Introduction: Expressions of dignity as a clinical phenomenon in nursing homes as expressed by caregivers were investigated. A coherence could be detected between the concepts and phenomena of existence and dignity in relationships and caring culture as a context. A caring culture is interpreted by caregivers as the meaning-making of what is accepted or not in the ward culture. Background: The rationale for the connection between existence and dignity in relationships and caring culture is that (...) suffering is a part of existence, as well as compassion in relieving suffering, and ontological interdependency. Aim: To describe different expressions of dignity in relationships and existence in context of caring cultures from the perspective of the caregivers. Research design: The methodology and method are hermeneutic. The method used was to merge the theoretical preunderstanding as one horizon of understanding with empirical data. Participants and research context: Focus group interviews with caregivers in nursing homes. Ethical considerations: The principles of the Helsinki Declaration have been followed to, for example, preserve self-determination, integrity, dignity, confidentiality and privacy of the research persons. Findings: Data interpretation resulted in four themes: Encountering existential needs that promote dignity in a caring culture; To amplify dignity in relationships by the creative art of caring in a caring culture; Violation of dignity by ignorance or neglect in a non-caring culture and The ethic of words and appropriated ground values in a caring culture. Discussion: Dignity-promoting acts of caring, or dignity-depriving acts of non-caring are adequate to see from the perspective of dignity in relationships and existence and the caring culture. Conclusions: Dignity in relationships seems to touch the innermost existential life, as the existential life is dependent on confirmation from others. (shrink)

The purpose of this qualitative study was to analyse nurses’ professional dignity in their everyday working lives. We explored the factors that affect nursing professional dignity in practice that emerge in relationships with health professionals, among clinical nurses working in hospitals and in community settings in central Italy. The main themes identified were: (i) nursing professional dignity perceived as an achievement; (ii) recognition of dignity beyond professional roles. These two concepts are interconnected. This study provides (...) insights into professional dignity in nursing being perceived as an achievement linked to the intrinsic dignity of every human being. The ‘nursing professional dignity perceived as an achievement’ was perceived as having declined in different social factors. Some factors of nursing professional dignity perceived as an achievement were attained more easily in community settings. ‘Recognition of dignity beyond professional roles’ underpins the intrinsic dignity as an expression of humanity, embedded in persons regardless of any profession, and values, such as: respect, moral integrity, humility, working conscientiously and kindness. (shrink)

The purpose of this qualitative study was to analyse nurses’ professional dignity in their everyday working lives. We explored the factors that affect nursing professional dignity in practice that emerge in relationships with health professionals, among clinical nurses working in hospitals and in community settings in central Italy. The main themes identified were: (i) nursing professional dignity perceived as an achievement; (ii) recognition of dignity beyond professional roles. These two concepts are interconnected. This study provides (...) insights into professional dignity in nursing being perceived as an achievement linked to the intrinsic dignity of every human being. The ‘nursing professional dignity perceived as an achievement’ was perceived as having declined in different social factors. Some factors of nursing professional dignity perceived as an achievement were attained more easily in community settings. ‘Recognition of dignity beyond professional roles’ underpins the intrinsic dignity as an expression of humanity, embedded in persons regardless of any profession, and values, such as: respect, moral integrity, humility, working conscientiously and kindness. (shrink)

Background: The concept of dignity can be divided into two main attributes: absolute dignity that calls for recognition of an inner worth of persons and social dignity that can be changeable and can be lost as a result of different social factors and moral behaviours. In this light, the nursing profession has a professional dignity that is to be continually constructed and re-constructed and involves both main attributes of dignity. Objectives: The purpose of this study (...) was to determine how nurses described nursing’s professional dignity in internal medicine and surgery departments in hospital settings. Research design: The research design was qualitative. Ethical considerations: This study was approved by the ethics committees of the healthcare organizations involved. All the participants were provided with information about the purpose and the nature of the study. Participants: A total of 124 nurses participated in this study. Method: The data were collected using 20 focus group sessions in different parts of Italy. The data were analysed by means of a conventional inductive content analysis starting from the information retrieved in order to extract meaning units and sorting the arising phenomena into conceptually meaningful categories and themes. Results: Nursing’s professional dignity was deeply embedded in the innermost part of individuals. Regarding the social part of dignity, a great importance was put on the values that compose nursing’s professional identity, the socio-historical background and the evolution of nursing in the area considered. The social part of dignity was also linked to collaboration with physicians and with healthcare assistants who were thought to have a central role in easing work strain. Equally important, though, was the relationship with peers and senior nurses. Conclusion: The organizational environments under scrutiny with their low staffing levels, overload of work and hierarchical interactions did not promote respect for the dignity of nurses. To understand these professional values, it is pivotal to comprehend the role of different health professions in their cultural milieu and the evolution of the nursing profession in diverse countries. (shrink)

Human dignity is grounded in basic human attributes such as life and self-respect. When people cannot stand up for themselves they may lose their dignity towards themselves and others. The aim of this study was to elucidate if dignity remains intact for family members during care procedures in a children’s hospital. A qualitative approach was adopted, using open non-participation observation. The findings indicate that dignity remains intact in family-centred care where all concerned parties encourage each other (...) in a collaborative relationship. Dignity is shattered when practitioners care from their own perspective without seeing the individual in front of them. When there is a break in care, family members can restore their dignity because the interruption helps them to master their emotions. Family members’ dignity is shattered and remains damaged when they are emotionally overwhelmed; they surrender themselves to practitioners’ care, losing their self-esteem and self-respect. (shrink)

Background:Maintaining patient’s dignity in intensive care units is difficult because of the unique conditions of both critically-ill patients and intensive care units.Objectives:The aim of this study was to uncover the cultural factors that impeded maintaining patients’ dignity in the cardiac surgery intensive care unit.Research Design:The study was conducted using a critical ethnographic method proposed by Carspecken.Participants and research context:Participants included all physicians, nurses and staffs working in the study setting. Data collection methods included participant observations, formal and informal (...) interviews, and documents assessment. In total, 200 hours of observation and 30 interviews were performed. Data were analyzed to uncover tacit cultural knowledge and to help healthcare providers to reconstruct the culture of their workplace.Ethical Consideration:Ethical approval for the study from Ethics committee of Isfahan University of Medical Sciences was obtained.Findings:The findings of the study fell into the following main themes: “Presence: the guarantee for giving enough attention to patients’ self-esteem”, “Instrumental and objectified attitudes”, “Adherence to the human equality principle: value-action gap”, “Paternalistic conduct”, “Improper language”, and “Non-interactive communication”. The final assertion was “Reductionism as a major barrier to the maintaining of patient’s dignity”.Discussion:The prevailing atmosphere in subculture of the CSICU was reductionism and paternalism. This key finding is part of the biomedical discourse. As a matter of fact, it is in contrast with dignified care because the latter necessitate holistic attitudes and approaches.Conclusion:Changing an ICU culture is not easy; but through increasing awareness and critical self-reflections, the nurses, physicians and other healthcare providers, may be able to reaffirm dignified care and cure in their therapeutic relationships. (shrink)

In light of recent criticisms of the concept of human dignity, this contribution offers a proposal for the continued relevance of the concept for tertiary chaplaincy. It is important to consider the concept of human dignity in tertiary chaplaincy because: many higher education institutions continue to identify human dignity as a key value; the kinds of ethical issues that tertiary students face will often involve appeals to human dignity; and the religious connotations that have come to (...) be associated with the concept fall within the scope of chaplains. Nevertheless, there have been recent calls for the concept of human dignity to be dismissed from ethical discourse as unhelpful. In ethical debate, dignity can be unhelpful when it leads to ‘dignity talk’, when there is disagreement about whether it is something human beings always already have or something that is realised through human activity, or when it conceals what people think is really at stake. In response to these criticisms, this contribution proposes a model for understanding human dignity that affirms the value of the human person as a multi-dimensional, historically-situated being in relationship to all that is, a being who is faced with difficult moral choices through which he or she makes meaning in his or her life. This model has both descriptive value in helping us to understand why people do what they do, and normative value in helping us evaluate what should be done. (shrink)

Dignity is a value inherent to all human beings, guaranteed to every individual from birth, and influenced by culture and society. It is protected by various laws and declarations, and represents one of the fundamental human rights. Preserving human dignity is an essential aspect of nursing practice and a central element of care. Dignity is a highly subjective and personal concept; there may be variations in the way that patients perceive it and in the ways that nurses (...) can guarantee it. A systematic review of the qualitative literature was conducted to obtain a comprehensive understanding of adult patients’ perceptions of dignity in a hospital setting. This review adhered to the PRISMA Statement for reporting systematic reviews, and the results were reported in accordance with the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) guidelines. Major databases (PubMed, CINAHL, Scopus, and PsycINFO) were consulted and resulted in the inclusion of 21 studies. Methodological quality was assessed using the Critical Appraisal Skills Program (CASP) Checklist for Qualitative Studies. Six main themes emerged from the data analysis: (1) The concept of dignity and its various dimensions; (2) The significance of maintaining one’s own privacy and confidentiality; (3) The hospital environment’s influence on patients’ dignity; (4) Healthcare professionals’ characteristics and behaviours that affect dignity; (5) The role of communication and the relationship with healthcare providers; and (6) The patient’s ability to make choices and be involved actively in their care. These findings underscore the importance of understanding caregivers’ perspectives on dignity to ensure that they provide respectful and dignified care and treatment that prioritizes the patient’s mental and physical needs. (shrink)

The objective of the present study is to examine the ethical grounding and process-relational nature of meaningful work through the relationship of dignity and meaningfulness. Adopting a practice lens, we show how a shift from methodological individualism to a process-relational worldview allows meaningful work to be understood through organizational activities rather than individual characteristics. Building on practice-based theorization, we present a process-relational model of meaningful work that 1) examines meaningfulness as a flow of experience in the stream of work (...) activity events; 2) highlights how experiencing meaningfulness is embedded in social practices, distinguishing it as a social phenomenon that is defined by this embeddedness; 3) delineates situationality, historicity, and contextuality of meaningfulness; and 4) shows how meaningful work is grounded in the prioritization of dignity in the logic of practice. Accordingly, our model enables a more holistic understanding of how dignity functions as the ethical basis for the experience of meaningfulness in the context of work and organization. (shrink)

The article critically analyzes the conservative conception of passive or static human dignity in accordance with which human’s value is seen as value coming from the exterior (from God or from a biological human’s nature), or value seen as existing per se. In opposition to this conception, a conception of active or created dignity is being developed, which aims at treating human’s dignity not like a social relationship, but rather like a person’s individual ability to live properly (...) in the society (participate in barter relations on the ground of equivalence) and using this propriety to create own individual social value (dignity), as a personal contribution towards maintenance of concord and collaboration in the society. (shrink)

Two values salient in the sub-Saharan tradition that are invoked to ground the superlative, equal worth of persons and the human rights to which they are entitled are, first, vitality or 'life-force' and, second, community or relationships of identity and solidarity. This entry, which draws heavily on an article appearing in Human Rights Review (2012), sketches these two conceptions of dignity and presents an overview of key strengths and weaknesses of them.

The study aims at making explicit the three spheres or planes, essential from the point of view of semiotics, on which the discourse regarding dignity takes place, and at clarifying the relations between these planes. The analysis uses the conception of Kazimierz Ajdukiewicz. There are three principal areas in which the discourse on dignity is conducted – the plane of linguistic expressions on which the name “dignity” is used; the plane of meanings on which the notion of (...) dignity is placed; and the plane of objects on which there is dignity itself. There is a relationship of meaning between the different concepts of dignity and the expression “dignity”, a relationship of signification between expression “dignity” and dignity as its referent, and a relationship of apprehension between the concepts of dignity and their referents. (shrink)

Illness narratives from patients with colorectal cancer commonly record patterns of change in social relationships that follow the diagnosis and treatment of the condition. We believe that these changes are best explained as a process of facework, which reflects losses of face on the part of the patient, and which assists in the creation of new faces that convey new senses of identity. Facework is familiar in the work by E. Goffman (1955) and has been extensively reworked since his (...) time. There is considerable agreement that face is a pervasive and universal constituent of all social interaction, and that it expresses the subject's view of the way he or she would like to be considered by others in interactions. Ho's concept of multiple faces negotiated dynamically according to social context is particularly useful in understanding the purpose and techniques of facework (D. Y.-F. Ho, 1994). We propose a model of face that uses dignity as the face-expression of personal attributes and acquisitions, and honor as the face-expression of systemic capabilities and attainments. This model can be used to examine individual variations in response and adaptation to colon cancer and its treatment, and it provides a useful means of teaching health care workers about the experience of illness. (shrink)

In response to the many changes currently going on in health care, this book offers the combined insight and wisdom of a stellar group of scholars and professionals with extensive experience in the health care field. The book opens with a look at people's actual experience of health care today, from four different perspectives. It then addresses foundational questions, including the nature of medicine, nursing, and justice. Surveyed next are the changing economics of health care as well as the impact (...) of these changes on such areas as mental health care, long-term care, health care for minorities, and legal malpractice. The closing section of the book assesses from a Christian perspective available constructive alternatives, including creative funding strategies with special attention to the needs of poor persons, physician unions, and the use of "alternative medicine" therapies. (shrink)

This paper is focused on the analysis of two documents (the Council of Europe's Bioethics Convention and the Additional Cloning Protocol) inasmuch as they refer to the relationship between human dignity and human genetic engineering. After presenting the stipulations of the abovementioned documents, I will review various proposed meanings of human dignity and will try to identify which of these seem to be at the core of their underlying assumptions. Is the concept of dignity proposed in the (...) two documents coherent? Is it morally legitimate? Is it, as some might assume, of Kantian origin? Does it have any philosophical roots? (shrink)

This article accepts the proposition that old people want to be treated with dignity and that statements about dignity point to ethical duties that, if not independent of rights, at least enhance rights in ethically important ways. In contexts of policy and law, dignity can certainly have a substantive as well as rhetorical function. However, the article questions whether the concept of dignity can provide practical guidance for choosing among alternative approaches to the care of old (...) people. The article explores the paradoxical relationship between the apparent lack of specific content in many conceptions of dignity and the broad utility that dignity appears to have as a concept expressive of shared social understandings about the status of old people. (shrink)

Human dignity has long been used as a foundational principle in policy documents and ethical guidelines intended to govern various forms of biomedical research. Despite the vast amount of literature concerning human dignity and embryonic tissues, the majority of biomedical research uses non-embryonic human tissue. Therefore, this contribution addresses a notable lacuna in the literature: the relationship, if any, between human dignity and human tissue. This paper first elaborates a multidimensional understanding of human dignity that overcomes (...) many of the shortcomings associated with the use of human dignity in other ethical debates. Second, it discusses the relationship between such an understanding of human dignity and ‘non-embryonic’ human tissue. Finally, it considers the implications of this relationship for biomedical research and practice involving human tissue. The contribution demonstrates that while human tissue cannot be said to have human dignity, human dignity is nevertheless implicated by human tissue, making what is done with human tissue and how it is done worthy of moral consideration. (shrink)

In October 2005, the United Nations Educational, Scientific and Cultural Organization adopted the Universal Declaration on Bioethics and Human Rights . A concept of central importance in the declaration is that of “human dignity”. However, there is lack of clarity about its scope, especially concerning the question of whether prenatal human life has the same dignity and rights as born human beings. This ambiguity has implications for the interpretation of important articles of the delcaration, including 2, 4, 8, (...) 10 and 11. The paper applies relevant provisions of the UDBHR to specific cases, addresses problems of internal consistency and considers attempts at clarifying the scope of “human dignity” by the negotiating parties. An analysis of the important relationship between the UDBHR and the Universal Declaration of Human Rights, to which the UDBHR refers in its title and elsewhere, shows that because of a crucial emphatic asymmetry, a broad reading according to which the UDBHR must be understood to ascribe human rights and dignity to prenatal life is untenable. However, the view that the UDBHR confers human rights and dignity on humans from the moment of birth onwards is robust and defensible. This conclusion is important for a proper understanding of the declaration and its use, as stated in Articles 1 and 22, the latter urging states “… to give effect to the principles … in this declaration”. Similarly, it has implications for the use of the declaration in the wider context of bioethics-related law and policy, as well as in academic and other discussions where increasing reference to the UDBHR is likely. (shrink)

Chronicling the history of gendered and sexualised violence in Zimbabwe, our article upholds the view that what transpired in Judges 19:20–48 offers the contemporary readers some important lessons that are worth pondering over. Looking through feminist hermeneutical lenses, we engage in a comparative analysis of the gender-based violations, human rights abuses, and the lack of hospitality depicted in Judges 19–21 with the lived realities of Zimbabwean women in our contemporary times. The discussion draws to a close by proffering a theology (...) of restorative justice. It is our argument that Zimbabwe needs healing through a non-retaliative response to some wrongdoing that prioritises repairing harm and the recognition that maintaining positive relationships with fellow humans is a core human need. This is the only way forward to reclaim and restore the humanity and dignity of women exposed to diverse forms of gender-based violence in our Mother Earth.Contribution: This article reveals the link between the violations and brutality endured by the woman in Judges 19–21 with the history of sexualised violence in Zimbabwe. It is worth noting that in African Traditional Religion, the three worlds (spiritual, natural, and human) are intertwined and make up the cosmic totality; sexually violating women is tantamount to desecrating Mother Earth. (shrink)

In this chapter the explanatory value of four conceptions of human dignity to account for two seemingly contradictory intuitions is tested. One is that many people think poverty violates the humanity of poor people. The other intuition is that poor people often act with remarkable dignity despite their trying circumstances. First Immanuel Kant’s influential view on human dignity that claims it is grounded in humans’ capability to make moral judgments is examined. Next, Martha Nussbaum’s theory of the (...) capability approach is tested, which is hugely influential across many academic disciplines and in the world of economic development. Thereafter, two related, though distinctly different African theories of human dignity, as offered by Thaddeus Metz and Polycarp Ikuenobe are assessed. Both base their theories on the core capacity of humans to engage in harmonious relationships within communities. Last, it is investigated the theory that Avishai Margalit provides of honour and humiliation as concepts that illuminate the value and risks for humans’ possession of dignity. His theory is linked to aspects of the recognition theory of Axel Honneth. In the end, it is concluded that these theories either cannot fully, or adequately, explain the complex relationship between poverty and human dignity. (shrink)

Introduction It is a goal in nursing education to promote students’ dignity and facilitate this core value. Students’ experience of dignity is shaped by the student–supervisor relationship. Literature shows limited knowledge about how nursing students experience their own dignity during education. Research aim The aim of the study is to develop an understanding of how nursing students experience their own dignity in relation to supervisors, and what significance these experiences have in education. Research design Gadamer’s philosophical (...) hermeneutics was chosen as the approach, and narratives and qualitative interviews were conducted. The interpretation process was inspired by Fleming, Gaidys and Robbs. Participants and research context Nineteen nursing students in the final year of their education were included in the study. They represented six different campuses at three different educational institutions. The qualitative interviews took place at the educational institutions. Ethical considerations The research recommendations of the Declaration of Helsinki were followed. Access to the students was given by the educational institutions. All interested students signed a continuous informed consent. Findings Students’ dignity was at stake in encounters with supervisors during education. Decisive for experience of dignity was the supervisor’s ability to confirm the student through acknowledgment, reassurance and seeing them as individuals. Experienced dignity had a crucial impact on students’ life courage and their ability to be present. Discussion The discussion emphasizes the vulnerable dignity of students, the importance of confirmation and the significance perceived dignity has. Conclusion Students’ experiences tilted between perceived dignity and offense, and placed students’ dignity in a vulnerable position. Crucial for perceived dignity was the confirmation the students received from their supervisors. Perceived dignity gave the students courage and increased their ability to be present, which provided better opportunities for learning and development. (shrink)

While many European countries are entering unknown legal terrain where the embryo in vitro is concerned, France can already look back on a long tradition of public discussion and legal codification of ways of dealing with in vitro embryos. In its comprehensive law of 1994, France had still rejected embryo research; however, due to the promising perspectives of stem cell research, the new law now pending implies a clear liberalization of the 1994 provisions. Both the French lawmakers and the National (...) Ethics Commission have repeatedly argued that possible utilization of embryos for research purposes may seem legitimate from the moment that there is no more "parental project." De facto, this concept implies that an embryo can be transformed into an object from the moment that the parents cease to desire it and that the value of protection is solely dependent on the will of third persons. At the same time, France is still speaking of guaranteeing respect for the "dignity of the embryo," which would mean that an embryo must not be reduced to a thing and treated for purposes which are not his own. Therefore, the French solution is not a consistent and honest solution, and in its new legal provisions, France has involved herself in manifold contradictions. France has rejected the conception of pre-embryo, but is de facto following Britain's model without making it explicit. (shrink)

As an important professional value, dignity has always been an ethical concern in nursing education and practice. However, the dignity of nursing students in clinical environments has remained a little-discussed topic. This study aims to explore and describe nursing students’ dignity in clinical learning environments. This study is a qualitative descriptive work in which data were collected via semi-structured, in-depth, individual interviews and subsequently analyzed according to conventional content analysis. Based on the inclusion criteria of the study, (...) nursing students were selected from different departments of university hospitals in the south of Iran from October 2019 to December 2020. Sampling continued to the point of data saturation. This study has been approved by the institutional review board of the university. Two themes emerged from the data collected in the interviews: trust-based relationships and formation of professional identity. The findings of the study show that nursing students need to be supported by their instructors and perceive that the personnel and patients believe in their ability. In an effectively supportive, trust-based atmosphere, these factors can contribute to maintaining nursing students dignity. Also, showing respect for their personal identity, projecting a positive image of nursing, and giving them authority to perform executive and clinical tasks in hospital departments play a major role in the formation of nursing students’ professional identity and development of their dignity. Accordingly, it is recommended that in cultural contexts and clinical learning environments, more attention should be given to nursing students’ dignity. (shrink)

Human dignity: social movements invoke it, several national constitutions enshrine it, and it features prominently in international human rights documents. But what is it, why is it important, and what is its relationship to human rights and social justice? Pablo Gilabert offers a systematic defence of the view that human dignity is the moral heart of justice. In Human Dignity and Human Rights (OUP 2019), he advanced an account of human dignity for the context of human (...) rights discourse, which covers the most urgent, basic claims of dignity. This book extends the dignitarian approach to more ambitious claims of maximal dignity of the kind encoded in democratic socialist conceptions of social justice. In particular, this book focuses on the just organization of working practices. It recasts in a dignitarian format the critique of capitalist society as involving exploitation, alienation, and domination of workers, and revamps a neglected but inspiring socialist principle. In its dignitarian interpretation, the Abilities/Needs Principle (‘From each according to their ability, to each according to their needs!’) yields reasonable and feasible requirements on social cooperation geared to empowering each human being to lead a flourishing life. While Human Dignity and Human Rights offered the first systematic philosophical account of human dignity in human rights discourse, Human Dignity and Social Justice presents the first systematic application of the dignitarian framework to the core ideals of democratic socialism. (shrink)

In the medical practice in China, giving and taking “red envelopes” is a common phenomenon although few openly admit it. This paper, based on our empirical study including data collected from interviews and questionnaires with medical professionals and patients, attempts to explore why “red envelopes” have become a serious problem in the physician-patient relationship and how the situation can be improved. Previous studies show that scholars tend to correlate the spread of “red envelopes” in health care sector to the commercialization (...) trend, the general erosion of traditional values, and the lowering of the moral level in the medical field. However, in this paper, the authors argue that medical professionals’ choice of taking “red envelopes” is actually more a way to compensate for their problematic self-image and marred dignity in real practice. Medical professionals in China as a whole are in an embarrassing situation where the work pressure and income, and the sense of pride that used to be part of their profession are not comparable to each other. Under this circumstance, we believe that the effective way to deal with the “red envelopes” issue does not lie solely in introducing more stringent regulations or granting medical professionals higher payments, but rather in protecting and enhancing the professional dignity of all those working in healthcare. And on top of that, there must also be effort to cultivate a more favorable moral environment. (shrink)

This paper articulates dignity as relational engagement in concrete care situations. Dignity is often understood as an abstract principle that represents inherent worth of all human beings. In actual care practices, this principle has to be substantiated in order to gain meaning and inform care activities. We describe three exemplary substantiations of the principle of dignity in care: as a state or characteristic of a situation; as a way to differentiate between socio-cultural positions; or as personal meaning. (...) We continue our analysis by presenting cases on dignity in care related to us in focus groups with medical professionals. Our empirical ethical lens is in this paper is to analyse, not the meaning of dignity, but the way in which it emerges in practices where it is pursued, within relationships between people, technologies, places, regulations, and the values cherished by or embedded in them. We show that professional caregivers recognize in the dignity of the person they care for their own dignity; giving up on the one implies no less than giving up on the other. This ‘mirrored experience’ of dignity expresses itself in professional’s engagement with the situation. The value of this engagement, we argue, lies not primarily in realizing the particular content of the values at stake. We point to the importance of engagement itself, even if the values engaged with cannot be realized to the full, and even if competing versions of dignity are at stake simultaneously. In this way the caregivers provide us with interesting examples of moral actorship in situations of conflicting values. (shrink)

Religious pluralism in healthcare means that conflicts regarding appropriate treatment can occur because of convictions of patients and healthcare workers alike. This contribution argues for a presumption in favour of respect for religious belief on the basis that such convictions are judgements of conscience, and respect for conscience is core to what it means to respect human dignity. The human person is a subject in relation to all that is. Human dignity refers to the worth of human persons (...) as members of the species with capacities of reason and free choice that enable the realisation of dignity as self-worth through morally good behaviour. Conscience is both a feature of inherent dignity and necessary for acquiring dignity as self-worth. Conscience enables a person to identify objective values and disvalues for human flourishing, the rational capacity to reason about the relative importance of these values and the right way to achieve them and the judgement of the good end and the right means. Human persons are bound to follow their conscience because this is their subjective relationship to objective truth. Religious convictions are decisions of conscience because they are subjective judgements about objective truth. The presumption of respect for religious belief is limited by the normative dimension of human dignity such that a person's beliefs may be overridden if they objectively violate inherent dignity or morally legitimate acquired dignity. (shrink)

Ruth Macklin argued that dignity is nothing more than respect for persons or their autonomy. During the COVID-19 pandemic, difficult decisions are being made about the allocation of scarce resources. Respect for autonomy cannot justify rationing decisions. Justice can be invoked to justify rationing. However, this leaves an uncomfortable tension between the principles. Dignity is not a useless concept because it is able to account for why we respect autonomy and for why it can be legitimate to override (...) autonomy in times of critical care resource shortages. Dignity affirms the worth of the human individual as a meaning-making embodied subject, who is always in relationship to others, the world, time, and transcendence, and who realizes their dignity through their moral behaviour. Such an understanding means people should be helped to make morally right decisions about their own treatment, which may include forgoing potentially beneficial treatment for the good of others. Respect for dignity does not require fulfilling the morally wrong choices of one who insists on treatment at the expense of others. Dignity also protects the discretion of clinicians to make decisions appropriate to their competence by prohibiting the application of broad-based criteria such as age. (shrink)

In the debates concerning the ethics of human enhancement through biological or technological modifications, there have been several appeals to the concept of human dignity, both by those favouring such enhancement and by those opposing it. The result is the phenomenon of ‘dignity talk', where opposing sides both appeal to the concept of human dignity to ground their arguments resulting in a moral impasse. This article examines the use of the concept of human dignity in the (...) enhancement debates and reveals that the problem of dignity talk arises because proponents of various positions tend to ground human dignity in different features of the human individual. These features include species-membership, possession of a particular capacity, a sense of self-worth, and moral behaviour. The article proposes a solution to this problem by appealing to another feature of human beings, namely their being-in-relationship-over-time. Doing so enables us to understand dignity as a concept that affirms the worth of human individuals as complex, multidimensional wholes, rather than as isolated features. Consequently, the concept of human dignity can serve both a descriptive and a normative function in the enhancement debates. At a descriptive level, asking what advocates of a position mean when they refer to human dignity will reveal what aspects of being human they deem to be most valuable. The debate can then focus on these values. The normative function, although it cannot proscribe or prescribe all enhancement, approves only those enhancements that contribute to the flourishing of human individuals as multidimensional wholes. (shrink)

Human dignity: social movements invoke it, several national constitutions enshrine it, and it features prominently in international human rights documents. But what is human dignity, why is it important, and what is its relationship to human rights? -/- This book offers a sophisticated and comprehensive defence of the view that human dignity is the moral heart of human rights. First, it clarifies the network of concepts associated with dignity. Paramount within this network is a core notion (...) of human dignity as an inherent, non-instrumental, egalitarian, and high-priority normative status of human persons. People have this status in virtue of their valuable human capacities rather than as a result of their national origin and other conventional features. Second, it shows how human dignity gives rise to an inspiring ideal of solidaristic empowerment, which calls us to support people's pursuit of a flourishing life by affirming both negative duties not to block or destroy, and positive duties to protect and facilitate, the development and exercise of the valuable capacities at the basis of their dignity. The most urgent of these duties are correlative to human rights. Third, this book illustrates how the proposed dignitarian approach allows us to articulate the content, justification, and feasible implementation of specific human rights, including contested ones, such as the rights to democratic political participation and to decent labour conditions. Finally, this book's dignitarian approach helps illuminate the arc of humanist justice, identifying both the difference and the continuity between the basic requirements of human rights and more expansive requirements of social justice such as those defended by liberal egalitarians and democratic socialists. -/- Human dignity is indeed the moral heart of human rights. Understanding it enables us to defend human rights as the urgent ethical and political project that puts humanity first. (shrink)

In this essay I present some of my thoughts on the issue of boundaries in the professional relationship between service users and social workers. As a graduate student of social work, I had an opportunity to discuss ethical dilemmas in an international perspective in one of my courses. A guest professor, who provided international perspectives, was Prof. Kim Strom from UNC at Chapel Hill in North Carolina, USA. The lectures offered a fresh perspective that raised many questions about thick and (...) thin boundaries in social work – especially when approaching social work by following prevailing guidelines for social work in Slovenia requiring us to co-create solutions through dialogue with service users, keeping in mind that service users are actually the ones who are the experts from experience. In this way, the working relationship seeks to foster a sense of partnership between social workers and service users. In this essay I would like to challenge the idea of rigid boundaries in social work and explore the possibility of fluid boundaries, keeping in mind that boundaries should reflect their main purpose, which I believe is to protect human dignity. (shrink)

Abstract Religious pluralism in healthcare means that conflicts regarding appropriate treatment can occur because of convictions of patients and healthcare workers alike. This contribution argues for a presumption in favour of respect for religious belief on the basis that such convictions are judgements of conscience, and respect for conscience is core to what it means to respect human dignity. The human person is a subject in relation to all that is. Human dignity refers to the worth of human (...) persons as members of the species with capacities of reason and free choice that enable the realisation of dignity as self-worth through morally good behaviour. Conscience is both a feature of inherent dignity and necessary for acquiring dignity as self-worth. Conscience enables a person to identify objective values and disvalues for human flourishing, the rational capacity to reason about the relative importance of these values and the right way to achieve them and the judgement of the good end and the right means. Human persons are bound to follow their conscience because this is their subjective relationship to objective truth. Religious convictions are decisions of conscience because they are subjective judgements about objective truth. The presumption of respect for religious belief is limited by the normative dimension of human dignity such that a person's beliefs may be overridden if they objectively violate inherent dignity or morally legitimate acquired dignity. (shrink)

Increasing global competition has intensified the use of informal sector workforce worldwide. This phenomenon is true with regard to India, where 92% of the workers hold precarious jobs. Our study examines the dynamics of workplace dignity in the context of Indian security guards deployed as contract labour by private suppliers, recognising that security guards’ jobs were marked by easy access, low status, disrespect and precariousness. The experiences of guards serving bank ATMs were compared with those working in large reputed (...) organisations. The former reported loss of dignity though their inherent self-worth remained partially intact, whereas the latter reclaimed dignity despite the precarious working conditions and the absence of unions. Guards from large reputed organisations evolved strategies by which they took advantage of the client’s vulnerabilities, developed ‘thick’ relationships at work and immersed themselves in 'doing dignity work' to ensure that they are not disposable. ‘Doing dignity work’ was a visible device which involved actions that met or went beyond the norms laid down by the client and was used by security guards to limit the extent of their precariousness. Since the opportunity to reclaim dignity was facilitated by large reputed clients’ adherence to legal regulations, we see implications of the study for the moral economy. (shrink)

This article aims to deconstruct the concept of dignity in a way that is meaningful, in particular to nurses and other health workers who seek to promote the dignity of children in their care. Despite the emphasis in a variety of codes and policies to promote dignity, there is a lack of a clear definition of dignity in the literature. In particular there is little reference to dignity, theoretically or empirically, as it relates to children. (...) Without clarity it is not possible to act in an ethical way on behalf of children whose dignity could otherwise be compromised. The theoretical position taken has evolved from the medico-nursing and philosophical discourse concerning the nature of human dignity and more recent sociological texts that discuss the social construction of the child and childhood. The article is further influenced by additional insights derived from an ethnographic pilot study at a large district general hospital. This study was undertaken in an attempt to appreciate the subjective experience of dignity by children, and to begin to address the empirical gap in the literature and promote discussion. The concept of a macro and a micro dignity is discussed, together with the role of the nurse in articulating the relationship between the two. The importance of control and witnesses in the experience of dignity is discussed and, finally, also the ethical implications when seeking to promote the dignity of children. (shrink)

In this paper I argue that the idea of human dignity has a precise and philosophically relevant sense. Following recent works,we can find some important clues in the long history of the term.Traditionally, dignity conveys the idea of a high and honourable position in a hierarchical order, either in society or in nature. At first glance, nothing may seem more contrary to the contemporary conception of human dignity, especially in regard to human rights.However,an account of dignity (...) as high rank provides an illuminating perspective on the role it plays in the egalitarian discourse of human rights. In order to preserve that relational sense regarding human dignity, we can use the notion of moral status, towhich somemoral philosophers have paid attention in recent years.I explore the possibilities of the idea of moral status to better understand the idea of human dignity and its close relationship with human rights. (shrink)

This chapter, contrary to moderate, radical and limited communitarians’ attempts to include and defend human rights in African political thought, shifts our attention to the primacy of needs in African political thought. It does so by appeal primarily to the ethical concept of personhood in African philosophy. It offers an interpretation of the relationship between ethics and politics inherent in the normative concept of personhood, which has tended to be construed to entail the politics of human rights. To unfold a (...) novel interpretation of politics in relation to the ethical notion of personhood, it relies on Menkiti’s philosophical writings that points us to the politics of duties. It proceeds to explain the importance of duties in the political thought associated with Afro-communitarianism in terms of the primacy of needs. The basic insight that emerges in this chapter is that the provision of basic needs is indispensable for the kind of agency required for the achievement of personhood. (shrink)

One of the several reasons given in calls for the prohibition of autonomous weapons systems (AWS) is that they are against human dignity (Asaro, 2012; Docherty, 2014; Heyns, 2017; Ulgen, 2016). However there have been criticisms of the reliance on human dignity in arguments against AWS (Birnbacher, 2016; Pop, 2018; Saxton, 2016). This paper critically examines the relationship between human dignity and autonomous weapons systems. Three main types of objection to AWS are identified; (i) arguments based on (...) technology and the ability of AWS to conform to International Humanitarian Law; (ii) deontological arguments based on the need for human judgement and meaningful human control, including arguments based on human dignity; (iii) consequentialist reasons about their effects on global stability and the likelihood of going to war. An account is provided of the claims made about human dignity and AWS, of the criticisms of these claims, and of the several meanings of ‘dignity’. It is concluded that although there are several ways in which AWS can be said to be against human dignity, they are not unique in this respect. There are other weapons, and other technologies, that also compromise human dignity. Given this, and the ambiguities inherent in the concept, it is wiser to draw on several types of objections in arguments against AWS, and not to rely exclusively on human dignity. (shrink)

Globally, healthcare has become dominated by women nurses. Gender is also known to impact the way people are cared for in various healthcare systems. Considering gender from the perspective of how lived bodies are positioned through the structural relations of institutions and processes, this systematic review aims to explore the meaning of gender in the caring relationship between the nurse and the older person through a synthesis of available empirical data published from 1993 to 2022. CINAHL, PUBMED, EMBASE and Web (...) of Science were searched from the beginning of each database's temporal range, and PRISMA guidelines were used for the screening, reviewing and selection processes of available records. A thematic synthesis of the available data resulted in three analytical themes: (i) vulnerability of the gendered body, (ii) norms and values related to gender and sexuality and (iii) balancing closeness and distance in the nurse‐patient relationship. These themes are intertwined and represent different aspects of gender meaning in the nurse–patient relationship. This research shows that gender, through its influence on the gendered body, its relationship with power dynamics in the caring process, and its intersection with dimensions of identity, has a significant meaning for the experienced vulnerability in the nurse–patient relationship. This has implications for the well‐being and sense of dignity of the older person as well as the nurse. (shrink)

Biobanking policy needs to take into account the concept of human dignity, because this concept is enshrined in both international and South African law. The accepted understanding of informed consent, which is also required by law, is inadequate for biobanking because it is often not possible to inform people of possible uses of their stored tissue. If human dignity is understood as a multidimensional concept that corresponds to the multidimensionality of the human person, then human dignity can (...) be said to be both (i) something that all people already have, as an inviolable worth that inheres in their potential to live meaningful lives; and (ii) something that people seek to realize through morally good behavior in historically-situated relationships. This understanding of human dignity can be used as both an interpretive lens and a normative vision. It is interpretive because it reveals how various attitudes to biobanking and the various proposed consent regimes--presumed, broad, and specific--might all be underpinned by appeals to human dignity. It is a normative vision because, given that all of these positions can be underpinned as morally meaningful with respect to human dignity, provision should be made for all of the possible consent regimes in law and in biobanking practice. Nonetheless, where compromise cannot be avoided, then, at the very least, human dignity understood as the human potential to live a meaningful moral life must be protected. (shrink)

Background Preserving persons’ dignity is integral to nursing. More research is needed to explore how a diversity of patients, particularly those that experience illness from a young age, experience dignity. Aim Describe the characteristics of dignity for persons living with serious illness. Research design Using a secondary data set of twenty audio-recorded interviews, a thematic content analysis was conducted to identify characteristics of dignity. The research team employed van Gennip et al.’s, 2013 “Model of Dignity (...) in Illness” (1) to create a codebook, which the authors utilized to independently code twenty narrative interview transcripts. Participants and research context Twenty persons living with serious illness of heart failure and/or dialysis-dependent renal failure who were admitted in an acute care hospital. Ethical considerations This study was approved on August 26, 2019, by the Colorado Multiple Institutional Review Board (COMIRB) IRB Protocol #19-1874. Findings Early-onset participants expressed markedly different dignity concerns than late-onset participants. In the individual domain, early-onset participants felt that their illness was “normal”; they did not experience the “healthy person to patient” transition described by older onset participants. In the relational domain, early-onset participants expressed that their relationships had already integrated their illness while late-onset participants felt that their illness harmed many of their relationships. In the societal domain, early-onset participants described dignity concerns related to how society impacted their ability to financially support themselves during their illness. Discussion Differences in the dignity experience of early-onset and late-onset participants are informed by Erikson’s “Model of Development” and by Aranda and Jones feminist critique of dignity in healthcare. Conclusions Persons with early-onset illness experience dignity differently. Awareness of the importance of work and financial independence to the experience of dignity for seriously ill patients may enhance persons’ dignity experience. (shrink)

Critiques of the dehumanising aspects of contemporary medical practice have generated increasing interest in the ways in which health care can foster a holistic sense of wellbeing. We examine the relationship between two areas of this humanistic endeavour: narrative and dignity. This paper makes two simple arguments that are intuitive but have not yet been explored in detail: that narrative competence of carers is required for maintaining or recreating dignity, and that dignity promotion in health care practice (...) is primarily narrative in form. The multiple meanings that dignity has in a person’s life are what give the concept power and can only be captured by narrative. This has implications for health care practice where narrative work will be increasingly required to support patient dignity in under-resourced and over-subscribed health care systems. (shrink)

This paper examines how the intercultural conception of human rights, fueled by the modes of reciprocal recognition associated with Hegel’s social philosophy, draws on traditional understandings of human dignity while avoiding the essentialism associated with those understandings. Part 1 summarizes core elements of an intercultural theory of human rights while addressing the general question of how that theory accommodates an understanding of the relationship of human dignity and human rights. Part 2 presents the intercultural approach as committed to (...) a view of human dignity focused on the intrinsic worth of individuals, but understood, not—with Kant—as an anthropologically inherent property, but as one forged in relations of intersubjective recognition. Part 3, critically engaging arguments of C Beitz and J Habermas, claims that an intercultural approach entails a status-based conception of human dignity, one that construes the latter, not as a metaphysically conceived inherent quality, but as a function of membership in a social order supportive of both liberal right claims and a republican commitment to rights systems generally. Drawing on the work of Hegel and critically engaging the position of A Sangiovanni, Part 4 construes human dignity in terms of a doctrine of human rights expressive of a common humanity, one understood, however, not as an essential attribute of human beings, but in terms of a globally realized legal-political order whose members are dispositionally committed to the worth of all members of the human community and the value of human community itself. Critically appropriating the work of H Arendt for the intercultural theory, Part 5 considers the centrality of actual politics to a dignitarian account of human rights. Part 6 construes human dignity, again with Kant, in terms of the principle of autonomy, but one understood, not abstractly, but—engaging Pico della Mirandola—as the fallibilistically conceived process of social learning on the part the members of the human community. Part 7 considers how the intercultural view, with the idea of social practice expressive of collective human agency, accommodates a concept of human dignity understood as the “foundation”—nuanced and variegated—of human rights. Part 8 details the specific normativity of an intercultural conception, asserting that despite and even because of its attention to the empirical realities of social, historical, and political life, that conception remains committed, as with essentialist views, to context-transcending norms capable of calling into question actual practices and policies. Here, recourse is had to a concept of recognition understood both as a principle of evaluation and as a social practice encompassing the activity of individuals and groups engaged in the discourse on human rights. (shrink)

The purpose of this study was to investigate what strategies people with severe functional disabilities who receive personal assistance in their homes use in their daily life to achieve autonomy, integrity, influence and participation. Qualitative interviews were carried out and subjected to qualitative latent content analysis. The main finding was expressed in terms of six subthemes: trying to keep a private sphere; striving to communicate; searching for possibilities; taking the initiative; striving to gain insight; and using one's temperament. These generated (...) the overall theme: maintaining dignity in close relationships. This study contributes an understanding of the strategies used by people who are dependent on personal assistance. Future efforts in nursing must focus on supporting personal assistants with ethical knowledge and guidance in order that people with severe functional disabilities are empowered to achieve autonomy, integrity, influence and participation in their daily lives. (shrink)

In their report for the Swiss government onthe notion of the dignity of creatures, PhilippBalzer, Klaus-Peter Rippe, and Peter Schaber analyzethe relationship between human dignity and the dignityof creatures, taking them as two categoricallydifferent concepts. Human dignity is defined as the``moral right not to be humiliated,'' whereas thedignity of creatures is taken to be ``the inherentvalue of nonhuman living beings.'' To my mind there isno need to draw a categorical distinction between thetwo concepts. Both notions could be (...) brought togetherunder an all-encompassing concept of the inherentvalue of living beings, humans and non-humans alike,a concept one could name ``the dignity of livingbeings.'' Indeed, this very notion underlies theposition taken in the report, although this is notmade explicit by the authors themselves.As the aim of the paper is only to clarify theconcepts used, I do not go beyond this ``internal''critique of their position, i.e., I don't assess howthe claims articulated via these concepts – theclaim that humans and/or creatures have an inherentvalue consisting in a supposed intrinsic good – areto be justified, although I myself would be ratherskeptical that this might be successfully done. (shrink)

In Peter Singer’s article “The Challenge of Brain Death for the Sanctity of Life Ethic”, he articulates that ethics has always played an important role in defining death. He claims that the demand for redefining death spreads rather from new ethical challenges than from a new, scientifically improved understanding of the nature of death. As thorough as his plea for dismissal of the brain-death definition is, he does not avoid the depiction of the complementary relationship between science and ethics. Quite (...) the opposite, he tends to formulate a stronger, philosophically more consistent argument to help science and medical practitioners to define life, death, and the quality of life. In my commentary, I would like to focus on two issues presented in Singer’s study. Firstly, I will critically analyze the relationship between science and ethics. Secondly, I will follow on from Singer’s arguments differentiating between end of life as an organism and end of life as a person. The latter case is necessarily linked with man’s participation in her/his life, setting life goals, and fulfilling her/his idea of good life. Through the consequential definition of the dignity in ethics of social consequences, I will try to support Singer’s idea. (shrink)

In this article I spell out a conception of dignity grounded in African moral thinking that provides a plausible philosophical foundation for human rights, focusing on the particular human right not to be executed by the state. I first demonstrate that the South African Constitutional Court’s sub-Saharan explanations of why the death penalty is degrading all counterintuitively entail that using deadly force against aggressors is degrading as well. Then, I draw on one major strand of Afro-communitarian thought to develop (...) a novel conception of dignity as the view that what is special and inviolable about human nature is our capacity for harmonious relationships. I argue that a principle of respect for the dignity of such a capacity entails that the death penalty is an indignity but that deadly force in self- or other-defense need not be, and I contend that this African- inspired principle promises to do no worse than the more Western, Kantian principle of respect for autonomy at accounting for a broad range of human rights. (shrink)

The COVID-19 pandemic has impacted medical care in many ways; previously, a patient would enter a hospital and had an approximate idea of what would happen upon his admission, the physician informed them about it, but in the last two years this scenario has changed. Therefore, our aim was to identify if bioethical principles are present in the physician–patient relationship and the effect of these in the health care provided, through an observational and descriptive study where patients answered the validated (...) ReMePaB questionnaire that measures the presence of bioethical principles in the physician–patient relationship, on the seventh day of their hospital stay and 24 h after discharge, during the period from 1 August to 5 November 2020. In autonomy, an improvement in the score was observed in the second application compared to the first measurement; in the principle of non-vulnerability, the same scenario was observed for the first and second measurements, respectively. In the principles of beneficence, dignity, and justice, no statistically significant differences were observed. Considering the presence or absence of bioethical aspects in health care in this pandemic creates an area of opportunity to know the feelings of the patient during the care received and to maintain what is done well and improve those aspects that can be improved. (shrink)

Dignity is one of the essential values and central concepts in nursing care. Dignity can be threatened due to radical life changes; therefore, this idiographic case study aimed to explore the sense of dignity experienced by a woman with multiple sclerosis. An interpretative phenomenological analysis was adopted, using data collected through a face‐to‐face semistructured interview with Emily, a 45‐year‐old woman. The study was approved by the local ethics committee. Six personal experiential themes were identified: To be ruled (...) by a sick body; Silent progression; Loss of independence as a burden for the family; Will to fight for the meaning of life; Maintaining dignity‐in‐relation; Dignified care in a period of greater vulnerability. Emily's dignity is based on the effort to fight for a meaningful life, utilization of her full potential, maintain independence in activities of daily living and support in relationships. Continuous changes in functional ability, loss of self‐control and an uncertain future have a negative impact on the experience of her dignity. In the context of dignified health care, she considers individual care and maintaining autonomy important. The idiographic case study can contribute to a better understanding of the experience of a woman suffering from multiple sclerosis. It is possible to carry out interventions that aim to support her dignity, improve her quality of life and contribute to individually oriented health care. (shrink)