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D Seedhouse

Publications and source records attributed to D Seedhouse.

At least 19 recordsLinked to original sources
PubMed2002

Undignifying institutions.

Declarations of the importance of dignity in health care are commonplace in codes of practice and other mission statements, yet these documents never clarify dignity's meaning. Their vague aspirations are compared to comments from staff and patients about opportunities for and barriers against the promotion of dignity in elderly care institutions. These suggest that while nurses and health care assistants have an intuitive understanding of dignity, they either do not or cannot always bring it about in practice. Thus, despite stated intentions to promote dignity, it appears that the circumstances of at least some elderly care institutions cause patients to experience avoidable indignities. Such institutions are "undignifying institutions" because they fail to acknowledge dignity's basic components, focus excessively on quantifiable priorities, and have insufficient resources available to assure consistently dignifying care. As a partial solution, we argue that health workers should be taught to understand and specify the components of dignity, which will better prepare them to challenge undignifying practices and to recognise opportunities for dignity promotion.

Aged↗
PubMed1998

Practical dignity in caring.

It is difficult to understand the meaning of 'dignity' in human rights, bioethics and nursing literature because the word is used so vaguely. Unless dignity's meaning is spelt out it can disappear beneath more tangible priorities. In this article we define dignity and show how this can help health workers to maintain the dignity of people in their care.

Beneficence↗
PubMed1997

The importance of care.

This paper is in three parts. In Part One we briefly explain that an unsophisticated form of utilitarianism--economic rationalism (ER)--has become dominant in many health systems. Its proponents argue that one of ER's most important effects is to increase consumer choice. However, evidence from New Zealand does not support this claim. Furthermore, the logic of ER requires the construction of systems which tend to restrict individual participation. In Part Two we argue that although some have advocated an 'ethic of care' in an attempt to counteract ER's utilitarianism, two decades of campaigning have had little influence on health policy. ER's pro-care adversaries have failed to make an impact because they have not developed a taxonomy of care--they have not established a language compatible with, or as powerful as, ER's. In Part Three, in an attempt to raise the conceptual and practical status of caring in contemporary health systems, we distinguish four different forms of care. In opposition to those who believe the 'ethic of care' can adequately direct health care practice, we demonstrate that care is a secondary notion. We show that in order for a carer to decide which form of care to adopt in different situations she requires a more powerful idea. We contend further that health care ought to be governed by a theory of health, and suggest that 'the foundations theory of health' should be adopted by planners searching for a more humane alternative to ER. We conclude that ER's dominance can and must be challenged. However, only those arguments which offer detailed theoretical analyses of health care, as well as meticulously derived practical policies, have any chance of success.

Budgets↗
PubMed1995

The way around health economics' dead end.

Many leading health economists hold misconceived ideas about central components of their work. In particular, they assume that their methods are in principle value-neutral. This belief is demonstrably false. Health economic investigations incorporate mainly unexpressed theories of health. Unless this fact is recognised health economics will shortly reach a conceptual and practical dead end. The way to avoid this dead end is to express implicit theories of health, and explicitly to base philosophically and economically justifiable policy proposals on them.

Delivery of Health Care↗