Feeds:
Posts
Comments

Posts Tagged ‘compassion’

I came across a term recently, “suicidal empathy”. Musk talked about it in an interview with Joe Rogan, and it seems to have originated from a man called Gaad Saad. As best I can tell he suggests that a big problem in society these days is an excess of empathy. In fact, in some pieces this concept is put forward as a big “threat to Western civilisation”.

I was pretty shocked when I read this, and explored a bit further to try and understand exactly what they were claiming. They seem to be saying that if we have “too much” empathy for certain people then we risk damaging the lives and values of the great majority. Who are these certain people? The usual suspects I’m afraid, immigrants, minority ethnic groups, trans people and, well, it seems to me, pretty much anyone they don’t actually like.

I don’t buy this. Not at all. Empathy doesn’t determine your actions. But it can, and, I believe, should, influence them. My point is that empathy does not lead inevitably to any particular strategies or policies at a societal level, and whatever an excess of it is, do we seriously believe that having empathy for a minority group actually harms the lives of the majority?

We only have individuals in life. We only have individuals in relationships. There is no “the people”, or “the majority” which has a single view of anything. The claim that there is such a thing is the path to despotism or populist fascism.

I spent an entire career over four decades where the core of my everyday was a sequence of one to one relationships with individual patients. I had empathy for every single one of them. I believe that was the only way to understand them, to really get to know them, and, so to help them. I believe that without empathy for every single person I worked with, I wouldn’t have been as good at my job as a doctor. Can you imagine a doctor who reserves their empathy for select groups of individuals? Well, actually we can imagine that, but it’s not something I’d like to support.

No, it’s not an excess of empathy, or a “misdirected” empathy, which is the biggest threat to our way of life. It’s a deficiency. We don’t care enough.

When immigrants are vilified, treated as less than human, when children are bombed, blown to pieces and killed in pursuit of “terrorists” or in an attempt by one country to grab some of the land occupied by others, then we have an empathy deficiency.

Back when 9/11 happened, the novelist, Iain McEwan, said the greatest failing of the terrorists was a lack of empathy….or did he say a lack of imagination? I’m not sure at the moment, I’ll look it up. Ah, it was both…..

If the hijackers had been able to imagine themselves into the thoughts and feelings of the passengers, they would have been unable to proceed. It is hard to be cruel once you permit yourself to enter the mind of your victim. Imagining what it is like to be someone other than yourself is at the core of our humanity. It is the essence of compassion, and it is the beginning of morality.

We need MORE empathy. Not less.

Read Full Post »

A wide ranging review of General Practice in the UK has just been published in the British Journal of General Practice. It makes for disturbing reading. Here’s one of their conclusions –

Overall, these findings reveal a system that is approaching — or, in some cases, beyond — breaking point. Staff members are stressed, demoralised, and leaving; clinical care appears to be compromised; and many patients are dissatisfied, frustrated, and unable or less willing to seek care. We believe there are significant risks to patient safety and to the future survival of traditional general practice in UK.

Here’s another –

Quality efforts in UK general practice occur in the context of cumulative impacts of financial austerity, loss of resilience, increasingly complex patterns of illness and need, a diverse and fragmented workforce, material and digital infrastructure that is unfit for purpose, and physically distant and asynchronous ways of working. Providing the human elements of traditional general practice (such as relationship-based care, compassion, and support) is difficult and sometimes even impossible. Systems designed to increase efficiency have introduced new forms of inefficiency and have compromised other quality domains such as accessibility, patient-centredness, and equity. Long-term condition management varies in quality. Measures to mitigate digital exclusion (such as digital navigators) are welcome but do not compensate for extremes of structural disadvantage. Many staff are stressed and demoralised.

I first expressed the desire to be a doctor when I was three years old. The role model I had was the family doctor who attended the home birth of my younger sister. I was trained according to the dominant values of the time (which are referred to within this study) – “relationship-based, holistic, compassionate care, and ongoing support to patients and families”. The authors of this study find that it is increasingly difficult, and in many cases, impossible, to practice according to these values, even though, GPs still hold them. This results in stress, frustration, and burn-out which impacts adversely on both recruitment and retention of doctors in Primary Care.

So, what’s going on? How did we get here? This paper outlines several factors, not least financial austerity, underfunding, increasing inequality, increasing complexity of illness and an ageing population. But it also highlights a problems which arise from a particular management philosophy – the authors don’t actually use that term – where on the grounds of so-called greater efficiency, health care teams have become more diverse, digital and both algorithmic and protocol-driven services delivered by less qualified staff have increased, and the whole service is disintegrating. The efficiency actually goes down, the dangers increase, and dissatisfaction mounts (in both patients and staff).

The authors don’t give any quick and easy solutions but they shine a bright clear light on the problems, and put their finger on at least one issue at the heart of the problem – the loss of continuity of relationship-focused care delivered by holistically and compassionately.

They do use the word “dehumanised”, and that’s long been my experience. We need to get back to those traditional values and stop doing what impairs them. We need to get back to a health service which puts patients and their GPs at the heart of the system, and stop thinking we can use new technologies and industrial management practices to make things better.

Read Full Post »