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Some researchers suggest that altruism operates on empathy. Empathy is the capacity to understand another person’s perspective, to feel what he or she feels. An empathetic person makes an emotional connection with others and feels compelled to help (Batson, 1991). Empathy can be expressed in several ways, including cognitive, affective, and motor. 
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Smiling through clenched teeth: why compassion cannot be written into the rules.

Yinchu Wang1

  • 1Correspondence to Dr Yinchu Wang, Barts and the London, London, E1 2AD, UK; y.wang@smd11.qmul.ac.uk.

Journal of Medical Ethics
|November 5, 2015
PubMed
Summary

Compassion in healthcare cannot be mandated by rules. Attempts to enforce it in healthcare workers may lead to cynicism and perfunctoriness, undermining patient care quality.

Keywords:
Codes of/Position Statements on Professional EthicsEducation for Health Care ProfessionalsHealth WorkforceHistory of Health Ethics/Bioethics

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Area of Science:

  • Healthcare Management
  • Medical Ethics
  • Organizational Psychology

Background:

  • Public discourse frequently identifies a lack of compassion as a key failing within the National Health System.
  • Proposals have emerged to implement regulations mandating compassion among healthcare professionals to enhance care quality and prevent future scandals.

Purpose of the Study:

  • To critically evaluate the feasibility and consequences of enforcing compassion through rules in healthcare.
  • To examine the impact of the current contractual doctor-patient relationship on fostering compassion.

Main Methods:

  • Argumentative analysis based on ethical principles and organizational behavior.
  • Comparative review of experiences in other service industries regarding enforced empathy.

Main Results:

  • Compassion cannot be effectively mandated or enforced by any regulatory framework.
  • The transactional nature of contemporary doctor-patient relationships is inherently unsupportive of genuine compassion.
  • Evidence from service industries indicates that attempts to enforce compassion yield counterproductive outcomes, fostering perfunctoriness and cynicism.

Conclusions:

  • Mandating compassion in healthcare workers is an ineffective strategy.
  • The current healthcare system structure may inadvertently impede the development of compassionate care.
  • Alternative approaches focusing on systemic and relational factors are needed to cultivate genuine compassion in healthcare.