(De)humanization and health care: an integrative review

Abstract

Background: Dehumanization in health - viewing or treating patients as less than human - is a pervasive and relevant social issue. Most research on the topic has been conducted by health service researchers, who mainly seek to identify and describe (de)humanizing health care practices. This literature, rather a-theoretical, has been blind to recent theoretical developments on dehumanization processes taking place in social psychology. We contend that the integration of social psychological models and health services research on dehumanization is important for the development of this topic. As such, this study aimed to develop a comprehensive and integrative review of research on (de)humanization and health. Methods: Drawing on scoping review methodology, a database search was first performed and identified 2,867 records on (de)humanization and/or social representations/metaphors of the body in health, which were screened by to independent researchers according to inclusion/exclusion criteria; a total of 59 papers were included. Results: Findings show that (de)humanization in health has been investigated by different theoretical/empirical perspectives and levels of analysis (intra and interpersonal, organizational). Two main groups of studies were identified: (1) on contents and meanings of (de)humanization, which either explored dehumanizing social representations/metaphors of the ill body or health care practices and services; (2) on psychosocial processes, which investigated predictors, outcomes, mediators, or moderators of (de)humanization. Discussion: An integrative model of (de)humanization processes in health is put forth, which will contribute to the empirical and theoretical development of research on the topic.