Patient Dignity: the significance of relationship

Abstract

<p>How do we preserve patient dignity in the health care context? I begin with a brief overview of dignity according to Kant, and follow this with an examination of what dignity means to patients and practitioners. I then propose a relational and care approach to dignity that does not indelibly tie individual dignity to any particular capacity or set of capacities. A relational and care account of the equal dignity all individuals possess ensures all human beings have value as particular individuals – value that demands respect – regardless of individual capacity. With a relational and care approach to dignity in mind I suggest and defend that patient dignity is best preserved and promoted in the context of the patient-practitioner relationship. I reject the notion patient-practitioner relationships are contractual in nature and suggest adopting a model of ‘relationship as engagement’ (Bergum and Dossetor, 2005) as a means to respecting patient dignity. I look at two major barriers to ‘relationship as engagement’ – the manner in which health care is delivered and the evidence-based medicine movement – and suggest ways to address and overcome these barriers. I conclude the paper by highlighting the various accounts of centredness (patient, person, client, family, relationship) espoused by many health care organisations, affirming relationship is the appropriate vehicle for respecting patient dignity.</p>