The Lesson of Sleeping Beauty: Person-Centred Care for the Unconscious, Unresponsive ICU Patient in the Face of Levinas' Radical Alterity.

Abstract

The development of person-centred practice is inextricably linked with the debate about being a person and personhood. This debate takes on a particular relevance when certain prerequisites, which are often used as defining characteristics of persons, can no longer be autonomously fulfilled. This is the case, for example, with intensive care patients who are often (temporarily) impaired in their responsiveness and consciousness due to their critical state of health. Due to sedation, severity of illness and loss of voice, delivery of person-centred care in the intensive care setting is described as challenging. Despite far reaching implications on the therapeutic, ethical, and legal handling of patients in the intensive care setting, a definition of personhood at the stage of briefly diminished (by anesthetic measures), limited, or absent consciousness and ability to communicate has so far been discussed only superficially. To meet this challenge and to develop an understanding of person-centred practice suitable for the context of intensive care, Emmanuel Levinas' relational ethics and his understanding of radical alterity is discussed. We uncover the implications of Levinas Ethics of Radical Alterity on the care of the unconscious and unresponsive patient in the intensive care unit and further on the person-centred approach to practice. The perspectives proposed in this paper provide an opportunity for the ontological embedding of a person-centred care approach, which makes it possible to meet and care for these patients in a person-centred manner.