[Bad habits of the Spanish language (and II). Pleonasms, solecisms, synecdoches, dehumanization, and other problems].
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Linguistics↗
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Results for “Dehumanization”
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[Traditional medicine versus scientific medicine: aspects of the technicalization and dehumanization of medicine].
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Clinical Medicine↗
Any nurse can prevent dehumanization by the CCU experience.
This presentation deals with the Air Force Nurse as a movice assigned to a CCU area and her contributions to patient care as a member of the Air Force Health Care Team. The novice nurse's contributions to the patients care lie in her ability to manage expected behavioral responses to the CCU experience even with a basic working knowledge of normal sinus rhythm and CPR procedure. The expected responses to the CCU expereince discussed are: anxiety, denial, depression, and aggressive sexual behavior. These usual behavioral responses have, at times, been referred to as "a disease of medical progress" or the so-called "intensive care syndrome". The nurse is in a key position to observe the patient's behavioral responses since she spends most of the time with the patient. When these behavioral patterns are considered as part of a normal patterns of adaptation, the nurse can utilize these for effective management of the patient's hospitalization experience as well as an indicator to the patient standpoint in his process of adaptation. It would be wise to mention that the detailed manifestations and primary causes of these behavioral responses should be part of the nurse's working knowledge and can be easily referred to in recent texts on coronary care nursing. The presentation progresses to specific discussion on nursing intervention of the behavioral responses. In summary, the Air Force novice nurse to a CCU area can be an equally contributory member on the Health Care Team if not compelled to place an exaggerated amount of attention on equipment, but focus more on the patient, leaving more technical learning until she becomes more aware of the unit administration and has the opportunity to attend a coronary training course.
Acute Disease↗
Dehumanization in medical education.
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Curriculum↗
Dehumanization triumphant.
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Ethics, Medical↗
The contexts of caring: conscience and consciousness.
In this paper, I have maintained a distinction between person and self in order to describe and analyze contexts of caring in nursing encounters. As the nursed person's perspectives are examined in light of the nurse's capacity to engage his or her own experience, four contextual categories emerge: comprehension, consideration, concern, and communion. Such concepts can help us describe and analyze many situations in clinical nursing and in nursing education. The following paragraphs describe several of the possibilities for future research. It is important to study in which contexts in nursing personhood and selfhood are enhanced and when they are diminished. Diminishment of personhood leads to depersonalization which describes a condition of loss of agency and helplessness in a world where others are in control. This can happen to the nursed person and to the nursing person. When nurses are placed in contexts where they experience lack of agency and authority in their practice settings (even when they attempt to engage others with concern and compassion), they can start to feel and become depersonalized. Diminishment of self leads to dehumanization, which describes a loss of contact with one's own experience. Rules and relationships are oppressive or inflexible and the participants experience meaninglessness. For example, how long can nurses be in daily situations of administering painful procedures to patients without experiencing dehumanization? The same question can be asked of nurses at all levels in hierarchies, and in all relationships, for example, nursing instructors with students, nurse administrators with staff nurses, faculty in academic institutions, and staff nurses with each other. Depersonalization and dehumanization eventually lead to one another. Another significant question to explore could be this: In which of the four contexts defined above does the nurse experience most satisfaction, most dissatisfaction, and the condition we call burnout? We live in a world, a society, and a profession where depersonalization and dehumanization are the plight of many. How can personhood and selfhood be enhanced or even restored in our hospitals, clinics, classrooms, and academic institutions? I propose that investigations of the contexts of caring can help us explore, discover, describe, and analyze these questions.
Conscience↗
Family therapy workshops in the United States: potential abuses in the production of therapy in an advanced capitalist society.
A market for family therapy workshops has mushroomed in recent years. Treatment of families by therapists conducting such workshops, however, can be dispassionate and dehumanizing. Using the distinction between curing and healing, I do not question the curative potential of family therapy, but I question whether this kind of doctor/patient interaction promotes healing. Also, by demonstrating how the systems model tends to objectify patients and alienate therapists from those they treat, this paper challenges claims that family therapy recognizes the social nature of illness. The dehumanizing treatment cannot be attributed solely to the therapists, but requires further interpretation by analyzing the biases of the therapy model, the commodified context of the workshops, and epistemological issues arising from the application of general systems theory to a social model of treatment. Family systems therapy shares epistemological features with biomedicine, and like the biomedical model, alienates therapists from patients. This alienation, ironically, can be even greater when the family systems model is used than in biomedical treatment. Finally, I suggest that family therapy workshops have grown in popularity because the mechanistic features of the treatment model, drawn largely from cybernetics, promote the production and reproduction of a form of therapy compatible with the emphasis on 'functional health' favored in an advanced capitalist society.
Cybernetics↗
Valuing people as individuals: development of an instrument through a survey of person-centredness in secondary care.
BACKGROUND: Person-centred care is regarded as the optimum way of delivering health care and is defined as valuing people as individuals (Winefield et al. 1996). So how can practitioners find out if their service 'values people as individuals'? Serious doubts have been expressed about the validity of the concept of patient satisfaction and the ability of instruments to measure patients' views of care. However, qualitative research among people who had experienced problems with their health care has identified an alternative concept better able to articulate patient's complex experiences (Coyle 1997). The study found that that patients' identity was threatened by experiences perceived as dehumanizing, objectifying, disempowering and devaluing. Thus the concept of 'personal identity threat' showed the extent to which people felt valued (or not) as individuals. AIM OF THE STUDY: The aim of the research reported in this paper is to build upon the earlier qualitative work and to identify the frequency and distribution of inpatients' experiences of 'personal identity threat'. DESIGN/METHODS: The study adopted a cross-sectional survey design. Ninety-seven patients from general medical, surgical and otolaryngology wards completed a questionnaire developed from the qualitative study containing items on dehumanization, objectification, disempowerment and devaluation. FINDINGS: Although many patients expressed positive sentiments about their care, problems were highlighted around power/control, involvement in care, and the approachability and availability of staff. The findings also revealed that women were more at risk than men of 'threats to identity' in health care settings. CONCLUSIONS: Improvements are suggested to help promote a service that truly values people as individuals. These include improving health practitioners' understanding of the impact of illness on everyday life, promoting practitioners' listening and enquiring skills, and increasing the 'visibility' and availability of staff. Further research should also explore gender and age differences in perceptions of the lay-practitioner relationship.
Adolescent↗
Psycho-affective disorder in intensive care units: a review.
This paper reviews the literature related to the Intensive Care Unit (ICU) Syndrome. The intention of the paper is to explore the range of psychotic and affective phenomena that may be observed in practice, together with the management of contributory stressors. Patients experience a range of psycho-affective disturbances that may be triggered by drugs, the environment, dehumanizing practices and sleep deprivation. Symptoms do not always disappear following discharge and further research is required to determine the long-term psychological effects of an ICU. Comprehensive assessment of the patient's psychological state, using an appropriate tool, is necessary and should form an integral part of ongoing care. Interventions identified include eradication of dehumanizing behaviour, modification of environmental stimuli, effective communication and therapeutic touch. Where possible, communication needs should be addressed prior to admission, and patients and their families prepared for the unfamiliar world of the ICU.
Affective Disorders, Psychotic↗
The use of pejorative terms to describe patients: "Dirtball" revisited.
BACKGROUND: The use of pejorative terms for patients is well documented. Reasons include frustration and anger in managing certain patients, fostering group solidarity among caregivers under stress, and the alleged "dehumanization" of medical training. Medical students were surveyed to document and understand the phenomenon. METHODS: The 1988, 1989, 1990, and 1996 Johns Hopkins University Medical School graduating seniors were asked about their attitudes towards such use and about the nature of medical school. RESULTS: Class response rates varied from 75% to 95%, with 8% to 13% of respondents recording having heard no pejorative terms. The reported number of different terms declined during the period from 75 to 55, as did use of "dirtball" and "gomer." Only 2% to 13% of particular classes considered such usage to be helpful, whereas 30% to 50% considered it harmful. Pejorative terms were used most frequently for self-destructive or abusive patients. From 12% to 24% of students thought medical school to be humanizing; 10% to 24%, dehumanizing; and 38% to 59%, both. CONCLUSION: Most students had heard pejorative references to patients, but few thought the practice useful. Monitoring such usage may help identify individual or institutional problems and lead to better management strategies for certain subgroups of patients.
Journal Article↗
Impact of workshop on students' and physicians' rejecting behaviors in patient interviews.
The "dehumanization" process is often documented among medical students during their clinical clerkship and among physicians. This dehumanization is characterized by an increase in rejecting behaviors (manifested by sarcasm, verbal rejection, contempt, evading eye contact, and ignoring patients' verbal or nonverbal cues) and a decrease in supporting, empathic behaviors. In the study reported here, the authors observed rejecting behaviors during medical interviews and determined that participation in a workshop on supporting behaviors in the medical interview resulted in long-term decrease or abolishment of rejecting behaviors among medical students and physicians.
Attitude of Health Personnel↗
Technology and medicine.
Technology, which is older than science, has been of vital importance in the development of modern medicine. Even so, there are voices of dissent to be heard. The disenchantment with technology expressed by Aldous Huxley in Brave new world has been echoed by contemporary writers on the technology of modern medicine. Medicine is seen by some to have been dehumanized by technology, and techniques that are expensive are thought to be consuming a greater proportion of health resources than they deserve. The practice of medicine has, nevertheless, been transformed by modern technology and diagnostic techniques and therapeutic measures undreamed of a few short decades ago are now commonplace. There is no reason why these developments should be any more dehumanizing than the use of similar techniques in modern transportation or communication, nor is their expense out of proportion when compared with other demands on the nation's purse. British workers have been at the forefront of many recent advances. Yet, even though the National Health Service provides a ready market for the products of British medical technology, the nation depends to an inordinate degree on imported products. In the development of appropriate medical technology there is an urgent need for better communication between inventors, scientists, industrialists and the National Health Service. At the same time there is an equal need for improved evaluation of untried techniques. The pressure for a central integrating body to coordinate resources could well be supported by the establishment of evaluation units in the different health authorities in this country.
Diagnosis↗
[Anatomy practice and medical education].
Medical education is committed to a distant and impersonal model of medical care that does not take into consideration the complexity of the encounter between physician and patient. Some authors believe that the "dehumanizing posture" of physicians is encouraged by the pedagogical practice of dissecting cadavers. In this sense the relationship between student and cadaver would be a model preceding and shaping the relationship between physician and patient. This article describes a study on the impact of anatomy practice on first-semester medical students enrolled in the anatomy course at the Federal University of Rio de Janeiro, Brazil. Groups of 16 students attended four 1-hour meetings over the semester. Thirty-two groups were assessed over four semesters, with a total of 384 students. The activity was coordinated by medical psychology and anatomy professors, who took notes during the sessions. At the end of each semester the students filled out a questionnaire to help evaluate this teaching activity. In the groups, the most frequent themes were the first encounter with the cadaver, respect for the cadaver, and the presence or absence of humanity in the cadaver. In general the questionnaire showed that the students found the experience to be positive. We believe that the pedagogical activity described here provides an opportunity to reverse the gloomy state of affairs of dehumanized medical care. Group discussions help decrease students' anxiety with the cadaver. This in turn results in a more humane model for the physician-patient relationship and promotes change in the ideology of coldness and distance on the part of the physician. The paradox of medical education--being technical and also having to take into account the complexity of human relationships--can be resolved through activities such as this one.
Anatomy↗
Medical malpractice suits can be avoided.
As medical treatment has become increasingly complex over the years, patient care has become more and more dehumanized. The author explains how this feeling of dehumanization can cause patients to file malpractice suits and explores ways in which hosptial administrators can attempt to remedy the situation.
Hospital Administration↗
Social context and historical emergence: the underlying dimension of medical ethics.
I argue that work in medical ethics which attempts to humanize medicine without examining hidden assumptions (about medicine's ontology, explanations, goals, relationships) has the dehumanizing effect of legitimating practices which treat persons as abstractions. After illustrating the need to reexamine the field of medical ethics and the doctor-patient relationship in particular, I use Foucault's work to provide a social, historical framework for discussion. This background begins to demonstrate that doctor-patient relationships cannot be made satisfactory by new hospital policies or interpersonal skills, but have deep-rooted problems due to medicine's place in social history. Real progress requires social or structural change.
Dehumanization↗
Penal managerialism from within: implications for theory and research.
Unlike the bulk of penological scholarship dealing with managerialist reforms, this article calls for greater theoretical and research attention to the often pernicious impact of managerialism on criminal justice professionals. Much in an ideal-typical fashion, light is shed on: the reasons why contemporary penal bureaucracies endeavor systematically to strip criminal justice work of its inherently affective nature; the structural forces that ensure control over officials; the processes by which those forces come into effect; and the human consequences of submission to totalitarian bureaucratic milieus. It is suggested that the heavy preoccupation of present-day penality with the predictability and calculability of outcomes entails the atomization of professionals and the dehumanization of their work. This is achieved through a kaleidoscope of direct and indirect mechanisms that naturalize and/or legitimate acquiescence.
Criminal Law↗
Dignity in situations of ethical difficulty in intensive care.
In intensive care, situations of ethical difficulty are common. For the purpose of illuminating the meaning of being in ethically difficult situations, 20 registered nurses (RNs) employed in six intensive care units in Sweden narrated episodes of ethical difficulty. From a phenomenological hermeneutic perspective, the core theme of 'dignity' was identified in 85 stories. Stories with the concept of dignity reveal a threefold meaning; transforming disrespect into respect for the inviolable value of the human being; transforming ugly situations into beautiful ones; transforming discord of death into togetherness. Stories without the concept of dignity were oriented toward skills and physical care without reflection on actions and a 'taken-for-granted attitude' that good will prevail. Comparing and contrasting stories with and without dignity revealed the demands of dignity: attentiveness, awareness, personal responsibility, engagement, fraternity and active defence of dignity. In light of the philosophies of Weil, Marcel and Ricoeur, the demands of dignity correspond to qualities generated when struggling for respecting the dignity of human beings. This study reveals that dignity begets dignity, which opens the RNs to the ethical dimension. This, in turn, counteracts the risk of dehumanizing care in technocratic environments.
Adaptation, Psychological↗
An ethical assessment of intensive care.
Any evaluation of intensive care must include an ethical assessment of that technology. This allows us to consider the use of technology in light of the ends that we desire. The most pressing ethical issues in intensive care are: forgoing life-sustaining treatment, dehumanization of patients and staff within the technological environment, and the allocation of the technology that is integral to intensive care.
Consensus↗