Dignity unbroken — palliative care as an affirmation of personhood

This article was exclusively written for European Sting by Mr. Franco Miguel Nodado, a 4th-year medical student from the Philippines. He is affiliated with the International Federation of Medical Students Associations (IFMSA), cordial partner of The Sting. The opinions expressed in this piece belong strictly to the writer and do not necessarily reflect IFMSA’s view on the topic, nor The European Sting’s one.

World Hospice and Palliative Care Day reminds us that care for the critically ill is not about prolonging life at all costs, but about preserving personhood until the very end. As a clinical clerk involved in palliative rounds, I have seen patients from all walks of life—adult and pediatric, cancer patients and those intubated—and what strikes me most is that dignity can be preserved throughout the entire journey.

How does this look in practice? It is about empowerment. It is about ensuring patients, as long as they are able, are the primary architects of their own care plans. Dignity is intact in the ways we approach conversations about goals of care, whether they opt for aggressive solutions like intubation or choose to focus solely on comfort and pain management. We ask them, not their family, about their wishes concerning Do Not Intubate (DNI) or Do Not Resuscitate (DNR) status, giving them control over their final moments.

Crucially, preserving dignity means seeing the individual beyond the diagnosis. We converse with them, seeing them as fathers, mothers, daughters, sons, or children who want to explore the world—not as mere statistics or a collection of failing organs. We empathize deeply, but we never pity. Pity is the last thing they need; empowerment is what they deserve.

I recall Mr. X, a patient with rectal adenocarcinoma and bone metastasis. Physically, he was cachectic and frail. Yet, when we met him on rounds, the familiar smiling face of the father of four would greet us. One day, he stated his definitive choice: “Doc, I want to go home already. I am very thankful for everything that you all do for me, but I want to spend my last moments at home. And I really don’t want to be intubated.”

His pain was managed with simple medication—“Doc, I’m good. I promise. The paracetamol and tramadol work perfectly,” he’d reassure us. In his peace and in his ability to articulate his final wish, I saw the portrait of a dignified farmer who had enjoyed his life to the fullest, controlling his exit with profound courage.

Palliative care shouldn’t be the sad, romanticized ending we read in novels. It is a vital branch of medicine, dedicated to fulfilling a person’s wishes and giving them back their dignity. 

Of course, we healthcare professionals are human, and sometimes, tears well up. But it is in these moments that I feel humanity at its peak. Our take-away message is simple: Palliative care is not a failure; it is the ultimate affirmation of a patient’s autonomy. We honor their life by empowering their choices about its conclusion.

About the author

Franco Miguel Nodado is a 4th-year medical student from the Philippines. He currently serves as the National Officer on Human Rights and Peace for the Asian Medical Students’ Association (AMSA-Philippines). Nodado’s advocacy work often emphasizes championing rights and promoting peace in healthcare settings, even when confronting uncomfortable truths. He previously applied this passion as the Editor-in-Chief of the Western Visayas State University College of Medicine’s Vital Signs publication