C
Intimate care, using the toilet and embarrassment
In an imagined situation, Ilya needs help with clothing after using the toilet. The helper acts quickly and habitually leaves the door open to speak to someone else. Ilya finds it difficult to interrupt. He wants necessary assistance and also wants not to be discussed before an audience. Asking for privacy begins to look like ingratitude.
Epigraph
“In the kingdom of ends everything has either value or dignity.”
Immanuel Kant, Fundamental Principles of the Metaphysic of Morals, section II, the complete sentence in Thomas Kingsmill Abbott's translation. Value here concerns replaceability, while dignity exceeds that measure. This is a philosophical argument, not an assessment of bodily control or clinical capacity to consent.
What this article is about
In an imagined situation, Ilya needs help with clothing after using the toilet. The helper acts quickly and habitually leaves the door open to speak to someone else. Ilya finds it difficult to interrupt. He wants necessary assistance and also wants not to be discussed before an audience. Asking for privacy begins to look like ingratitude.
Intimate help can be needed in different circumstances and does not itself explain a diagnosis. Disability does not always mean illness, and needing care does not turn an adult into a child. This article helps agree one task, privacy conditions, a way to participate and a professional question. It teaches no skin-cleaning, transfer or procedural technique and selects no product. Ethical conduct and bodily care are related, but a fine attitude does not replace competent action.
I. Asking for assistance does not authorise disclosure
Ilya may request help with clothing without inviting others to hear details. Buying supplies, performing an action and sharing information are different tasks. Necessary information depends on the recipient: a medical professional may need one thing, someone carrying out an everyday errand another.
NICE CG138 sections 1.2.1 and 1.2.9 connect adult care with respect, confidentiality, participation and privacy for personal needs. This is NHS guidance for England and Wales, not a legal ruling for every country. It provides a concrete quality reference rather than proving care is already organised.
Who needs to be present and which information is necessary can be discussed. Limiting disclosure does not require declaring the issue shameful. Shame and privacy differ: someone can be comfortable with a bodily need while not wanting an audience. Helpers may need support too, but that does not automatically require retelling every intimate detail to acquaintances.
II. Convenience of care does not measure a person's importance
Kant distinguishes replaceable value and dignity through rational nature and the kingdom of ends. A person must not be treated merely as a means to another's task. Here this helps reveal a substitution: attention goes entirely to efficient handling, while Ilya's answer becomes an obstacle.
Kantian autonomy cannot simply mean independent toileting. His philosophical argument is not a bodily-control, speech or cognition test. Respect is extended here to everyone, including people with substantial difficulties understanding. This is our explicit position rather than a diagnostic inference from Kant.
Dignity does not make a helper's time infinite. Duration, distribution and resources can be discussed without humiliating the recipient. An exact limit helps more than an irritated suggestion that assistance must be earned through causing little inconvenience. Resource limits and human worth answer different questions.
III. Reciprocity does not reveal another's preference
In Analects 15.24, Confucius answers Zigong's question about a lifelong rule by advising against doing to others what one would not want oneself. The digitised Legge edition labels the passage XV, XXIII. It concerns restraining one's own impositions through reference to oneself.
This is a useful beginning for a helper, but not Ilya's entire answer. One person prefers a relative, another a professional. One wants a brief explanation at each step, another needs only a clear explanation beforehand. Imagining oneself unembarrassed does not determine another's agreement.
Kant's footnote to the humanity principle specifically criticises reducing moral law to the usual reciprocity rule. Their comparison therefore does not claim identical traditions. Confucian restraint and Kant's argument about ends have different foundations. In everyday application both still need the person's actual answer; neither selects care technique.
IV. Agreement needs to be accessible and specific
In an ordinary safe situation, briefly explain the proposed action and ask which part needs help. Agreement to prepare belongings need not mean agreement to direct touch. Previous agreement does not automatically answer a changed task. This is clarification of what matters rather than endless questioning.
Difficulty speaking calls for an accessible response method. Silence must not become convenient confirmation. CG138 sections 1.1.2 and 1.5 address participation and suitable communication. Speaking only to a helper may be faster, but speed does not establish quality. The question is addressed to the person accessibly and to an appropriate extent.
Refusal may concern pain, timing, method or a particular helper; it must not automatically be called a whim. Advice to pause, however, does not authorise leaving necessary care absent. Danger, an unclear response or questions about capacity to consent require the appropriate professional and local legal process. This article gives families no authority to coerce and establishes no universal safe waiting period.
V. Skill does not arise from kinship or good intentions
Being close and knowing how to perform a bodily action safely are different things. Preparing belongings, transferring someone and undertaking an intimate procedure are different tasks. An unfamiliar technique needs clarification from an appropriate professional rather than learning through the recipient's pain.
CG138 section 1.5.17 calls for suitable information about medicines and equipment; NHS bowel-incontinence information includes individual skin and product advice. No cleaning technique, cream, body position, exercise or invasive action is derived here. Having a package does not mean knowing how to use it.
A helper can state a limit: one errand is possible, another task is unfamiliar. This identifies a missing resource rather than a moral failure. Necessary assistance still needs arranging. The person struggling need not coordinate the whole system alone while appearing grateful for every unsuitable action.
VI. A bodily change is not explained by calling it usual
NIDDK recommends professional assessment for bladder problems. Bowel-control difficulties require their own question. Similar practical consequences do not establish identical causes or treatment. Existing disability and age do not automatically explain a new change.
Some needs cannot wait for a convenient conversation. NIDDK advises care without delay for inability to pass urine or empty the bladder, blood in urine and painful urination. The NHS calls for urgent contact with black or dark red stool or bloody diarrhoea. These are examples rather than an exhaustive list or home risk-exclusion method. Immediate danger requires urgent medical help before practice.
In an ordinary consultation, describe what changed and which need remains unsupported. This article selects no fluids, diet, medicines, holding exercises or toilet routine. Saving supplies and reducing others' embarrassment are not grounds for independently changing a medical plan.
VII. Privacy needs actual conditions
Ilya's question may begin with a door, an unnecessary listener and a clear way to request help. A closed door alone does not guarantee safety or needed participation. Conditions must be discussed for the particular person and action. No general rule replaces assessment of necessary care.
An accessible-toilet sign also does not establish usable access: actual barriers and a suitable method matter, and this article has not checked them for the reader. Without a helper, purchasing a service is not a ready solution without money and an available provider. A telephone number is not assistance already obtained.
One unmet need can be named to an appropriate health or social care contact. Services and procedures depend on location; free provision is not promised. When an ideal option is absent, distinguish what has been agreed from what remains unsafe or unmet. Necessary care must not be the price paid for privacy.
VIII. Ordinary life remains after care
Bodily assistance creates no entitlement to sexual intimacy, disclosure of every feeling or a particular expression of gratitude. Someone may want conversation, solitude, a relationship or another subject. These wishes need not be reduced to reactions to care or guessed from a couple's history.
After assistance Ilya may want to return to his activity without another hour of discussion. The helper may have a question about future involvement. Discuss it separately and specifically, without turning bodily need into a duty to comfort everyone else. A good agreement leaves room for both people.
The nearest outcome is particular help through an appropriate method, needed privacy and a clear professional question. It proves neither removal of a cause nor stability of the whole system. It nevertheless changes Ilya's position: his answer becomes part of care, while assistance does not absorb every relationship and the rest of life.
What this means in practice
First account for medical urgency: the new symptoms above do not wait for a discussion of embarrassment; immediate danger requires urgent help. In an ordinary situation, choose one care task and clarify its action, accessible response method, suitable helper and presence of others with the person.
Separate agreement from what is still absent. No diary, app purchase or family is compulsory. If skill, supplies or a person are missing, name the unmet need to an appropriate contact. Do not learn technique through pain or change fluids, diet, medicines, procedures or necessary care through this article.
After help, one question about whether the method suited and what adjustment is needed may suffice. Do not demand a gratitude report. Agreement, completed action and medical improvement are different outcomes. Embarrassment need not disappear before respectful treatment begins.
Key quotation
“What you do not want done to yourself, do not do to others.”
Confucius, Analects, commonly 15.24; XV, XXIII in the digitised Legge edition, answering Zigong on reciprocity. The complete sentence in the English version. Another's preference must be learned rather than replaced by one's own.
Connections between traditions
| Foundations | Connection and difference |
|---|---|
| Kant section II / Analects on reciprocity | Not reducing someone to convenience and restraining imposition are related questions with different foundations. Kant himself challenges the usual reciprocity rule's sufficiency. |
| Kant / bodily assistance | Dignity exceeds replaceable utility. Autonomy is not measured by bodily control; respect for all is our explicit position here. |
| Confucius / a recipient's preference | Looking to oneself can restrain imposition without revealing another's wishes. An accessible answer is needed. |
| CG138 / everyday care | Participation and privacy need conditions and competence. NHS guidance does not establish worldwide law and services. |
| NIDDK, NHS / timing | Assessing causes and sensitive assistance do not replace each other. Embarrassment must not delay needed medical contact. |
Primary sources
- Kant, Fundamental Principles, section II, Thomas Kingsmill Abbott; selected argument on humanity as an end, reciprocity footnote and dignity read. Not the entire book or a clinical capacity assessment.
- Confucius, Analects Book XV, James Legge; selected context and reciprocity answer. Short RU/TH quotations are translated from English rather than Chinese or German.
- NICE CG138, 24 February 2012, updated 17 June 2021; visible recommendations read through the browser. Respect, personal needs, communication and equipment knowledge used, without claiming linked national laws read.
- NIDDK, Symptoms & Causes of Bladder Control Problems, reviewed July2021; main body read. Timing of assessment, without treatment selection.
- NHS, Bowel incontinence, reviewed 15 August 2024; main body read, video not watched. Urgency and individual support, without UK numbers or procedures.
Tags
intimate care, using the toilet, embarrassment, privacy, dignity, agreement, participation, adult language, bodily assistance, accessible communication, personal information, incontinence, bladder, bowel, medical assessment, urgency, skills, care supplies, helper, resources, absent family, limited money, Kant, Confucius, reciprocity, ordinary life
About the authors
Andrey Zarinsh is the author and founder of United Wisdom. He explores inner transformation, unity across traditions, intercultural dialogue, and contemporary spiritual discipline. Instagram: @andrey.zarinsh.
Maria Evilkut is a co-author of United Wisdom. Alongside her research, she seeks to test these ideas in practice and observe how principles of unity and mutual understanding work in real life between people and cultures. Instagram: @ilkutki.