The Good of the Many and the Dignity of the Few
Why the legitimacy of any appeal to the common good depends on how it treats the few — and why informed consent is the first test.
Editorial — April 2026
In every age, societies are tempted by a familiar moral shorthand: the good of the many must prevail over the claims of the few. Sometimes that claim is justified. No serious ethical system can ignore the common good, and no responsible polity can function if every collective decision is held hostage by individual preference. Yet the phrase becomes dangerous when it is used too quickly, too vaguely, or too triumphantly. The common good is not a moral solvent in which personal dignity disappears. On the contrary, the legitimacy of any appeal to the many depends precisely on how it treats the few.
This tension is not confined to one historical episode, one treatment, or one public controversy. It arises whenever institutions invoke safety, efficiency, solidarity, or social necessity to justify measures that affect persons in their bodies, beliefs, livelihoods, or moral convictions. The real question is not whether the many sometimes have claims upon the few. Of course they do. The real question is what ethical discipline must govern those moments. My answer is straightforward: informed consent remains paramount. Indeed, the stronger the collective claim, the greater the obligation to inform, explain, clarify, and justify.
Consider a moment familiar to any surgeon. A patient is prepared for a major operation; the room is booked, the team is assembled, and a consent form has been signed. The institutional machinery is efficient and well-intentioned. Yet when one sits at the bedside and asks, simply, what the patient has understood — what he fears, what alternatives he has weighed, what uncertainties still trouble him — one discovers with humbling frequency that the signature and the consent are not the same thing. The form protects the institution. It does not, by itself, honour the person. The gap between the two is narrow in a single case and vast across a society. Whatever is true in the operating theatre is true, writ larger, whenever authority asks citizens to accept burdens in the name of the collective.
Too often, informed consent is misunderstood as a technical formality: a signature, a checkbox, a legal shield. That view is ethically impoverished. Informed consent is not exhausted by paperwork. It is an encounter between moral agents. It is the practical expression of respect for autonomy, dignity, and bodily integrity. It requires that the person affected understand not only what is being proposed, but why it is being proposed, what alternatives exist, what risks attend the decision, what uncertainties remain, and what consequences may follow from acceptance or refusal.
This is especially important when the burden falls on minorities, dissenters, or those whose convictions do not align with prevailing institutional judgment. A civilized society must resist the urge to treat such persons as obstacles to be managed rather than interlocutors to be engaged. The dissenter may be mistaken; the hesitant person may ultimately consent; the fearful person may be reassured. But none of these outcomes is ethically sound unless they are reached through serious explanation rather than social humiliation, administrative pressure, or rhetorical simplification.
There is also a deeper anthropological point. Human beings do not process complex risk, uncertainty, and institutional authority in a detached or uniformly rational manner, particularly under conditions of fear, urgency, or public stress. In such settings, formal consent may exist while authentic understanding is diminished. That is why informed consent must be conceived not as a single event but as a process. It must make room for questions, hesitation, repetition, clarification, and, when appropriate, time.
This may demand patience. It may slow implementation. It may expose disagreement that authorities would prefer to avoid. It may generate uncomfortable questions and reveal the limits of certainty. Yet these are not reasons to shorten the process. There are reasons to honour it. When institutions become impatient with explanation, they usually become more reliant on authority. When they become more reliant on authority, trust erodes. And once trust erodes, even sound policies are weakened because they are no longer experienced as legitimate acts of shared reason but as directives imposed from above.
The ethical stakes are therefore considerable. To say that the good of the many sometimes outweighs the preferences of the few is not enough. One must ask: what kind of many, and at what cost to what kind of few? Are those affected being treated as persons with intrinsic worth, or as instruments of a social objective? Are they being invited into a morally serious conversation, or merely informed that the conversation is over? Are uncertainty and adverse consequences being acknowledged honestly, or minimized for the sake of compliance? These distinctions mark the line between public ethics and managerial paternalism.
My own work in Medical Ethics: The Surgeon’s Perspective has insisted that informed consent is not a ceremonial prelude to intervention but an ethically dense process of communication grounded in autonomy, trust, and respect for persons. That lesson, though developed in the surgical setting, has implications far beyond the operating room. Wherever human beings are asked to bear risk, surrender control, or accept burdens in the name of collective benefit, the same principle applies: they deserve truthful disclosure, intelligible communication, and the opportunity for genuine understanding.
A mature society must hold together two moral truths that are often separated for convenience. First, the common good is real, and it may at times justify coordinated action that constrains individual preference. Second, no appeal to the common good is ethically sound if it bypasses the dignity of those who bear its weight. The measure of moral seriousness is not whether we can speak eloquently of solidarity, but whether we are willing to do the harder work of explanation, persuasion, and respectful engagement with those who stand at the edge of consensus.
The good of the many may sometimes require sacrifice. But when that sacrifice touches the few in what they believe, what they fear, what they value, or what they must physically endure, informed consent is not a secondary courtesy. It is the first test of legitimacy. The dignity of the few is not an exception to the common good. It is one of the things the common good exists to protect.
