Maintaining Personhood – by Sheila Jones (Team Member)

Given a choice most of us would prefer to be treated by medical professionals as a person rather than as a case or condition. Nobody wants to be referred to as “the appendectomy in Room 4” or “the fracture on Ward D” Person-centred care is therefore a welcome alternative to depersonalized care based entirely on the illness or condition.  Instead of putting all of the attention on one’s limitations, person-centred care engages the individual’s strengths and abilities to support the over-all well-being of a person and aims at restoring and maintaining his or her independence. This approach is particularly important for individuals with age-related memory and cognitive impairment. It aims at maintaining their personhood rather than centring on any incapacity.

In an article in the Canadian Alzheimer Disease Review, April 2003, Dr. Epp of the University of Waterloo, states that focusing on a person’s losses only aggravates the problem, causing a greater loss of personhood. He writes that person-centred care rests on the principle that “an individual’s life experience, unique personality and network of relationships should be valued and used to their fullest to sustain personhood.”

This approach to memory and cognitive challenges is as much a philosophy as a treatment model. As Dr. Epp points out, as such it raises a key philosophical question: what is personhood? To answer that question we can turn to a Canadian professor of philosophy, Dr. Thomas De Koninck  of Laval University. He writes that the core of the meaning of personhood is that each and every person has an absolute value, not a relative value. No one is less or more a person because of his abilities or limitations. But does this apply to someone whose judgement has been impaired by age or illness? The answer  begins with the observation that by the word individual we mean the indivisible uniqueness of the human person—the unity of body and soul. Regardless of the state the living body is in, the body and soul remain undivided and consequently, the individual person is there and possesses full human dignity.

We arrive then at the inescapable conclusion that no human being, regardless of their  condition, can ever be reduced to the status of an object rather than a person. The human being remains an end in himself, and must never be reduced to a means to an end. By recognizing the indivisibility, the uniqueness of each individual, we respect their human dignity and recognize their personhood. It is not something we confer on others but something we appreciate. In doing so we are appreciating the beauty of a person’s life. And it is this beauty that gives true meaning to each life, no matter what state the body or mind is in. With this  definition of personhood, we can build a caring relationship that emphasizes the integrity of the individual and opens up possibilities for meaning and sense that are entirely missed when we mistakenly locate the self entirely in the mind or entirely in the body.