Disrespect in health care often persists despite firm commitments to respectful service provision. This conceptual paper
highlights how the ways in which respect and disrespect are characterised can have practical implications for how well
disrespect can be tackled. We stress the need to focus explicitly on disrespect (not only respect) and propose that
disrespect can usefully be understood as a failure to relate to people as equals. This characterisation is consonant with some
accounts of respect but sometimes obscured by a focus on respecting people’s autonomy and dignity. Emphasising equality
is consistent with connections patients draw between being (dis)respected and (in)equality. It readily accommodates microaggressions as forms of disrespect, helping to understand how and why experiences of disrespect may be unintentional and to explain why even small instances of disrespect are wrong. Our view of disrespect with an emphasis on equality strengthens the demand that health systems take disrespect seriously as a problem of social injustice and tackle it at institutional, not just individual levels. It suggests several strategies for practical action. Emphasising relational equality is not an easy or short-term fix for disrespect, but it signals a direction of travel towards an important improvement ambition.
Original languageEnglish
Pages (from-to)42-50
Number of pages9
JournalJournal of Health Services Research and Policy
Issue number1
Early online date27 Jul 2023
Publication statusPublished - Jan 2024


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