Dignity is a useless concept

Macklin, Ruth

doi:10.1136/bmj.327.7429.1419

Cited by 704 publications

(294 citation statements)

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“…Rare studies have indeed indicated that key components of patient respect encompass not only support of autonomy and provision of information but also caring/emotionally supportive behaviours such as empathy, care, recognising individuality, respecting dignity and paying attention to their needs [14,20,21]. Treating someone with dignity likely forms part of treating someone with respect, that is as a worthy human being [22]. Respect is likely to underpin several dimensions of patient-centred communication to the extent that these communicate to the patient that s/he is a worthy and valuable human being.…”

Section: Introductionmentioning

confidence: 99%

Cancer patients’ respect experiences in relation to perceived communication behaviours from hospital staff: analysis of the 2012–2013 National Cancer Patient Experience Survey

Clucas

2015

Support Care Cancer

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Section: Introductionmentioning

confidence: 99%

Cancer patients’ respect experiences in relation to perceived communication behaviours from hospital staff: analysis of the 2012–2013 National Cancer Patient Experience Survey

Clucas

2015

Support Care Cancer

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“…While some consider it to be implicit in the four ethical principles of autonomy, justice, beneficence, and nonmaleficence that make up the core of biomedical ethics [22], others consider it to be distinct. For instance, human dignity stands alone in the first tenet of the American Medical Association (AMA) Principles of Medical Ethics, which states, "A physician shall be dedicated to providing competent medical care, with compassion and respect for human dignity and rights" [23].…”

Section: Human Dignity: the Ethical Principle Justifying Use Of Compamentioning

confidence: 99%

Compassionate Release Policy Reform: Physicians as Advocates for Human Dignity

Mitchell¹,

Williams

2017

AMA Journal of Ethics

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A rapidly aging correctional population has led to an increasing number of patients with serious progressive and terminal illnesses in correctional settings. "Compassionate release" describes a range of policies offering early release or parole to incarcerated patients with serious or debilitating illnesses. However, in many states that have compassionate release policies, few patients are actually granted release. We describe how the continued incarceration of patients with serious or debilitating illness can constitute a violation of human dignity if appropriate palliative care is unavailable. We argue that, given the importance in medical ethics of upholding dignity, physicians should advocate for the appropriate application and use of compassionate release. We describe several opportunities for physicians to take leadership on this issue. IntroductionIncarcerated patients are more likely to have severe or debilitating medical illnesses than the general population [1]. More than 4,000 people died in jails and state prisons annually from 2003-2011, with heart disease and cancer being major causes of death [2]. These illnesses disproportionately affect older patients, who make up an increasingly larger share of prison populations. From 1993 to 2013, the 55-and-older population in state prisons more than tripled, increasing from 3 percent to 10 percent [3]. "Compassionate release" policies have been designed to allow some of these patients to be released from prison or jail before sentence completion. However, few patients are actually granted compassionate release [4,5]. This article provides an overview of ethical principles used to justify compassionate release and explores how physicians can leverage their commitment to upholding ethical principles to advocate for more effective compassionate release policies. AMA Journal of Ethics, September 2017 855Compassionate Release For humanitarian, practical, and economic reasons, 47 states and the District of Columbia have some form of early release mechanism for seriously ill or disabled incarcerated patients [6][7][8]. "Compassionate release" is a broad term used to describe a range of these types of policies (including medical parole, emergency parole, and medical release). Most, if not all, share the requirement for a physician to determine medical eligibility for potential candidates, although medical eligibility differs by jurisdiction [9]. Nationwide, compassionate releases occur relatively infrequently. Out of 2,621 requests for compassionate release during a one-year span in the Federal Bureau of Prisons, only 85 (3.24 percent) were granted [10]. State prison systems are likely to have similar if not lower rates of release [11]. These low rates stem in large part from state and federal policies with restrictive medical and criminological eligibility criteria for release, including mandated short-term "terminal prognosis" and exclusion of nonterminal but debilitating conditions [9,11]. These policy barriers are compounded by administrative barriers t...

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“…It would be however a mistake to conclude from this lack of defi nition that dignity is a simple slogan that means no more than " respect for autonomy " and therefore could simply be eliminated without any loss of content ( Macklin, 2003( Macklin, , 1419.…”

Section: Can ' Human Dignity ' Be Defined By Law?mentioning

confidence: 99%