Abstract
Background: The Francis report into the catastrophic failures of care in a UK NHS hospital Trust identified lack of compassion as a major factor. Developing a ‘culture of compassion’ was emphasized in the Report, but the sources and meaning of compassion and empathy were not discussed further. In this paper we consider aspects of the scientific, theological and philosophical literature covering these key subjects. Findings and discussion: Compassion is an ancient concept found in all of the World’s major religions. Empathy is the intellectual recognition of someone suffering and the emotional response to this and compassion adds in the volition to act to relieve suffering. Karl Jaspers regarded empathic understanding as essential to psychology. Medicine is both an art and a science and as health practitioners we need to be able to view people from both interpersonal and objective perspectives. Exhausted, demoralized and threatened staff cannot sustain empathy and compassion and many UK NHS staff report such feelings. Unregulated empathy can also lead to clinician burnout and failure of compassion is indeed recognized as a symptom of burnout. Empathy shows a high heritability, it develops through the first five years, supported by responsive and consistent parenting. It is asserted that compassion needs to be deeply embedded in our characters, not least through spiritual practices such as meditation, reflection, modeling and direct teaching. In healthcare, compassion is sustained by individual supervision and group reflection.Conclusion: The need for compassion and empathy in healthcare has been highlighted repeatedly since at least 1927. Individuals need support and appropriate systems to enable compassionate care to be given. The NHS in England, UK is under severe strain and the current competitive business model has led to a culture of secrecy and ‘splitting’. In our opinion, the current system is not fit for purpose.
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