BMS 115 · Common Core (Tronc commun)Section 1.2 · Foundations of health care ethics
Section 2 of 15
The human person and the ethical dimension
Explain what the notes mean by a person, describe the five aspects of the human person — ontological singularity, being-in-the-world, being with others, historical and in progress, open to transcendence — and derive the ethical respect they require.
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Why this matters
Every rule you will learn later — consent, confidentiality, truth-telling, respect for life — rests on an answer to a question you have probably never been asked out loud: what is a person? If a patient is only a body with a problem, then washing, turning and medicating exhaust your duty. If a patient is the being the notes describe, then the same acts are addressed to someone who thinks, belongs to a family, has a history and may hold a meaning larger than his diagnosis. This section gives you that answer, and it also shows why the answer is contested: every definition of the person has been used somewhere to decide who is included and who can be quietly excluded.
What you need to know first
No philosophy is required. Bring one habit you already have: when you meet a patient, you notice things about him that his file does not contain — how he speaks, whom he asks for, what he is afraid of losing. This section simply organises those observations and shows what follows from them.
Words to know (5)
Person
A being who has capacities such as reason, morality and consciousness, and who belongs to culturally established social relations such as kinship, property or legal responsibility. A patient who has lost speech after a stroke remains a person, because personhood is not a test he must keep passing.
Ontological singularity
The claim that each human person is one of a kind: a rational and free individual, sole mistress of her actions, at once body and soul. Two patients with the same diagnosis receive different care plans because each is a singular person with her own circumstances.
Being-in-the-world
The condition of a person who lives in the world, communicates with it, is open to it, and can transform it by work while discovering physical and moral demands. A hospitalised farmer is separated from his field, his animals and his income, and that separation is part of the clinical picture.
Transcendence
The openness of the human person to a destiny and a meaning that go beyond the observable world; the notes say faith reveals the complete meaning of his being. A patient asks for a chaplain before a risky operation, and the request belongs to his care, not to a separate department.
Reciprocity of I and you
The notes’ warning that a person arises in the exchange between an I and a you, so the reference to the person can never be read as a narrow individualism. Asking the patient what he wants and, with his agreement, involving the people who will care for him at home respects reciprocity.
One idea at a timeIdea 1 / 7
In one sentence A person is not only a living body: a person has capacities such as reason, morality and consciousness, and belongs to social relations such as kinship, property or legal responsibility.
A person is a being with reason, morality and consciousness
The notes begin with a definition before any rule: a person, male or female, is a being who has certain capacities or attributes such as reason, morality and consciousness, and who is also part of a culturally established form of social relations — kinship, ownership of property, legal responsibility. The philosophical approach treats the human person as the subject of moral action, and it puts two questions to the caregiver: who is this man or woman that you are to care about, and what do you know of yourself? The Greek injunction know thyself is not an ornament; it asks the professional to examine what he or she brings to the bedside.
For example
A patient who cannot speak after a stroke is still a person: the capacities and the social ties did not disappear with the words. The team must therefore find another way to learn what he wants, by asking the family and by reading the record.
Pause and check yourself
A patient with advanced dementia can no longer reason and no longer manages her property. Does she stop being a person under this definition?
Show the answer
No. The definition lists capacities and social relations as what a person has, not as an examination she must keep passing. Losing reason or property changes what she can do; it does not remove her from the human family or cancel the respect owed to her. The difficulty of the marginal cases begins when the list is read as a checklist.
Read detailed explanations
How the word person was built: Boethius, Kant and the human-rights articles
The definition you have just read was not invented for nursing. In the sixth century Boethius defined a person as an individual substance of a rational nature — persona est rationalis naturae individua substantia — and that formula passed from theology into law. Two consequences followed. First, rationality became the test of who counts, which is why philosophers still argue about marginal cases: the newborn, the person with advanced dementia, the patient in a vegetative state, where the capacity to reason cannot be observed. Second, the capacity was paired with an unconditional worth. Kant expressed that pairing as a practical rule: act so that you treat humanity, whether in your own case or in another’s, always at the same time as an end, and never merely as a means. Notice what the rule forbids: it forbids using a patient as an instrument for teaching, for research, for the reputation of the service or for the tranquillity of the family. Positive law has since written the same idea into binding texts. Article 1 of the Universal Declaration of Human Rights, adopted in Paris in 1948, states that all human beings are born free and equal in dignity and rights and are endowed with reason and conscience. Article 2 forbids any distinction of any kind, such as race, colour, sex, language, religion, political or other opinion, national or social origin, property, birth or other status. The International Covenant on Civil and Political Rights, in force since 1976, adds in Article 10 that all persons deprived of their liberty shall be treated with humanity and with respect for the inherent dignity of the human person. The clinical consequence is concrete: the vaguer your appeal to dignity, the easier it is to override. Naming the article, the capacity at stake or the Kantian formula gives the team an argument that can be examined and a decision a committee or a court can review.
From the five aspects to the ward: total pain, the dignity model and the care plan
The five aspects are not a lecture ornament; each one has an instrument that nurses already use. Cicely Saunders, working at St Christopher’s Hospice in London from 1967, observed that suffering does not arrive in one piece and described total pain as the sum of four interacting components: physical, psychological, social and spiritual. Those four map directly onto the aspects — the body and its singularity, the interior life, the relationships, and openness to transcendence — and treating only the physical component explains the frequent failure in which analgesia is adequate and the patient still suffers. The second instrument is the dignity model published by Harvey Chochinov and colleagues in 2002 from interviews with terminally ill people. It holds that dignity is maintained or undermined through illness-related concerns, a repertoire of preserved self, and a social dignity inventory, and it is taught to clinicians through the mnemonic ABCD — attitude, behaviour, compassion, dialogue. The third instrument is the nursing process itself, the cycle of assessment, diagnosis, planning, implementation and evaluation. Assessment is where the philosophical claim becomes an obligation: you cannot record a spiritual need, a fear of being a burden or a family conflict unless you ask about it, and what is not recorded is not planned. The tools therefore do different jobs. Total pain tells you which dimensions to look for. The dignity model tells you what threatens the person’s worth. The care plan turns both into named actions with a review date. A student who can move between the three can explain, in a handover, why a patient who is medically stable is still deteriorating.
The usual mistake: splitting the person, and the objectifying gaze
Once you define a person as a thinking substance joined to a machine, a ward can quietly care for only one half. René Descartes made that split explicit in the seventeenth century: res cogitans, the thing that thinks, and res extensa, the thing extended in space, were for him two distinct kinds of substance. The objection is not that Descartes was foolish but that the picture is unstable, because a human being does not experience herself as a pilot in a cockpit. The nursing consequence is an objectifying gaze in which the body on the trolley is handed over, washed, turned and medicated while the occupant is not addressed at all. Notice that the fault is not cruelty; it is a habit, and it survives because it is efficient. The corrective is embodiment: the body is not something a person possesses, it is how a person is present to the world, so washing a patient, positioning a limb or inserting a catheter are acts of relationship and cannot be delegated to technique. Two checks catch the habit before it becomes harm. The first is linguistic: read your own handover aloud and count how many sentences have the patient as the grammatical subject rather than as the object of a task. The second is procedural: any intimate care is preceded by an explanation and an invitation, and the patient’s refusal — even of a wash — is recorded and answered, not overridden for convenience. Consent is not exhausted by the signature on a surgical form; it is renewed at every touch.
Explore the diagram
Look at the whole drawing first. Then select one numbered part and connect it to the idea you just read.
The human person: five aspects and one ethical demand
One being, described from five angles that the lecture notes name one after another. Select any part to read what it claims and what it changes at the bedside.
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01 / 7The human person
If the drawing is wider than this panel, scroll it sideways. Labels stay readable; the numbered explanations below show the same ideas.
The human person
Everything on this plate hangs from this band. The notes make the human person the subject of moral action and put two questions to the caregiver: who is this man or woman that you are to care about, and what do you know of yourself? The Greek injunction to know thyself is not an ornament; it asks you to examine what you carry into the room before you touch anyone. Notice the grammar of care: the person, not the disease, is the subject of the sentence.
Teaching schematic. The five aspects describe the same person; the shared line returns each aspect to that person. Numbers identify selectable explanations, not stages or separate people.
Key points to remember
✓A person is a being with reason, morality and consciousness who belongs to culturally established social relations; the caregiver’s first question is who this person is, not what disease he has.
✓The notes describe five aspects: ontological singularity (unique, rational, free, body and soul); being-in-the-world (open to the world and transformed by work); being with others (dialogue and a universal vocation to love); historical and in progress (not a fixed fact); open to transcendence (a destiny and a meaning beyond the observable).
✓Because human subjects share one nature beyond their differences, the same values can be sought for all, and the person arises in the reciprocity of I and you rather than in a narrow individualism.
✓The ethical dimension of the person is respect: respect for life, for freedom, for the search for truth and for justice for all — and each of these follows from what the person is, not from a preference.
Go deeper
Worked example
The grandmother who insists on going home alone. Mrs A., 74, is a retired primary-school teacher, widowed, who lives alone in the family compound. She runs a small shop in her front room and is the one who pays her grandson’s secondary-school fees. She was admitted after a fall and now has a fractured wrist and newly diagnosed hypertension. She is medically ready for discharge, but her son wants her to move into his house in another region so that she is not alone. Mrs A. refuses: the compound is where her husband is buried, the shop is her income, and she attends Mass there every morning; she says she wants to die in her own house. She is oriented and answers questions coherently, but she has mislaid her reading glasses twice and cannot yet say how she will remember the new tablets.
Start from the subject and test the decision, not the diagnosis. Establish what she understands about the discharge, what she can repeat back, and whether she appreciates the consequences of living alone. She can communicate a choice, understand the plan and reason with it, so she has decision-making capacity, and that finding is written in the file. It settles the rest of the case: because she has capacity, no formal best-interests process is opened and the ethics committee is not the route — her own stated wish governs.
Read the discharge through her world. The obstacle is not the hospital but the shop, the school fees and the walk to Mass. Ask what she can still do with a healing wrist, who can carry stock or mind the shop, and how far the health post is from the compound. The answer decides whom the team contacts next: because the shop is her income and the health post is her follow-up, the team asks the son and the parish to arrange practical support and writes a referral to the local health post, rather than simply sending her home.
Take her relations seriously, and find the limit. She has not told her son about the hypertension, and he is the one proposing to move her in. Ask her exactly what he may be told. Because family pressure is already shaping the discharge, this finding changes the next step: if she refuses disclosure, the nurse gives the son general information about her recovery and renegotiates confidentiality explicitly, and the care plan is built around what she has authorised rather than around what the family assumes.
Treat the plan as a moment in a history, not a verdict. A wrist heals, blood pressure stabilises and memory for new routines can improve with support. Set a review date and choose simple aids — a pill organiser, a neighbour’s reminder, a follow-up appointment — because the answer here becomes the review clause in the plan. The point is not that she is declining; it is that what she can do next month may differ from today.
Handle transcendence and close the loop with what the earlier steps decided. Ask what her faith requires and what the compound means to her, record her own words, and make room for the priest she names. Because step 1 found capacity, the plan follows her wish; because step 3 settled what the son may be told, the family conversation is built on that authorisation; no ethics committee is engaged, and the only remaining condition is the review date from step 4.
The team does not override her and does not abandon her to a plan she cannot keep. The discharge follows her stated wish because she has capacity; her son is given only what she authorised; the shop, the parish and the health post are given named roles; and a review date turns the arrangement into something that can be checked. What the five aspects change here is the sequence of the decisions: the capacity finding sends the case away from the committee, the answer about the shop decides whom the team contacts, and the family’s attitude decides how confidentiality is handled. The process, not the verdict, is what a nurse can control.
Common misconception
The beginner’s mistake is to hear the phrase the human person as a piece of abstract philosophy that belongs in an examination and disappears at the ward door. The opposite is true: the five aspects are the most practical content in the chapter. The second mistake, harder to see, is to treat the person as a self-sufficient individual who owns his choices, so that respect means leaving him alone with them. The notes explicitly refuse that reading: the person arises in the reciprocity of I and you, so care is a relationship, not a transaction. A third mistake follows from the first: beginners imagine that dignity is earned by capacities, so that a patient who can no longer reason, speak or work makes a smaller claim on us. If dignity depended on capacities, the ward would have to rank its patients every morning; the notes claim dignity for the human being because of what he is.
Check your reasoning
Think of a patient or a relative you have seen treated as a body rather than as a person — a curtain left open, a question left unanswered, a name replaced by a bed number. Which of the five aspects was most clearly disregarded: the singularity, the world they came from, the people around them, their history, or the meaning they gave to their illness?
Reveal an answer
Most people find that more than one aspect was ignored at once, which is normal: the aspects describe one being from five angles, not five separate duties. Naming the one that mattered most in that scene turns a memory of indignity into something you can act on. If it was the singularity, you will introduce yourself and use the patient’s name. If it was the world, you will ask what he must return to. If it was the people, you will ask who should be told and with whose permission. If it was the history, you will read yesterday’s notes before you speak. If it was the meaning, you will ask what the illness means to him and let the answer stand.
Where this comes from
BMS 115 Health Care Ethics lecture notes (Mme Bakume Jessey) · Chapter 1 — PHILOSOPHICAL CONCEPT (NOTION) OF THE MAN: ‘A PERSON’, the five aspects (ontological singularity; being-in-the-world; being with others; historical and in progress; open to transcendence), and ‘Concept of the man seen through its ethical dimension’ (source notes lines 34–50).
BMS 115 Health Care Ethics lecture notes — reading corrections used in this section · the notes’ ‘kingship’ (line 37) is read as kinship, parenté — a mistranslation of the French parenté; ‘man’ is used throughout the notes in the inclusive sense of the human person, as the heading ‘A PERSON (male or female)’ confirms; and ‘achive’ (line 44) is read as achieve.
C. Saunders (St Christopher’s Hospice, London) — total pain; H. Chochinov et al. (2002) — dignity model and the ABCD mnemonic · named clinical instruments used in the detailed explanation to turn the five aspects into an assessment and a care plan.
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About this course and its sources
Bilingual lessons organised from the supplied BMS 115 Health Care Ethics lecture notes (Mme Bakume Jessey, St Louis University Institute Douala) and the international texts those notes reproduce — the Universal Declaration of Human Rights 1948, Pacem in terris 1963, the African Charter on Human and Peoples’ Rights (drafting launched at Monrovia in 1979 by Decision 155; adopted 1981; in force 21 October 1986), the 1959 Declaration of the Rights of the Child, the ICN codes of 1953 and 1973, and the Cameroon code of ethics of 3 March 1989. The short guided notes and the longer “Read detailed explanations” panels are written as two different jobs: the notes state one idea plainly, and the detailed panels add mechanism, vocabulary and worked judgement that the notes do not contain. Diagrams are original teaching schematics. Ethics, nursing and French-language review are pending.