Respect and dignity
Human dignity and equal moral status are basic principles underlying human rights and are important to consider in health priority-setting. There are various ways in which health coverage decisions can demonstrate respect for human dignity and peoples’ equal moral status in the health system. There are also health interventions that help preserve or promote people’s sense of dignity and respect. These include respect for people’s personal preferences, values and traditions, and considerations of choice and privacy.
Promoting respect and dignity includes considering:
Self-respect
- In what ways might this intervention either positively or negatively affect people’s experience of self-respect, dignity, and personal identity? For example:
- Does the health intervention enable people to be more independent in self-care activities like bathing?
- Does the intervention enable people to participate in activities that improve their self-esteem?
Enabling environment for personal choice
- Will this intervention affect people’s opportunities to make meaningful choices and decisions about their wellbeing in line with their personal values, beliefs, and life plans?
- Some health interventions may relate to very personal decisions about how a person manages their health condition.
- Certain interventions may improve health in ways that enable people to pursue other important goals.
- Some interventions may give people a greater sense of control over their lives and how they experience the health condition addressed.
- Other interventions may undermine people’s sense of control or intrude on their privacy, such as when close monitoring or supervision is required to take a medication.
Social stigma and negative discrimination
- Might the intervention make people vulnerable to stigma and discrimination?
- Could the intervention make existing stigma and negative discrimination even worse?
- Are there ways to deliver the intervention that would help protect people from possible sources of social stigma and discrimination?
- Might the intervention proactively prevent or alleviate stigma and negative discrimination relating to the health condition addressed?
Respect for people’s religious, spiritual, and cultural beliefs
- How acceptable, in general, will the health intervention be in the light of people’s values, religious beliefs and other cultural norms?
- Are there any groups for whom the intervention will be perceived as disrespectful of their values? An example of this is religious / spiritual belief systems that do not allow for certain medical procedures such as blood transfusions or organ transplants.
- Are there any ways an intervention could be adapted to make it acceptable? If not, are there any reasonable alternatives that can be offered to meet the needs of people who find the current options unacceptable?
How might people’s religious, spiritual, or cultural belief and practices effect the Expected Health Benefits or Harms of the intervention?
When there are concerns about Respect and Dignity, consider:
- Are there reasonable alternatives that can be offered where there is a clash between people’s values and the nature of the intervention?
- Will there be additional costs for communication, or outreach, to address concerns relating to people’s self-respect, dignity, personal identity or personal autonomy, or their cultural or religious / spiritual acceptance of a health intervention?
Consider how these costs may affect Budget Impact & Cost-Effectiveness
Respect & Dignity as it relates to Systems Factors & Constraints
In the real-world context of the health system & other factors
- Are there special considerations related to how, where, and by whom health services are offered that relate to respect and dignity for patients? For example:
- Does the gender of the provider matter based on their personal values or religious and cultural practices, such as for certain women seeking sexual and reproductive health services?
- Are the facilities equipped to protect the privacy of patients, particularly those who may have a stigmatized condition?
- Does the intervention raise or address any issues related to respect and dignity of the health providers? For example:
- If the intervention is going to be delivered by community health workers, could it help or harm their social standing or self-respect?
- Is the intervention likely to raise any issues of religious or cultural importance from the provider perspective?