Fluent Essays

After reading Dignitarian Medical Ethics assigned attached below, in an initial post consider how the concept of conferring patient dignity as offered in the article applies to the need for cultural competence in health care.62 Barclay L. J Med Ethics 2018;44:62–67. doi:10.1136/medethics-2017-104467 AbstrAct Philosophers and bioethicists are typically sceptical about invocations of dignity in ethical debates. Many believe that dignity is essentially devoid of meaning: either a mere rhetorical gesture used in the absence of good argument or a faddish term for existing values like autonomy and respect. On the other hand, the patient experience of dignity is a substantial area of research in healthcare fields like nursing and palliative care. In this paper, it is argued that philosophers have much to learn from the concrete patient experiences described in healthcare literature. Dignity is conferred on people when they are treated as having equal status, something the sick and frail are often denied in healthcare settings. The importance of equal status as a unique value has been forcefully argued and widely recognised in political philosophy in the last 15 years. This paper brings medical ethics up to date with philosophical discussion about the value of equal status by developing an equal status conception of dignity. IntroductIon The field of medical ethics is already saturated with ethical terms and phrases—the right to life, autonomy, respect, informed consent and benevo- lence, to name just a few. ‘Dignity’ has never really taken hold to the same extent. Although many commentators in the field of medical ethics use the term, it does not enjoy the philosophical respect- ability of other key terms. It has not been subject to the same kind of extensive philosophical analysis, and there is an absence of agreement as to what it really means. When Ruth Macklin declared that ‘dignity is a useless concept,’ she almost certainly stated explic- itly what many philosophers already believed.1 ‘Dignity’, she argued, is either just a rhetorical device used when one has run out of good argu- ments, or else nothing other than a fashionable new term for existing values like autonomy or respect for persons. There is certainly no evidence that appeals to dignity have done anything to advance intractable debates around the right to life, eutha- nasia and abortion. There are further reasons to be sceptical about dignity. The other main area in which the phrase is repeatedly used is human rights law. References to dignity are scattered throughout international and domestic human rights declarations and conven- tions. Yet here too there is no real attempt to explain what it means, or why the supposed dignity of every human being should endow them with human rights, or how human rights protect that dignity. Indeed, in the field of human rights law we have quite explicit reasons to be sceptical about dignity. The historical record shows that those charged with drafting the Universal Declaration of Human Rights could not agree on the foundations for those rights, that is, what it is about human beings that justifies them. As Jacques Mar