Compassion in Healthcare: Practical Policy for Civic Life

Compassion in healthcare has rightly been of major concern in recent years. The Francis Report into the mid-Staffordshire NHS Foundation Trust highlighted this matter clearly. However, the nature of compassion has typically not been sufficiently thought about or worked out in practical detail in institutional, professional and public settings. Rather compassion's meaning and practice have been thought obvious and not a matter for sustained reflection. Historically, compassion has often been conceived in religious terms. Where serious scholarly reflection has been conducted on compassion, it has commonly been shaped by theological, philosophical or other religious commitments. Prominent contributions, differing significantly in their analyses, have come from streams of Christian and Buddhist thought. More recently, a belief in the storied or narratival nature of human self-understanding has informed much medical humanities thinking about compassion. Parallel policy turns have included an emphasis on 'patient-centred care' (seeing patients as persons with stories and wishes) and the overall 'life-course' of patients (seeing patients in the here and now in terms of their needs for care over the course of their lives). Moreover, while underlying Christian ideas of solidarity and co-suffering have to some extent endured, versions of Buddhism have become more influential for how compassion is conceived in healthcare, accompanied practically, for example, by 'mindfulness' training. Finally, in academic reflection on healthcare, philosophy of emotion has emphasised the cognitive nature of compassion and thus its crucial role in institutional life and professional training. This analysis highlights the diversity of meanings attributed to compassion and so complicates public discourse about health and suffering, providing it with points of reference whereby suffering's individual, social and political significance can be explored. It remains important in a plural, democratic society that debate is constantly stimulated about the interpretation of compassion and the pathways to its social and political realisation. If it is to be conceptually rich and practically useful, this debate should be interdisciplinary, research-intensive and attentive to the experience of both healthcare workers and patients. The research to be conducted in this project will significantly advance this debate, drawing Christian traditions into constructive 'secular' conversation with Buddhist and philosophical interpretations of compassion. By 'secular' here, the research will not mean non-religious but rather what the Augustinian Christian tradition has intended, namely a humble, shared, critically respectful civic life which does not exclude either religious or non-religious voices but seeks common ground, better quality disagreement and advanced understanding through rigorous conversation. This project will focus on four themes to organise this secular conversation and construct its own account of compassion: time, responsibility, personalisation and privatisation. Through analysis of these themes, it will seek greater clarity on the variety of ways in which compassion is conceived while at the same time constructing and advocating a specific account of compassion, shaped primarily by Christian moral theology, as a contribution towards the formation of healthcare policy concerning institutional organisation, professionalism and the role of citizenship in healthcare. The project's goals will be achieved through reflective research, informed by knowledge exchange with relevant project partners especially the Oxford University Hospitals NHS Foundation Trust. Collaborative, knowledge exchange seminars in partnership with healthcare workers will be focussed around how the four themes noted above provide conceptual pathways towards a better understanding of compassion and its realisation in practice.