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. 2021 Oct 20;14(1):71-86.
doi: 10.1007/s41649-021-00192-0. eCollection 2022 Jan.

Extending the Ring Theory of Personhood to the Care of Dying Patients in Intensive Care Units

Natalie Pei Xin Chan  1   2 , Jeng Long Chia  1   2 , Chong Yao Ho  1   2 , Lisa Xin Ling Ngiam  1   2 , Joshua Tze Yin Kuek  1   2 , Nur Haidah Binte Ahmad Kamal  1   2 , Ahmad Bin Hanifah Marican Abdurrahman  1   2 , Yun Ting Ong  1   2 , Min Chiam  3 , Alexia Sze Inn Lee  3 , Annelissa Mien Chew Chin  4 , Stephen Mason  5   6 , Lalit Kumar Radha Krishna  1   2   3   5   6   7   8   9
Affiliations

Extending the Ring Theory of Personhood to the Care of Dying Patients in Intensive Care Units

Natalie Pei Xin Chan et al. Asian Bioeth Rev. .

Abstract

It is evident, in the face of the COVID-19 pandemic that has physicians confronting death and dying at unprecedented levels along with growing data suggesting that physicians who care for dying patients face complex emotional, psychological and behavioural effects, that there is a need for their better understanding and the implementation of supportive measures. Taking into account data positing that effects of caring for dying patients may impact a physician's concept of personhood, or "what makes you, 'you'", we adopt Radha Krishna's Ring Theory of Personhood (RToP) to scrutinise the experiences of physicians working in intensive care units (ICU) using a fictional scenario that was inspired by real events. The impact of death and dying, its catalysts, internal constituents, external factors, dyssynchrony, and buffers, specific to ICU physicians, were identified and explored. Such a framework allows for ramifications to be considered holistically and facilitates the curation of strategies for conflict resolution. This evaluation of the RToP acknowledges the experience and wide-ranging effects it has on ICU physicians. As such, our findings provide insight into their specific needs and highlight the importance of support on a personal and organisational level. Although further research needs to be conducted, the RToP could serve as the basis for a longitudinal assessment tool supported by the use of portfolios or mentorship due to their provision of personalised, appropriate, specific, timely, accessible and long-term support.

Keywords: COVID-19; Death and dying; Intensive care unit (ICU); Personhood; Ring theory of personhood (RToP).

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Conflict of interest statement

Competing InterestsAll authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Ring Theory of Personhood. Radha Krishna’s Ring Theory of Personhood – personhood is conceived as four interconnected, concentric rings: innate, individual, relational and societal rings
Fig. 2
Fig. 2
Catalyst interacting with Physician A’s Rings. Conflicting and supporting constituents that interact and affect Physician A’s Rings
Fig. 3
Fig. 3
“Dyssynchrony” in Physician A’s Rings of Personhood. Dyssynchrony due to supporting and conflicting constituents within Physician A’s Rings
Fig. 4
Fig. 4
Physician A’s movement from dyssynchrony to synchrony. Movement from dyssynchrony to synchronny within Physician A’s Rings
Fig. 5
Fig. 5
Spheres of personhood. Moving from rings to the spheres of personhood
See this image and copyright information in PMC

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