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  1. Jason W Boland
  1. 1Senior Clinical Lecturer and Honrary Consultant in Palliative Medicine, Hull York Medical School, University of Hull, Hull, UK
  2. 2Care Plus Group and St Andrew's Hospice, Grimsby, UK
  1. Correspondence to Dr Jason Boland; Jason.Boland{at}

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Patient perspectives of dignity, autonomy and control at the end of life: systematic review and metaethnography

▸ Rodríguez-Prat A, Monforte-Royo C, Porta-Sales J, et al. PLoS ONE 2016;11:e0151435. doi:10.1371/journal.pone.0151435

In a systematic review and metaethnography to explore the relationship between perceived dignity, autonomy and sense of control in patients at the end of life, 21 studies (400 participants) were included. There were three broad themes: (1) dignity mediated by the loss of functionality, linked to the loss of control and of the value ascribed to one's life; (2) dignity as identity, which is related to self-identity and the impact of social factors; and (3) autonomy as a determining factor of perceived dignity, was linked to the desire for self-determination and control over dying. The authors suggest that dignity and autonomy are interconnected, multidimensional and dynamic concepts, similar to personal identity. Patients with an intrinsic sense of dignity maintained a positive view of themselves despite their illness, thus it is central to care to address the areas of life on which a patient's dignity is based.

Perspectives of people with mild intellectual disabilities on care relationships at the end of life: a group interview study

▸ Bekkema N, de Veer AJ, Hertogh CM, et al. Palliat Med 2016;30:625–33.

Seven group interviews including 33 people …

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  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.