Tuesday, June 26, 2012

Time for More Compassion

All professional bodies have codes of conduct, expounding the ethical principles that underpin the manner in which its members are expected to act. For doctors, the code comes in the guise of a document called Good Medical Practice, published by the General Medical Council (GMC). Likewise, the House of Commons produces a guidance code for Members of Parliament, Funeral Directors have theirs, and the Press Complaints Commission operates a Code of Practice for newspapers. In Addis Ababa, Ethiopia, where the World Congress on Public Health recently took place, there was a publically displayed list of Principles of Ethical Public Service, listing integrity, loyalty, transparency, confidentiality, honesty, accountability, serving the public interest, exercising legitimate authority, impartiality, respect for law, responsiveness and leadership as pre-requisites for service. In America there is even a Code of Practice for Columnists. The interesting thing is that nowhere in these documents appears the word ‘compassion’.

The Oxford English Dictionary defines compassion as ‘sympathetic pity and concern for the sufferings or misfortunes of others’. In turn, ‘sympathy’ is the feeling of pity and concern for the affected person or people; it is showing that one understands their plight.

However, Kamran Abbasi, editor of the Journal of the Royal Society of Medicine, recently expressed the opinion that ‘compassion isn’t even a dirty word in the NHS…with clinicians too preoccupied with targets, efficiency drives, and restructuring to care for their patients’ (JRSM 105, p. 93).

Yet, according to a survey by the GMC, compassion, kindness and empathy are qualities which people feel are important and should be portrayed by doctors. Why then, do so many codes of practice leave out such important values? Is it that you can train people to act with all the principles expounded in the Addis Ababa example above, but cannot enforce a quality that comes from deep within one’s own personality?

The Dalai Lama, the Tibetan Buddhist spiritual leader, recently wrote on the social network site Twitter (@DalaiLama) that ‘even our personal virtues, such as patience and our sense of ethics, are all developed in dependence upon others’. He said ‘fear, hatred, and suspicion narrow your mind - compassion opens it’. In his view, ‘once you realize that compassion is useful, that it is something really worthwhile, you immediately develop a willingness to cultivate it’.

To those who are religious and profess their faith in their daily lives and actions, the concept of compassion is real and becomes second nature. Many would agree that compassion helps in effectively communicating with others. Such action can also be self-rewarding for, again in the words of the Dalai Lama, ‘if you become more concerned for the welfare of others, you will experience a sense of calm, inner strength and self-confidence’.

Of course, self-reward is not principally what serving humankind is all about. However, nobody should object to a free dose of the ‘feel-good factor’, and if it means that the behaviour that earned the reward is more likely to be repeated, then who should complain about that? The sad part about all this is that ‘tender loving care’ or TLC as it was often known, is no longer seen as an appropriate form of treatment on its own. Indeed, it is often completely lacking, even when every other treatment has been exhausted.

Even in the 21st century, nobody has all the answers, and there is no cure for all ills. Compassion is often the most valuable tool left in the armoury and it should be deployed more frequently and effectively by all healthcare workers. It is also a tool that should be honestly wielded by everyone in public service (politicians take note), and indeed, by all of us in our daily interactions with each other. That said, it is not something that can be learned or fabricated; it needs to be felt. The starting point is to search deep inside oneself, find that hidden quality, and then bring it to the surface. The entire world would be a better place if we all put compassion into it.

First published in the Scunthorpe Telegraph, Thursday, 24th May 2012.

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