“In healthcare, the importance of respect and dignity is often invoked, but has not been clearly defined in regard to treatment in the ICU,” said Jeremy Sugarman, MD, a professor at the Johns Hopkins Berman Institute of Bioethics. “To prevent harms related to respect and dignity in the ICU there is a prerequisite need for clarity regarding what exactly constitutes optimal treatment in this regard, and then to develop methods to measure it.”
According to the model, the three sources of patient dignity are shared humanity, personal narrative and autonomy. The framework lays out the types of respect that each source of dignity requires in the ICU as well as how clinicians can identify and rectify threats to patient dignity.
“Harms to patients’ dignity are more difficult to identify and rectify in part because we lack a conceptual lens through which to view and correct them,” the researchers wrote in an article presenting their findings. Dr. Sugarman added, “Now we have the lens, and we can move forward toward careful measurement and developing means to help prevent loss of dignity in the ICU.”
To put together the model, researchers collected data from interviews with patients and families in the ICU, focus groups with healthcare professionals and direct observations. The full model can be found in the journal Narrative Inquiry in Bioethics.
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