Background: The intensive and critical care units are high-dependency areas, with patients requiring complex care. The intubated status of the intensive and critical care patients makes them dependent on healthcare providers not only for acute care, but also for intimate care, imposing a threat to their dignity. Nurses, being the central care providers, become the stakeholders for dignity promotion. The incorporation of dignity in patient care improves the quality of care, and promotes the health and well-being of intubated patients. Objective: (...) The purpose of the study was to explore nurses’ perceptions about the dignity of intubated patients in the intensive and critical care units. Research design: A qualitative descriptive exploratory study design was used to explore the nurses’ perceptions about the dignity of intubated patients. Participants and research context: The intensive and critical care nurses of a tertiary care hospital were recruited using the purposive sampling technique. The data were collected through in-depth individual interviews, using a semi-structured interview guide. The findings were manually analyzed into themes and categories through content analysis. Ethical consideration: The study was conducted after the approval from the Ethical Review Committee of the Aga Khan University. Findings: Four major themes emerged from the data analysis: (1) two sides of the contemporary nursing practice; (2) benefits of dignified nursing care; (3) challenges to the dignity of intubated patients; and (4) strategies for promoting the dignity of intubated patients. Discussion: Dignity incorporates both the science and the art of nursing. The provision of dignified care is the core component of the quality nursing care and patient well-being in the high-dependency units. Conclusion: This is the first exploratory and descriptive study conducted in Pakistan that explored the nurses’ perceptions about the dignity of intubated patients, and also generated contextual understanding about the phenomenon. (shrink)

This response addresses criticisms in this journal of an Editorial written by Willem Landman and Udo Schuklenk. I demonstrate that the UNESCO Declaration on Bioethics and Human Rights is in crucial aspects deficient, despite attempts in this journal to defend the Declaration against its critics. I focus on individual versus societal interests, research ethics, informed consent and the use of “human dignity” to illustrate the weaknesses of the UNESCO Declaration on Bioethics and Human Rights. This article concludes with reflections on (...) what documents such as the UNESCO Declaration on Bioethics and Human Rights ought to be called to avoid the mislabelling of what essentially are policy documents. (shrink)

This paper considers the utility of Ethnomethodology (EM) for the study of healthcare ethics as part of the empirical turn in Bioethics. I give a brief introduction to EM through its respecification of sociology, the specific view on the social world this generates and EM's posture of ‘indifference’. I then take a number of EM concepts and articulate each in the context of an EM study of healthcare ethics in professional practice. Having given an overview of the relationship and perspective (...) EM might bring to the professional practice of healthcare ethics I consider whether and how such an approach could be deployed. Whilst an ethnographic study might be problematic I suggest a number of alternative methods through which such EM research could be accomplished. I conclude with the suggestion that, as a particular approach to sociological research, EM offers good deal of potential for the empirical study of healthcare ethics in practice which could result in an improved reflexive understanding of professional ethical practices in bioethics. (shrink)

The discussion of the nature and value of dignity in and for bioethics concerns not only the importance of the concept but also the aims of bioethics itself. Here, I challenge the claim that the concept of dignity is useless by challenging the implicit conception of usefulness involved. I argue that the conception of usefulness that both opponents and proponents of dignity in bioethics adopt is rooted in a narrow understanding of the role of normative theory in practical ethical thinking. (...) I then offer an alternate understanding of the nature and value of dignity. I begin by recognizing that claims that one’s dignity has been violated point to an important difference between “respect for autonomy” and “respect for persons.” I then suggest three different conceptions of how dignity can be normatively guiding for bioethics, and conclude that, ultimately, understanding dignity as the cornerstone of a reflective perspective that frames moral reflection and deliberation is valuable for doing bioethics well. (shrink)