PLoS One. 2016 Mar 24;11(3):e0151435. doi: 10.1371/journal.pone.0151435. eCollection 2016.
Rodríguez-Prat A, Monforte-Royo C, Porta-Sales J et al
In a systematic review and meta-ethnography to explore the relationship between perceived dignity, autonomy and sense of control in patients at the end of life, 21 studies (400 participants) were included. There were three broad themes: a) dignity mediated by the loss of functionality, linked to the loss of control and of the value ascribed to one’s life; b) dignity as identity, which related to self-identity and the impact of social factors; and c) autonomy as a determining factor of perceived dignity, was linked to the desire for self-determination and control over dying. The authors suggest that dignity and autonomy are interconnected, multidimensional and dynamic concepts, similar to personal identity. Patients with an intrinsic sense of dignity maintained a positive view of themselves despite their illness, thus it is central to care to address the areas of life on which a patient’s dignity is based.
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