Asked What Dignity Means, I Was Lost for Words── Restating "ethics" and "dignity" in terms of relationships, and looking for a way to pass on a sense that can't be defined

I started to write "this may lack dignity" in a review comment, and my hand stopped. What is dignity? I had used the word for years, yet when the question came back at me, I had no answer. Borrowing from philosophy and the science of learning, I tried to get a grip on these two slippery words — and on how to hand them to someone who does not yet have the sense.

01I started to write "this lacks dignity" — and stopped

It was a Friday evening. One item was left on my desk in the review room: a promotional material (= a pamphlet or slide deck used to explain a medicine) waiting for approval. A bar chart comparing our product with a competitor's jumped out at me. Only our company's bar was a deep red, shooting upward as if it would break through the ceiling. The numbers themselves matched the cited paper. You couldn't quite call it exaggerated. Still, something about it was excessive. I began to type into the comment field, "As this may lack dignity—" and my hand stopped.

It wasn't fatigue. A question had slipped in. Could I explain, to the person on the other end, what this word "dignity" I was about to write actually means? If it were an exaggerated claim, I could cite Article 66 of the Pharmaceuticals and Medical Devices Act (= the provision that bans false or overstated claims about a drug's effects). For an unapproved indication, Article 68. Legal articles have numbers, official notices, past enforcement cases. "Dignity" has none of that. Where does a dignified expression end and an undignified one begin? There is no scoring table for it in any drawer of my desk.

Looking back, I had used the word hundreds of times. "This color scheme lacks dignity." "Could you aim for a more dignified tone?" The people I said it to usually nodded in silence. While nodding, they may well have been thinking, "That's just your taste." And if they had said so out loud, did I have enough substance to argue back? A word I had worn smooth with years of use turned out to be hollow at its core — and the person who noticed was the one who had been using it. That is an uncomfortable discovery.

In the end, I went home that day without finishing the comment. Writing "this lacks dignity" is easy. But when the junior colleague who takes over my reviews next month asks me, "So what is dignity?" — what do I say? This essay is the record of one reviewer who was left speechless by that question, and who kept thinking while still speechless.

02It sits at the front of the Code, but is defined nowhere

On the train home, I pulled the JPMA Code of Practice out of my bag (= a code of conduct that pharmaceutical companies set for themselves. Not a law, but a document the whole industry has promised to follow). I figured some clue would be near the beginning. There was. From the preamble onward, the words "ethics" and "dignity" appear again and again. Information about prescription medicines must be provided with dignity. Corporate activities must rest on high ethical standards. Over and over. And yet, even flipping through to the glossary at the back, there is no clause anywhere that defines what dignity is.

At first I took it for a defect. How careless, to forget to define the most important word in the document. But as I watched the scenery pass the window, another hypothesis surfaced. Maybe they didn't forget. Maybe it belongs to a kind of word that cannot be defined. Some words in this world break precisely when you try to define them.

The British philosopher Bernard Williams called these "thick ethical concepts": concepts in which factual description and value judgment are mixed inseparably inside a single word. Take "cruel." When we call someone cruel, we are describing a fact — they did something that hurts another person — and passing a judgment — that is bad — at the same time, in one word. "Honest" works the same way. You cannot pry the fact apart from the evaluation and define them separately. Williams held that the meaning of such words lives not in a dictionary but only in the daily life of the community that actually uses them.

"Dignity" is exactly this kind of thick concept. When I looked at that red bar chart and felt it lacked dignity, the factual recognition — the bar's color and scale visually exaggerate the difference — and the evaluation — that is not fitting for a material — rose up in me at once, undivided. That is why no defining clause can be written. Write one, and only the factual half survives as a checklist; the evaluative core drains away. It is a word you cannot use from memorization — only by passing many times through the situations where it is used. The people who wrote the Code may have known this, and placed it at the front, deliberately undefined.

Seen that way, my Friday-evening paralysis looks a little different. I didn't stall because I "didn't know the definition." I stalled because I have to hand over something that cannot be defined — and I didn't know how to hand it over. That is where the real question begins.

03Drop the abstraction; restate it with a person's face in view

Over the weekend, I spread out a material on my desk at home — the one I had left undecided on Friday. No rule violation. Not exaggerated. Still, something snagged. "It feels like it lacks dignity." I started to write that and stopped again. That one line would give the author nothing on Monday. The word dignity is too convenient; it passes as currency even when it is empty.

So I practiced changing the words. Throw away the abstraction and restate it through the face of the person on the far side of the material. "A patient who sees this headline in a waiting room — what will they come to expect from this drug?" "A doctor who glances at it for thirty seconds between outpatients — what will they take in, and what will they miss?" "A family trying to choose a treatment in the middle of their anxiety — how will they read the smile in this photo?" The moment the question pointed at a concrete person, the snag began to take shape. This material tells no lies. It simply leans on the reader's weakness. That was what had been bothering me.

The philosopher Mark Johnson argued that at the center of ethics lies not the application of rules but moral imagination (= the ability to picture, concretely, what your action will do inside another person's life). A person who can imagine how an act will work in someone's daily life tends to behave more ethically, in the end, than a person who mechanically applies the correct rule. If judgments about dignity can never be fully explained by the letter of a regulation, that is because they are not a problem of rules but a problem of imagination. Framed that way, it made sense to me.

• "This lacks dignity" → "A patient could read this phrasing as a guarantee that the drug works."
• "The tone is inappropriate" → "A busy doctor reading this in thirty seconds will never see the risk information, given this layout."
• "Overly promotional" → "It uses the anxiety of someone still undecided about treatment as a push toward a choice."

By Sunday night I had reached my own restatement. Dignity is not about a material's polish or elegance. It is how you treat the person on the far side of the material. Do you treat the reader not as a target of persuasion, but as one person who thinks and chooses for themselves? What seeps onto the page from that treatment — that is what we have been calling dignity. This version I could hand across the consultation desk on Monday. And the fact that it had become handable meant I had finally grasped it myself.

04Why does being right fail to reach people?

At Monday's consultation desk, I stumbled right away. I told a young materials author, "Please revisit this expression from the standpoint of dignity," and what came back was, "Where does the regulation say that?" It wasn't a hostile comeback. He genuinely wanted grounds. I added my weekend restatement and stacked up the reasoning: it's about how we treat the reader; the regulation is a floor, and above it lies room for judgment. The more I talked, the stiffer his face became. I was saying something correct, and it was not getting through.

On the way home, I remembered the 18th-century philosopher Hume: "Reason is the slave of the passions." What moves people is not the argument itself but the movement of feeling; reason serves it afterward. The psychologist Jonathan Haidt carried Hume's view into modern psychology as the social intuitionist model (= a framework in which moral judgment is made first by fast intuition, with reasoning arriving afterward to justify it). People tend not to reason their way to a conclusion; they feel first, then search for reasons.

Reading this as "so persuasion is pointless" would be a mistake. Reason isn't powerless. But handing arguments to someone whose intuition hasn't moved yet — they don't go in. It is a problem of order. In him, an intuition was already running: a material that follows the rules is a correct material. When I threw a different argument at it, his intuition simply went looking for reasons on its own side; of course his face stiffened. My failure was not in the content of the argument but in the order of delivery.

The next day, I changed my approach. I set aside both the regulation and the word dignity, and asked only this: "This headline — how do you think a patient reading it in a waiting room would take it?" He was quiet for a moment, then said, "...They might think they've been promised it works." That was the instant his intuition moved. Only then did I hand over my weekend restatement. The reasoning was the same; the way it landed was completely different. Correct arguments do work — after the other person's intuition has moved. What I learned was that order.

05Who did I learn dignity from? Not the one who lectured — the one who hesitated

I trace my memory back. The first time anyone taught me the word dignity was, I think, in new-employee training. But I remember none of the definitions I heard there. What I remember is the back of an old boss of mine. A single material lay on the desk, and one sentence in it pushed a comparison with a competitor as hard as the data would just barely allow. Everyone knew it would help sales. Facing that sentence, he went silent for a long time. Pen in hand, two minutes, maybe three. Then he murmured, "If a patient read this, how would they take it?" — and marked it in red. He knew the sales department would call. He marked it anyway.

What I saw that day was not an answer but hesitation. Read against the rules, there was room to let it pass. The numbers backed it. Yet here was a person, right in front of me, deciding not to let it pass. The memory of being told what dignity is has faded; the memory of watching how a person behaves at the moment dignity is tested has stayed, deep.

The psychologist Albert Bandura called this observational learning (= people learn less from being told in words than from watching how others behave). Modeling in particular (= taking a respected person as an example and absorbing their whole way of judging) carries great force in passing on values. In Bandura's experiments, what the children learned was not the adults' explanations but their actions. When adults behaved aggressively, the children turned aggressive; children who watched calm adults held their aggression back. A norm that is witnessed is stronger than a norm that is spoken.

Here is my turning point. If I want to pass on dignity, the answer is not to spend more time talking about it. It is to let people see the scene of judgment: me falling silent and thinking; me hesitating between the wish to approve and the reasons I can't — and doing it where younger eyes can see. The awkward, unflattering hesitation was the most eloquent teaching material of all. That boss, I suspect, was not silent because he knew this. He was simply, genuinely torn. Genuine hesitation cannot be acted. That, I now think, is why it carried.

06Training doesn't reach people; sitting in does

The surveys after our annual ethics training are always favorable. "Very instructive." "It changed my awareness." But the materials that come in the following month have not changed. The numbers someone wants to emphasize are as large as ever; the cautionary notes as small as ever. Training satisfaction and material quality, as far as I can observe, barely move together.

Meanwhile, there is a group of people who change without fail: authors who keep sitting in on reviews. For the first month or two, they just sit there in silence. Around month three they start asking, "Would this one get flagged?" By the half-year mark, before submitting their own material, they say on their own, "Could this expression mislead a patient?" Nobody taught them the line.

The explanation that made the most sense to me comes from the anthropologist Jean Lave and the education theorist Etienne Wenger: legitimate peripheral participation (= a newcomer joins the edge of a community's practice as a genuine member, and absorbs its methods and values whole). The tailors' and midwives' apprentices they studied did not become full practitioners by attending lectures. Doing chores at the edge of the workshop, they were steeped in what their seniors spent time on, what they were ashamed of, what they refused to concede — and gradually moved toward the center. The unit of learning was not knowledge but participation.

Training fails not because the content is bad. As long as ethics is handed over in the form of knowledge, it stops at "can say it." Sitting in works because the person steps halfway into the community of practice called review. They watch us spend fifteen minutes on a single expression. They hear, on a call with sales, which points we concede and which we don't. And in time, what transfers is not the criteria for judgment but the posture of judgment. Dignity is not taught; it is caught. If so, the review room must not be a closed chamber. What I can do is open the door and put one chair beside mine. Who will sit in that chair next month, I don't yet know.

07Not a definition — two real examples, side by side

The next time a young author came for a consultation, I stopped lecturing on definitions. Instead, I laid two old materials side by side on the desk. One was an explanatory material that had been sent back internally a few years ago. The data was correct, but only the efficacy graph was printed large, and the side-effect information was crammed into small type on the last page. The other, from the same therapeutic area, stated the limits of the drug's effect — and the plain fact that "some patients will not respond" — in the middle of the main text, without flinching. I asked only this: "Neither one violates the rules. But where do you think the difference is?"

He looked back and forth between them in silence, and finally said: "This one is trying to persuade the reader. This one is trying to let the reader judge." It was far more precise than the words I had spent weeks searching for. The moment someone can state the difference in their own words, the ungraspable concept starts to move inside them. Memorizing a definition never sets off that movement.

I learned afterward that this method has an old name: casuistry (= the tradition of deriving judgments not from abstract principles but by comparing individual cases with one another). Medieval clergy refined it to answer confessions (= consultations about sins), and the philosophers Jonsen and Toulmin rehabilitated it in The Abuse of Casuistry (1988). Their claim is simple. People are bad at descending from principles to particulars, and good at walking sideways — from clear cases toward ambiguous ones. Bedside judgment in medical ethics, in practice, runs on this sideways walk.

Education research points the same way. The cognitive scientist Dedre Gentner and colleagues showed that having people compare two cases side by side draws out the underlying structure better than showing the cases one at a time (structural extraction through comparison = the shared skeleton becomes visible by comparing). Given one case, people memorize its surface details and stop there. Put two side by side, and the details cancel out, leaving only the deeper difference in view. A thick, undefinable concept like dignity can only be passed on this way.

I never once received a definition of dignity from my seniors. What I received was only the memory of a senior stopping still in front of a material. And what I managed to hand to this young author was, likewise, not a definition but the experience of a conscience moving. When he answered "where do you think the difference is" with his own words, something in him truly moved. Not a checklist of virtues (= line items of respectability), but the felt weight of a conscience in motion. That passes to the next person, and then to the next. Words we cannot grasp stay alive only inside this circulation.