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J Pain Symptom Manage. 2013 Nov;46(5):756-9. doi: 10.1016/j.jpainsymman.2013.08.004. Epub 2013 Oct 5.

Dignity in care: time to take action.

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1
Manitoba Palliative Care Research Unit, CancerCare Manitoba, Winnipeg, Manitoba, Canada; Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada. Electronic address: harvey.chochinov@cancercare.mb.ca.

Abstract

Providing care for patients and caring about patients should go hand in hand. Caring implicates our fundamental attitude towards patients, and our ability to convey kindness, compassion and respect. Yet all too often, patients and families experience health care as impersonal, mechanical; and quickly discover that patienthood trumps personhood. The consequences of a medical system organized around care rather than caring are considerable. Despite technical competence, patients and families are less satisfied with medical encounters when caring is lacking. Lack of empathy and emotional disengagement from patients typifies health care provider burnout. Caring is the gateway to disclosure; without it, patients are less likely to say what is bothering them, leading to missed diagnoses, medical errors and compromised patient safety. There are also liability issues, with most complaints levied against health care professionals stemming from failures in care tenor. Formal education for health care providers lacks a continued focus on achieving a culture of caring. If caring really matters, health care systems can insist on certain behaviors and impose certain obligations on health care providers to improve care tenor, empathy, and effective communication. Caregivers need to be engaged in looking at their own attitudes towards patients, their own vulnerability, their own fears and whatever else it is that shapes their tone of care. Health care professionals must set aside some time, supported by their institutions, to advance a culture of caring-now is the time to take action.

KEYWORDS:

Care; caring; dignity; patienthood; personhood

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