Patients’ concept of dignity may help direct end-of-life care

by Nicholas Ng Fat Hing, Avneesh Bhangu

Originally published by 2 Minute Medicine® (view original article). Reused on AccessMedicine with permission.

1. Three main domains of dignity were identified: definitions of dignity, factors affecting patients’ perceptions of dignity, and dignity conserving care.

2. The concept of dignity was linked to self-concepts of personhood. Effective dignity conserving measures at the end of life must be guided by the patient’s concept of dignity.

Evidence Rating Level: 2 (Good)

The understanding of dignity is complex as they are not only person dependent but also varies depending on the clinical context. Despite this, dignity conservation is crucial at the end of life to provide the highest quality care to patients and their loved ones. As a result, the objective of the present systematic scoping review was to identify key characteristics and knowledge gaps in current concepts of dignity.

Of 78575 identified articles, 127 were included from January 2000 to December 2020. Studies were included if they studied the impact of dignity conserving care on patients’ dignity at the end of life (i.e., palliative care patients). Studies were excluded if they included patients with non-life-limiting conditions or were the perspectives of healthcare professionals. Krishna’s Systematic Evidence-Based Approach (SEBA), as well as the Ring Theory of Personhood (RtoP), were used to evaluate patients’ perspectives on dignity.

Results identified three main domains of dignity: definitions of dignity, factors affecting patients’ perceptions of dignity, and dignity conserving care. Furthermore, it was found that the concept of dignity was linked to self-concepts of personhood and that effective dignity conserving measures at the end of life must be guided by the patient’s concept of dignity. Despite this, the study was limited by its inability to differentiate personalized concepts of dignity. However, this review underscored the need for an effective tool such as the RtoP to better support patients and their loved ones at the end of life.

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