Human Dignity and Bioethics

Conclusion
Human Dignity and the Seriously Ill Patient | 511
Patients may have the freedom to decide about treatment, yet still
feel subjected to indignities. Patients’ interests in confidentiality and
being protected from abuse and discrimination may be adequately addressed,
but they may still experience care as impersonal and demeaning.
Many dignity violations occur when patients feel they are regarded
as objects, rather than as persons worthy of equal respect. In this
situation, it would be dangerous to tell clinicians (and bioethicists)
that they need not worry about the dignity of seriously ill patients.
The bioethics field has existed for several decades, but many
people still feel devalued when they receive medical treatment or
are hospitalized. This is the case even though patient autonomy is
much more respected than it used to be. One could argue that bioethicists’
failure to emphasize protection of dignity has hindered efforts
to improve the medical experience for patients. In support of
this view, Hilda Bastian argues that dignity’s place in medical ethics
must be recognized: “Maybe when there’s no indignity possible in
illness or medical procedures, when all caregivers, policymakers and
members of ethics committees are superhumans incapable of having
lapses in empathy, then retiring this notion from active duty could
be considered.”*
The good news is that many clinicians do treat patients with
dignity. The doctors and nurses in this group would be horrified
by the notion that dignity no longer matters. For them, treating
patients with dignity seems to be part of their character, as well as
their sense of professional integrity. People concerned with bioethics
should join them in recognizing dignity as a crucial component of
ethical patient care.
For patients, dignity is a precious possession. Serious illness
threatens one’s place in the human community. Ordinary activities
fall by the wayside and relationships are no longer the same. How
should the patient, clinicians, loved ones, and others respond to this
* Hilda Bastian, “An Offensive Slogan.” Michael Marmot makes a similar point:
“Having had experience of the way patients are treated in large public hospitals in
different parts of the world, I have little doubt that human dignity is fragile and
can be affected by the way one is treated.” Michael Marmot, “Dignity and Inequality,”
Lancet 364 (2004): 1019-1021.