BMJ  2007;335:184-187 (28 July), doi:10.1136/bmj.39244.650926.47

Analysis

Dignity and the essence of medicine: the A, B, C, and D of dignity conserving care

CancerCare Manitoba, Winnipeg, MB, Canada R3E 0V9

Kindness, humanity, and respect—the core values of medical professionalism—are too often being overlooked in the time pressured culture of modern health care, says HarveyChochinov, and the A, B, C, and D of dignity conserving care can reinstate them

The first 150 words of the full text of this article appear below.

The late Anatole Broyard, essayist and former editor of the New York Times Book Review, wrote eloquently about the psychological and spiritual challenges of facing metastatic prostate cancer. "To the typical physician," he wrote, "my illness is a routine incident in his rounds while for me it's the crisis of my life. I would feel better if I had a doctor who at least perceived this incongruity . . . I just wish he would . . . give me his whole mind just once, be bonded with me for a brief space, survey my soul as well as my flesh, to get at my illness, for each man is ill in his own way."¹

Broyard's words underscore the costs and hazards of becoming a patient. The word "patient" comes from the Latin patiens, meaning to endure, bear, or suffer, and refers to an acquired vulnerability and dependency imposed by . . . [Full text of this article]

Dignity and patienthood

The A, B, C, and D of dignity conserving care

Attitude
Box 1: Attitudes
Questions to be asked
Actions to be taken
Behaviour
Box 2: Behaviours
Disposition
Clinical examination
Facilitating communication
Compassion
Box 3: Compassion
Getting in touch with one's own feelings requires the consideration of human life and experience
Ways to show compassion
Dialogue
Box 4: Dialogue
Acknowledging personhood
Knowing the patient
Psychotherapeutic approaches

Conclusions

Summary points
Further reading

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