Abstract
This study makes an original contribution to the understanding of dignity and children in hospital. Despite theoretical deconstructions and empirical studies of dignity and adults (Nordenfelt and Edgar, 2005), there has been a dearth of theoretical or empirical work regarding dignity and children (Reed, et al, 2003). In response to this, I have taken an ethnographic approach to understanding the meaning of dignity by exploring and analyzing the perspectives of children, staff and parents on a hospital ward. The main phase of the study took place over a nine-month period in a children’s ward of a District General Hospital. My main methods were participant observation and qualitative interview. During the fieldwork, I made observations on 97 children. In addition, I taped 31 qualitative interviews with children and their parents. 16 staff members gave interviews. I used principles from grounded theory to code responses and identify themes from data and reconstruct meaning through successive levels of abstraction to propose a theoretical framework. Four factors were fundamental to the context of the study: the environment, power relations, the social construction of the children and the changing role of the nurses and parents in caring for a sick child in hospital. From my findings, I identified a dualism of the meaning of dignity, as something that is both intrinsic and extrinsic to the individual. Drawing from symbolic interactionism (Goffman, 1971), I describe how extrinsic dignity is performed using socially proscribed acts and rules and argue that dignity is “played out” on the body of the child. Dignity is important because of the intensity of emotions its loss provokes. I describe the emotional work involved in the promotion and production of dignity (Hochschild, 1983; Smith, 1992) and discuss the nature and role of the witness as influencing the experience of dignity. By placing children centre stage I have challenged the philosophical and theoretical notions of dignity as something acquired and dependent upon autonomy and bodily control. Dignity is a product of social interaction (Soyinka, 2004) where the macro analysis of dignity as the intrinsic worth of an individual is articulated through micro, socially proscribed acts of extrinsic dignity.