The practice of respect in the ICU

Samuel M. Brown, Elie Azoulay, Dominique Benoit, Terri Payne Butler, Patricia Folcarelli, Gail Geller, Ronen Rozenblum, Ken Sands, Lauge Sokol-Hessner, Daniel Talmor, Kathleen Turner, Michael D. Howell

Research output: Contribution to journalReview articlepeer-review

Abstract

Although “respect” and “dignity” are intuitive concepts, little formal work has addressed their systematic application in the ICU setting. After convening a multidisciplinary group of relevant experts, we undertook a review of relevant literature and collaborative discussions focused on the practice of respect in the ICU. We report the output of this process, including a summary of current knowledge, a conceptual framework, and a research program for understanding and improving the practice of respect and dignity in the ICU. We separate our report into findings and proposals. Findings include the following: 1) dignity and respect are interrelated; 2) ICU patients and families are vulnerable to disrespect; 3) violations of respect and dignity appear to be common in the ICU and overlap substantially with dehumanization; 4) disrespect may be associated with both primary and secondary harms; and 5) systemic barriers complicate understanding and the reliable practice of respect in the ICU. Proposals include: 1) initiating and/or expanding a field of research on the practice of respect in the ICU; 2) treating “failures of respect” as analogous to patient safety events and using existing quality and safety mechanisms for improvement; and 3) identifying both benefits and potential unintended consequences of efforts to improve the practice of respect. Respect and dignity are important considerations in the ICU, even as substantial additional research remains to be done.

Original languageEnglish (US)
Pages (from-to)1389-1395
Number of pages7
JournalAmerican journal of respiratory and critical care medicine
Volume197
Issue number11
DOIs
StatePublished - Jun 1 2018

Keywords

  • Dignity
  • Patient engagement
  • Patient experience
  • Patient-centered care
  • Respect

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine

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