Granting death with dignity: patient, family and professional perspectives.
Dignity is a complex construct lacking clear meaning. While conceptualizing dignity as a basic right is useful in determining and justifying social and economic costs of health care, it is insufficient in considerations of personal dignity at the end of life. There is a dissonance between how dignity is shown to matter to healthcare professionals compared to patients. Furthermore, dignity is not clearly linked in the empirical literature to variables of quality of life and to a dignified death. Current studies about the construct of dignity enhance understanding of how we extrinsically construct moral worth, but not of how individuals interpret intrinsic moral worth through maintaining their personal integrity and attitudes of being cared for. References to key qualitative studies illuminate how clinicians ethically negotiate a creation of dying with dignity. As one's personal integrity fades, caregivers (i.e. healthcare providers, family and friends) are challenged to recognise and attend to the individual's vulnerability. I suggest that caregivers nurture personal integrity - through gestures that remember and honour aspects of the other as he/she was once known. Perhaps only through others can dying people be granted death with a sense of personal dignity.
Leung
Doris
D
Faculty of Nursing, Institute of Aging, University of Toronto, Canada. doris.leung@utoronto.ca
D001291:Attitude of Health Personnel; D001293:Attitude to Death; D001294:Attitude to Health; D003073:Cognitive Dissonance; D003220:Conflict, Psychological; D005190:Family / Q000523:psychology*; D006379:Helping Behavior; D006801:Humans; D007206:Individuality; D009014:Morals; D017008:Negotiating / Q000523:psychology; D015404:Nursing Methodology Research; D010166:Palliative Care / Q000941:ethics / Q000458:organization & administration / Q000523:psychology*; D010344:Patient Advocacy / Q000941:ethics / Q000523:psychology; D024382:Professional Role / Q000523:psychology; D011368:Professional-Family Relations / Q000941:ethics; D011369:Professional-Patient Relations / Q000941:ethics; D036301:Qualitative Research; D011788:Quality of Life / Q000523:psychology; D012297:Right to Die / Q000941:ethics; D012941:Social Responsibility; D012944:Social Support