Gustafsson AW, Hommerberg C, Sandgren A. Coping by metaphors: the versatile function of metaphors in blogs about living with advanced cancer. Med Humanit. 2020;46:267–77. https://doi.org/10.1136/medhum-2019-011656 In 1984, France set up the National Consultative Committee for Ethics in the Life and Health Sciences (CCNE) to advise the government about the regulation of medical practices and research. In 1986, the CCNE said, "Respect for human dignity must guide both the development of knowledge and the limits or Each of the stories describes a unique individual, whose history, career, skills, interests and routines need to be recognised and respected. They have care and medical needs, but that is not who they are.

A philosopher of the Age of Enlightenment (18th century), Immanuel Kant held that there were things that should not be discussed in terms of value, and that these things could be said to have dignity. ' Value' is necessarily relative, because the value of something depends on a particular observer's judgment of that thing. Things that are not relative–that are "ends in themselves", in Kant's terminology–are by extension beyond all value, and a thing is an end in itself only if it has a moral dimension; if it represents a choice between right and wrong. In Kant's words: " Morality, and humanity as capable of it, is that which alone has dignity." [19] Specifically with respect to human dignity, which his writings brought from relative obscurity in Western philosophy into a focal point for philosophers, Kant held that "free will" is essential; human dignity is related to human agency, the ability of humans to choose their own actions. [20] Mortimer Adler and Alan Gewirth [ edit ]

Author contributions

This study had some methodological limitations. First, most participants were women. This may have resulted in a female perspective of dignity-conserving interventions. A male perspective might have added other aspects. Alternatively, women generally live longer than men [ 64], and, as NHs foremost are populated by women, a female perspective is important. Second, social desirability bias must always be considered in studies [ 65]. This may have influenced residents to respond in a way they believed more appropriate or socially acceptable, resulting in the withholding of true thoughts and feelings. To reduce this, the first author spent a considerable amount of time in the NH, in fact, 170 h over six months, which provided a rich amount of data and a great depth of understanding of the aspects that influence the residents’ dignity. Third, data collection took place in 2017. This might appear to be a limitation; nevertheless, the conditions concerning staff and median length of stay in NHs in Sweden are similar today. Further, the insights revealed here add valuable knowledge to inform how dignity is embodied in NH practice. Recommendations for practice Nordenfelt L. The varieties of dignity. Health Care Anal. 2004;12:69–81; discussion 83–89. https://doi.org/10.1023/B:HCAN.0000041183.78435.4b Wellbeing is defined as a broad concept relating to a number of factors, such as personal dignity, including treating the person with respect. Gratton, Brigitte. Survey on the National Regulations in the European Union regarding Research on Human Embryos (July 2002), 53. Reeves S, Peller J, Goldman J, Kitto S. Ethnography in qualitative educational research: AMEE Guide No. 80. Med Teach. 2013;35:e1365-1379. https://doi.org/10.3109/0142159X.2013.804977

Chochinov HM. Dignity-conserving care—a new model for palliative care: helping the patient feel valued. JAMA. 2002;287:2253–60. https://doi.org/10.1001/jama.287.17.2253 In 1997, the National Consultative Committee for Ethics in the Life and Health Sciences, as well as other observers, noted that France's dignity-based laws on bio-medical research were paradoxical. The law prohibited the willful destruction of human embryos but directed that human embryos could be destroyed if they were more than five years old. [57] The law prohibited research on human embryos created in France but permitted research on human embryos brought to France. [57] The law prohibited researchers from creating embryos for research but allowed researchers to experiment with embryos that were superfluous after in vitro fertilization. [58] Germany [ edit ] Dignity also tends to connote the features of self-contained serenity, of a certain inward and toned-down but yet translucent and perceptible power of self-assertion: the dignified type of character is chary of emphatic activity rather than sullenly passive, perhaps impassive rather than impassible, patient rather than anxiously defensive, and devoid but not incapable of aggressiveness [8] Violations [ edit ] Categories [ edit ]This ethnographic and deductive study was based on participant observations and interviews inspired by focused ethnographic principles [ 34, 35]. Focused ethnography has its roots in anthropology [ 35] and enables exploration of a particular issue in a specific setting. The method focuses on subcultural groups sharing particular traits instead of looking at whole societies [ 35, 36]. It is a recommended method in research involving older people [ 37] and palliative care [ 38] as it allows a deep understanding of a particular question and context and is carried out in an everyday setting. A deductive analysis approach was chosen as its structure was operationalized on the basis of an existing theory [ 39]. In this study, the theoretical dignity model (DM) by Chochinov was used [ 31]. Setting None of the residents mentioned how they wanted to be remembered, and they were not observed being active with life projects, i.e., journaling. Quality of life is positively linked to certain building features about choice and control, community involvement, physical and cogniti

Hedelin B, Strandmark M. The meaning of mental health from elderly women’s perspectives: a basis for health promotion. Perspect Psychiatr Care. 2001;37:7–14. https://doi.org/10.1111/j.1744-6163.2001.tb00611.x rules to be observed by research." The CCNE said that research on human embryos must be subject to "the rule of reason" and must have regard for "undefined dignity in its practical consequences." [48] The CCNE insisted that, in research on human embryos, the ethical principles that should apply are "respecting human dignity" and respecting "the dignity of science." [48] Portugal [ edit ] Cleland J, Hutchinson C, Khadka J, Milte R, Ratcliffe J. What defines quality of care for older people in aged care? A comprehensive literature review. Geriatr Gerontol Int. 2021;21:765–78. https://doi.org/10.1111/ggi.14231

Although residents’ bodies were the largest violators of dignity, the most dignity-conserving repertoire came from within. It was apparent that they had different personalities, coloured by their previous lives. Despite this, they were proud of having coped independently and with endurance. Their acquired perspectives of self-knowledge provided them with tools to distinguish what was still possible from what they just had to accept. Thus, even those with extensive care needs and no control found ways to escape negative thoughts and find meaning in everyday life. This ability may result from inner creativity, helping residents to remain self-dependent, even if their bodies fail [ 53]. Residents in this study appeared to have found dignity by accepting disease and deterioration with a fighting spirit, which aligns with research with younger people with multiple sclerosis [ 54]. Cairns D, Williams V, Victor C, Richards S, Le May A, Martin W, Oliver D. The meaning and importance of dignified care: findings from a survey of health and social care professionals. BMC Geriatr. 2013;13:28. https://doi.org/10.1186/1471-2318-13-28 Both absolute and relative poverty are violations of human dignity, although they also have other significant dimensions, such as social injustice. [9] Absolute poverty is associated with overt exploitation and connected to humiliation (for example, being forced to eat food from other people's garbage), but being dependent upon others to stay alive is a violation of dignity even in the absence of more direct violations. Relative poverty, on the other hand, is a violation because the cumulative experience of not being able to afford the same clothes, entertainment, social events, education, or other features of typical life in that society results in subtle humiliation; social rejection; marginalization; and consequently, a diminished self-respect. All human beings are born free and equal in dignity and rights. They are endowed with reason and conscience and should act towards one another in a spirit of brotherhood. Philosophers of the late 20th century who have written significant works on the subject of dignity include Mortimer Adler and Alan Gewirth. [20] Gewirth's views on human dignity are typically compared and contrasted with Kant's, for like Kant he theorizes that human dignity arises from agency. [21] [22] But while sharing Kant's view that rights arise from dignity, Gewirth focused far more than Kant on the positive obligations that dignity imposed on humans, the moral requirement not only to avoid harming but to actively assist one another in achieving and maintaining a state of "well-being". [21]

This can be a good test of the degree to which social care staff really understand what life is like for the people they work with. Are microwaved frozen meals, or sandwiches on paper plates really like mealtimes? Are care homes the sort of places we think of when we think of ‘home?’ What makes life for people receiving adult social care services a real, satisfying life? Remembering your life history is an important part of your identity. Where people are at risk of losing their personal story, treating them with dignity involves supporting them in maintaining and celebrating it. The aim of this study was to explore aspects of dignity in older persons’ everyday lives in a nursing home. Research questions Dahlke S, Hunter KF. Harnessing nursing to diminish ageism. Int J Older People Nurs. 2021:e12417. https://doi.org/10.1111/opn.12417

The memory of the individual

Demjén Z. Laughing at cancer: humour, empowerment, solidarity and coping online. J Prag. 2016;101:18–30. https://doi.org/10.1016/j.pragma.2016.05.010 Human dignity can be violated in multiple ways. The main categories of violations are: [9] Humiliation Violations of human dignity in terms of humiliation refer to acts that humiliate or diminish the self-worth of a person or a group. Acts of humiliation are context dependent but we normally have an intuitive understanding where such a violation occurs. As Schachter noted, "it has been generally assumed that a violation of human dignity can be recognized even if the abstract term cannot be defined. 'I know it when I see it even if I cannot tell you what it is'". [10] More generally, etymology of the word "humiliation" has a universal characteristic in the sense that in all languages the word involves "downward spatial orientation" in which "something or someone is pushed down and forcefully held there". [11] This approach is common in judicial decisions where judges refer to violations of human dignity as injuries to people's self-worth or their self-esteem. [12] Instrumentalization or objectification This aspect refers to treating a person as an instrument or as means to achieve some other goal. This approach builds on Immanuel Kant's moral imperative stipulating that we should treat people as ends or goals in themselves, namely as having ultimate moral worth which should not be instrumentalized. Degradation Violations of human dignity as degradation refer to acts that degrade the value of human beings. These are acts that, even if done by consent, convey a message that diminishes the importance or value of all human beings. They consist of practices and acts that modern society generally considers unacceptable for human beings, regardless of whether subjective humiliation is involved, such as selling oneself to slavery, or when a state authority deliberately puts prisoners in inhuman living conditions. Dehumanization These are acts that strip a person or a group of their human characteristics. It may involve describing or treating them as animals or as a lower type of human beings. This has occurred in genocides such as the Holocaust and in Rwanda where the minority were compared to insects. Examples [ edit ] I think I’ve been quite healthy actually, so why did I have a stroke now, I don’t understand? I took my Warfarin and had staff who gave it to me, so I didn’t miss any. I don’t understand what happened. (Interview with resident, 88 years)