Birth with dignity from the Confucian perspective

Abstract

The development of biotechnologies has broadly interfered with a number of life processes, including human birth. An important moral question arises from the application of such medical technologies to birth: do biotechnological advancements violate human dignity? Many valid arguments have been raised. Yet bioethicists are still far from reaching a consensus on how best to protect the dignity of human birth. Confucianism is an influential ethical theory in China and presents a distinctive understanding of human dignity. In this paper, we reconstruct the two Confucian concepts of dignity—namely, universal dignity and personal dignity. We then apply these concepts to human birth in the context of biotechnologies involving embryos and genetic enhancement. We conclude that the dual Confucian understanding of dignity contributes a valuable perspective to the question of whether biotechnologies related to human birth violate human dignity.

Full text

Vol.:(0123456789)
Theoretical Medicine and Bioethics
https://doi.org/10.1007/s11017-018-9460-1
1 3
Birth withdignity fromtheConfucian perspective
JianhuiLi1,2 · YamingLi3
© Springer Nature B.V. 2018
Abstract
The development of biotechnologies has broadly interfered with a number of life
processes, including human birth. An important moral question arises from the
application of such medical technologies to birth: do biotechnological advancements
violate human dignity? Manyvalid arguments have been raised. Yet bioethicists are
still far from reaching a consensuson how best to protect the dignity of human birth.
Confucianism is an influential ethical theory in China and presents a distinctive
understanding of human dignity. In this paper, we reconstruct the two Confucian
concepts of dignity—namely, universal dignity and personal dignity. We then apply
these concepts to human birth in the context of biotechnologies involving embryos
and genetic enhancement. We conclude that the dual Confucian understanding of
dignity contributes a valuable perspectiveto the question of whether biotechnolo-
gies related to human birth violate human dignity.
Keywords Bioethics· Birth with dignity· Confucianism· Universal dignity·
Personal dignity· Dignity of embryos· Genetic enhancement
Introduction
The development of medical technologies has precipitated far-reaching interference
with many life processes, including the process of human birth. Various forms of
biotechnologies related to human birth (e.g., test-tube babies, sperm banks, human
cloning, surrogate mothers, and genetic editing), while satisfying the reproduc-
tive needs of human beings,give rise to a number of ethical problems. The most
* Jianhui Li
ljh@bnu.edu.cn
Yaming Li
liym-zxs@cass.org.cn
1 School ofPhilosophy, Beijing Normal University, Beijing100875, China
2 Beijing Normal University-Hong Kong Baptist University United International College,
Zhuhai519087, China
3 Institute ofPhilosophy, Chinese Academy ofSocial Sciences, Beijing100732, China

J.Li, Y.Li
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controversial problem among them is whether the application of biotechnology to
human birth harms human dignity. Thus, contemporary discussions about birth and
dignity for the most part ask whether human dignity is infringed when biotechnol-
ogy is applied to human birth.
Ethical disputes surrounding the application of bioscience and technology to
human birth largely come down to three questions: (1) What is the moral status
of the embryo? (2) Will biotechnology artificially change the essential nature of
humanity? (3) Will design technology be used to create babies with perfect quali-
ties and talents? Manyvalid views on the answers to these questions have been pre-
sented. Yet the field of bioethics is still far from reaching a consensus on howbest
to protect the dignity of human birth. This strategic disunity primarily stems from
a myriad of distinct and controversial views on human dignity, meaning that judg-
ments about whether birth technologies violate human dignity are bound to differ.
In this paper, we expound the Confucian perspective on human dignity. Drawing
on Confucian concepts, we then consider how best to avoid incurring harm to the
dignity of human birth in the application of reproductive biotechnologies. There are
similarities as well as vital differences between the Confucian and Western concepts
of dignity. The Confucianapproach is thuspoised to offer new insight into the dig-
nity of human birth, while also helping to clarify the meaning of birth with dignity
and settle related ethical disputes.
Confucian concepts ofhuman dignity
Though the expression human dignity is not explicitly mentioned in classical Con-
fucian texts, a Chinese analogue to the Western concept of human dignity can be
found. In our paper “Death with Dignity from the Confucian Perspective,” we
systematically elaborated the meaning of human dignity in Confucianism [1, pp.
63–81]. Here, we endeavor to expound it again.
Dignity is a concept that is very difficult to pin down. It often refers to the worthi-
ness, nobility, or honor possessed by individuals that founds other people’s respect
for them. In Western traditions of thought, dignity is usually interpreted as a human
being’s supreme inner value. Markedly similar views are found in Chinese Confu-
cianism. For example, in the Book of Rites, Confucius says: “The human being is
the heart of heaven and earth” [2, p. 147].1 Similarly, in Liezi, Confucius agrees
with Rong Qiqi: “Of all natures produced by Heaven and Earth, human being is the
noblest” [3, pp. 16–17]. Mencius observes in kind: “The people are the noblest, the
land and grain are second” [4, p. 324]. These sayings together suggest that humans
are the most precious beings and possess a supreme inner value. Since such value is
held by all human individuals, it can be aptly termed universal dignity.
But why are human beings more precious thanall else? Xinzi believes that human
beings are more precious because they are born with moral capacities and have the
ability to lead moral lives: “Water and fire have essences, but no life; herbs and trees
1 Unless otherwiseindicated, all translations are the authors’ own.

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Birth withdignity fromtheConfucian perspective
have life, but no knowledge; birds and beasts have knowledge, but no sense of right-
eousness. Man has an essence, life, knowledge, and in addition, a sense of righteous-
ness; thus he is the noblest on earth” [5, p. 127]. Moreover, as Mencius says, “All
human beings have aheart that sympathizes, a heart aware of shame, a heart that
defers to others,anda heart that approves and condemns” [4, p. 245]. In this way, “a
heart that sympathizes is the sprout of co-humanity; a heart that is aware of shame is
the sprout of rightness; a heart that defers to others is the sprout of ritual propriety;
a heart for the sense of right and wrong is the sprout of wisdom” [4, p. 69]. Men-
cius believes that the above four hearts compose the origins of human morality. In
the world, humans possess moral capacities; it is these unique moral capacities that
make them the most precious beings. Because all human individuals are equipped
with equal moral capacities, they all possess equal universal dignity.
According to Confucius, “by nature, all humans are the same” [6, p. 263]. In
other words, every human being possesses the same dignity with the same value.
Mencius shares in Confucius’conviction, holding that saints and ordinary people
are of a piece. Hebelieves that everybody is able to become a saint or an ideal per-
son [4, p. 265]. Although Xunzi’s understanding of human nature is quite different
from that of Confucius and Mencius—with Xunzi believing that human nature is
evil and theother two believing that human nature is good—he also says that “the
nature of all men, of Yao and Shun, of Jie and Zhi, is the same” [5, p. 383].2
Nonetheless, Confucius says of saints and lesser people that “by practice, they
get to be wide apart” [6, p. 263]. It is true that each person has the innatecapac-
ity to become a saint; yet, in reality,most people fail to do so. Although everyone
is equipped with equal moral capacities, people develop these capacities to differ-
ent degrees. Some individuals may develop them into full virtues, while others may
develop them into partial virtues. Insofar as they demonstrate varying degrees of
moral development, people command different degrees of respect from their com-
munities. This type of respect, which is informed by one’s degree of moral develop-
ment, may be called personal dignity. Given these distinct levels of morality, Confu-
cianism classifies people into several discrete moral groups. Confucius, in particular,
uses the terms junzi 君子 (gentleman) and xiaoren 小人 (vile character) to compart-
mentalize people’s differing dispositions into a dichotomous moral scheme. To these
two classifications, Confucians have also added three more categories—shengren
圣人 (sage), shidafu 士大夫 (scholar-bureaucrat), and shuren 庶人 (plebeian)—to
form a quintuple classificatory scheme. In the dichotomous classification, gentle-
men, as persons with perfect morality, have the highest level of personal dignity,
while vile characters, as persons with the lowest morality, have the lowest level of
personal dignity. In the quintuple classification, sages, as persons with the highest
morality, serve as paragonsof the ultimate goalin life. In turn, scholar-bureaucrats,
gentlemen, plebeians, and vile characters each possess an increasingly lower pro-
portion of the sages’ consummate morality and, consequently, an increasingly lower
level of personal dignity. Still, some people fail to develop their moral capacitiesat
all, discarding them completely. As a result, they forfeit their claim to personal
2 Yao and Shun are saints, while Jie and Zhi are bad people.

J.Li, Y.Li
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dignity. Confucian ethicists argue that everyone should instead endeavor to develop
her moral capacities and pursue a higher level of personal dignity.
Another term in Confucianismthat pertains to personal dignity is jue 爵, which
translates to “nobility” or “honor.” Mencius differentiates two kinds of nobility:
tianjue 天爵 (heavenly nobility) and renjue 人爵 (human nobility). The former is
based on virtue, and the latter is based on social status. In Mencius’ words: “There
are heavenly nobilities, and there are human nobilities. Having benevolence, right-
eousness, loyalty, and fidelity with unwearied joy in these virtues constitutes the
heavenly nobility. Being a duke, a minister, or a counselor constitutes the human
nobility” [4, p. 258]. All human beings desire dignityqua honor and nobility. Ide-
ally, those who attain high social positions would have high moral virtue; however,
in practice, many people see heavenly nobility only as a means by whichthey may
achieve human nobility. This can be seen in Mencius’ saying: “The men of antiq-
uity cultivated their heavenly nobility, and the human nobility came to them in its
train. The men of the present day cultivate their heavenly nobility in order to seek
human nobility, and when they have obtained that, they throw away the other—their
delusion is extreme. At the end they must lose that human nobility as well” [4, pp.
258‒259].On thisaccount, heavenly nobility is to be obtained by acting morally and
being virtuous. Furthermore, the human nobility of a duke, minister, or counselor
is genuine nobility only if this authority is exercised in a humane way. Xunzi shows
hislike-mindedness with Mencius when he says:
A gentleman is noble even though he has no title; he is rich even though he has
no official emoluments; he is trusted even though he does not advertise him-
self; he is majestic even though he does not rage; he is glorious even though he
is poor; he is happy even though he lives alone. That is the situation where you
can find the most honorable, wealthiest, most important, and the most digni-
fied. [5, p. 99]
These arguments reveal two senses of dignity in Confucianism: universal dignity
and personal dignity. The former is possessed in accordance with one’s innate mem-
bership in the class of human beings, while the latter is possessed in accordance with
one’s individual moral virtues or respectable achievements. Some scholars think that
the concept of different levels of personal dignity, in theory, excludes many people
from the sanctuary of universal dignity. But, in reality, the notion of different levels
of personal dignity and heavenly nobility can strengthenuniversal dignity’s protec-
tive function. One’s possession of personal dignity or heavenly nobility hinges on
the way one treats others. Most of all, it depends on whether one respects the other’s
universal dignity and whether one fulfills one’s moral obligations. If an individual
does not respect the universal dignity of other humans or if he neglects his moral
obligations to others, his personal dignity will be impaired. The pursuit of one’s per-
sonal dignity naturally engenders a respect for and inclination to protect the univer-
sal dignity of others.
In fact, in Confucianism, the value of personal dignity or heavenly nobility is
greater than that of universal dignity. For all individuals, personal dignity is more
worthy ofpreserving and cherishing than is universal dignity. For instance, in the
Analects, Confucius proposes: “The determined scholar and man of virtue will not

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Birth withdignity fromtheConfucian perspective
seek to live at the expense of their virtues. They will even sacrifice their lives to pre-
serve their complete virtue” [6, p. 235]. In other words, people who are actuated by
high ideals do not damage righteousness for the sake of their own survival; instead,
they realize their moral achievement by giving up their lives. The life of a human
being is that which universal dignity should protect, whereas the different levels of
moral achievement are that towhich personal dignity corresponds. In this way, Con-
fucianism makes clear that the value of personal dignity is greater than the value
of universal dignity. Mencius similarly observes: “Life is what I desire, and so is
righteousness. If I cannot have them both, I would choose the latter and forsake the
former” [4, p. 252]. Ping-cheung Lo summarizes this classical view as a Confucian
Thesis: “one should sacrifice one’s life, if necessary, either passively or actively, for
the sake of upholding the cardinal moral values of ren [benevolence] and yi [jus-
tice]” [7, p. 55]. Confucianism requires humans to regard their own personal dignity
as a higher value than their universal dignity.
The ideas of universal dignity and personal dignity can be found in Western
thought as well. As Daniel Sulmasy points out, there are three historical senses of the
word dignity in Western philosophy: intrinsic dignity, attributed dignity, and inflores-
cent dignity [8]. The intrinsic sense of dignity is similar to the Confucian concept of
universal dignity; the attributed and inflorescent senses of dignity together resemble
the Confucian concept of personal dignity [8, p. 473]. However, Western theories of
dignity tend to emphasize only one sense. They do not integrate multiple concepts
of dignity into a unified theory that generates systematic explanations for the differ-
ences and similarities between them. As such, Confucian ethics ispoised to contrib-
ute to thedevelopment ofa common theory of dignity. Drawing on an analysis of the
respective features of universal dignity and personal dignity,as well as the differences
and connections between them, this paper proposes to break downcertain areas of
confusion plaguing contemporary Western ethics and further advance discussions on
the theoretical puzzles surrounding the dignity of human birth.
The moral status ofembryos andthedignity ofhuman birth
The moral status of embryos is an unavoidable topicwhen discussing the dignity of
human birth. Currently, many biotechnologies related to human reproduction invari-
ably cause harm to embryos. In stem cell research, embryos are disrupted and dis-
mantled in theearly stages of their development; in therapeutic cloning, scientists
harvest stem cells from embryos for use in various treatments; in the process of cul-
tivating test-tube babies, some embryos are necessarily abandoned and discarded;
and in various genetic testing techniques, pre-birth resultspointing to the defects of
future children inform parents’ decisions to terminate pregnancies. These technolo-
gies and their harm to embryos have caused widespread controversy. Many people
argue that harming embryos violates human dignity, since embryos have human dig-
nity as well, while many others hold a completely antithetical view. Embryos are
treatedsometimes as humans, sometimes as property, and sometimes as something
in between [9, p. 737].

J.Li, Y.Li
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Do human embryos have dignity? Do they possess the same dignity as those
who are born? Does harming an embryo violate human dignity? To answer these
questions, one must first identify the origins and foundations of human dignity as
well as that by which human dignity is endowed. If human embryos, like humans
who are born, possess the qualities that confer human dignity, it should be agreed
that embryos have dignity and that harm to them is a violation of their dignity
per se. By contrast, should embryos not possess these qualities, then it would fol-
low thattheydo not have human dignity and thus the harm done to themis not an
infringement of their dignity per se.
In discussions of human dignity, the first question that arises concerns the origins
or foundations of said dignity. One view holds that dignity is an intrinsic attribute
of human beings: all individuals, so long as they are human, have dignity. Another
view holds that dignity originates from unique features of human beings, such as
rationality or autonomy: all individuals, so long as they exhibit these features, have
dignity. If human dignity proves to stem fromthe mere fact of one’s being human,
then, naturally, human embryos would possess the same dignity as humans who are
born, since human embryos belong to the category of human beings. The word for
“embryo” in Chinese comprises two morphemes: pēi tāi, meaning an organism in its
early development.From this lexicalization it follows thatthough the embryo is not a
full person, it is the beginning of a person. Ifall humansare the bearers of human dig-
nity, then an embryo or fetus is alsoa bearer of human dignity—or, at least, a degree
of human dignity. It is not just a thing, but the beginning of a human being. However,
if human dignity originates from unique human qualities, then human embryos would
be unlikely to possess it, since they are not equipped with these qualities.
Irrespective of whether one ascribes the source of human dignity to the human
species or to human characteristics, one is bound to encountercertain theoretical
puzzles. If human dignity originates from specific characteristics of human beings,
such as rationality or autonomy, then certain individuals—such as people with
dementia, people in debilitating pain, vegetative patients, and, of course, human
embryos—are necessarily excluded from its possession given that they lack the fea-
tures in question. Excluding certain people from the protections of human dignity
tends to bring about serious consequences. Richard Rorty notes that whenever a cer-
tain theory of human nature is brought to bear, a pattern of what is or is not human
is established [10]. As a result, some people receive cruel treatment, as in the imple-
mentation of slavery or genocide, while the rest do not feel uncomfortable about
this cruel treatment, for they consider those people as having been excluded from
humanity [10, pp. 167–169].
If human dignity is instead believed to originate from membership in the human
species, then the above difficulty is avoided. As long as one is a human being, one is
equally entitled to enjoy human dignity, no matter the particular developmental stage
or level of consciousness. Consequently, people with intellectual disability, people
in debilitating pain, vegetative patients, embryos, and even human corpses are pro-
tected under the auspices of human dignity. However, proving such a view is no easy
task. Christian theology proposes that humans, by virtue of bearing God’s image,
have unconditional dignity. This may be sufficient demonstration for Christians, but
not for those outside Christianity. Another problem with this conception of dignity

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Birth withdignity fromtheConfucian perspective
is that it is afforded to humans at all development stages—human embryos, fetuses,
babies, adults, the elderly, and even the dead.On this view, when there are conflicts
between different life forms (e.g.,between pregnant women and fetuses)it is hard to
decide whose life and dignity take precedence. Yet we often instinctively feel that
born human individuals are equipped with more inner value than are embryos, and
thus should be given priority in protection. The human species theory of dignity is
unable to justify this instinct or common sense.
The dualConfucian concepts of dignity can help to solve the theoretical difficul-
ties facing the above two theories. Confucianism ascribes human dignity not to the
human species or to human characteristics, but to a combination of both. This syn-
thesis not only successfully avoids the problems associated with the human charac-
teristics theory of dignity but also artfully sidesteps the difficulties surrounding the
human species theory of dignity. Whereas the former over-narrows the protective
scope of human dignity and the latter over-expands it, the current approach finds a
happy middle between the two.
In Confucian ethics, the origin of universal dignity is different from that of per-
sonal dignity. The source of universal dignity lies in every individual’s having been
equipped with equal moral capacities. All human beings have innate moral capaci-
ties, which distinguish humans from other species and enable them to enjoy respect-
able moral status. However,such moral capacities do not themselves enable humans
to acquire personal dignity; rather, personal dignity must be earned through their
development. The higher the level of virtues people develop from their capacities,
the higher the degree of personal dignity they will enjoy. According to Confucianism,
universal dignity derives from the human species, while personal dignity is earned
through human moral effort alone; and this moral effort depends on the specific
human features of moral ability, autonomous act capability, and rational judgment.
Because embryos are forms of human life, they naturally possess the univer-
sal dignity that comes with being human. Universal dignity does not exclude any
form of human life. Every human individual, including embryos, can enjoy its basic
protection. However, one’s personal dignity must be obtained through one’s moral
behaviors. Since embryos lack the opportunity to exercise their moralcapacities, it is
impossible for them to possess personal dignity before becoming a full moral agent.
Examining the differences and connections between universal dignity and per-
sonal dignity helps to form a coherent moral analysis of contemporary birth-related
biotechnologies. Confucian ethics cherishes universal dignity. Since embryos have
universal dignity, they are to be carefully protected so asto ensure their survival
and growth. At the same time, Confucian ethics cherishes personal dignity, hold-
ing personal dignity to be more precious and of higher value than universal dignity.
Thus, in a conflict between two beings at different stages of life, it is the one with
the higher degree of personal dignity whose protection takes priority over the other.
For example, in a difficult labor, the decision to save the pregnant woman instead
of her fetus does not typically arouse moral opposition—the reason being, from a
Confucian perspective, that the fetus does not yet possess personal dignity, while the
mother possesses both universal dignity and a level of personal dignity. Therefore,
relinquishing an expectant mother’s life harms human dignity to a higher degree
than does relinquishing the life of a fetus. But when the survival of a fetus does

J.Li, Y.Li
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not threaten her mother’s life, and her mother chooses abortion due to economic
considerations, living conditions, or future planning, abortion is morally objec-
tionable—the reason being that, in this case, abortion violates the fetus’s universal
dignity, while the mother’s personal dignity declines at the same time. Confucian-
ism accepts abortion in a scenario in which testing results show that a fetus suffers
from a serious disability, when such disability would obstruct or greatly hinder the
fetus’spotential to obtain personal dignity in the future.
It is also important to remember thatembryosand fetuses develop from a com-
bination of egg and sperm. Without a father, the embryo or fetus does not exist.
Thus, given the father’s existential role, when discussing whether an embryo has
dignity or not, one needs totake the father of the fetusinto account. Parents are the
direct fosterersof their sons and daughters. Confucius says in the Classic of Filial
Piety (Xiaojing): “We dare not hurt our body, hair, and skin because they come from
parents” [11, p. 256]. It is commonly accepted that mother, father, and child form
a basic family unit. Yet, in Confucianism, family is a very important notion that is
“understood expansively to include not merely those most immediate members of a
family but also the family’s extension from the past and into a future” [12, p. 236].
In this way, the question of whether an embryo or fetus is the beneficiary of dignity
need be considered in light of this broader understanding of family. As modern Con-
fucian scholar Ruiping Fan says:
Since issues relating to reproduction significantly affect the interests of the
family, Confucianism holds that every family member must participate in
the process of shared-determination of the family. Family members together
explore the specific implications of individual acts for the integrity, continu-
ity and prosperity of the family as well as for the interests of the individual at
stake. [13, p. 138]
In some situations, it is in the best interest of the embryo to be brought to birth;
but in other situations, “the best interest of the family, all things considered, is to
terminate the pregnancy” [13, p. 139]. For example, if an embryo is brought about
through the will of a committed couple, then the embryo requires careful protection;
but if an embryo is the product of rape or adultery, then the family may choose to
terminate the pregnancy in view of its potential risk to their dignity. The Chinese
concept of family strongly emphasizes lineage and descendance as well as the repu-
tation of the collective. An embryo conceived outside of the familial lineage would
bring great shame to the family. Immoral behavior by the familial matriarchs and
patriarchs would also bring great shame.
Designing perfect babies andthedignity ofhuman birth
In recent years, with the invention and development of CRISPR techniques, editing
the DNA of living cells has become fast, accurate, cheap, and widespread. Gene
editing techniques make it possible to control or to cure certain diseases that oth-
erwise lack satisfactory treatment—such as genetic conditions, viral epidemics,
or malignant tumors. Apart from its role in curing and preventing disease, genetic

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Birth withdignity fromtheConfucian perspective
editing can also be used to enhance human abilities by altering normal genes to gen-
erate better physical or mental traits.Whereas gene therapy targets the standard level
of healthy human body functioning, genetic enhancement seeks a level that exceeds
normal human functioning—that is, it aims not at health but at perfection.
In contrast to gene therapy geared toward curing and preventing diseases, genetic
enhancement technology hasgiven rise to widespread ethical disputes. One of the
core questionsin such disputes is whether designing perfect babies elevates or vio-
lates human dignity. Some scholars believe that designing perfect babies can “make
the future generations of humans live longer, more talented, and hence achieve
more” [14, p. 452]. Lengthening the lifespan of human beings allows their knowl-
edge to grow and accumulate; enhancing their health enables them to better adjust
to their environments; and increasing their intelligence undoubtedly promotes the
development of science, technology, and culture at large. These improvements are
bound to carry human society into a more civilized age—one in which individuals
develop more fully with respect to spirit, morality, intelligence, and social contact
and thus live with more dignity. However, other scholars are not so optimistic. They
believe that not only willapplications of these techniques fail to bring about greater
human development, but they will, in fact, hamper individuals in the course of their
personal development as well. For instance, Leon Kass doubts that the achievements
made by genetic enhancement are able to promote real human development:
To the extent that an achievement is the result of some extraneous interven-
tion, it is detachable from the agent whose achievement it purports to be. “Per-
sonal achievements” impersonally achieved are not truly the achievements of
persons. That I can use a calculator to do my arithmetic does not make me
a knower of arithmetic; if computer chips in my brain were to “download” a
textbook of physics, would that make me a knower of physics? [15, p. 23]
In other words, the improvements afforded by technology may not genuinely boost
one’s ability to adapt to the world. Some scholars have even proposed that alter-
ing human nature to fit the world, rather than the reverse, actually represents a deep
form of disempowerment. Enhancement technologies distract one from reflect-
ing critically on the world and deadenone’s impulse to pursue social and political
improvements [16, p. 97]. This trend impedes humans’ overall moral development
in the long run and hence threatens their personal dignity. Moreover, for quitesome
time into the foreseeable future, genetic enhancement will continue to remain an
oppressively expensive process, accessible only to the very wealthy, thus stratifying
its application. Genetic enhancement may also serve to solidify people’s understand-
ing of the traits that do or do not count as good human qualities. As such, incorrect
or superficial perceptions about what constitutes perfection for traits like beauty and
intelligence risk being intensified. As biases for certain human qualities are brought
to bear, artificial discrimination and inequality emerge and take root. Thus, the
important reasons laid out above explain why designing perfect babies may present
an active threat to human dignity.
From the above discussion, it becomes apparent that different stances on whether
designing perfect babies maintains or violates human dignity ultimately stem from
different understandings of the meaning of dignity. Here Confucian ethical thought

J.Li, Y.Li
1 3
offers a new perspective on the relationship between the pursuit of perfect babies
and the status of human dignity.
On the one hand, Confucians believe that universal dignity comes from the moral
capacities innate to each human individual. Usually, these capacities are granted by
nature. However, when babies are genetically enhanced, some of their characteris-
tics or abilities are acquired through technology. Because technological interven-
tion may alter the capacities granted by nature, universal dignity may be violated.
If some specific brutal animal abilitiesor traits, such as long horns,were enhanced
in a human being, thensuch enhancementwould pose a threat to human dignity. Of
course,where genetic enhancement does not alter human nature per se, itdoes not
damage human dignity. On the other hand, because personal dignity, unlike univer-
sal dignity, is gained by one’s moral efforts, improvements to a genetically modified
baby—specifically, moral enhancements—may assist the baby in earning personal
dignity later in life.
Equality is the kernel of universal dignity in Confucianism. It is also one of the
main characteristics of human dignity as laid out in the Universal Declaration of
Human Rights adopted by the United Nations General Assembly in 1948. Equality
means that all human individuals, regardless of their race, intelligence, appearance,
gender, or health condition, are equally entitled to dignity and equally protected
under its auspices. This emphasis on equality is the most significant difference
between the modern concept of human dignity and past conceptsof dignity [17, pp.
215–230]. The Confucian concept of universal dignity is based on humans’ natural
capacities. Since all people are born with human nature, all people possess equal
inner value. Just as Confucius says, human beings are born with the same nature
but develop distinct personalities through the impact of their different environments.
With effort, “all man can be Yao or Shun” [4, p. 265].3 Everyone can be a sage
and achieve moral consummation through hard moral practice. In short, Confucians
believe that since the natural capacities of human beings are equal, their universal
dignity is equal too.
Through genetic enhancement, future generations may have higher levels of intel-
ligence, mental acuity, or physical power. No matter how many of these abilities are
enhanced, if designing perfect babies does not bring about fundamental change to
basic human nature, it does not threaten the equality of human universal dignity.
In Confucian ethics, personal dignity is unequal among human individuals. It
must be obtained through one’s effort to develop one’s natural abilities into virtues.
Different people achieve different levels of morality, and hence they possess dif-
ferent levels of personal dignity. If genetic editing enhances an individual’s natu-
ral gifts, the enhanced individual will be able to realize virtues more easily and, in
doing so, acquire a higher level of personal dignity.
Genetic editing can enhance babies’ human abilities through biotechnology and
help them to perform better in their ethical practice. For instance, if the capacities
for sentimentality or intelligence can be strengthened through biotechnology, mak-
ing people more compassionate or more intelligent in distinguishing right from
3 Yao and Shun are sages in ancient China.

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Birth withdignity fromtheConfucian perspective
wrong, genetic editing will inevitably provide more sufficient conditions for the for-
mation of virtues, enabling people to achieve a higher level of personal dignity. In
Confucian ethics, consummate personal dignity is seen as the highest valuein life.
All individuals should try their best to engage in moral practicesthat elevate their
personal dignity. The abilities generated by genetic enhancement, if they help people
to pursue personal dignity, are clearly of high moral value.
However, with respect to earning personal dignity, it is not enough to merely
obtain relatively stronger abilities. Confucian personal dignity must be acquired
through the use of one’s subjectivity to treat others morally in the course of human
interaction. Genetic enhancement may help humans to fulfill their moral duties by
conditioning them to treating others in a better way. However, the qualities or abili-
ties brought about by genetic enhancement do not directly confer higher personal
dignity. Possession of enhanced abilities merely affords designer babies a capacity
for higher personal dignity. In order to achieve higher personal dignity in actuality,
the babies must develop these capacities into full virtues later in life.
Fan draws a conclusion very similar to the one we draw here, but using a different
analysis. In his paper “A Confucian Reflection on Genetic Enhancement” [18], Fan
agrees with Michael Sandel’s view in The Case Against Perfection [16], which holds
that anti-genetic enhancement arguments from safety, equality, justice, freedom, or
personal rights are superficial and unsound and that human babies should insteadbe
seen as gifts; however, he does not agree with Sandel’s view that all kinds of genetic
enhancement should be banned. For Sandel, the deep moral problem of genetic
enhancement concerns “the gifted character of human powers and achievements”
and the proper stancefor human beingsto take toward the given world [16, p. 83].
He says: “The hyperparenting familiar in our time represents an anxious excess of
mastery and dominion that misses the sense of life as gift. This draws it disturbingly
close to eugenics” [16, p. 62]. That is to say, genetic enhancement is another kind
of hyperparenting, and it causes us to fail to appreciate our children as the gifts they
are. For Sandel, “to appreciate children as gifts is to accept them as they come, not
as objects of our design, or products of our will, or instruments of our ambition”
[16, p. 45]. Sandel thinks that the giftedness of life is inevitably involved in our
religious sensibilities and metaphysical convictions. Perhaps Sandel’s sensibilities
and convictions can be traced to the Judeo-Christian tradition, but for the sake of his
theory’sgenerality, Sandel denies this lineage. He intends his ethics of giftedness
not to be grounded in any particular religious understanding but to remain general so
that it may be applied to a range of religions and even nonreligious metaphysics. Fan
doubts Sandel’s “generalist” strategy, believing that “in order seriously to take one’s
life as a gift, one has to trace it to a conscious, intentional source” [18, p. 65]. It is
here that Fan believes Sandel fails to offer a full ethics of giftedness:
His account of children as gifts has to be a very thin account, and his argu-
ment has to draw a very small circle: Once we try to genetically enhance our
children, we would make them “as objects of our design, or products of our
will, or instruments of our ambition,” no matter in what way or how humbly
we attempt to do it. He fails to offer any detailed argument for his grave allega-
tions because he only has a thin ethics of giftedness. [18, p. 66]

J.Li, Y.Li
1 3
To give a full account of the giftedness of children, Fan thinks that one first needs to
answer “where this gift is from, what kind of gift it is, in which way it is given, and
for what purpose it is given” [18, p. 66]. In treating these questions from Confucian
familism, Fan responds that the giftedness of children is from ancestors; it is a gift
with the capacity or potential for virtue to live a good life; it is a gift from ancestors
that one should be able to cultivate one’s nascent potential virtue and become a vir-
tuous person in actuality;its purpose isto enable humans to lead a virtuous, family-
oriented way of life whereby certain familial values, such as the continuity, integrity,
and prosperity of the family, are preserved and promoted [18, pp. 67–68]. Based on
this full ethics of giftedness, the Confucian position on genetic enhancement sharply
diverges from that taken by Sandel. Specifically, Confucianism does not support
Sandel’s sweeping rejection of genetic enhancement. If a particular enhancement
favors the core values of Confucianism, it is ethically permissible. For example,
administering a genetically-engineered vaccine to a child so as to prevent her from
catching a disease later in life is ethically permitted by Confucianism, since doing
so benefits the child’s health and helps the family to flourish. However, if a genetic
enhancement damages the core values of Confucianism, it is ethically impermissi-
ble. For example, a Chinese couple’s changing their child’s haircolor to blond and
skin color to white is ethically prohibited, since doing so damages the Confucian
value of venerating one’s ancestors [18, p. 68].
Thus, it is clear that Fan reaches the same conclusion that we do; but Fan’s line
of reasoning is different from the line of reasoning that we adopt here. We base our
conclusion on an argument from Confucian dignity, while Fan bases his conclu-
sion on an argument from Confucian familism. Yet the main theme of the two argu-
ments is the same. Fan’s familism argument can be coordinated with our dignity
argument: if a genetic enhancement increases a child’s potential for personal dignity
and his family’s potential for prosperity, then it may be favored; if an enhancement
decreases a child’s potential for personal dignity and his family’s potential for pros-
perity, then it should be banned.
Conclusion
In this paper, we began by reconstructing the Confucian understanding of dig-
nity, finding that in Confucianism the concept of dignity bifurcates into two sub-
concepts: universal dignity and personal dignity. We then applied these concepts to
human birth to solve ethical questions surrounding the moral status of embryos and
the moral implications of designing “perfect” babies. These discussions illustrate
that the Confucian perspective on dignity offers a unique tool for solving contempo-
rary bioethical puzzles.
In our analysis of the moral status of embryos, we examined the origins and
basis of both universal dignity and personal dignity, proposing that the former
comes from being human while the latter comes from possessing the qualities
of human beings. By positing discrete origins for the two kinds of human dig-
nity, many of the theoretical dilemmas engendered by Western concepts of dig-
nity ostensibly dissolve. According to Confucianism, embryos have universal

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Birth withdignity fromtheConfucian perspective
dignity. The way in which embryos are treated should thus conform with the
moral requirements of universal dignity. That is, the conditions necessary for
their growth should be met, and they should not be regarded as mere things. Yet
embryos do not have personal dignity—though most born humans are equipped
with both universal dignity and personal dignity. Therefore, insituation where the
dignity of an embryo comes into conflict with the dignity of a born human, it is
morally right to give priority of protection to the latter.
With respect to designing perfect babies, we conclude that when genetic
enhancement does not alter human nature, it does not violate universal dignity;
and by improving humans’ individual capacities, genetic enhancement can also
provide favorable conditions for earning a higher level of personal dignity. But
elevating one’s personal dignity eventually hinges on a person’s individual efforts
to engage in moral behaviors with others. Genetic enhancement alone is not suf-
ficient for a person to achieve personal dignity.
Acknowledgements We thank Katelyn MacDougald very much for her professional editing of this
paper. Thanks also go to two anonymous reviewers for their helpful suggestions. We are indebted to
the National Foundation of Social Science of China for funding support for this research. Our grati-
tude also goes to Marcus Düwell for inviting us to take part in the joint research project Human Dig-
nity in the Context of Bioethics—China and the West. This China Exchange Programme is jointly
organized by the Koninklijke Nederlandse Akademie van Wetenschappen (Royal Netherlands Acad-
emy of Arts and Sciences) and the Ministry of Education of China. Marcus Düwell and Jianhui Li are
the leaders of the project on theDutch and Chinese sides, respectively.
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