Posted at 10.11.2018
Every individual, irrespective of gender, contest and culture exists with equal to respect, in order to keep dignity. A person strives to be respected and respected throughout their life. However, in environment where we live, sometimes we as a individual intentionally or unintentionally breaks this basic principle of respect and split individual dignity into spatial elements. What goes on if a person is mentally sick and faced disrespect in front of others? Have we ever before seen or understood the impact of this act on a person self-esteem? It could be that we have seen them many times but have failed to ever realize their impact. Similarly, on my medical visit, I encountered a patient, Ms. X, 40 years old, was a bedridden patient identified as having Schizophrenia. Presently, she was experiencing severe diarrhea, and due to her condition she was struggling to perform her hygiene care herself and therefore needed assistance. At that point it came under my observation that the personnel of the institution had not been only neglecting her, but also degrading her and adding problems for her self-esteem. While I was interviewing the individual, I observed that a staff entered the area and started to verbally abuse the individual by stating that, "She had not been worthwhile their time as they were not here to clean up her clutter or to solve her issues on a regular basis". Furthermore, she exclaimed, "Her parents kept her on our mercies and we don't possess enough time to get this done work rather we must look after other patient's as well". In those days, other patients were also hearing this conversation. All of which were disregarding the admiration and dignity of an individual.
Respect is thought as "To show deferential respect for; to be cured with esteem, matter, consideration or understanding; to protect an individual's level of privacy; to be very sensitive to cultural distinctions; to allow an individual to make alternatives. " Furthermore, dignity is thought as "To be treated with esteem, honor, and politeness; to be tackled in a fashion that is not patronizing or condescending; to be treated as an equal; to be cured the way anybody would like to be treated" (Ray, 2010, p. 1). In other words, if the person gets respect, person feels dignified. In addition, respecting person this means we have been respecting their right and this cannot be accomplished without each other.
In above circumstance, the first honest principle, esteem and dignity of a patient have been violated by the personnel in front of others. Moreover, staff verbally abused the individual although it was her responsibility to care for patient. "Respect for people signifies the clinician's honest obligation to regard the ill individual fully, genuinely, intrinsically" (Roberts, 2003, p. 340). It really is our responsibility to give respect to all or any individuals equally to keep up dignity. Even then, I encountered the case of disrespect. Do these happenings happen because psychiatric patients are perceived as not deserving respect? Do their mental conditions deprive them of esteem and dignity which is the essential right of most humans? These are the questions which surfaced in my head while reflecting onto it and led me to choose this matter.
The process of admiration and dignity applies everywhere inside our daily lives and everyone deserves to be treated with respect. (Kazim, 2007). However, to discuss this concept in mental health is significant because these patients are at risk of shedding value and dignity at all times. "People with mental disorders are, or can be, especially vulnerable to mistreatment and violation of protection under the law. " (Freeman, & Pathare, 2005, p. 1). Also, frequently society does not respect the psychologically sick patient as they value others. In many countries mental patients are still maintained in chained, beaten, parts of their bodies burnt. Even these are treated worthwhile than local family pets (Pridmore & Pasha, 2004). Additionally, "People who suffer from mental health conditions are often excluded from sociable culture. " (Santegoeds, &Tekeer, 2006, p. 3). Psychiatric patients lack interpersonal support because they often times excluded from population. Similarly, in my own circumstance patient was insulted before others and was verbally abused and called 'mental. ' If my patient was suffering from diarrhea only then there would be any difference in giving respect? Study disclosed that health professionals frequently keep negative behaviour and action towards mental sick patients (Kapungwe, Cooper, Mwanza1, Mwape, Sikwese, Kakuma, Flisher, 2010). Alike, as my patient was suffering from diarrhea and the likelihood of a physical grievance has been overlooked due to bad attitude towards mental health issues by verbal maltreatment which might impairs the mental well-being of patient. Otherwise, there would be a big difference in interacting diarrhea of normal patient. As, my patient got disturbed way of thinking so, does we've to break the theory of esteem which is identical for all? Corresponding to Islamic bioethics, "Patient must be treated with esteem and compassion and that the physical, mental and spiritual dimensions of the illness experience be taken into consideration" (Kazim, 2007, p. 72). It means, all human beings are worthy of equal, no matter any factor like dissimilarities in social status, gender, mental status are an important to the personality and give so this means with their lives. Of course, if society remains behaving like this, because of this, other participants of contemporary society might do the same which function will continue alternatively being halted. Also, violation of this principle would increase at great amount by affecting the whole society. However, it's the key ideas of the Human Rights Act. When a person's dignity is jeopardized and no value is afforded them, it is an abuse of the human protection under the law (Gostin, & Hodge, 2003).
There are numerous factors which get excited about violation of this principle. Firstly, in mental health adjustments, "younger and well educated staffs have mainly found their work to become more stressed and psychologically worn out" (Valimaki, Scott, Lahti, & Chambers, 2007, p. 8). It really is evident in my own case that credited the exhaustion, staff ventilates their anger or verbally abuses the individual, alternatively understanding the patient's condition. Corresponding to a study, patients connection with violation of rights in Kenya as "It really is obvious that the nurse's verbal impoliteness constituted violations of dignity and not only rudeness. " (Ojwang, Ogutu, & Matu, 2010, p. 106). Also, words play a key role in the mental health adjustments, may impacts patient dignity to a great magnitude. "Using respectful dialect and gestures promotes dignity. "(Cass, Robbins, & Richardson, 2009, p. 92). However, psychiatric patients are at threat of disrespect and sacrificing dignity in private hospitals. "Staff patterns and the hospital environment impact patients' dignity, and risks to patients' human needs can lead to lack of dignity. " (Ojwang et al. , 2010, p. 104). Alike, in above circumstance due to personnel behavior patient's right to respect violated which might threaten patient's dignity.
Now, considering the patients view, if the process of to respect violates, does this act adds further problems for one's self? Would it not hurt for an individual? Does indeed the dignity of patient get infected? Does this work helps her to cope or further deteriorates her health? These are the question that arouse in my mind at that point and time.
When patient gets value, seems dignified. "Dignity includes the positive emotions that the average person has for the self, including esteem, self-esteem, self-worth, trust, valuing home, and honoring self" (Ojwang, et al. , 2010, p. 103). Quite simply, dignity makes a person to believe positive which promotes mental health. Alternatively, when dignity and respect are absent from care and attention, patient feel devalued, ashamed and uncomfortable. They could also lack self-assurance, struggling to make decisions for themselves, and feel disgraced. (Chambers, & Ryder, 2009). Corresponding to a Jacobson, "dignity may be considered a link that points out the relationship between the promotion and cover of human privileges and health position. " (Jacobson, 2007, p. 292). As, patient seems dignified, it shows improvement in mental health status and recovery somewhat deterioration in mental health. Regarding to Declaration of patient group on mental healthcare, if patient gets no esteem then, ultimately contributes to an outbreak of psychic problems. (Santegoeds, & Tekeer, 2006). Similarly, if I held myself in patient shoes, I felt very bad about it, felt insufficient self confidence and worthlessness.
According to real human dignity platform, (n. d. ), dignity is a subjective theory, referring to an internal sense of self-worth. Second, dignity is affected by a host of psychological, ethnic, and communal factors. Third, real human dignity belongs to every individual; it is designed by and dependent on relations of the average person with others. Fourth, there is a sense that individual dignity is also a holistic concept; that it is always more than the total of the privileges that constitute it. In addition, the primary of dignity contains three fundamentals: the fundamental worth of most human beings, to value each other's worth, and to protect and accomplish everyone's worth. On the other hand, in my circumstance, patient believed disrespect which impacts worth of an individual. It affected by public factors and has negative effect on health. In addition, psychiatric patients are believed to be the vulnerable. It increases questions for those people who are unable to communicate the incident of mistreatment either emotional or physical. So, this platform helps to evaluate the knowledge related to individual rights and also to understand its vulnerability. In same way, this construction can assist in my case because my patient was struggling to communicate her emotions to anyone rather thinking on it.
In european countries, patient dignity has been well explored, but only one study has reviewed this topic within an Asian country that is Taiwan. Through North american Nurses Connection 2001, Canadian Nurses Connection 2002, Australian Nursing and Midwifery Council 2003, London Nursing and Midwifery Council 2004 organizations, maintenance of patient dignity and admiration for differences in personality, gender, contest, age, culture, financial position and lifestyle has been promoted. Similarly, nurses in Taiwan are required to respect patient's individuality dignity, religion, customs, values and cultural differences. Currently, clinical practice education in Taiwan will not signify dignity in care (Lin, Tsai, & Chen, 2011).
For this, some successful interventions should be done in order to prevent the further violation of this basic principle and also to promote mental health of psychiatric patient. During scientific, we have seen and identified the need of teaching on ethical guidelines, its importance and discuss some alternate interventions through showing practical cases. So, inside our forthcoming professional medical we gives coaching on these key points. The purpose of this teaching would be to provide awareness also to realize the importance of ethical rule while caring with psychiatric patient.
The psychiatric workforce needs collaboration between individual doctor, organizations and federal to market the dignified care and attention to great amount (Hung, 2008). Corresponding to Baillie, Gallagher and Wainwright (2008) suggested advice on three levels i. e. : micro, meso and macro level. Micro level includes individual responsibility and accountability in treatment. Being in a medical job it is our primary responsibility to give respect to your patient as we have taken oath if we overlook this responsibility it means we aren't honest with ourselves and as well much like our job. However, regarding to BBC Media, "Nurses have a work to treat patients with dignity all the time by giving admiration. "(Carter, 2008). So, we as an individual must take some initiative on our part to avoid disrespect and work as a big change agent for those patients who are facing disrespect. With the, individual nurses must develop their understanding of dignity in attention through awareness trainings and role modeling. Because of this, in 2004, requirements for better health founded its central standard that staff must treat all patients with admiration and dignity (Baillie, Gallagher and Wainwright, 2008). Moreover, individuals should be reflective and invite responses from others regarding their performance. Furthermore, staff must incorporate dignity framework to understand its value and popularity of vulnerability. Also, individuals must record the cases where rule violates. Meso level includes role of firm. Organization must definitely provide environment, in which patients are appreciated and reputed in care environment. Furthermore, "It's been shown that multiple organizational and public interventions have a good effect to health care staffs work satisfaction, moral and well-being and additional the quality of patient treatment. "(Gilbody, 2006, p. 10). In addition, organization must watch over staff and steer clear of taking young staff in mental health setting up because it requires patience. Also, those organizations which are already attempting to maintain esteem and dignity of patients so, they must continue their work without neglecting. Establishment must take serious action where principle violates. Macro level includes the role of federal government. Federal government must take serious steps in delivering dignified care and plans should be produced to avoid violation of this basic concept. Nurse and patient ratio must be appropriate so that it may not impede in health care. Also, in east, research has been done in Taiwan only. For this, further studies should be achieved in mental health options to explore the variations in respect of patient.
In conclusion, treating one another with value and dignity is everyone's responsibility. No one should be forced to pay attention to bad language in front of others in any way. We should treat psychiatric patients as we would want to be cared for ourselves if we were in an identical situation.
Hence, Government, NGO's, civil population, must interact to handle this challenge head on and to increase the quality of life by giving value to psychiatric patients. "All human beings are blessed free and equal in dignity and protection under the law" (The General Declaration of Individual Rights).