Care and compassion

Public perception of care and compassion in health care has recently taken a beating, following the media exposé of the seemingly unfeeling treatment of a woman in the throes of a threatened abortion in the emergency department of a major metropolitan hospital. The story of a woman allegedly being abandoned in a hospital toilet, in pain and panic, does not paint a picture of care and compassion.

The ensuing public outcry precipitated at least two high-level inquiries. Importantly, the recommendations and protocols that followed insisted that practitioners be ever sensitive to the dignity and integrity of patients, while seeking to improve their journey through the health care system. However, protocols alone cannot always guarantee care and compassion.

As noted in a recent Lancet editorial: “Care is not a ‘thing’ — a product provided by clinicians and received by patients.” * In a similar vein, Francis Peabody, a prominent Bostonian physician, poignantly captured the essence of care in a lecture delivered to Harvard students in 1925: “One of the essential qualities of the clinician is interest in humanity — for the secret of the care of the patient is in caring for the patient.”†

The Lancet editorial also suggests the acronym CARE — Compassion, Attention, Respect and Empathy — as a framework for exploring care and compassion in medical training.

Ironically, all these essential human qualities had already been distilled in the seminal moral command, the Golden Rule: “Do unto others as you would have them do unto you. Treat others as you would want to be treated if you were in their place.” Universal adoption of this rule would certainly be an antidote to much of the dehumanisation fostered by modern medicine’s emphasis on protocols, outcome measures, efficiency and effectiveness — hardly an environment conducive to care and compassion!