TY  - JOUR
T1  - Dignity in Intimate Assistance at the End of Life: A Normative Framework for Negotiating Privacy, Dependence, and Patient Preferences during Toileting and Personal Nursing Care
A1  - Thomas Berger
A1  - Nadia Frei
JF  - Journal of Integrative Nursing and Palliative Care
JO  - J Integr Nurs Palliat Care
SN  - 3006-5550
Y1  - 2026
VL  - 7
IS  - 2
DO  - 10.51847/GYQDKKOFLR
SP  - 63
EP  - 72
N2  - Intimate assistance with toileting, continence, washing, dressing, and related personal care is often unavoidable as serious illness progresses, yet the ethical significance of these encounters is easily obscured when they are treated as routine nursing tasks. Dependence can increase bodily exposure, reduce control over timing and personnel, and intensify vulnerability, while the same assistance may also relieve distress, preserve comfort, and enable patients to remain involved in their own care. This normative analysis examines how dignity should be protected when privacy, physical dependence, patient preference, safety, and professional responsibility cannot all be maximized simultaneously. Drawing on contemporary palliative-care, nursing, dignity, continence, relational-autonomy, and clinical-ethics scholarship, the analysis distinguishes necessary assistance from avoidable exposure and rejects the assumption that dependence itself extinguishes agency. It argues that dignity-preserving intimate care requires attention to the form of authorization under which assistance occurs, the minimum exposure reasonably necessary for care, the opportunities patients retain to influence how assistance is provided, the possibility that preferences change during illness, and the responsibility to explain and review constraints imposed for safety or feasibility. The proposed normative direction therefore treats dignity as relational and context-sensitive while maintaining the patient as the primary locus of authorization. This approach provides a basis for negotiating intimate nursing care without romanticizing independence, treating privacy as an absolute value, or allowing routine and benevolent intention to substitute for patient-specific ethical justification.
UR  - https://journalinpc.com/article/dignity-in-intimate-assistance-at-the-end-of-life-a-normative-framework-for-negotiating-privacy-de-cuvsd5brvvyopb4
ER  -