Why and How Is Compassion Necessary to Provide Good Quality Healthcare?

Document Type: Editorial

Author

Warwick Business School, University of Warwick, Coventry, UK

Abstract

Recent disclosures of failures of care in the National Health Service (NHS) in England have led to debates about compassion deficits disallowing health professionals to provide high quality responsive care. While the link between high quality care and compassion is often taken for granted, it is less obvious how compassion – often originating in the individual’s emotional response – can become a moral sentiment and lead to developing a system of norms and values underpinning ethics of care. In this editorial, I argue why and how compassion might become a foundation of ethics guiding health professionals and a basis for ethics of care in health service organisations. I conclude by discussing a recent case of prominent healthcare failure in the NHS to highlight the relationship between compassion as an aspect of professional ethics on the one hand, and values and norms that institutions and specific policies promote on the other hand.

Highlights

Commentaries Published on this Paper

  • Healthcare and Compassion: Towards an Awareness of Intersubjective Vulnerability; Comment on “Why and How Is Compassion Necessary to Provide Good Quality Healthcare?”

            Abstract | PDF

  • Why the Critics of Poor Health Service Delivery Are the Causes of Poor Service Delivery: A Need to Train the Policy-makers; Comment on “Why and How Is Compassion Necessary to Provide Good Quality Healthcare?”

            Abstract | PDF

  • Why and How Is Compassion Necessary to Provide Good Healthcare? Comments From an Academic Physician; Comment on “Why and How Is Compassion Necessary to Provide Good Quality Healthcare?”

            Abstract | PDF

  • Beyond Compassion: Replacing a Blame Culture With Proper Emotional Support and Management; Comment on “Why and How Is Compassion Necessary to Provide Good Quality Healthcare?”

            Abstract | PDF

  • Compassion Is a Necessity and an Individual and Collective Responsibility; Comment on “Why and How Is Compassion Necessary to Provide Good Quality Healthcare?”

            Abstract | PDF

  • Is It Possible to Develop a Compassionate Organization?; Comment on “Why and How Is Compassion Necessary to Provide Good Quality Healthcare?”

            Abstract | PDF

  • Imagined in Policy, Inscribed on Bodies: Defending an Ethic of Compassion in a Political Context; Comment on “Why and How Is Compassion Necessary to Provide Good Quality Healthcare?”

            Abstract | PDF

  • Why Good Quality Care Needs Philosophy More Than Compassion; Comment on “Why and How Is Compassion Necessary to Provide Good Quality Healthcare?”

            Abstract | PDF

 

Author’s Response to the Commentaries

  • What Money Cannot Buy? Compassion in Healthcare: A Response to the Recent Commentaries

            Abstract | PDF

Keywords

Main Subjects


1.     Leget C, Olthuis G. Compassion as a basis for ethics in medical education. J Med Ethics 2007; 33, 617–20. Doi: 10.1136/jme.2006.017772

2.     Flynn M, Mercer D. Is compassion possible in a market-led NHS? Nursing Times 2013; 109: 12-4.

3.     Fotaki M. On compassion, markets and ethics of care. Centre for Health and the Public Interest; 2013. Available from: http://chpi.org.uk/on-compassion-markets-and-ethics-of-care/

4.     Francis R. Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry (ed). The Mid Staffordshire NHS Foundation Trust Public Inquiry. London; 2013.

5.     Donnelly L. Stafford Hospital: the scandal that shamed the NHS [internet]. 6th January, 2013. Available from:

6.     Cole-King A, Gilbert P. Compassionate care: The theory and the reality. Journal of Holistic Health Care 2011; 8: 29-37. 

7.     Gilbert P, Choden K. Mindful Compassion: Using the Power of Mindfulness and Compassion to Transform Our Lives. London: Constable-Robinson; 2013.

8.     Gilbert P. Compassion Focused Therapy: The CBT Distinctive Features Series. London: Routledge; 2010.

9.     Brown B, Crawford P, Gilbert P, Gilbert J, Gale G. Practical compassion: Repertoires of practice and compassion talk in acute mental healthcare. Sociol Health Illn 2014; 36: 383-99. Doi: 10.1111/1467-9566.12065

10.   Tronto JC. Creating caring institutions: Politics, plurality, and purpose. Ethics and Social Welfare 2010; 4: 158-71.

11.   Smajdor A. Compassion is not the answer to failings in the NHS. The Guardian [internet]. 19th September 2013. Available from: http://www.theguardian.com/healthcare-network/                     2013/sep/19/compassion-failings-nhs 

12.   Halpern J. From a Detached Concern to Empathy. Humanizing Medical Practice. Oxford: OUP; 2001.

13.   Matthews DA, Suchman AI, Branch WT. Making ‘connexions’: Enhancing the therapeutic potential of patient-clinician relationship. Ann Intern Med 1993; 118: 973-7. Doi: 10.7326/0003-4819-118-12-199306150-00010

14.   White M. Kantian Ethics and Economics: Autonomy, Dignity, and Character. Berkeley: Stanford University Press; 2011.

15.   Ross KL. Immanuel Kant (1724-1804). 2008. Available from: http://www.friesian.com/Kant.htm#note-1

16.   Schopenhauer A. The Basis of Morality (trans. E.F.J. Payne). New York: Bobbs-Merrill; 1995.

17.   Solomon R. The moral psychology of business: care and compassion in the corporation. Bus Ethics Q 1998; 8: 515-33. Doi: 10.2307/3857435

18.   Andre J. Learning to see: moral growth during medical training. J Med Ethics 1992; 18: 148-52.

19.   Noddings N. Caring. Los Angeles: University of California Press; 1984.

20.   Gilligan C. In A Different Voice. Cambridge: Harvard University Press; 1982.

21.   Butler J. Giving An Account of Oneself. New York: Fordham University Press; 2005.

22.   Fotaki M. Can consumer choice replace trust in the National Health Service in England? Towards developing an affective psychosocial conception of trust in health care. Sociol Health Illn 2014; 36: 1276-94. Doi: 10.1111/1467-9566.12170

23.   Berlant L. Compassion: The Culture and Politics of an Emotion. London and New York: Routledge; 2004.

24.   Poppke J. Geography and ethics: everyday mediations through care and consumption. Prog Hum Geogr 2006; 30: 504-12. Doi: 10.1191/0309132506ph622pr

25.   Guyett GH, Haynes B, Jaeschke RZ, Cook DJ, Green L, Naylor CD, et al. Users’ guide to the medical literature: XXV. Evidence-based medicine: principles for applying the users’ guides to patient care. JAMA 2000; 284: 1290-6. doi: 10.1001/jama.284.10.1290

26.   Bazerman M, Banaji M. The social psychology of ordinary ethical failures. Soc Justice Res 2004; 17: 111-5. Doi: 10.1023/b:sore.0000027544.56030.04

27.   Schwartz H. Anti-social actions of committed organizational participants: An existential psychoanalytic perspective. Organization Studies 1987; 8: 327-40. Doi: 10.1177/017084068700800403

28.   Fotaki M, Hyde P. Organizational blind spots: Splitting, blame and idealization in the National Health Service. Hum  Relat 2014; 68: 441-62. Doi: 10.1177/0018726714530012

29.   Ferlie E, McGivern G, FitzGerald L. A new mode of organizing in health care? Governmentality and managed networks in cancer services in England. Soc Sci Med 2012; 74: 340-7. Doi: 10.1016/j.socscimed.2011.03.021

30.   Weng HY, Fox AS, Shackman AJ, Stodola DE, Caldwell JZ, Olson MC, et al. Compassion training alters altruism and neural responses to suffering. Psychol Sci 2013; 24: 1171-80. doi: 10.1177/0956797612469537