The Precious Necessity of Compassion

Halifax, Joan

doi:10.1016/j.jpainsymman.2010.08.010

Cited by 70 publications

(50 citation statements)

References 19 publications

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“…Mindfulness practices that cultivate awareness of bodily experience help decrease a tendency to get caught up in self-relevant narratives or imagery that can blur the distinction between self and other experience. 17 (continued) not stabilized, these emotional responses may exacerbate feelings of distress and instigate a focus upon one's own pain instead of Maria's suffering. In these instances, a clinician may try to convince the patient and family that their appraisals are inaccurate, or that they should accept the clinician's recommendations to forgo life-sustaining therapies.…”

Section: Develop Methods To Foster Reflection and Inquirymentioning

confidence: 99%

“…15,16 When there is a clear recognition that the patient's suffering is not their own, and there is empathic resonance, clinicians may be able to enter Maria's world and remain personally and professionally grounded. 17 As Maria's condition deteriorated, however, clinicians may have questioned actions that they perceive as causing harm. 18 For example, a nurse may not be able to witness Maria's suffering with healthy empathy.…”

Section: Empathymentioning

confidence: 99%

“…Coupled with the facial expressions, body language, mute cries, and mouthed requests to relieve her pain, the physical decline may have ignited an attunement between her suffering and feelings of despair, personal distress, and moral outrage in some of the clinicians caring for Maria. 17,18,21 Perspective taking Perspective taking or cognitive attunement involves the ability to understand and appreciate the unique vantage points of others. Aggressive interventions to treat Maria's physiologic and emotional needs may have been motivated by the patient, family, and health care team's alignment about the goals of care and the values informing decisions.…”

Section: Addressing Moral Distressmentioning

confidence: 99%

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Addressing Moral Distress: Application of a Framework to Palliative Care Practice

Rushton

Kaszniak

Halifax³

2013

Journal of Palliative Medicine

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Application of the proposed framework to a clinical case provides opportunities for understanding mechanisms of response that may be amenable to intervention and for suggesting appropriate alternative strategies and practices. A full understanding of the process can help to mitigate or to avoid the progression of distress and concurrently to appraise the situation that leads to moral distress or moral outrage.

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Section: Develop Methods To Foster Reflection and Inquirymentioning

confidence: 99%

Section: Empathymentioning

confidence: 99%

Section: Addressing Moral Distressmentioning

confidence: 99%

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Addressing Moral Distress: Application of a Framework to Palliative Care Practice

Rushton

Kaszniak

Halifax³

2013

Journal of Palliative Medicine

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“…[4] For junior doctors this may be even more difficult, because they have limited exposure to death in families outside the hospital. On the other hand, the family practitioner has often come a long way with the patient and family, which can add to feelings of responsibility, inadequacy and grief.…”

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confidence: 99%

Physician self-care

Kirby

Lück

2014

S Afr Med J

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“…Affect has become a generic term referring to any non-cognitive, non-technical or non-skills based aspects of learning, including emotions, attitudes, beliefs, moods, motivations, and intuition (Martin, 1999). The response to this challenge has been addressed by reframing what are perceived as emotions such as empathy -a stepping stone to compassion (Bailey, 2001) (Halifax, 2011) -as cognitive attributes (Hojat et al, 2011) or as an 'intellectual rather than an emotional form of knowing' (Halpern, 2003, p. 670). Through the continued emphasis on the acquisition and assessment of knowledge and skills (Kumagai, 2008), we allow the more quantifiable aspects of learning to dominate.…”

Section: Conflicting and Complementary Theoriesmentioning

confidence: 99%

Unpacking affective learning: a longitudinal, qualitative study exploring how junior doctors learn to be compassionate through practice

Davin¹

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This thesis provides a rich understanding of how junior doctors learn 'to be' compassionate through working in a complex community of practice. Despite compassion being considered a core attribute of a 'good doctor' and the existence of a considerable body of literature addressing the transition of medical students into medical practice -many questions continue to go unanswered. Researchers continue to question how, and why, for many medical students and junior doctors, their humanistic attributes decline as they undertake their studies and engage in practice.This thesis asked junior doctors how they learned to express compassion in the clinical setting.Eight medical students elected to participate in this qualitative, longitudinal study.Reflecting the interpretative nature of this exploratory study, narrative was generated from reflective journals and unstructured interviews to interpret meaning from the lived experience of the eight interns as they completed their first year of medical practice.In interpreting the interns' narratives, answers were sought as to how the junior doctors learned to express compassion. The interns' stories illustrated how they struggled to maintain their compassionate aspirations when confronted with the complexity and competing demands of daily practice. Their emotional distress was not hard to discern, forming a dominant discourse woven throughout their narratives, but more difficult to determine and disentangle from the texts, was how and why their emotional distress came to frame the way in which they provided compassionate care. Emotional vulnerability emerged as the over-riding theme to frame this learning trajectory.The interns' reflections uncover an untold narrative of how emotional vulnerability underpinned by a fear of failure and imperfection, a search for certainty, and a diminished self-efficacy resulted in risk aversion. This risk aversion triggered the safety ethic of the participating interns resulting in their compassion, a prosocial moral emotion, being replaced for a more reductionist approach where patient care is reified as patient management.This study provides new insights into medical professional identify, shedding light on what novice doctors bring to medicine, what they aspire to be, and what they fear they will become. The data provides a nuanced exploration of the enabling and inhibiting factors in providing compassionate care as a commodity embedded in practice and providesPage ii scaffolding on which to explore and respond to the shifting culture of medical professionalism and the expression of emotion in a complex community of practice.Findings from this research provide an original and significant contribution to the research field. This study emphasises novice doctors' relationships with their patients as significant influences on how they provide care. These complex sociocultural issues are previously untold in this context. This study is providing a fresh interpretation of the social dimensions of contemporary medical practice and educati...

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The Precious Necessity of Compassion

Cited by 70 publications

References 19 publications

Addressing Moral Distress: Application of a Framework to Palliative Care Practice

Addressing Moral Distress: Application of a Framework to Palliative Care Practice

Physician self-care

Unpacking affective learning: a longitudinal, qualitative study exploring how junior doctors learn to be compassionate through practice

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