Mental Health Ethics

Humanness, Introduction

What does it mean to be human? On the surface, this may seem a frivolous question. Isn’t the answer obvious? Here are a few definitions:

Dictionary definition – The Oxford Dictionary defines a human being as a “man, woman, or child of the species Homo sapiens, distinguished from other animals by superior mental development, power of articulate speech, and upright stance.” [1] Although I think the concept of ‘superior mental development’ needs to be articulated further, I have no real problem with this definition.

Medical definition – J.M. Goldenring, defines a human being in terms of an organism that has a functioning brain. “The brain is the only unique and irreplaceable organ in the human body, as the orchestrator of all organ systems and the seat of personality. Thus, the presence or absence of brain life truly defines the presence or absence of human life in the medical sense.” [2] He admits, however, to a murky area in which cortical activity is absent and yet subcortical functions remain, as in a “’severe vegetative state’ – a medico-ethical limbo wherein a human is technically still alive or rather ‘not quite dead’ but is no longer capable of higher brain functions.” [3]

But the limbo to which Goldenring refers, concerns the difference between life and death. Does consciousness matter in defining a human being? Is self-awareness necessary for human consciousness? Flipping this question on its head, is someone with no self-awareness considered human? Is there a test for this self-awareness? These are also important questions ethically and morally. The answers have consequences in the way society treats those that it doesn’t understand or those who cannot contribute to the goals of society.

Cultural definition – Cultural definitions of humanness can be traced back to different creation stories and the placement of mankind in relation to life in the rest of the natural environment.

Creation stories in different cultures

There is a long history of thought that the human being is the apex of creation. Genesis (1:28) mentions that humans are superior to the rest of the animal kingdom when God blesses Adam and Eve saying “Be fruitful and multiply, fill the earth and subdue it, and have dominion over the fish of the sea and over the birds of the sky, and over every living thing that moves upon the earth.” [4]

American Plains Indians have similar stories of creation to that found in Genesis. Since animals were created prior to human beings, they were deemed closer to the Great Spirit, thereby commanding respect and veneration. This helps us to understand the importance of communicating with their god, through animal spirits. [5]

Placing life forms in order

The classification and ranking of the order of life dates to Aristotle (384-322BC). Aristotle’s History of Animals classified organisms hierarchically, placing them according to complexity of structure and function. [6] This ‘great chain of being’ (in Latin: scala naturae, or “stairway of nature”), ranked all matter and life. “The chain starts from God and progresses downward to angels, demons (fallen/renegade angels), stars, moon, kings, princes, nobles, men, wild animals, domesticated animals, trees, other plants, precious stones, precious metals, and other minerals.” [7]

A small step for man

In medieval times, the concept of the ‘great chain of being’ was applied to subdividing humanity into groups or races. The classifiers at that time noted common physical and character qualities among groups that distinguished them from others. “Society gave different values to those differentiations, which essentially created a gap between races by deeming one race superior or inferior to another race, thus a hierarchy of races. In this way, science was used as justification for unfair treatment of different human populations”. [8] Historical examples of this unequal and deadly treatment abound throughout history. 

Is there hope?

It is safe to say that the rank and file of each cultural group values its own members above those in other groups. Indeed, Dr. Wolf Wolfensberger [9] developed a means of analyzing human relationships called Social Role Valorization (SRV). “The theory is based on the idea that society tends to identify groups of people as fundamentally ‘different’, and of less value than everyone else. It catalogs the methods of this ‘devaluation’ and analyzes its effects. It may be used by those seeking to counteract these methods and effects” [emphasis added] [10]

What about those with differing abilities?

Mistreatment of this category of people, which cuts across racial lines, has also been rampant through the centuries. For example, those with greater, or misunderstood abilities have been burned at the stake in American history. Those with lesser mental or physical abilities have been marginalized at best and at worst, hounded and bullied.

I am sad to report that I, myself have heard medical doctors in a major city medical center refer to some of their patients as SHPASs. This stands for Sub Human Piece of Shit. Excuse the vulgarity, but I didn’t make up this reprehensible view of a segment of humanity, and I don’t know the criteria by which the doctors classified these patients.

Does the definition of humanness matter?

Yes it does. How society sees an individual matters quite a bit. More importantly, the denial of humanity to certain groups has familiar consequences. To classify those who do not understand; those who cannot communicate and those who are physically different or disfigured as less than human gives those who consider themselves superior license to abuse, misuse or even destroy, with impunity.

Aside from the moral repugnance of this idea, each and every one of us is just one blow to the head away from this class of people.

[2] Goldenring, J.M. The brain-life theory: towards consistent biological definition of humanness Journal of Medical Ethics, 1985, 11, 198-204 print

[3] Ibid pg 200

[5] Brown, J.E. The Spiritual Legacy of the American Indian Studies in Comparative Religion, Vol. 14, nos. 1 & 2. World Wisdom, Inc. from web resource 9-20-13


More About Humanness

I began with definitions of the what it means to be human. Does the definition of humanness matter? Yes. It matters because many human beings feel free to mistreat others they deem non-human or less than human.


One’s worldview has an influence on one’s view of humanness. There seem to be two basic categories of creation myths: those which contend that mankind is dominant to all other forms of life and those which place mankind on a par with the rest of creation. While the idea that mankind is the top of the natural hierarchy and endowed with dominance over nature has probably contributed to knowledge and development of technology, it has not necessarily advanced the cause of humane treatment of fellow human beings. The believers in philosophies of coexistence with nature, such as many of the American Indian cultures, have been overrun by societies that believe in dominance of man over the natural order, or the placement of man just below the gods.

Societies based on philosophies of mankind dominance over nature can act humanely if guided by thoughtful leadership that realizes dominion comes with responsibility. But this is far from the case if these societies are run by those who are either ignorant of the fine points, or willfully distort them to their own advantage. At its most extreme, the philosophy of dominance results in terrible treatment of those who are dominated. We see this constantly in world history, from the Spanish Conquistadors, to Nazi Germany, to Bosnia and Rwanda.

Mental and physical attributes of human beings

If we set aside ethnicity, there are many who believe that mental or physical abilities define classes of people. Many in society treat those with compromised mental or physical health less respectfully.

Words are cheap and platitudes abound: “There but for the grace of god go I”; “Do unto others as you would have them do unto you”; “Walk a mile in his shoes” are a few examples. These sayings encourage one to have more than just empathy for another – the ability to feel what another is feeling – but to have compassion. Compassion is the awareness of another’s suffering plus a desire to act to relief it. [1] However, there is nothing like first-hand experience to drive a point home. For example, it is very unlikely that many of us who are not African American would artificially darken our skin, as did the main character in the movie Black Like Me [2] to get first hand knowledge of what it is to be a member of another group. But it is possible, even inevitable that mentally and physically fit people will slip into a ‘lesser category’, whether through an injury or debilitating illness.

Wisdom (sometimes) comes with age and experience. How surprising it must be for a young person, never sick a day in his/her life, to experience eroding abilities that come with age, or an accident or head injury that renders them reliant on others; or for the father who truly loves his son and believes that AIDS is retribution, who discovers that his son has this dreaded disease.

Wholesale approach

There must a better way than this retail approach to realizing the plight of people with lesser abilities and empathizing with them. How do we disseminate the notion on a large scale that the entire range of humanity – from those with little or no mental or physical abilities to those who are mentally and physically fit – deserves equal consideration? Is it possible? Perhaps social engagement is one way, even taking backlash into account; there is a chance, if lines of communication are open. However I fear that isolated enclaves will stick with their sclerotic views and perpetuate the idea that there is only one dominant human type, and it is theirs.

My brother

I have had the advantage of an older brother who taught me life lessons. It wasn’t easy. Mike has never said a word to me, but my lessons arose from my efforts to understand him. Although he is very low functioning and autistic, he taught me tolerance; patience; sensitivity to others; an acute desire to express myself; and the desire to be understood.

That I am biologically closer to Mike than either of my parents, makes me particularly sensitive to the notion that some view him as less than human. No doubt, he is a low outlier at the end of the statistical bell-curve-of-abilities, but that does not equate to being less than human. His existence is one instance of the diversity of human life. If he is not human, then I am not human either. Not only is he human, he evokes the humanity of the people who care for him and care about him.

[1] I will address the concept of compassion as a component of the definition of humanness in another post.

6 thoughts on “Mental Health Ethics

  1. I am struck by your work and the seeds that helped them grow. I continue to work with aspirer’s clients in counseling after a career in special education and mental health specializing in developmental disabilities. I will continue to follow your work!

  2. Jack.very profound. Can society embrace itself as a whole? I doubt it as we are all different – no one is perfect, we all have “issues”, some more than others. Millenium years ago man was tribal, only the fittest survived. I don’t think that has gone completely from our makeup. But we strive to understand, accept, engage – even celebrate. We know what we live. We open our minds to make it better. Then we pass it on as you are doing with your excellent articles.

  3. You might be interested in a new program on TV. Comedian Kamau Bell. Shades of America. CNN 8:00 pm Sunday. Kamau goes out into American cities and societies to understand the how and why of their lives. So far he’s been to the south visiting the modern day Ku Kiux Klan and to Chicago so find out is it really that bad living there.

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