A moment for compassion: emerging rhetorics in end-of-life care

Abstract

Compassion is an emotional response to the suffering of others. Once felt, it entails subsequent action to ameliorate their suffering. Recently, ‘compassion’ has become the flagship concept to be fostered in the delivery of end-of-life care, and a rallying call for social action and public health intervention. In this paper, we examine the emerging rhetorics of compassion as they relate to end-of-life care and offer a critique of the expanding discourse around it. We argue that, even where individuals ‘possess’ compassion or are ‘trained’ in it, there are difficulties for compassion to flow freely, particularly within Western society. This relates to specific sociopolitical structural factors that include the sense of privacy and individualism in modern industrialised countries, highly professionalised closed health systems, anxiety about litigation on health and safety grounds, and a context of suspicion and mistrust within the global political scenario. We must then ask ourselves whether compassion can be created intentionally, without paying attention to the structural aspects of society. One consequence of globalisation is that countries in the global South are rapidly trying to embrace the features of modernity adopted by the global North. We argue that unrealistic assumptions have been made about the role of compassion in end-of-life care and these idealist aspirations must be tempered by a more structural assessment of potential. Compassion that is not tied to to realistic action runs the risk of becoming empty rhetoric.

Compassionate leadership in palliative and end-of-life care: a focus group study

“…It has been noted that compassion is 'having a moment' in contemporary palliative and endof-life care discourse, although there is a need for caution if unrealistic expectations about its potential are to be avoided because there are difficulties for compassion to flow freely, particularly within Western society (Zaman et al, 2018). Although the number of participants in the study was low, this is more a reflection of the nature of their work pressures and difficulties in securing time to attend the focus groups rather than a lack of (King's Fund, 2017), and compassion, respect and humanity from frontline staff need to be better supported and engendered by a leadership community that holds these qualities as central to the core mission and purpose of the NHS (Storey and Holti, 2013), then the key components of compassion-attending, understanding, empathising and helping (Atkins and Parker, 2012)must be demonstrated by NHS leaders through their leadership of health care organisations, at every level .…”

The epidemic of compassion fatigue

“…Surely we all went into medicine to 'help' people, and compassion is one of the simplest and most effective ways of doing this. 2 In my personal and professional experience, simple acts of kindness are being neglected. Have we become 'too busy' to show kindness, or has medical school conditioned us to see only pathology and physiology rather than emotion?…”

“…Literature demonstrates that compassion fatigue can result in a pervasive negative attitude that affects patient care and professional well-being. 2 To avoid a recurrence of events such as those that occurred in Mid-Staffordshire in the UK, where inadequate care (driven by poor staffing and low morale) led to innumerable avoidable deaths, we need to reignite our compassion. 4 Schwartz rounds, supervision and education in self-care have been interventions that have shown reductions in compassion fatigue and burnout, and I believe should be encouraged for all medical staff across Australasian hospitals.…”

“…It disappoints me that as medical professionals we are missing opportunities to show our compassion. Surely we all went into medicine to ‘help’ people, and compassion is one of the simplest and most effective ways of doing this …”

“…Literature demonstrates that compassion fatigue can result in a pervasive negative attitude that affects patient care and professional well‐being . To avoid a recurrence of events such as those that occurred in Mid‐Staffordshire in the UK, where inadequate care (driven by poor staffing and low morale) led to innumerable avoidable deaths, we need to reignite our compassion .…”