The Meaning of Respect in Bioethics

Carl Bloch, Resurrection Of Christ, 1875.

Respect is a term employed frequently in society and in bioethics. Unfortunately, the word respect is used equivocally today. It should mean treating others with consideration and the recognition that some realities and values must always be upheld. That is what respecting human rights means. Many today think that respect requires accepting the vision of reality adopted by others and treating them as they want even if others are forced to contradict what they believe to be true.

To be respectful is not merely to be polite, it is to be truthful. Yes, we should take people’s feelings into account and be polite rather than abrasive. There is even such a thing as being truthful in a disrespectful way. The sin of detraction comes to mind. This is telling a truth about a person that will harm their reputation without a serious reason to do so. The wise old saying that one should always speak the truth, but it is not necessary to tell all the truth all the time, is a good rule. The reason for this is that truth and charity go together. It is possible to use the truth in a hurtful way and possible to heal with truth.

There is a modern attempt to go beyond the Golden Rule—do unto others as you would have done unto you. This so-called Platinum Rule states that one should do unto others as they would have done unto them. It sounds good at first, but it can lead to problems. Some people may want to be treated in unethical ways and complying with their wishes would be wrong. A clear example is a request for euthanasia or assisted suicide. As I mentioned in another essay on autonomy, we must recognize free will and autonomy but not at the cost of doing or condoning evil.

A great ethical concern is when there are situations of “forced speech” in the name of respect. Requiring people to say certain things that they believe to be wrong is a terrible violation of freedom of speech and thought. Transgender activists often seek to impose the use of certain pronouns that are at times in direct contradiction to the biological sex of the person. It is not a sign of disrespect to refuse to call a biological male “she” but rather a fundamental disagreement that should be treated with tact on both sides. It is also plainly false to refer to one person in the plural “they/them.”

In a health care setting it is necessary to know the biological sex of patients in order to give proper medical interventions. Nurses or doctors, without compromising the truth, can carefully avoid using pronouns when referring to transgender patients. It can be ethical to use the legal name of the patient or a nickname they have adopted. Patients are in a vulnerable situation that requires careful treatment, but this cannot mean imposing the burden to violate the consciences of health care professionals.

It is not ethically acceptable to allow proper truthful speech to be categorized as disrespectful or worse. Thankfully, there are ways to maintain civility while disagreeing. This has been practiced by diplomats for centuries. When there is a deep disagreement, every attempt must be made to find the objective truth. If consensus or an acceptable compromise are not possible, then it still remains essential to avoid unfair attacks on opponents. Peaceful persuasion of the majority is the most ethical and respectful way forward.

We cannot allow the human rights to freedom of speech and thought to be violated by enforcing a misguided notion of respect. It is true that freedom of speech is not an unlimited right. One does not have the right to slander others or to scream fire in a crowded theater. On the other hand, the negative right to free speech—the right not to be forced to say something false, clearly is a fundamental right of conscience. St. Thomas More chose to accept execution rather than be forced to swear falsely that King Henry VIII was validly remarried after he divorced his first wife and entered into a union with another.

I think it is extremely important to resist the popular notion that people cannot disagree respectfully. There is a famous phrase attributed to St. Augustine, “In essentials, unity; in doubtful matters, liberty; In all things charity.” It is a totalitarian impulse to claim that those who do not accept 100% of what I say or believe must be declared to be enemies and coerced. The culture of taking grave offense when subjected to slights, real or imagined, is one that leads to endless strife and war. In the end, reason is not the means for resolving problems but power or force.

Respect requires freedom, charity, and truth. Flatterers or cowed subjects do not show true respect. Demanding respect, when this is defined as requiring everyone to agree, is actually the opposite of respect. It is power politics or coercion. The concept of civility is a key part of respect. We should not provoke or attack another unnecessarily. Even in a conflict, it is possible to treat enemies with respect. This means avoiding unjust actions or lies in your interactions with them. Respect is a beautiful base for building relationships and investigating the truth in bioethics and all spheres of life.