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2. The Structures That Deny Dignity
- Vanderbilt University Press
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51 Chapter 2 The Structures That Deny Dignity The rebuilding of denied human dignity is brought about . . . [through] changing the structures that deny this dignity. Recognizing inner dignity without transforming the structures that deny it will remain just so many words. —Juan José Tamayo-Acosta (2003) The first time I spoke to an audience about dignity violation, it was to the staff of an agency that provides health and social care services to homeless and underhoused individuals in Toronto. Midway through my presentation, a listener dismissed my recounting of the social processes of violation as a detailed but aimless inventory of the ways some people have of “being mean” to other people. (He prefaced his remarks by stating he had little use for research.) “What’s the point?” My critic continued, “Telling us all about how people are mean to each other doesn’t challenge injustice.” Documenting the processes of dignity violation is important for several reasons. Conceptually, violation provides “empirical content” to dignity (Gewirth 1992, 15). Any number of authors have noted that we see dignity most clearly when it is at risk or once it has been lost: “One of the best approaches to an exploration in depth of what human dignity means is to start from the experience of ‘indignation’” (Spiegel berg 1970, 60). We discover dignity “through its opposite” (Dussel 2003, 93). That is, an understanding of dignity violation deepens our understanding of dignity itself. In practice, a comprehensive catalog of viola- 52 Dignity and Health tions is crucial to realizing the prescriptive uses of dignity. As Jona than Mann (1997, 1998) argued, the work of amelioration begins with identifying and describing the many types and permutations of dignity violation; such identification and description can then be applied analytically to explore how social dignity may affect health status and other important dignity outcomes, and the resulting knowledge integrated into policy and practice in order to devise effective interventions. Detailed accounts of dignity violation also can be marshaled to raise moral awareness—to give voice to that which is often experienced, but too rarely articulated. In all these ways, holding the social processes of dignity violation up to the light can be instructive. Indeed, at the same presentation, others were quick to begin a conversation about how an improved understanding of dignity violation might be used to change the ways in which they designed and delivered their services. Any dignity violation can be broken down into several moving parts: the act, or the process or processes of violation (the subject of Chapter 1); the actors involved; the context; and the consequence. Specific violations can be conceptualized as the outcomes of specific dignity encounters , or dignity-laden interactions that take place between specific actors in specific times and places—the context in which the encounter is situated . Analyzing context means examining a number of such encounters singly and together, paying attention to any patterns that emerge in the connections between social processes, actors, context, and consequence. These patterns are the contextual conditions of dignity violation. There are four main types of contextual conditions: conditions that pertain to the positions of the actors involved in a specific dignity encounter—actors that may include individuals, organizations, geographic communities or communities of affinity, and whole societies; conditions that pertain to the nature of the relationship between the actors; conditions that pertain to the setting in which the encounter takes place; and conditions pertaining to the social order in which actors , encounters, and settings all are situated. These conditions are layered , overlapping. In some instances, they may best be conceptualized as risk factors, features of the encounter that increase the chances that violation will occur. At other times, the conditions are themselves constitutive of violation. The four types of conditions are linked to one another : certain kinds of relationships between actors are more common [44.204.94.166] Project MUSE (2024-03-28 09:47 GMT) The Structures That Deny Dignity 53 in certain kinds of settings, for example. While conditions and violation processes tend to be patterned, the possibility of dignity promotion (which I explore conceptually in Chapter 4 and again, more practically, in Chapter 5) suggests that no single condition or set of conditions need always be determinative of violation and, further, that conditions themselves are mutable. Dignity violation is facilitated when an (individual or collective) actor in a dignity encounter is in a position of vulnerability. Vulnerability may be conferred internally or externally, by physical, psychological, or social attributes...