Dignity-based approaches in the care of terminally ill patients

PURPOSE OF REVIEW: Promoting dignified dying is an altruistic goal in palliative care. Until recently, what was meant by this construct was poorly understood. This review seeks to clarify what is meant by dignity at the end of life, what threatens dignity, and evidence of the domains that define dignity. A model of dignity is proposed from which interventions can be derived. RECENT FINDINGS: A paucity of research exists exploring the concept of dignity. What can be gleaned from this work is that dignity is socially constructed and mediated in our relationships with others. Research has noted that self-perceived burden, depression, hopelessness, and 'the reflection patients see of themselves in the eye of the beholder' are intimately connected to one's notion of dignity. A model of dignity in the terminally ill has been developed that outlines three areas that are most influential in shaping dignity. Interventions such as dignity therapy and critical personal reflection are proposed as tools to promote dignity. SUMMARY: Despite the fact that little research exists exploring the notion of dignity at the end of life, a robust model of dignity exists and is helpful in directing interventions aimed at improving care at the end of life.