Dignity and autonomy are the two most controversial terms commonly used in debates on end-of-life care. Dignity refers to the right of an individual to be respected, valued and treated ethically (1). It also means respecting other people’s decisions or choices without making any assumptions. Autonomy refers to the right of an adult to make informed decisions regarding their medical care (1). It is mandatory for care providers to seek the patient’s consent before administering any treatment. The difference between these two terms lies in their definitions. Unlike dignity, autonomy can be limited when its exercise violates the physician’s team’s conscience. (2). Dignity is concerned with the ability of an individual to maintain self-respect and be valued by others while autonomy refers to an individual having control of decision making.
Nursing personnel’s attitude toward the autonomy and dignity of older adults affects the quality of care the patients receive. Most nurses believe that older adults do not have the capacity to freely make decisions regarding their well-being (3). Consequently, they hide information from these patients or even ignore their opinion. This affects the quality of care they receive, raising ethical concerns. Similarly, there are several factors that can affect the two concepts. They include: “effective communication, maintenance of privacy, staff decency, protecting patients and providing confidential conditions” (4). For instance, a lack of effective communication may affect the patient’s ability to inform the provider of their wishes.
The feedback
I appreciate the way the writer opened their discussion by noting that both autonomy and dignity, despite being human rights, are being undermined in the healthcare setting. However, the writer needed to show how these two concepts are being undermined. For instance, Persson, Benzein, and Morberg Jämterud (5) argued that dignity is threatened by the lack of respect for patients’ privacy and general insensitivity. Autonomy is undermined when the providers deny the patients the information and informed consent. Additionally, the writer’s decision to rely on the survey by the World Health Organization to emphasize the importance of dignity makes the whole discussion credible. The only thing I can add at this point is the fact that many patients value dignity because it helps them establish effective relationships with healthcare professionals (6). Overall, I agree with the writer’s observation that involving dignity in decision-making would lead to high patient satisfaction and positive outcomes.
References
- Horner J. Moral features of the therapeutic relationship with adults: dignity, trust, autonomy, vulnerability, and resilience. Semin Speech Lang. 2020; 41(3): 212-220. Web.
- Oshodi TO, Bruneau B, Crockett R, Kinchington F, Nayar S, West E. Registered nurses’ perceptions and experiences of autonomy: a descriptive phenomenological study. BMC Nursing. 2019; 18(1): 1-4.
- Šaňáková Š, Čáp J. Dignity from the nurses’ and older patients’ perspective: a qualitative literature review. Nursing Ethics. 2019; 26(5): 1292-309.
- Kadivar M, Mardani-Hamooleh M, Kouhnavard M. Concept analysis of human dignity in patient care: Rodgers’ evolutionary approach. J Med Ethics Hist Med. 2018; 11.
- Persson C, Benzein E, Morberg Jämterud S. Dignity as an inter-subjective phenomenon: experiences of dyads living with serious illness. Qual Health Res. 2020; 30(13): 1989-2000.
- Tehranineshat B, Rakhshan M, Torabizadeh C, Fararouei M. Patient Dignity in Iranian Clinical Care Settings as Perceived by Physicians, Caregivers, and Patients. J Multidiscip Healthc. 2020; 13: 923.