This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on ISI (78)  • Contact me when this article is cited  Related Content  • Related article  • Similar articles in JAMA  Topic Collections  • Oncology  • Lung Cancer  • End-of-life Care/ Palliative Medicine  • Psychosocial Issues  • Psychiatry  • Pulmonary Diseases, Other  • Perspectives on Care at the Close of Life  • Alert me on articles by topic

Helping the Patient Feel Valued

Harvey Max Chochinov, MD, PhD, FRCPC

JAMA. 2002;287:2253-2260.

The basic tenets of palliative care may be summarized as the goal of helping patients to die with dignity. The term "dignity" provides an overarching framework that may guide the physician, patient, and family in defining the objectives and therapeutic considerations fundamental to end-of-life care. Dignity-conserving care is care that may conserve or bolster the dignity of dying patients. Using segments of interviews with a patient with advanced lung cancer, his wife, and his palliative care physician, this article illustrates and explores various aspects of dignity-conserving care and the model on which it is based. Dignity-conserving care offers an approach that clinicians can use to explicitly target the maintenance of dignity as a therapeutic objective and as a principle of bedside care for patients nearing death.

Author Affiliations: Department of Psychiatry, University of Manitoba, and CancerCare Manitoba, Winnipeg, Manitoba.

RELATED ARTICLE

May 1, 2002
JAMA. 2002;287(17):2295-2296.
EXTRACT | FULL TEXT  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

New Standards and Implications for Improving the Quality of Supportive Oncology Practice
Ferrell et al.
JCO 2008;26:3824-3831.
ABSTRACT | FULL TEXT  

Dignity work in dementia care: Sketching a microethical analysis
Orulv and Nikku
Dementia 2007;6:507-525.
ABSTRACT  

Dignity and the essence of medicine: the A, B, C, and D of dignity conserving care
Chochinov
BMJ 2007;335:184-187.
FULL TEXT  

Human Dignity in Paediatrics: The Effects of Health Care
Lundqvist and Nilstun
Nurs Ethics 2007;14:215-228.
ABSTRACT  

End-of-Life Care: Issues Relevant to the Geriatric Psychiatrist
Lyness
Focus 2007;5:459-471.
ABSTRACT | FULL TEXT  

'Would you like to talk about your future treatment options?' discussing the transition from curative cancer treatment to palliative care
Schofield et al.
Palliat Med 2006;20:397-406.
ABSTRACT  

Dying, Dignity, and New Horizons in Palliative End-of-Life Care.
Chochinov
CA Cancer J Clin 2006;56:84-103.
ABSTRACT | FULL TEXT  

Improving the Quality of End-of-Life Care in the Pediatric Intensive Care Unit: Parents' Priorities and Recommendations
Meyer et al.
Pediatrics 2006;117:649-657.
ABSTRACT | FULL TEXT  

Dignity Therapy: A Novel Psychotherapeutic Intervention for Patients Near the End of Life
Chochinov et al.
JCO 2005;23:5520-5525.
ABSTRACT | FULL TEXT  

Existential issues do not necessarily result in existential suffering: lessons from cancer patients in Israel
Blinderman and Cherny
Palliat Med 2005;19:371-380.
ABSTRACT  

Do Patients Treated With Dignity Report Higher Satisfaction, Adherence, and Receipt of Preventive Care?
Beach et al.
Ann Fam Med 2005;3:331-338.
ABSTRACT | FULL TEXT  

End-of-Life Care: Issues Relevant to the Geriatric Psychiatrist
Lyness
Focus 2005;3:341-353.
ABSTRACT | FULL TEXT  

Palliative Wound Care at the End of Life
Hughes et al.
Home Health Care Management Practice 2005;17:196-202.
ABSTRACT  

Interpersonal processes in palliative care: an attachment perspective on the patient-clinician relationship
Tan et al.
Palliat Med 2005;19:143-150.
ABSTRACT  

Understanding the Will to Live in Patients Nearing Death
Chochinov et al.
Psychosomatics 2005;46:7-10.
ABSTRACT | FULL TEXT  

Identifying barriers to psychosocial spiritual care at the end of life: A physician group study
Chibnall et al.
AM J HOSP PALLIAT CARE 2004;21:419-426.
ABSTRACT  

End-of-Life Care: Issues Relevant to the Geriatric Psychiatrist
Lyness
AJGP 2004;12:457-472.
ABSTRACT | FULL TEXT  

Barriers to the Treatment of Depression in Cancer Patients
Greenberg
J Natl Cancer Inst Monogr 2004;2004:127-135.
ABSTRACT | FULL TEXT  

Major Depression, Adjustment Disorders, and Post-Traumatic Stress Disorder in Terminally Ill Cancer Patients: Associated and Predictive Factors
Akechi et al.
JCO 2004;22:1957-1965.
ABSTRACT | FULL TEXT  

Dignity and the Eye of the Beholder
Chochinov
JCO 2004;22:1336-1340.
FULL TEXT  

Facing requests for euthanasia: a clinical practice guideline
Gastmans et al.
J. Med. Ethics 2004;30:212-217.
ABSTRACT | FULL TEXT  

Dying with dignity: The good patient versus the good death
Proulx and Jacelon
AM J HOSP PALLIAT CARE 2004;21:116-120.
ABSTRACT  

Supporting Family Caregivers at the End of Life: "They Don't Know What They Don't Know"
Rabow et al.
JAMA 2004;291:483-491.
ABSTRACT | FULL TEXT  

The TLC Model of Palliative Care in the Elderly: Preliminary Application in the Assisted Living Setting
Jerant et al.
Ann Fam Med 2004;2:54-60.
ABSTRACT | FULL TEXT  

Professionally perceived effectiveness of psychosocial interventions for existential suffering of terminally ill cancer patients
Hirai et al.
Palliat Med 2003;17:688-694.
ABSTRACT  

Health professionals' views on advance directives: a qualitative interdisciplinary study
Thompson et al.
Palliat Med 2003;17:403-409.
ABSTRACT  

Practical Considerations in Dialysis Withdrawal: "To Have That Option Is a Blessing"
Cohen et al.
JAMA 2003;289:2113-2119.
ABSTRACT | FULL TEXT  

Living as a Cancer Surpriser: A Doctor Tells His Story
Knuti et al.
The Oncologist 2003;8:108-122.
ABSTRACT | FULL TEXT  

Commentary
Michel et al.
J. Gerontol. A Biol. Sci. Med. Sci. 2002;57:M812-813.
FULL TEXT  

Behavioral Science and the End of Life: Introduction to the Second of Two Issues on End-of-life Care and Decisions
WERTH
American Behavioral Scientist 2002;46:323-326.
 

A Biopsychosocial-Spiritual Model for the Care of Patients at the End of Life
Sulmasy
Gerontologist 2002;42:24-33.
ABSTRACT | FULL TEXT  

Dignity-Conserving Care at the End of Life
Girsh and Chochinov
JAMA 2002;288:162-162.
FULL TEXT