Respect is defined as “to be treated with regard, concern, to protect an individual’s privacy; to be sensitive to cultural differences; to allow an individual to make choices” Furthermore, dignity is defined as “To be treated with honor, integrity, and courtesy; to be addressed in a manner that is not supercilious or patronizing; to be treated as an equal; to be treated the way any person would like to be treated”. In other words, if a person gets respect, person feels dignified. Moreover, respecting person it means we are respecting their right and this cannot be attained without one another. Patient dignity entails each person’s individuality and their feelings, and having control, particularly over decisions and behavior. Dignity also comprises the presentation of self to others in terms of physical appearance and personal behavior. The final component is that dignity is reflected by the attitudes and behavior from others  Respect is defined as to treat something or someone with kindness and care and to respect someone’s feelings (Cambridge dictionary 2015).
Significance of Issue
The principle of respect and dignity applies everywhere in our daily lives and every person deserves to be treated with respect. Among the most important human needs is the desire for respect and dignity. That need doesn’t change when a person becomes ill or disabled. Indeed, it may grow even stronger. There are many things you can do to make sure the person in your care takes the respect and dignity that is every person’s basic human right. However, to discuss this principle in mental health is significant because these patients are at risk of losing respect and dignity at all times. People with mental disorders are, or can be, particularly vulnerable to abuse and violation of rights . Also, most often society does not respect the mentally ill patient as they respect others. In many countries mental patients are still kept in chained and beaten, they are treated worth than animals Moreover, “People who suffer from mental health illnesses are often excluded from social society.”
Psychiatric patients lack social support because they often excluded from society. People with mental and psychosocial disabilities in Low and Middle-Income Countries (LMIC) continue to experience a wide range of human rights violation including the inability to access adequate mental health services in a safe, therapeutic, and affordable setting . In western countries like Nepal, not being an exception has been reported with routine and rampant cases of human rights violations against people with mental disorders throughout the country. Therefore, this article advocates that protection of human rights of mentally ill people should receive appropriate attention from the global mental health setting  Similarly, in my case patient was insulted in front of others and was verbally abused and labeled as ‘mental.
Scenario Related to Issue
On my clinical placement in Mental Hospital, I went to female ward and I saw that on duty staff worker do not behave well. They perform their own work from patients. When one patient refused to perform their work. The staff worker verbally abused her by saying that get out from here mental patient at that time, other patients were also listening to this conversation. All of which were disregarding the respect and dignity of a patient. This is ethically wrong. Every patient has right to be treated with respect and dignity as human beings. Does this incident happen because psychiatric patients are perceived as not deserving respect? Do their mental conditions deprive them of respect and dignity which is the basic right of all humans? These are the questions which emerged in my mind while reflecting on it and led me to choose this issue.
Literature Review and Theory or Framework
In above scenario, the first ethical principle, respect and dignity of a patient have been violated by the staff worker in front of others. Moreover, worker verbally abused the patient although it was her duty to take care of patient. Studies revealed that health worker frequently hold negative attitudes and behavior towards mental ill patients . Psychiatric patients are at risk of disrespect and losing self-respect in hospitals. “behavior of health worker and the hospital environment impact patients’ self-esteem, dignity and threats to patients’ human needs can lead to loss of dignity . Words also play a key role in the mental health settings, may affects patient dignity to a great extent. “Using respectful language and gestures promotes dignity  According to Islamic bioethics, “Patient must be treated with respect and compassion and that the physical, mental and spiritual dimensions of the illness experience be taken into account” . Alike, in above scenario due to health worker behavior patient’s right to respect disrupted which may threaten patient’s dignity. It is our responsibility to give respect to all individuals equally to maintain dignity.
According to human dignity framework, dignity is a subjective concept, referring to an inner sense of self-worth. Second, dignity is influenced by a host of psychological, cultural, and social factors. Third, human dignity belongs to each individual; it is constructed by and dependent on relations of the individual with others. Fourth, there is a sense that human dignity is also a holistic concept; that it is always more than the sum of the rights that constitute it. So, this framework helps to analyze the experience related to human rights and to recognize its vulnerability. In addition, the core of dignity consists of three basics: the essential worth of all human beings, to respect each other’s worth, and to protect and fulfill everyone’s worth. On the contrary, in my case, patient felt disrespect which affects worth of a patient. It influenced by social factors and has negative impact on health. So, this framework helps to analyze the experience related to human rights and to recognize its vulnerability.
Relationship of Issue with Mental Health and Illness
When patient gets respect, feels dignified. “Dignity entails the positive feelings that the individual has for the self, including respect, self-regard, self-confidence, trust, esteeming self, and honoring self”. In other words, dignity makes an individual to think positive which promotes mental health. As, patient feels dignified, it shows improvement in mental health status and recovery rather deterioration in mental health. On the other hand, when dignity and respect are absent from care, patient feel degraded, humiliated and uncomfortable. They may also lack self-reliance, unable to make decisions for themselves, and feel disgraced. Dignity may be a link that explains the relationship between the promotion and protection of human rights and health status” . Similarly, if I kept myself in patient shoes, I felt very bad about it, felt lack of confidence and worthlessness.
Strategies / Recommendations
For this, some fruitful interventions should be done in order to prevent the further violation of this basic principle and to promote mental health of psychiatric patient. During clinical, I have observed and identified the need of giving teaching on ethical principles. The purpose of teaching would be to provide awareness and to recognize the significance of ethical principle while caring with psychiatric patient. Staff of the hospital should arrange seminar on the topic of human rights and also discuss the rights of mental ill patients such as dignity and respect of the mental ill patients. Being in a Health Care profession it is our primary responsibility to give respect to our patient if we neglect this responsibility it means we are not sincere with ourselves and as well as with our profession. Government must take serious steps in delivering dignified care and policies should be made to stop violation of this basic principle.
In conclusion, treating each other with respect and dignity is everyone’s responsibility. Nobody should be forced to listen to bad language in front of others in any way. We must treat psychiatric patients as we would want to be treated ourselves if we were in a similar situation.
- Baillie, Lesley (2011) Patient dignity in an acute hospital setting: a case study. International journal of nursing studies 46(1): 23-37.
- Kapungwe A, Cooper S, Mayeya J, Mwanza J, Mwape L, et al. (2011) Attitudes of primary health care providers towards people with mental illness: evidence from two districts in Zambia. African journal of psychiatry 14(4): 290-297.
- Drew, Natalie, Funk, Michelle, Tang, et al. (2011) Human rights violations of people with mental and psychosocial disabilities: an unresolved global crisis. The Lancet 378(9803): 1664-1675.
- Upadhyaya, Kapil Dev, Joshi, Devbrat (2014) Ethics in mental health in a resource poor setting: Experiences from Nepal. Journal of Psychiatrists Association of Nepal 1(1): 5-10.
- Atighetchi, Dariusch (2014) Islamic Perspectives on Vulnerable Groups Religious Perspectives on Human Vulnerability in Bioethics. Springer, pp. 175-191.
- Donnelly, Jack (2013) Universal human rights in theory and practice: Cornell University Press, New York, USA.