Table Of ContentMoral Respect,
Objectification, and
Health Care
Meredith Celene Schwartz
Moral Respect, Objectification, and Health Care
Meredith Celene Schwartz
Moral Respect,
Objectification,
and Health Care
Meredith Celene Schwartz
Department of Philosophy
Ryerson University
Toronto, ON, Canada
ISBN 978-3-030-02966-1 ISBN 978-3-030-02967-8 (eBook)
https://doi.org/10.1007/978-3-030-02967-8
© The Editor(s) (if applicable) and The Author(s) 2019
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Acknowledgements
My academic thinking has been deeply shaped by the work of Susan
Sherwin who was my supervisor and continues to offer guidance and
support. I am grateful to Dr. Sherwin for reading an early draft of this
book. Adam Auch, Alex Wellington, Anna Macdonald, Jo Kornegay,
Jordan Wadden, Khadija Coxon, Laurenne Ava Kredentser, Madelaine
Ley, Mara Marin, Mitchell Wideman, Robert Murray, Rosemary
Wharton, Tim Mt. Pleasant, and Victor Bruzzone all read early drafts of
some of the chapters and I benefitted greatly from their feedback. I have
also presented versions of these chapters at the International Feminist
Approaches to Bioethics conference and the Canadian Society for
Bioethics conference and received useful feedback from the audiences.
Jordan Wadden was my research assistant for part of the writing process
for this book, and he offered invaluable advice on restructuring some of
the arguments.
I would like to thank my parents, Mary Ann and Paul Schwartz in
whose back yard most of this book was written. I benefitted greatly
from our conversations and their comments on multiple drafts as I was
writing. My stay at their home was a perfect demonstration of the sec-
ond-person care-respect that I described in the chapters of this book.
v
vi Acknowledgements
I am also grateful to my partner, Joel Swedburg, who supports me
through my worst angst-ridden moments of writing and my most joy-
ous moments of living.
I would most especially like to thank Kelly Oliver whom I met in
October 2017. I had been casting about in need of guidance and meet-
ing Dr. Oliver helped me to set my course. I was deeply moved by how
much interest Dr. Oliver took in proving me with mentorship even
though we had only just met. Without Dr. Oliver’s guidance on strate-
gies for academic publishing, this book would never have materialized.
Dr. Oliver is a truly generous philosopher, not only with her own stu-
dents and junior faculty but for even those junior faculty members she
has just met.
All of the errors, omissions, and oversights remain my responsibility
alone.
Contents
1 Introduction 1
2 Dignity, Respect, and Objectification 23
3 Respect and Non-autonomous Patients 55
4 Respect and the Lived Experience of Illness 87
5 Conclusion 111
Index 127
vii
Abbreviations
ACT Assertive Community Treatment
hCG Human Chorionic Gonadotropin
HSG Hysterosalpingogram
NT Nuchal Translucency
ix
1
Introduction
Abstract Schwartz fills an important gap in existing health care ethics
literature by describing an egalitarian conception of moral respect which
applies to autonomous and non-autonomous patients alike. It reframes
questions about respect, from its target to the role that respect plays in
our moral lives. Taking into account various forms of objectification, it
suggests that the unique role of moral respect is to recognize a person
as more than a mere object; to recognize them as an equally intrinsi-
cally valuable being who possesses dignity. Schwartz describes various
forms of objectification and considers three cases in which patients
are disrespected even while the doctor is upholding their autonomous
decision-making.
Keywords Moral respect · Objectification · Dignity ·
Second-person standpoint · Respect for autonomy · Informed consent
© The Author(s) 2019 1
M. C. Schwartz, Moral Respect, Objectification, and Health Care,
https://doi.org/10.1007/978-3-030-02967-8_1
2 M. C. Schwartz
1.1 Introduction
My aim is to provide an egalitarian account of moral respect as it
applies in health care contexts. The concept of respect is central to
medical ethics. Some discussion of ‘respect’ has been part of medi-
cal ethics since the early days of the discipline (e.g. The Belmont Report
1979). The dominant discussion of ‘respect’ in the context of health
care ethics focuses on ‘respect for autonomy’ and this conception is
well-entrenched in legal frameworks in a number of countries. The
conception of ‘respect for autonomy’ leaves a gap in medical ethics
because it does not apply to those patients who are not autonomous.
In the seventh edition of The Principles of Biomedical Ethics, Beauchamp
and Childress explicitly write that the principle of respect for auton-
omy does not include those who are not autonomous and cannot be
rendered autonomous, such as children or patients diagnosed with late-
stage Alzheimer’s disease. They state that those who are not autono-
mous are still covered by the concept of moral respect (Beauchamp and
Childress 2013, p. 108). The concept of moral respect remains unan-
alysed in their edition, however. I fill this gap by reframing questions
about moral respect around the role that the concept plays in our moral
lives. I suggest that the fundamental role of moral respect is to recognize
a person as more than a mere object, as an entity with intrinsic value of
dignity rather than merely use-value of price.
To further explore the role of respect as recognizing someone as
more than a mere object, I consider what it means to treat someone as
an object. I suggest that disregarding someone’s autonomy or violating
their autonomy is one important way of treating someone as a mere
object. So respect for autonomy will remain central on my account.
There are, however, a number of additional ways that we can reduce
someone to a mere object and I pay particular attention to these addi-
tional forms of objectification.
I describe three aspects of the concept of respect: the grounds of
respect, the target of respect and the behaviour that enacts respect. The
ground or basis of respect tells us why respect is owed or warranted.
The target of respect identifies what sorts of things must be respected.
