Win Tadd

• Cardiff University

Older age is one stage of the lifecourse where dignity maybe threatened due to the vulnerability created by increased incapacity, frailty and cognitive decline in combination with a lack of social and economic resources. Evidence suggests that it is in contact with health and welfare services where dignity is most threatened. This study explored th...

Drawing on perspectives from the governmentality literature and the sociology of risk, this article explores the strategies, tools and mechanisms for managing risk in acute hospital trusts in the United Kingdom. The article uses qualitative material from an ethnographic study of four acute hospital trusts undertaken between 2008 and 2010 focusing o...

In recent years, there has been a growing understanding that organizational culture is an important characteristic that may influence the effectiveness of health care provision, not least for the growing numbers of older people needing care. The purpose of this paper is to review the literature to uncover any reliable evidence supporting the assert...

Despite improvement in the care and experience of older people being prominent features of NHS health policy over recent years, a number of high level reports show the effectiveness of such policy initiatives has been limited and the provision of dignified care for older people remains difficult to translate into practice.

To examine: older people's and their relatives' views of dignified care; health care practitioners' behaviours and practices in relation to dignified care; the occupational, organizational and cultural factors that impact on care; and develop evidence-based recommendations for dignified care. An ethnography of four acute trusts in England and Wales...

This paper reports on an ethnographic study to explore the experience of dignity in the acute care of older people in four acute NHS trusts. It explores the prevalent view that acute care is not the right place for older people and the failure to acknowledge that the largest group of users are the very old, the frail and the dependent, which result...

The need for dignity is frequently mentioned in policy documents relating to the care of the elderly. It is also described as an important value in professional codes. Yet concerns about the standards of care for an important number of elderly people abound, despite global ageing being a challenging phenomenon. Not least among these is how to ensur...

IntroductionThe Dignity and Older Europeans studyFindingsDiscussionConclusion AcknowledgementsReferences

Nurses are responsible for the well-being and quality of life of many people, and therefore must meet high standards of technical and ethical competence. The most common form of ethical guidance is a code of ethics/professional practice; however, little research on how codes are viewed or used in practice has been undertaken. This study, carried ou...

To examine the experiences of communication between older people and health and social care providers in six European countries. Focus groups were carried out with groups of older people (91 focus groups, 391 participants), and health and social care professionals (85 focus groups, 424 participants), in order to gain insights into concepts of good...

This paper describes the creation of the educational materials developed as part of the Dignity and Older Europeans Project. Following a discussion of the development process, the materials themselves are described. The materials includes a poster of the dignity balance, which contains five core messages and illustrates the impact of both enhancing...

Professionals' views concerning the importance of dignity and how this can best be maintained is important for the planning and provision of appropriate services, especially for older people.Dignity was described as an integral part of being human and closely related to respect. Overall, participants painted a negative image of the lives of older p...

This paper describes the methods used within the Dignity and Older Europeans (DOE) Project and in particular the approach involved in developing the bibliographical database, the philosophical methods used in creating the theoretical model of dignity, together with the empirical methods involved in data collection with older people, health and soci...

This paper reports the findings of 89 focus groups and 18 individual interviews (involving 391 older people in 6 European countries) that were held to explore how older people view human dignity in their lives. Participants were all aged over 60 years and 25% were aged 80+ years. They were from a range of educational, social and economic background...

This paper describes the findings from 89 focus groups held with 505 young (13-39 years) and middle-aged (40-59 years) adults in the UK, Ireland, Spain, France, Slovakia and Sweden.There were many similarities across all countries and most differences were between the different age groups, rather than the different countries. Five major themes were...

The aim of this study was to explore the salience and meaning of dignity and dignified care for care providers and the implications for the proviosion of care. The project forms part of an international study being undertaken in different European countries comparing health and social care workers' views on dignity. Focus groups were chosen as the...

Dignity is a complex concept and there is little empirical research to show how older people view dignity. This study, using qualitative methods, explored the concept of dignity from the older person's perspective. 15 focus groups and two individual interviews were conducted in 12 different settings, with a total of 72 participants. Participants we...

The study addressed the following questions: (1) What are the information needs of older people with Parkinson's disease (PD) and how can these needs be classified? (2) How effectively do persons with PD perceive professional information/communication giving? (3) Do information needs change over the stages of the disease? Data were collected in sem...

Virtues and vices possessed by patients may affect their quality of life and how well they cope with disease. The objective of this study is to assess the relevance of the concept of virtue and vice to patients with chronic arthritis. Aristotle's theory of virtue and vice was used to construct a guide for in-depth interviews, carried out with 5 pat...

The availability of high-quality, evidence-based, clearly communicated, user-focused information is central to the new NHS. Reliable information empowers patients and their families and enables them to become more knowledgeable about their care and condition following consultation and diagnosis or before a therapeutic intervention. It is an integra...

Increasingly, the term ‘dignity’ is becoming a part of contemporary discussions of health care. Phrases such as ‘respect for human dignity’, ‘treatment with dignity’, ‘death with dignity’ and the ‘right to dignity’ are so commonplace as to have almost become clichés. This is especially so in the context of older people. In the UK, the NHS Plan uses...

Ageism in clinical practice1 and published research2 is well recognised. We were interested in whether research protocols submitted to the local research ethics committee contained unjustified upper age limits and how the committee dealt with this. We reviewed all studies submitted to Bro Taf local research ethics committee in the first seven mont...

Since 1964, the Declaration of Helsinki has been accepted internationally as the cornerstone for research ethics. As such it has been incorporated into a number of guidance documents for research undertaken on human subjects. In 1999, the American Medical Association put forward a proposal for wide-ranging revision of the document, which would sign...

Editorial Whilst preparing this editorial, I was struck by the ambivalent attitudes displayed towards older people in Western society. In London, for example, the crowds thronging the Mall and cheering the Queen Mother for reaching her centenary belied the fact that society generally treats its older members with disdain. That is, until they reach...

In the introduction to his textbook, Ethical Issues in Nursing (1994) Geoff Hunt decries the manner in which ethics is being introduced into nursing curricula throughout the UK. He states, many ethics courses presuppose that nurses have a need for ‘help with moral decision-making’ and that to satisfy this need they should be taught ‘moral concepts’...

One of the first questions posed to me when discussing the initial idea for this book was ‘Is there a European perspective to nursing ethics or indeed, can there be?’ Europe after all is enormous in geographical terms, comprising some 50 or so countries and encompassing a vast diversity of values, languages, cultures, races and religions. At a supe...

With the opening of physical barriers and borders, European nurses have new opportunities to share knowledge and develop fresh insights by working and studying throughout Europe. This book aims to assist this process by discussion of key ethical issues faced by nurses in a number of European countries. In doing so, it is hoped that the diverse cult...

There has been much controversy about the diagnosis and treatment of mental illness. The ‘anti-psychiatry’ movement has argued that there is no such thing as mental illness (Szasz, 1962). What we call mental illness, according to such a view, either has a physical cause or it does not. If it does, then it can be counted as real, in so far as it is...

Nursing in the field of mental handicap is presently in the process of great change. The reasons for the changes are many, but include the shift towards community-based care resulting first, from the 1971 White Paper, ‘Better Services for the Mentally Handicapped’ and later from the adoption of the philosophy of normalisation. This has meant a grea...

We have already noted that the Code of Conduct states, in clause 5, that each nurse shall ‘work in a collaborative and cooperative manner with other health care professionals and recognise and respect their particular contributions within the health care team’ (UKCC, 1984). Similarly, the ANA Code for Nurses says that nurses should ‘actively promot...

The issues raised in the context of nursing the unborn and newborn are sometimes agonising ones. They frequently concern matters of life and death, and many problems, such as that of abortion, have generated and continue to generate much discussion. What we shall try to do in this chapter is to throw light on new developments, and on the ways in wh...

The concept of childhood is relatively new in terms of social history. From the ancient Greeks until the latter part of the nineteenth century, children were regarded as chattels or the property of their parents. Aristotle in the Nicomachean Ethics stated: for there can be no injustice in the unqualified sense towards things that are one’s own, but...

The issues surrounding death and dying are many, ranging from those that arise in relation to organ transplantation, such as how death is to be defined and when is it thought to occur, to those concerning how the dying person is to be treated. The focus of this chapter will be on the problems raised in the latter category, as these represent the co...

We have tried to present a variety of moral problems experienced by nurses in their day-to-day practice, as well as a discussion of the issues which impinge upon them. One recurring theme has been that of individual autonomy and the difficulties that this raises in health care, be it the patient’s or the practitioner’s autonomy which is under discu...

By 1992, it is likely that 30 000 people in the UK will have been diagnosed as suffering from acquired immune deficiency syndrome (AIDS) and, of these, 17 000 will have died (Cox, 1988). In the USA, the picture is even more disconcerting with projections suggesting that 270 000 people will have been diagnosed and 170 000 will require hospitalisatio...

Bandman and Bandman define adulthood as the period between 20 and 65 years of age, dividing this rather lengthy period of time into two phases; early adulthood (20 to 35 years of age) and middle age (35 to 65 years of age). They admit, however, that these figures are arbitrary (Bandman and Bandman, 1985, p. 186). In English law, a young person offi...

The proportion of elderly people in the population is growing fast, and they are major consumers of health care. In addition, they require and will require for the foreseeable future a large number of carers and, as Muyskens points out, in this area of health care it is nurses who will be required, rather than physicians. ‘For the ailing aged and t...

In thinking about the principles that nurses might apply when facing moral dilemmas, it is useful to look at the guidance given by professional codes of ethics. In recent years, several codes for nurses have emerged. Not only is there an international code (ICN, 1973), but there are also codes for Canada, the USA, and the UK. In the course of the b...

The doctor, nurse and patient constitute the fundamental triad of the health care system, and much has been written about the traditional structure and roles of the participants. Characteristically the doctor has been portrayed as ‘all-knowing’ and powerful; the nurse as caring, unselfish, obedient and submissive; and the patient as helpless and ut...

The nurse-patient relationship, along with other professional-client relationships, is often described as special (Tschudin, 1986, p. 12). Fromer describes special relationships as ‘those in which particular duties and obligations are owed and in which certain duties and obligations go beyond the scope of ordinary social intercourse’. (Fromer, 1981...

The Nursing Students' Bill of Rights shows how little understanding there is among its authors of the concept of rights. It also demonstrates serious problems about the expectations student nurses face.

Philosophy is often regarded as a subject which is only of interest to those engaged in academic pursuits. This paper suggests that it can be of practical value to nurse teachers. Indeed never more so than today, with the current emphasis on change and decision making, be it in relation to curriculum development or the future of professional educat...

Thesis (Ph. D.)--University of Wales. Cardiff, 1995. In 2 vols.