Recognition

Recognition theory, as formulated by Honneth among others, analyses societal dynamics in terms of a struggle for recognition. It states that it is a necessary condition for freedom, autonomy and self-development that individuals in a given society feel recognised as beings whose aspirations, values and goals are legitimate and worthy to strive for. Our ability to lead good lives and develop/maintain healthy identities strongly relies on successful relations of social recognition. Three levels of inter-human recognition can be distinguished. Each level pertains to a different domain of human existence.

 
The first level of recognition is modelled on the unconditional love between parents and children. This type of recognition teaches individuals to perceive themselves as creatures worthy of being loved. If this initial relationship of recognition is flawed, it negatively impacts our sense of self throughout our lives.

 
The second level of recognition is modelled on the relationship between citizens and society. This type of recognition teaches individuals that they are recognised and respected as equal subjects of a societal legal order, which comes with fundamental rights and duties. If this type of recognition is flawed, people can be denied equal access to certain rights and goods in society (such as education or healthcare), for example because they belong to a societal minority. This impedes both their sense of self and their sense of citizenship.

 
The third level of recognition is also modelled on a relationship between individual and community, but whereas the second level stresses the equality of citizens, the third level focuses on the diversity and individual uniqueness of persons. Recognition of this third type implies that people are acknowledged as unique individuals who are able and entitled to strive for personal goals in life that they find meaningful. If this type of recognition is absent, people can feel like they are denied the opportunity to strive for certain goals because they don’t match the dominant cultural expectations of their societal subgroup.

Applied to our context of the healthcare experiences of older persons from diverse minorities, we should be aware that being part of a minority already often comes with a diminished experience of social recognition, due to various forms of discrimination. But the healthcare system in itself and the attitude of healthcare professionals is also very impactful. Various biases and assumptions can (unconsciously) prevent healthcare professionals from granting their patients with diverse minority backgrounds the full status of agents, thereby risking to not take seriously their claims to equal treatment and the legitimacy of their personal life goals and values.