8 Ways to Help Patients Feel Human
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Dehumanization is endemic in medical practice. This article discusses the psychology of dehumanization resulting from inherent features of medical settings, the doctor–patient relationship, and the deployment of routine clinical practices.
First, we identify six major causes of dehumanization in medical settings (deindividuating practices, impaired patient agency, dissimilarity, mechanization, empathy reduction, and moral disengagement).
Next, we propose six fixes for these problems (individuation, agency reorientation, promoting similarity, personification and humanizing procedures, empathic balance and physician selection, and moral engagement).
Finally, we discuss when dehumanization in medical practice is potentially functional and when it is not. Appreciating the multiple psychological causes of dehumanization in hospitals allows for a deeper understanding of how to diminish detrimental instances of dehumanization in the medical environment.
Many patients are satisfied with their care from physicians and find their stay in hospitals to be quite meaningful. But when you starting looking for it, bad bedside manner — and dehumanization — is everywhere.
For example, a physician enters a room and begins examining a patient’s abdomen without permission, or even an introduction. Or, in bedside conversations, medical professionals or trainees call people by their diseases rather than their names. Caregivers can also slip into the habit of interrupting patients or avoiding eye contact.
These scenarios are not only examples of bad bedside manner; they’re also dehumanizing. "Dehumanization" means denying a distinctively human mind to another person. It refers to any situation in which one person has diminished appreciation for another’s mental state.
Dehumanization — which lies at the heart of the majority of moral transgressions in medicine — makes caregivers feel like people are less worthy of moral concern. Worse, dehumanization can exacerbate preexisting racial, gender, and class disparities in care.
For an article published in Perspectives on Psychological Science, we uncovered how dehumanization happens in medicine and what you can do about it. On the basis of our review of the social and cognitive psychology literature, here are 8 ways in which you as a medical student can help your patients feel more human.
Dress Like an Individual
Admittedly, medical students don’t have much say in how they are supposed to dress in the hospital. But try to stand out in small ways, such as wearing a nametag or a personalized pin related to your specific affiliations in medicine.
Share Decision-Making With Patients
Illness is intrinsically dehumanizing: It robs patients of their ability to plan, intend, and act, and it takes away their sense of self. You can empower your patients by making them active partners in decision-making. Specifically, remember to engage them in the process of informed consent before you make decisions about treatment and procedures. Informed consent should be ongoing throughout your inpatient or outpatient relationship, not a 1-time deal.
Talk to Patients About Their Lives
You can empower patients even through informal conversation. As much as possible, talk with them about their professional or personal lives, their goals and accomplishments. For example, ask about their children and their recent activities together.
Give Patients Small Responsibilities
When your patients are hospitalized, give them small daily responsibilities, such as taking care of a plant. Encourage them to take control of and make daily choices about how their days and nights are organized, such as whether to watch television or receive visitors.
Relate to Your Patients
Because you as a physician in training are likely to differ somewhat from your patients in various ways (in race, class, or gender, for example), it may be inherently challenging to take their perspective and know how they feel and what they need. One way you can relate to your patients is by thinking about your common humanity: At some point in life, everyone suffers, loses loved ones, or is vulnerable to disease or disability.
Do not call patients by their diseases, body parts, or ID numbers in conversations with fellow students and friends.
Personalize Your Patients
When you interview and describe a patient, extract a social history that helps represent him or her as more than an abstraction, and instead as a person. For instance, mention to your team the patient’s professional life, hobbies, family, particular interests, or unique past. These are often left out of presentations.
Focus on Both the Subjective and the Objective in Your Patient Encounters
Even though it is helpful to think of people as being made up of interacting parts when you are learning to diagnose and treat diseases, it is important during interviews and procedures to keep thinking about and empathizing with the subjective experience of your patient with that disease.
Medicine is by definition a humane profession, yet compassionate care is sometimes overlooked. The more we understand about the psychological underpinnings of dehumanization, the more likely we are to prevent it. Until then, the small changes you can make in your interactions with patients as a medical student will make a big difference as you go through your training and beyond.
Perspectives on Psychological Science Omar S. Haque, MD, MTS; Adam Waytz, PhD. March 2012 vol. 7 no. 2 176-186