Sanctity of Life" is rather etymologically interpreted as "the sacredness or inviolability of life." Schweitzer's sense of awe in the face of life can also be expressed by the concept of "metaphysical reverence," which reflects his own religious background. Furthermore, while Schweitzer preaches that life is a miserable state, on the other hand, he sees the contradiction in that such life provides the only value, and this concept is regarded as the principle of envoironmental ethics. The concept of "sanctity of life" is protectionist, and the ethics underlying respect for nature are also deliberately anti-human-centric. Despite the many dialogues outlined above, no persuasive grounds have been found to support "the sanctity of life."

With regard to “human dignity,” it is said that “those who deserve dignity should have dignity.” As Kant said, “Duty to oneself immediately demands duty to others,'' a person who has dignity must base such dignity on the intrinsic nature that secures it. It is this moral wellspring in every human being that furnishes the substance of basic human rights.

In Japan, there was an author who brilliantly embodied this concept of "human dignity." His name was Yukio Mishima.


  • Oration on the Dignity of Man (De hominis dignitate): Written by Giovanni Pico della Mirandola. Translated by Satoshi Oide, Kurumi Abe and Hiroaki Ito, 1985, Kokubunsha
  • Advanced/terminal cancer treatment – regarding the Quality of Life: Kunihiko Ishitani, Ichiro Urushizaki, Karada no Kagaku, Vol.142, p99-104, 1988, Nippon Hyoronsha
  • Reverence for Life - Albert Schweitzer - Letters 1905-1965: Written by Albert Schweitzer, edited by Hans Walter Bahr, Translated by Shin Aizu and Kunitaka Muramatsu, 1993, Shinkyo Publishing
  • Sanctity of Life and Human Dignity: Kurt Bayertz, Philosophy and Medicine, 1996, Springer Dordrecht
  • The Legal Revolution: From “Sanctity of Life” to “Quality of Life” and “Autonomy”: John Keown, J Contemp Health Law and Policy, 14,253-285, 1998
  • 2023.1.19 A New Year's Message from the President

Kunihiko Ishitani

President of the International Research Society of the SCPSC

President, Higashi Sapporo Hospital

Asian Editor, BMJ Supportive & Palliative Care

June 1st, 2023