Compassion in Primary & Community Care

Editor: Andrew Papanikitas and John Spicer

Chapter by Joshua Hordern in this new Handbook of Primary Care Ethics, Taylor and Francis/CRC Press (October 2017)

Abstract

Compassion is an attribute of a person’s affective understanding which seeks shared experience of the world’s ills and some alleviation of those ills’ effects. Compassion is cognitive, participative and alleviative. Compassion alleviates suffering by participating in it. Compassion’s cognitive content is shaped by the circumstances and beliefs of those concerned. Since present-day civic life is plural, primary and community healthcare workers’ compassionate understanding must grasp people’s diverse ways of perceiving health and illness. However, while taking patient perceptions seriously rightly excludes professional paternalism, it does not mean that compassion involves uncritical acquiescence to patient perceptions. What is required is a compassion suited for this ‘secular’ time when ultimate questions about human life and suffering have not been finally answered and in which diverse perceptions meet in sometimes critical conversation. Such conversation takes time. And so a lack of or misuse of time may result in failing to reach the goal of compassion and in doing injustice to some in favour of others. Compassion is not in opposition to justice but rather a constitutive feature of justice’s realisation. If both compassion and justice are to characterise practice, both a supportive organisational ethos and regular personal refreshment are required. Pointing to one rich source of refreshment, the motto of the Royal College of General Practitioners, cum scientia caritas, wisely emphasises the greatest of the three theological virtues, love.