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Dignity-Conserving Care in Medicine

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Person Centered Approach to Recovery in Medicine

Part of the book series: Integrating Psychiatry and Primary Care ((IPPC))

Abstract

Dignity-conserving care is a multifactorial construct, consisting of three primary domains, i.e. illness-related concerns, such as symptom distress; dignity-conserving perspectives and practices, such as continuity of the self, maintenance of pride and hopefulness; and social dimensions of dignity, such as privacy concerns, burden to others and aftermath concerns. Dignity-conserving care has recently been the focus of research in both somatic and mental care settings. In patients suffering from somatic disorders, particularly chronic and progressive disorders, loss of dignity is often manifested by loss of identity, shattering of their self-image or having psychological, interpersonal, spiritual and existential needs that are not being adequately addressed. Similar issues apply to psychiatric patient healthcare, where stereotypes, prejudice and discrimination continue to exist. Fractured dignity has been associated with increasing levels of physical and psychological symptoms, including spiritual pain. The delivery of dignity-conserving care is essential in achieving a holistic and healing approach, improving the satisfaction of patients, families and healthcare professionals alike.

“The patient enters the hospital as if he were entering a business concern, to be served in the best possible way by an impersonal apparatus. And the physician of modernity acts as if he were a collectivity, which cares for the patient without a physician’s entering into the treatment in any personal way. […]”

(Jaspers, 1959, The physician in the technological age, p. 254)

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Notes

  1. 1.

    Personhood here is intended as the status of being a person, a human person as the natural inherent capacity to give rise to human functions, whether or not those functions are ever attained.

  2. 2.

    What I feel regarding my body, that is, the intentional, living aspects of my body, is often described in terms of Leib to be differentiated by Körper, where Leib is the intentional lived body, to be a body, and Körper is the material body, to have a body. These concepts, which are important in a psychosomatic approach in medicine, were introduced by Husserl and re-proposed by Merleau-Ponty and are still crucial in the mind-body problem.

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Authors and Affiliations

  1. Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy

    Luigi Grassi

  2. Department of Psychiatry, University of Manitoba, Winnipeg, MB, Canada

    Harvey Chochinov

  3. Manitoba Palliative Care Research Unit, CancerCare Manitoba, Winnipeg, MB, Canada

    Harvey Chochinov

  4. Research Institute of Oncology and Hematology, CancerCare Manitoba, Winnipeg, MB, Canada

    Harvey Chochinov

  5. Division of Neurology, Palliative Care Programme, Integrated University Hospital, Verona, Italy

    Giuseppe Moretto

  6. Department of Biomedical and Specialty Surgical Sciences, Institute of Psychiatry, University of Ferrara, Ferrara, Italy

    Maria Giulia Nanni

  7. University Hospital Psychiatry Unit, Program on Psycho-Oncology and Psychiatry in Palliative Care, Integrated Department of Mental Health, S. Anna Hospital and Local Health Authorities, Ferrara, Italy

    Maria Giulia Nanni

Authors
  1. Luigi Grassi
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  2. Harvey Chochinov
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  3. Giuseppe Moretto
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  4. Maria Giulia Nanni
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Correspondence to Luigi Grassi .

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Editors and Affiliations

  1. Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy

    Luigi Grassi

  2. University of Michigan Rogel Cancer Center, Ann Arbor, MI, USA

    Michelle B. Riba

  3. Inova Fairfax Hospital, Johns Hopkins University Inova Fairfax Hospital, Falls Church, VA, USA

    Thomas Wise

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Grassi, L., Chochinov, H., Moretto, G., Nanni, M.G. (2019). Dignity-Conserving Care in Medicine. In: Grassi, L., Riba, M., Wise, T. (eds) Person Centered Approach to Recovery in Medicine. Integrating Psychiatry and Primary Care. Springer, Cham. https://doi.org/10.1007/978-3-319-74736-1_6

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  • DOI: https://doi.org/10.1007/978-3-319-74736-1_6

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