What do we need to do to sustain compassionate medical care?

Clinical Ethics, 2013

Philosophical and scientific understandings of compassion converge, both stressing its necessity for the moral life and human flourishing. I conceptualise a dynamic and frangible account of professional virtues, including compassion, and propose that mechanistic organisational systems of care and the biomedical paradigm create a strong risk of dehumanisation and the obliteration of compassion in healthcare. Additionally, the neoliberal market ideology, with its instrumental approach to individuals and commodification of healthcare creates a corrosive influence that alienates clinicians from their patients and severely curtails the scope for compassionate practice. The tension between efficiency and patient orientated care -although they need not be mutually exclusive -has become more acute in the current economic climate, at a time when the boundaries of medicine have broadened and expectations for healthcare have risen. This has created an unsustainable dynamic within which alienated healthcare professionals struggle to fulfil their healing roles and patients experience abandonment and more anxiety.

OBM Integrative and Complementary Medicine

University of Plymouth, 2020

The literature review was carried out following searches of relevant health related databases and once relevant inclusion and exclusion criteria had been met, the resultant literature (n = 160) was analysed using the evolutionary method detailed by Rodgers (2000). Healthcare staff (n = 23) were recruited and asked to recount a story of when either they or a colleague had behaved in a compassionate way within a healthcare setting. Service users (n = 14) were also recruited and asked to tell their story of when they had experienced compassionate care. The data from both cohorts of study participants was then analysed using a phenomenological approach based on a modified version of the methodology described by Moustakas (1994). The final concept is based on a synthesis of the findings from the literature review with those of the fieldwork elements of the study. Analysis of this data has demonstrated that compassion can be defined, that much that is written about allied subjects can be seen as synonymous and that the antecedent conditions needed to enable compassion can be described. Importantly, for future practice, education and research, compassionate behaviours and attributes have been identified.

Ceylon Journal of Medical Science, 2017

Sympathy, empathy and compassion are a family of connected mental states or emotions that relate to understanding and responding to another"s feelings. Compassion can be defined as a feeling that arises when witnessing another"s suffering, and motivates a desire to help. It differs from empathy, which is experiencing another"s feelings, and sympathy (a feeling of sorrow and concern to another"s pain or suffering). There is a public demand for health workers to demonstrate more compassion. This is reflected in compassion being stressed in mission statements of health institutions, and in the goals of regulatory organizations and medical councils. Increasingly, compassion and technical competence are both considered as integral elements of quality care. Despite their acknowledged importance in health care, empathy and compassion are rarely researched or taught explicitly. Measuring compassion is difficult and there is a need for psychometrically validated instruments. As a result, most research is on empathy. Empathy improves diagnostic accuracy, patient satisfaction, drug compliance, and lead to better outcomes (e.g. improved glycaemic control in patients with diabetes). Studies have found a rapid decline in empathy during the undergraduate medical course, believed to be due to poor role models, students experiencing harassments by senior staff, confronting clinical realities that counter student idealism, higher workload, and poor psychosocial support. Facing distressing situations with little support leads to empathic distress. The intensity of the latter is reduced by functioning as teams, listening to each other"s concerns non-judgementally, selfreflection to understand one"s own emotional reactions and cultivation of self-compassion. Skills of self-compassion and compassion towards others may be learnt through contemplative approaches and certain religious meditation techniques (e.g. "Metta" meditation in Buddhism). Sri Lanka could also draw on these indigenous cultural and religious practices and take a lead role globally in the emerging interdisciplinary "science" of compassion and health. Sympathy, empathy and compassion are conceptualized to be a family of connected mental states or emotions. They all relate to understanding and responding to another"s feelings. A simple, yet useful definition of compassion is that it is a feeling that arises in an individual who witnesses another"s suffering and is motivated to help [1]. There are other definitions especially in the context of compassion-based therapies in psychology. In INVITED REVIEW

Clinical Ethics, 2013

BMJ Supportive & Palliative Care, 2020

Compassion is deemed a "basic social emotion" (Nussbaum) and decreed a National Health Service core value—yet, what does ‘compassion’ really mean? Moreover, why is it so important, how can we deliver it best and how do we measure achievement here?This essay will argue that compassion stands apart from other forms of interpersonal engagement as a deeply human recognition of another’s suffering which inherently motivates action to do something about this. There are two inextricable elements here: the role of suffering, and the resultant call to action it motivates.The role of compassion pivots on suffering, and thus, our interpretation of suffering and what we consider its upstream cause: the problem to be fixed. Palliative medicine here stands apart, priding itself on the holistic care of what is important to the patient; thus, the symptoms problematic to the patient are the problem, rather than the underlying cause per se.Compassion drives motivation to act; medicine equip...

Health Professions Education, 2017

Concerns have been periodically raised about care that lacks compassion in health care settings. The resulting demands for an increase in consistent compassionate care for patients have frequently failed to acknowledge the potentially detrimental implications for health care professionals including compassion fatigue and a failure to care for oneself. This communication suggests how mindfulness and self-compassion may advance means of supporting those who care for a living and extends the call for greater compassion to include people working within a contemporary health care setting in the United Kingdom. The potential benefits for both health professionals and patients is implied, and may well help to create a healthier, more authentically compassionate environment for all. & 2016 King Saud bin AbdulAziz University for Health Sciences. Production and Hosting by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Concerns about deficits of compassionate practice in contemporary UK health care have been widely discussed in policy reports, research and media. 1 To address these concerns, a number of policy directives and training have been planned and actioned including value based recruitment , 2 an e-learning program called Compassion in Practice 3 and the adoption of the 6 C's as part of a national strategy i.e., Care, Compassion, Competence, Communication, Courage and Commitment. 4,5 Therefore, the expectation for UK NHS staff to act compassionately is now mandatory, whether it is possible to train people to become (more) compassionate is a separate issue that has been explored in the literature. 6 The emerging question now is how can staff be enabled and supported to consistently act with compassion towards their patients without detriment to their own wellbeing. Recent suggestions and directives aimed at improving the health and wellbeing of healthcare workers, 7 whilst having the primary aim of reducing staff absence, could also be seen as a way of demonstrating care for NHS staff. These initiatives include plans to www.elsevier.com/locate/hpe http://dx.

Background: Recent concerns about suboptimal patient care and a lack of compassion have prompted policymakers to question the preparedness of clinicians for the challenging environment in which they practice. Compassionate care is expected by patients and is a professional obligation of clinicians; however, little is known about the state of research on clinical compassion. The purpose of this scoping review was to map the literature on compassion in clinical healthcare.

International Journal of Practice-based Learning in Health and Social Care, 2014

Compassion is a health professional value that has received a lot of attention recently. In this paper we consider the nature of compassion, its definition and its expression in practice. We further link compassion to patient-centred care. There is debate about whether compassion can be learned, and therefore assessed. There are similar discussions in relation to 'professionalism' and the effects of the hidden curriculum. We conclude that compassion is everyone's business and that learners require early and sustained patient and client contact with time for reflection to enable the delivery of compassionate care.

2015

The absence of compassion, argues the author, is not the cause of healthcare failures but rather a symptom of deeper systemic failures. The clinical encounter arouses strong emotions of anxiety, fear, and anger in patients which are often projected onto the clinicians. Attempts to protect clinicians through various bureaucratic devices and depersonalization of the patient, constitute as Menzies noted in her classic work, social defences, aimed at containing the anxieties of clinicians but ending up in reinforcing these anxieties. Instead of placing additional burdens on clinicians by bureaucratizing and benchmarking compassion, the author argues that proper emotional management and support is a precondition for a healthcare system that offers humane and effective treatment to patients and a humane working environment for those who work in it.