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Thursday, October 9, 2014

Reification and compassion in medicine: A tale of two systems

By Anna Smajdor
Clinical Ethics 
December 2013 vol. 8 no. 4 111-118


In this paper, I will explore ideas advanced by Bradshaw, Pence and others who have written on compassion in healthcare. I will attempt to see how and whether their assumptions about compassion can be justified, and explore the role compassion should play in a modern healthcare system. I will justify scepticism at the idea of attempting to incentivise compassion through metrics. The Francis Report raises important questions concerning the nature of a healthcare system that harms rather than helps patients. If something is failing in modern healthcare, those in charge should naturally seek to remedy it. I will investigate whether this is due to the disappearance of compassion, and if so, what is it that is emerging to fill its place. I will consider whether we need to rehabilitate or enforce compassion in the system, or to acknowledge that our modern healthcare systems are incompatible with compassion and how we can make the best of what remains.

The entire article is here.

Here is an excerpt:

Compassion is neither necessary nor sufficient for the provision of good healthcare

The following assumptions are commonly made about compassion in healthcare:

1. Compassion is intrinsically, rather than instrumentally valuable
2. Compassion is incommensurable
3. Compassion is a necessary attribute for healthcare professionals

In this paper, I do not question the first two assumptions, though it seems plausible that they
could be challenged. Rather, I want to suggest that if we accept the first two assumptions, the
third cannot follow as a matter of course.