Dimensions of humanization/dehumanization
Each of the eight dimensions of humanization and
dehumanization expresses a spectrum of possibilities.
In each case, the positive humanizing value is
first articulated, followed by how it may be obscured
by a dehumanizing emphasis. Dehumanization occurs
when any one or more of the humanizing
dimensions are obscured to a significant degree. We
should like to note here that the dimensions of
humanization and dehumanization are not absolutes
The humanization of healthcare 69
but rather a matter of emphasis. For instance we
acknowledge that forms of assessment and other
health care practices, which are problem solving in a
technically helpful way, are important. However, it is
when these technical problem strategies overshadow
the humanizing dimension we refer to, that there
is a potential for dehumanization. Each of the eight
dimensions clearly overlap in some respects, but
each emphasizes something special as captured in
the name of the dimension in each case. Such
distinctiveness is also indicated by the choice of
example from the qualitative research literature. We
searched the qualitative literature for everyday
examples that would illustrate something distinctive
about the specific dimension. There are numerous
examples in the literature that could be used, so we
‘‘handpicked’’ examples that we thought would
provide some understanding of how the dimension
could be relevant to practice and situations.
Insiderness/objectification
What makes each of us intimately human is that we
carry a view of living life from the inside. To be
human is to live in a personal world that carries a
sense of how things are for the person. Only
individuals themselves can be the authorities of
how this inward sense is for them. Such subjectivity
is central to human beings’ sense of themselves. Our
sense of feeling, mood and emotion is the lens by
which our worlds are coloured. This provides
important human textures for valuing the qualities
of things. If such a dimension is neglected then
something important is missing when responding to
human need.
In objectification, people are made into objects by
focusing excessively on how they fit into a diagnostic
system, part of a statistical picture or any other
strategy by which they are labelled and dealt with
that does not fully take account of their insiderness.
There is a whole psychology of how we separate
ourselves from one another through dissociation by
emphasizing the distance between insider and outsider.
For example, when nurses or doctors break
bad news to a patient, and sit at the computer, they
may focus the conversation on how the individuals
fit with the statistics of their condition, the diagnostic
category and other categories rather than attending
to the meaning the bad news has for the person.
Along our spectrum, this is an everyday example
of how an objectifying interaction may happen.
An extreme example of objectification is Arendt’s
reference to the use of ‘office-speak’ by Nazi executioners
when dealing with human beings in concentration
camps while putting aside the work of the
office before a family dinner (Arendt, 1963).
Another example of everyday objectification is
shown by a qualitative study. Holloway, Sofaer and
Walker (2007) examined the experiences and needs
of people who suffered from chronic low back pain
through interviews. Stigmatization by ‘‘the system’’
and health professionals as well as by significant
others, emerged as a key theme from the narratives
of participants. To be labelled as members of a group
that were not only expensive to the system but also
seen as ‘‘malingers’’ deeply affected the perception of
self and self-esteem and the behaviour of the
patients. The study demonstrated that pain management
programmes need to take into account the
feelings of participants to make them feel valued and
accepted. It illustrates how labelling is one form of
objectification