Trial lecture title: Palliative care that preserves and strengthens dignity – visions, opportunities and challenges.
Ordinary opponents
- First opponent: Professor Regner Birkelund, Department of Regional Health Research, University of Southern Denmark
- Second opponent: Professor Lena Wiklund Gustin, School of Health, Care and Social Welfare, Mälardalen University, Sweden
- Leader of the evaluation committee: Professor Karen Synne Groven, Department of Physiotherapy, Faculty of Health Science, OsloMet
Leader of the public defense is Associate Professor Dag Karterud, Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet.
The main supervisor is Professor Berit Sæteren, Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet.
The co-supervisor is Professor Dagfinn Nåden, Department of Nursing and Health Promotion, Faculty of Health Science, OsloMet.
Abstract
The body is the center of human experience. The bodily changes caused by cancer disease and treatment affect physical, psychological, social and existential dimensions of life. When meaning and knowledge have their origin in embodied experiences it is appropriate to explore dignity through the nurses’, relatives’ and patients’ stories about the vulnerable body.
Thus, the overall aim of the study was to gain a deeper understanding of the meaning of the body in order to understand dignity in health and suffering. The study consists of three empirical studies and a hermeneutic concept analysis. It has a hermeneutical approach based on Gadamer’s ontological hermeneutics.
Study 1
Study 1 revealed that the nurses described the patients as trapped in “alien bodies”, as suffering bodily in terms of disgust, shame and loathing, and that the decay of their bodies reminded them of the seriousness of death. The nurses were also concerned with supporting the patients in experiencing coherence and meaning in the midst of their suffering.
Study 2
Study 2, the hermeneutic concept analysis of flesh and fleshly, revealed dimensions of flesh as the corporeal, protective, temporal, sensuous, shameful and vigorous body. The study made visible some of the wordlessness and invisibility concerning the body, which is important for the human beings’ feelings of dignity and health.
Study 3
Study 3 revealed that the relatives experienced the patients’ bodies as totally changed, physically, mentally, socially and existentially, but the patients were still the same as before. The confirmation of ambivalence was understood as a strong ethical obligation and unselfish love to treat the other with dignity, which further was understood as the core of ethics and ethos.
Study 4
Study 4 revealed that the patients lived in interaction between suffering and health. The unpredictable, sick bodies were like unruly wrecks that threatened the patients’ identity and dignity. Simultaneously, the patients had a will to life and love that aimed at keeping the unruly bodies together in order to preserve dignity. Dignity was understood as the good ambiguity.
Nuanced understandings of dignity
Exploring the meaning of the suffering body opened up for nuanced understandings of dignity. The suffering body helped the human being to acknowledged and come in contact with the ambiguity, the paradoxes, the suffering and the vulnerability in life and discovered dimensions or truths that had been vague and difficult to verbalize.
Being in contact with the innermost being or the health inducing rooms, filled with love and goodness, was important for being able to experience the coherence and support needed to become oneself and experience dignity.
The studies reveal that dignity has breadth, depth and enough space to contain both health and suffering. Dignity is not a narrow or dualistic concept, but needs descriptions that embrace the goodness and love in ambivalence.
