Dr. Harvey Max Chochinov, (Director of the Manitoba Palliative Care Research Unit, CancerCare Manitoba, Canada) talks about what patients and healthcare providers can do to maintain personhood at end of life. Transcripts parts were taken by interview provided to the Canadian Virtual Hospice, and was released by Creative Commons license.
There’s something perhaps that feels demeaning, or even dehumanizing, to think that our entire existence can be reduced down to a symptom or an anomaly. None of us want to be seen exclusively as… “the blood test that has gone wrong”, or… “the lump that needs to be excised, or managed”. Even though we understand that the clinical focus at that moment in time needs to be there (at the issue), we don’t want to see that as defining the totality of who we are.
As illness becomes more profound, as it takes over more and more of our lives, it starts to lay claim to things that are really a core part of what we identify as “personhood”, or “self”. And that’s where this whole issue of “patient versus person” becomes pretty profound. Most of us can tolerate most things through the course of encountering illness, but one of the profound assaults is when you feel that what’s in jeopardy is personhood. That for me to go on living in the face of this kind of challenge makes me feel as if I have to relinquish Who I am and What I am.
So, the challenge for patients is how do you hold onto personhood, how do you maintain that sense of connectedness with that thing that is part of your core identity. On the flip side, I think for health care providers, we need to ask ourselves what can we do during the course of care, to make sure that we are treating people in a way that they don’t get lost!
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