Compassion is a word we use frequently but rarely precisely. One reason we lack a philosophically precise understanding of compassion is that moral philosophers today give it virtually no attention. Indeed, in the predominant ethical traditions of the West, compassion tends to be either passed over without remark or explicitly dismissed as irrelevant. And yet in the predominant ethical traditions of Asia, compassion is centrally important: All else revolves around it. This is clearly the case in Buddhist ethics, and compassion (...) plays a similarly indispensable role in Confucian and Daoist ethics. In Compassion and Moral Guidance, Steve Bein seeks to explain why compassion plays such a substantial role in the moral philosophies of East Asia and an insignificant one in those of Europe and the West. The book opens with detailed surveys of compassion’s position in the philosophical works of both traditions. The surveys culminate in an analysis of the conceptions of self and why the differences between these conceptions serve either to celebrate or marginalize the importance of compassion. Bein moves on to develop a model for the ethics of compassion, including a chapter on applied ethics seen from the perspective of the ethics of compassion. The result is a new approach to ethics, one that addresses the Rawlsian and Kantian concern for fairness, the utilitarian concern for satisfactory consequences, and the concern in care ethics for the proper treatment of marginalized groups. Bein argues that compassion’s capacity to address all of these makes it a primary tool for ethical decision-making. (shrink)

The term compassion fatigue has come to be applied to a disengagement or lack of empathy on the part of care-giving professionals. Empathy and emotional investment have been seen as potentially costing the caregiver and putting them at risk. Compassion fatigue has been equated with burnout, secondary traumatic stress disorder, vicarious traumatization, secondary victimization or co-victimization, compassion stress, emotional contagion, and counter-transference. The results of a Canadian qualitative research project on nurses? experience of compassion fatigue are presented. Nurses, self-identified as (...) having compassion fatigue, described a change in their practice by which they began to shield and distance themselves from the suffering of patients and families. Time to help patients and families cope with suffering seemed unavailable, and many felt they were running on empty and, ultimately, impotent as nurses. Feelings of irritability, anger, and negativity arose, though participants described denying or ignoring these emotions as a way to try to survive their work day. Difficulties with work carried over into the nurses? personal lives, affecting their relationships with family and friends. Such experiences invariably called into question the participants? identity, causing them to reflect on the kind of nurse they were. The participants? compassion fatigue created a sense of hopelessness regarding positive change, although some nurses described strategies that seemed to help alleviate their compassion fatigue. (shrink)

Background: Nurses who are constantly being exposed to patients’ suffering can lead to compassion fatigue. There is a gap in the latest research regarding nurses’ experiences of compassion fatigue. Little is known about how compassion fatigue affects the nurse as a person, and indications of how it affects the profession are scarce. Aim: The aim of this study was to explore compassion fatigue experienced by nurses and how it affects them as persons and professionals. Research design, participants, and research context: (...) A qualitative explorative approach was used. The data consisted of texts from interviews with seven nurses in various nursing contexts. Content analysis was used. Ethical consideration: Ethical approval was sought and granted from an ethics committee at the university where the researchers were based, and written, informed consent was obtained from all the participants. Findings: Five themes were discovered: Compassion as an empathic gift and compassion fatigue as a result of compassion overload, Compassion fatigue as exhausting the nurse as a professional and private person, Compassion fatigue as a crisis with potentially valuable insights, Compassion fatigue can be handled by self-care and focus on self, and Compassion fatigue is affected by life itself and multifaceted factors. Discussion: Compassion stress and overload can lead to compassion fatigue. Compassion fatigue affects the nurse’s ability to compassion, and the caring is no longer experienced in the same way; the nurses experienced it as being deprived of the gift of compassion. Compassion fatigue implicates a crisis with potentially valuable insights. Conclusion: Compassion fatigue can be symbolized as bruises in the soul, hurtful, but with time it can fade away, although it leaves a sense of caution within the nurse, which can affect the suffering patient. (shrink)

The concept, benefits and recommendations for the cultivation of compassion have been recognized in the contemplative traditions for thousands of years. In the last 30 years or so, the study of compassion has revealed it to have major physiological and psychological effects influencing well-being, addressing mental health difficulties, and promoting prosocial behavior. This paper outlines an evolution informed biopsychosocial, multicomponent model to caring behavior and its derivative “compassion” that underpins newer approaches to psychotherapy. The paper explores the origins of caring (...) motives and the nature and biopsychosocial functions of caring-attachment behavior. These include providing a secure base (sources of protection, validation, encouragement and guidance) and safe haven (source of soothing and comfort) for offspring along with physiological regulating functions, which are also central for compassion focused therapy. Second, it suggests that it is the way recent human cognitive competencies give rise to different types of “mind awareness” and “knowing intentionality” that transform basic caring motives into potentials for compassion. While we can care for our gardens and treasured objects, the concept of compassion is only used for sentient beings who can “suffer.” As psychotherapy addresses mental suffering, cultivating the motives and competencies of compassion to self and others can be a central focus for psychotherapy. (shrink)

This article describes compassion as perceived within the relationship between nurses and older persons with a chronic disease. The aim of the study is to understand the benefit of compassion for nursing practice within the context of long-term care. The design of the study involves a qualitative analysis of in-depth interviews with nurses and patients in three different care-settings. Results show the nature of compassion in seven dimensions: attentiveness, listening, confronting, involvement, helping, presence and understanding. Analysis of the data also (...) shows in what way opinions of participants relate to issues raised in a previous literature study, for example the difference between pity and compassion. The conclusion states that compassion is a valuable process which motivates patients as well as nurses to cooperate in achieving relevant outcomes of care. The discussion involves some methodological issues. For one thing, further confirmation of the dimensions found is recommended. (shrink)

In this article, I argue that the recent emphasis on compassion in healthcare practice lacks conceptual richness and clarity. In particular, I argue that it would be helpful to focus on a larger concept of empathy rather than compassion alone and that compassion should be thought of as a component of this larger concept of empathy. The first part of the article outlines a critique of the current discourse of compassion on three grounds. This discourse naturalizes, individualizes, and reifies compassion (...) leading to a decontextualized and simplified understanding of failures in healthcare practice. The second part uses resources from phenomenology and contemporary moral philosophy to construct a “hybrid” concept of empathy that includes both pre‐reflective/intuitive and cognitive/imaginative components. This “hybrid” concept of empathy leads to a more complex understanding of the multiple responses to others' distress. I conclude that there are no straightforward normative naturalistic responses to others' distress. Rather than conceptualizing compassion as a naturalistic impulse or a character‐based trait, we need to consider the complexity of our empathic recognition of vulnerable others. (shrink)

Background: Compassion fatigue, moral distress, and moral injury are interconnected phenomena that have a detrimental impact on the delivery of nursing care. Nurses possess the inherent resilience necessary to effectively handle these three adverse occurrences. Aim: To determine the mediating impact of resilience on compassion fatigue, moral distress, and moral injury among nurses in Saudi Arabia. Design: The final product was a structural equation model (SEM) generated using a quantitative correlation cross-sectional design, and we followed the STROBE guidelines for this (...) study. Methods: The study involved a sample of 511 staff nurses, who were selected using consecutive sampling. The study was conducted in three government hospitals in Saudi Arabia. Ethical considerations: This study received approval from Ethics Committee under approval number H-2021-151 on March 5, 2021. The survey’s description and consent statements were clearly presented on Google survey forms in both English and Arabic. Results: Results showed that resilience negatively influenced moral distress, while compassion fatigue and moral injury had a positive influence. Likewise, compassion fatigue had a direct, positive effect on moral distress and moral injury, and moral distress had a direct, positive effect on moral injury. Analyses also showed that resilience had positive, indirect effects on moral injury through the mediation of both compassion fatigue and moral distress. Similarly, compassion fatigue had a positive, indirect effect on moral injury through the mediation of moral distress. Conclusion: Because resilience enables nurses to adapt, it helps them overcome obstacles in their career and professional lives. Resilience is frequently cited by nurses as a protective quality. Moral injury, compassion fatigue, and moral distress can negatively impact the health of nurses. Implications for the profession and/or patient care: Nurse leaders should develop programs and initiate efforts to improve nurses’ resilience as an important protective trait against compassion fatigue, moral distress, and moral injury. Patient or Public Contribution: There was no public or patient participation in this study. (shrink)

Compassion is acknowledged as a key motivational source of prosocial opportunity recognition. This study examines the underlying processes of different types of compassion that lead to prosocial OR interventions designed to solve or ameliorate social problems. Self-compassion is associated with intimate personal experiences of suffering and encompasses a desire to alleviate the distress of others based on common humanity, mental distance and mindfulness. Other-regarding compassion is associated with value structures and social awareness and is based on a desire to help (...) the less fortunate. Using a life-story analyses of 27 Israeli social entrepreneurs, we identified two OR process mechanisms, reflexivity and imprinting. The relationship between these two types of compassion are equifinal, that is, both can lead to prosocial OR; however, the mechanisms differ. We contribute to the literature by showing that compassion serves as an internal enabler based on both cognitive and affective motivations for prosocial OR. We introduce a theoretical perspective that establishes a process model for further research on the role of compassion in identifying and leading prosocial action. (shrink)

A recurrent objection is that Kant misconceives of morality because he does not engage with the perspective of the suffering and the vulnerable. In this essay, I look closely at this objection, starting from Kant’s distinction between two concepts of compassion, which respectively respond to the vulnerable and the suffering. This distinction calls into play the concept of respect; compassion’s relation to respect explains whether, and under which conditions, compassion is a moral attitude toward others. In sections 1 and 2, (...) I show that the contention that Kant forced compassion out of the scope of moral philosophy is deeply rooted in a disagreement about the practical powers of reason. In sections 3 and 4, I compare Kant’s model of compassion with two others, respectively defended by Iris Murdoch and Theodor W. Adorno. Both these philosophers criticize Kant’s appeal to pure rational agency, but they point in different directions. Murdoch relates compassion to appreciation of concrete individuals, objecting that since Kant’s discussion of rational agency overlooks individuality, it cancels all differences between moral visions and outlooks. Instead, Adorno objects that Kant’s ethics overlooks the moral value of compassion because it is designed for purely rational agents—invulnerable to both misfortunes and emotions. I will argue that Murdoch’s critique misleads us by objecting to abstraction, while Adorno’s critique places compassion within the right perspective—that of the vulnerable. However, Adorno’s critique is also partly misplaced, because vulnerability is, in fact, a driving concern in Kant’s theory of practical reason. In section 5, I argue for the latter contention by introducing a distinction between constitutive and circumstantial vulnerability. This conceptual apparatus allows me to show that the criticisms presented in sections 1–4 misdiagnose Kant’s failure to account for compassion as a “moral emotion,” presenting it as a lack of attention to vulnerability and suffering. My contention in sections 6–7 is that, despite the powerful critiques against him, Kant provides a useful distinction between two kinds of compassion which explains how one should properly engage with the vulnerable and those who suffer. I deploy the distinction between proximal and distal compassion to capture the significance of another distinction, one which has been widely criticized (and is admittedly obsolete, but also little understood): the distinction between pathological and practical compassion, which takes center stage in Kant’s account of the duties of benevolence. Proximal compassion is felt in the presence of suffering, and mandates immediate action. By contrast, distal compassion is directed to suffering that is distant: it includes suffering that occurs in a distant future or past, or that is felt by persons unrelated to oneself by proximity and intimacy. While proximal compassion is not a virtue, and may undermine or even impede moral agency, distal compassion is a virtue that requires abstraction, imagination, and the exercise of rational capacities. In sections 8–9, I show that Kant’s complex account of compassion coheres with empirical psychology and succeeds in vindicating compassion’s different roles in practical reasoning. It thereby provides a convincing account of proper engagement with the vulnerability and suffering of others. (shrink)

The paper presents a perspective on our relation to our environment that is inspired by Confucian thought and that stands in contrast to certain common strands in contemporary philosophical discussions. It conceptualizes our relation to what we encounter on a day-to-day basis primarily in terms of the way we experience and respond to situations, rather than to the objects affected in the situations. From this perspective, the contemporary philosophical distinction between a first- and a third-person point of view is often (...) not suited for describing our responses to situations. Instead, our responses to situations can vary along different dimensions, including the way we direct our attention, our thoughts and sentiments, our motivations, etc., and these variations admit of degrees. Such variations depend on various factors, such as the different ways in which one relates to the object affected in a situation and the kind of person one is. and cannot be adequately described in terms of a shift from one point of view to another. The paper discusses two examples, anger and compassion, to illustrate this alternative perspective, but the discussion can be extended to other areas such as gratitude. (shrink)

The idea that ethics is a matter of personal feeling is a dogma widespread among medical students. Because emotivism is firmly rooted in contemporary culture, the authors think that focusing on personal feeling can be an important point of departure for moral education. In this contribution, they clarify how personal feelings can be a solid basis for moral education by focusing on the analysis of compassion by the French phenomenologist Emmanuel Housset. This leads to three important issues regarding ethics education: (...) the necessity of a continuous attention for and interpretation of the meaning of language, the importance of examining what aspect of “the other” touches one and what it is that evokes the urge to act morally and the need to relate oneself to the community, both to the medical community and to collectively formulated rules and laws. These issues can have a place in medical education by means of an ethical portfolio that supports students in their moral development. First, keeping a portfolio will improve their expression of the moral dimension of medical practice. Second, the effects of self-knowledge and language mastery will limit the pitfalls of emotivism and ethical subjectivism and will stimulate the inclination to really encounter the other. Third, it will show medical students from the start that their moral responsibility is more than following rules and that they are involved personally. (shrink)

To pursue the cultivation of a compassionate disposition is often perceived as an external demand, constraining one's individual freedom. Some might think of it as a necessary burden for the benefit of society, while others may exercise it only in the most convenient occasions. This most common view is gravely impoverished. Compassion is in fact a cognitive disposition with a certain historical life that actually frees us from our own perceptive constraints.

This paper challenges the assumption that to consider the subjective interests of others is to take on a burden that constrains our personal freedom. The nature of compassion will be examined as a disposition to have a certain subjective insight into a given social atmosphere. The inquiry will develop by showing the role that this emotive quality plays in freeing the will from perceptive constraints. The discussion will take place within the context of both Analytic and Buddhist philosophies of moral (...) psychology in order to show that together they provide a coherent groundwork in support of the thesis at hand. (shrink)

Balanced time perspective is associated with optimal social functioning and facilitates adaptation to pressure and changes in the environment. Previous studies have found that mindfulness is positively associated with and might promote balanced time perspective. However, the mechanism through which mindfulness affects balanced time perspective remains unexplored. The purpose of the present study was to investigate the mediating role of self-compassion and subjective well-being in the relationship between mindfulness and balanced time perspective. A total of 754 Chinese college students, aged (...) 17–27 years, completed the Chinese versions of the Five-Facet Mindfulness Questionnaire, Self-Compassion Scale, Subjective Well-Being Scale, and Zimbardo Time Perspective Inventory. There were significant positive correlations between mindfulness, self-compassion, subjective well-being, and balanced time perspective. Structural equation modeling indicated that in addition to the direct influence of mindfulness on balanced time perspective, self-compassion and subjective well-being played a partial mediating role. On the basis of these findings, we conclude that mindfulness has an important positive influence on balanced time perspective, and highlight the crucial role of the self-compassion in cultivating an individual's balanced time perspective. Limitations of the present study are also discussed. (shrink)

Compassion in healthcare has received significant attention recently, on an international scale, with concern raised about its absence during clinical interactions. As a concept, compassionate care has been linked to nursing. We examined historical discourse on this topic, to understand and situate current debates on compassionate care as a hallmark of high‐quality services. Documents we looked at illustrated how responsibility for delivering compassionate care cannot be consigned to individual nurses. Health professionals must have the right environmental circumstances to be able (...) to provide and engage in compassionate interactions with patients and their relatives. Hence, although compassionate care has been presented as a straightforward solution when crisis faces health services, this discourse, especially in policy documents, has often failed to acknowledge the system‐level issues associated with its provision. This has resulted in simplistic presentations of ‘compassion’ as inexpensive and the responsibility of individual nurses, a misleading proposal that risks devaluing the energy and resources required to deliver compassionate care. It also overlooks the need for organisations, not just individuals, to be charged with upholding its provision. (shrink)

When you think of compassion, what comes to mind? Kindness, understanding, tenderness, empathy, maybe warmth? Compassion can be all those things - but it is much more. Drawing on his many years of experience as a clinical psychologist and researcher, Dr James Kirby brings together hard science and real-life examples to offer a guide to a more compassionate life and society. Kirby debunks the myth that compassion is simple a feeling and shows us how it is a motivational force that (...) can shape our behaviour and relationships with each other and the world. He considers how it might help with self-criticism, parenting and grief, and he explores what part artificial intelligence might play in a compassionate future. In this engaging and timely book, Kirby traverses philosophy, psychology and pop culture to show how we can choose compassion to make our lives healthier, happier and more meaningful. (shrink)

Universal Compassion. Training the Mind in Seven Points. Geshe Kelsang Gyatso. Tharpa Publications, London 1988. 176 pp. £6.95.

‘Doing good medical ethics’ involves attending to both the biomedical and existential aspects of illness. For this, we need to bring in a phenomenological perspective to the clinical encounter, adopt a virtue-based ethic and resolve to re-evaluate the goals of medicine, in particular the alleviation of suffering and the role of compassion in everyday ethics.

Speaking of the public response to the deaths of children at the Bristol Royal Infirmary before 2001, the BMJ commented that the NHS would be ‘all changed, changed utterly’. Today, two inquiries into the Mid Staffordshire Foundation Trust suggest nothing changed at all. Many patients died as a result of their care and the stories of indifference and neglect there are harrowing. Yet Bristol and Mid Staffordshire are not isolated reports. In 2011, the Health Services Ombudsman reported on the care (...) of elderly and frail patients in the NHS and found a failure to recognise their humanity and individuality and to respond to them with sensitivity, compassion and professionalism. Likewise, the Care Quality Commission and Healthcare Commission received complaints from patients and relatives about the quality of nursing care. These included patients not being fed, patients left in soiled bedding, poor hygiene practices, and general disregard for privacy and dignity. Why is there such tolerance of poor clinical standards? We need a better understanding of the circumstances that can lead to these outcomes and how best to respond to them. We discuss the findings of these and other reports and consider whether attention should be devoted to managing individual behaviour, or focus on the systemic influences which predispose hospital staff to behave in this way. Lastly, we consider whether we should look further afield to cognitive psychology to better understand how clinicians and managers make decisions? (shrink)

Compassion in Healthcare gives an account of the nature and content of compassion and its role in healthcare based on notions of pilgrimage and civic life. Drawing on the author's real-world collaborations, the book proposes strategies for an improved understanding of compassionate relationships in healthcare practice.

Recent research has demonstrated the importance of positive emotions, and especially compassion, for well-being. Via two investigations, we set out to determine if facial expressions of happiness,...

Compassion is mentioned in the Principles of the American Medical Association but not in the Code of Ethics of the Canadian Medical Association. In this article, we assess the case for including compassion in a code of ethics for physicians. We argue that, properly understood, there is a strong case for including compassion in codes of ethics for physicians on the basis that it is both clinically and ethically central to the practice of medicine.

This paper discusses compassion failure and compassion deficits in health care, using two major reports by Robert Francis in the UK as a point of reference. Francis enquired into events at the Mid Staffordshire Hospital between 2005 and 2009, events that unequivocally warrant the description ‘appalling care’. These events prompted an intense national debate, along with proposals for significant changes in the regulation of nursing and nurse education. The circumstances are specific to the UK, but the issues are international.I suggest (...) that social psychology provides numerous hints about the mechanisms that might have been involved at Mid Staffs and about the reasons why outsiders are blind to these mechanisms. However, there have been few references to social psychology in the post‐Francis debate (the Francis Report itself makes no reference to it at all). It is an enormously valuable resource, and it has been overlooked.Drawing on the social psychology literature, I express scepticism about the idea that there was a compassion deficit among the Mid Staff nurses – the assumption that the appalling care had something to do with the character, attitudes, and values of nurses – and argue that the Francis Report's emphasis on a ‘culture of compassion and caring in nurse recruitment, training and education’ is misconceived. It was not a ‘failure of compassion’ that led to the events in Mid Staffs but an interlocking set of contextual factors that are known to affect social cognition. These factors cannot be corrected or compensated for by teaching ethics, empathy, and compassion to student nurses. (shrink)

This article is intended to examine and then compare ci bei in the Lotus S?tra and ren in the Analects of Confucius. Despite many similarities, compassion and benevolent love have shown a difference between Mah?y?na Buddhist ethics and the Confucian moral system. This difference is revealed in the content and meaning of compassion and benevolent love, but more importantly through the ways they are practised, followed and expanded. Through different ways or paths, compassion and benevolent love have nevertheless established two (...) different and yet mutually supplementary ideals that guide the spiritual and moral world of China and other parts of East Asia. (shrink)

Most approaches to animal ethics ground the moral standing of nonhumans in some appeal to their capacities for intelligent autonomy or mental sentience. _Corporal Compassion _emphasizes the phenomenal and somatic commonality of living beings; a philosophy of body that seeks to displace any notion of anthropomorphic empathy in viewing the moral experiences of nonhuman living beings. Ralph R. Acampora employs phenomenology, hermeneutics, existentialism and deconstruction to connect and contest analytic treatments of animal rights and liberation theory. In doing so, he (...) focuses on issues of being and value, and posits a felt nexus of bodily being, termed symphysis, to devise an interspecies ethos. Acampora uses this broad-based bioethic to engage in dialogue with other strains of environmental ethics and ecophilosophy. _Corporal Compassion_ examines the practical applications of the somatic ethos in contexts such as laboratory experimentation and zoological exhibition, and challenges practitioners to go beyond recent reforms and look to a future beyond exploitation or total noninterference--a posthumanist culture that advocates caring in a participatory approach. (shrink)

Inspired by the vision of care in Vincent van Gogh's depiction of the parable of the Good Samaritan, this article offers a paradigm for inhabiting compassion. Compassion is understood in this article as a moral emotion that is also a pathocentric virtue. This definition creates a dynamic view of compassion as a desire to alleviate the suffering of others, the capacity to act on behalf of others and a commitment to sustain engagement with the suffering other. To weave this vision (...) of compassion as a habitus rather than a theoretical construct, the article develops three phases of compassion: seeing, companioning and sighing. This framework deepens and augments a pastoral theological paradigm of compassion with the aim of inculcating an inhabited compassion in caregivers and the communities in which they participate. (shrink)

Although there are compelling reasons for believing otherwise, compassion cannot provide a basis for grounding a viable theory of civil and political society. Firstly, it is often irrational or personally irresponsible to be compassionate. Secondly, relations based on compassion do not require characteristics that are essential for a viable civil and political society. Thirdly, the unpredictable consequences of compassion are such that compassion alone is not sufficient for grounding a viable civil and political society. Finally, obligating people to be compassionate (...) is antithetical to what is required for being compassionate. (shrink)

BackgroundRecurrent Major Depressive Disorder is one of the most disabling mental disorders in modern society. Prior research has shown that self-compassion protects against ruminative tendencies, a key feature of recurrent MDD. In addition, self-compassion has been found to be positively related to higher psychophysiological flexibility in young, healthy adults. To our knowledge, there is a lack of studies on how self-compassion relates to vmHRV in patients with recurrent MDD. The aim of the current study was to investigate whether higher self-compassion (...) would associate with lower ruminative tendencies and higher vmHRV in a sample of adults with recurrent MDD.MethodsWe included a sample of 63 patients between 20 and 71 years old with a history of three or more depressive episodes. They filled out the Self-Compassion Scale, Beck Depression Inventory, and Rumination Rating Scale. ECG was acquired while resting and the square root of the mean squared differences of successive RR interval values was calculated as measure of vmHRV.ResultsAs hypothesized, self-compassion was associated with lower ruminative tendencies. However, self-compassion was not associated with level of vmHRV. Several confounding variables were controlled for in the statistical analyses, and higher age predicted lower vmHRV across all statistical analyses.ConclusionThe results confirmed our hypothesis that higher self-compassion would be associated with lower ruminative tendencies in recurrent MDD. Contrary to our expectation, we did not find that the tendency to be more self-compassionate was associated with higher vmHRV. As such, higher self-compassion seems to relate with a lower tendency to ruminate about past mistakes and events but does not seem to relate to a flexible autonomic stress response. Other potential explanatory factors for lower vmHRV in recurrent MDD is suggested as focus for exploration in future studies. (shrink)

Since Carol Gilligan's In a Different Voice (1982) the ethics of care has developed as a movement of allied thinkers, in different continents, who have a shared concern and who reflect on similar topics. This shared concern is that care can only be revalued and take its societal place if existing asymmetrical power relations are unveiled, and if the dignity of care givers and care receivers is better guaranteed, socially, politically and personally. In this first volume of a new series (...) leading care ethicists from Europe and the United States focus on the moral significance of two concepts in the debate that ask for further reflection. In discussion with the work of Axel Honneth on recognition and the work of Emmanuel Housset on compassion a contribution is made to a reconsideration of recognition and compassion from an ethics of care perspective. This volume contains contributions by Andries Baart, Estelle Ferrarese, Chris Gastmans, Mieke Grypdonck, Emmanuel Housset, Carlo Leget, Hilde Lindemann, Axel Liegeois, Christa Schnabl, Joan C. Tronto, Annelies van Heijst, Linus Vanlaere, Frans Vosman and Margaret Urban Walker. (shrink)

In this paper we investigate compassion and its place within mindfulness-based approaches. Compassion is an orientation of mind that recognizes pain and the universality of pain in human experience and the capacity to meet that pain with kindness, empathy, equanimity and patience. We outline how learning to meet pain with compassion is part of how people come to live with chronic conditions like recurrent depression. While most mindfulness-based approaches do not explicitly teach compassion, we describe how the structure of the (...) programme and teachers' embodiment enable participants to cultivate compassion in the landscape of suffering. We describe a case example of how this process unfolded for someone through mindfulness-based cognitive therapy. (shrink)

In _Character Compass_, Scott Seider offers portraits of three high-performing urban schools in Boston, Massachusetts that have made character development central to their mission of supporting student success, yet define character in three very different ways. One school focuses on students’ moral character development, another emphasizes civic character development, and the third prioritizes performance character development. Drawing on surveys, interviews, field notes, and student achievement data, _Character Compass _highlights the unique effects of these distinct approaches to character development as (...) well as the implications for parents, educators, and policymakers committed to fostering powerful school culture in their own school communities. (shrink)

Compassion: A Tibetan Analysis. Guy Newland. Wisdom Publications, London 1984. 167 pp. £6.95.

Compassion is often understood as central to nursing and as important to ensure quality nursing and healthcare. In recent years, there has been a focus on strategies in nursing education to ensure compassionate nurses. However, it is not always clear how the concept of compassion is understood. Theoretical conceptualisations that lie behind various understandings of compassion have consequences for how we approach compassion in nursing education. We present some ways in which compassion is often understood, their philosophical underpinnings and the (...) consequences these understandings can have for nursing education. We argue that it is useful for nursing education to understand compassion as a cognitive emotion and discuss how such an understanding can inform educational approaches to compassion. (shrink)

Background: Compassion fatigue is recognized as impacting the health and effectiveness of healthcare providers, and consequently, patient care. Compassion fatigue is distinct from “burnout.” Reliable measurement tools, such as the Professional Quality of Life scale, have been developed to measure the prevalence, and predict risk of compassion fatigue. This study reviews the prevalence of compassion fatigue among healthcare practitioners, and relationships to demographic variables. Methods: A systematic review was conducted using key words in MEDLINE, PubMed, and Ovid databases. Data were (...) extracted from a total of 71 articles meeting inclusion criteria, from studies measuring compassion fatigue in healthcare providers using a validated instrument. Quantitative and qualitative data were extracted and compiled by three independent reviewers into an evidence table that included basic study characteristics, study strength and quality determination, measurements of compassion fatigue, and general findings. Meta-analysis, where data allowed, was stratified by Professional Quality of Life version, heterogeneity was quantified, and pooled means were reported with 95% confidence interval. A table of major study characteristics and results was created. Ethical consideration: This paper contains no primary data obtained directly from research participants. Data obtained from previously published resources have been acknowledged within references. Psychological distress, particularly compassion fatigue, can be insidious, no health profession is immune, and may significantly impact the ability to provide care. Results: A total of 71 studies were included. Compassion fatigue was reported across all practitioner groups studied. Relationships to most demographic variables such as years of experience and specialty were either not statistically significant or unclear. Variability in reporting of Professional Quality of Life results was found. Interpretation: Compassion fatigue exists across diverse practitioner groups. Prevalence is highly variable, and its relationship with demographic, personal, and/or professional variables is inconsistent. Questions are raised about how to mitigate compassion fatigue. (shrink)

쇼펜하우어는 공감을 윤리학의 중심에 놓는 대표적인 철학자 중 한명이다. 그는 ‘이기주의(Egoismus)’를 변화할 수 없는 인간의 본성으로 보았고 ‘고통에 대한 공감(Mitleid)’을 이기주의를 극복할 수 있는 윤리의 기초로 삼는다. 왜 쇼펜하우어는 공감에서 윤리학의 가능성을 찾았을까? 기간 쇼펜하우어의 윤리학에 대한 연구들은 그의 철학 체계 내에서 형이상학과 윤리학의 관계를 해명하는 것에 집중되어 있었으며, 공감 개념에 관한 심도 있는 연구는 적다. 본 논문은 쇼펜하우어의 공감 규정에 주목할 것이고, 이를 통해 그가 공감을 윤리학의 기초로 삼을 수 있는 근거와 여기서 제기될 수 있는 몇 가지 난제를 검토할 (...) 것이다. 공감과 이기주의의 관계에 대한 쇼펜하우어의 입장은 명확하고 일관적인 것처럼 보이지만, 세부적으로 보면 모호하고 난해한 주장들을 포함하고 있다. 이러한 쇼펜하우어의 태도는 단순히 철저하지 못한 논의구도 때문이라기보다는 공감윤리학이 가질 수밖에 없는 한계 상황을 드러내는 것이라고 할 수 있다. 그리고 이러한 한계 상황은 역설적으로 현대의 공감윤리학이 나아가야 할 방향을 암시한다. (shrink)

Over the past years the relevance of compassion for society and specific practices such as in healthcare is becoming a focus of attention. Philosophers and scientists discuss theoretical descriptions and defining characteristics of the phenomenon and its benefits and pitfalls. However, there are hardly any empirical studies which substantiate these writings in specific societal areas. Besides, compassion may be in the eye of attention today but has always been of interest for many contemporary philosophers as well as philosophers in the (...) past, David Hume amongst them. Three themes related to Hume’s hypotheses on compassion are discussed and compared to outcomes of an empirical study amongst nurses and patients with a chronic disease. This comparison gives insights into the perception of those for whom compassion is of specific importance in their daily lives and into the usefulness of Hume’s notions on compassion. (shrink)

BackgroundNurses provide the majority of health-care services and face numerous health challenges during an epidemic. During the COVID-19 epidemic, nurses are subjected to physical, mental, and social disorders that impair their quality of life and hardiness. Therefore, it is important to be aware of the situation of nurses. The current study aimed to compare the compassion satisfaction, compassion fatigue and hardiness among nurses before and during the COVID-19 outbreak.Materials and MethodsThis cross-sectional study included 508 clinical nurses from one public hospital (...) in southern Iran. The subjects were recruited using census sampling methods in 2019–2020. Sampling was performed before and during the COVID-19 with a 1-year interval. Although, the study setting was the same before and during the COVID-19, questionnaires were completed by different nurses before and during the COVID-19. Demographic questionnaire, professional quality of life questionnaire and Occupational Hardiness Questionnaire were used to collect data.ResultsThe scores of compassion satisfaction, compassion fatigue and hardiness did not differ significantly during the COVID-19 compared with before the COVID-19. Before COVID-19, hardiness and work experience predicted 11% of the variance of compassion satisfaction, whereas during COVID-19, hardiness and gender predicted 26% of the variance of compassion satisfaction. Before COVID-19, hardiness and work experience predicted 3% of the variance of compassion fatigue, whereas during COVID-19, hardiness, type of employment and gender predicted 6% of the variance of compassion fatigue.ConclusionThe current study found that compassion satisfaction, compassion fatigue and hardiness did not change during the COVID-19 outbreak compared with before the COVID-19 outbreak. However, during the COVID-19, the hardiness was a significant predictor of compassion satisfaction and compassion fatigue. The study results showed that it was possible to increase the compassion satisfaction and reduce the compassion fatigue by strengthening the hardiness of nurses. However, these results need to be considered in future studies, especially in crises such as COVID-19 disease. (shrink)

We need modal imagination in order to extend our conception of reality - and, in particular, of human beings - beyond our immediate experience in the indexical present; and we need to do this in order to preserve the significance of human interaction. To make this leap of imagination successfully is to achieve not only insight but also an impartial perspective on our own and others' inner states. This perspective is a necessary condition of experiencing compassion for others. This is (...) the primary thesis I will try to defend in this discussion. (shrink)

Socrates (in the Meno) denied that virtues like courage could be taught, whereas Protagoras defended this claim. Compassion is discussed below in this context; it is distinguished from related, but different, moral qualities, and the role of imagination is emphasised. 'Sympathy's and role-modelling views of compassion's acquisition are criticised. Compassion can indeed be taught, but neither by the example of a few, isolated physicians nor by creation of Departments of Compassion. In replying to one standard objection to teaching compassion, it (...) is emphasised that scientific competence and compassion aren't mutually exclusive. (shrink)

This book explores the importance of compassion and empathy within educational contexts. While compassion and empathy are widely recognised as key to living a happy and healthy life, there is little written about how these qualities can be taught to children and young people, or how teachers can model these traits in their own practice. This book shares several models of compassion and empathy that can be implemented in schooling contexts, also examining how these qualities are presented in children’s picture (...) books, films and games. The editors and contributors share personal insights and practical approaches to improve both awareness and use of compassionate and empathetic approaches to others. This book will be of interest and value to all those interested in promoting compassion and empathy within education. (shrink)

The foundations of Horkheimer’s rational society are based on the premise that social philosophy could be a choice for the Critical Theory. Therefore [1] a dialectic interpretation of the social issue is developed between philosophy and social sciences theories, using the category of interdisciplinary materialism. [2] Characterizing an age in a state of indigence begins with the definition of Enlightenment as a process of disenchantment with the world that reduces human reality under the sign of domination. The liberator course of (...) the Enlightenment was marred from the beginning and ended up being a process of alienation and reification. [3] Hence, the moral sentiments of compassion and politic solidarity get to the stage in order to addressing a new ethical perspective in which it is posible to define an existential imperative that can view the human misery and the searching of happiness, in the purpose of overcoming the conditions and realities of the present age in state of indigence. (shrink)

Primary care givers commonly interpret shortages of time with patients as placing them between a rock and a hard place in respect of their professional obligations to fairly distribute available healthcare resources (justice) and to offer a quality of attentive care appropriate to patients’ states of personal vulnerability (compassion). The author argues that this a false and highly misleading conceptualisation of the basic structure of the ethical dilemma raised by the rationing of time in clinical settings. Drawing on an analysis (...) of the Aristotelian virtue of nemesis, or “the sense of justice”, it is argued that, far from being a moral orientation distinct from justice, compassion is a justice response insofar as it is conceptualised as a rational, appropriate response to others’ adversity. The author then proceeds to point out that the perspective on justice and compassion as attributes of healthcare professionalism suggests a novel critical viewpoint on the ethics of managed forms of clinical rationing and the “scarcity paradigm” they engender: clinical conditions where primary care givers’ time is intentionally rendered a commodity in chronically short supply run a deficit of justice, because they fail to make adequate accommodations for the provision of the quality of care human beings deserve in situations of illness and injury, and when they are dying. (shrink)

Compassion is a prosocial motivation that is critical to the development and survival of the human species. Cultivating compassion involves developing deep wisdom, insight, and understanding into the nature and causes of human suffering; and wisdom and commitment to take positive action to alleviate suffering. This perspective piece discusses how compassion relates to the context of modern technology, which has developed at a rapid pace in recent decades. While advances in digital technology build on humankind’s vast capacity to develop practical (...) tools that promise to enrich our lives and improve our social connections, in reality the effects are often far from benign. The motives underlying the development of many contemporary digital platforms seem rooted in competitiveness and capitalism; while modern social media and online platforms are having a profound and pervasive impact on the mental health and wellbeing of humans around the globe. Nonetheless, digital technology holds considerable potential to promote compassionate insight, wisdom, and prosocial behavior. We reflect on the current state of technology within human society and examine the notion of compassionate technologies; discuss how contemporary paradigm shifts such as the inclusive design movement may be harnessed to build tools and platforms that promote collective good and increase prosocial behavior; and highlight examples of initiatives that are harnessing modern technology to advance democracy, collective knowledge, and personal freedoms and agency. (shrink)

This commentary explores the background to, and implications of, the recently published Director of Public Prosecutions guidelines for prosecutors in respect of cases of encouraging or assisting suicide. It considers the extent of the provisions and questions the legitimacy of their focus on the compassionate motivation of the assistant, and the apparent prohibition on healthcare professionals providing such help. It concludes by suggesting that a permissive change in the law would provide better safeguards for those who seek assisted dying.

Compassion is generally thought to be a morally valuable emotion both because it is concerned with the suffering of others and because it prompts us to take action to their behalf. But skeptics are unconvinced. Not only does a viable account of compassion’s evaluative content—its characteristic concern—appear elusive, but the emotional response itself seems deeply parochial: a concern we tend to feel toward the suffering of friends and loved ones, rather than for individuals who are outside of our circle of (...) intimates. In response, I defend a sophisticated, non-cognitivist account of compassion and explain how it avoids the difficulties that undermine other proposals. (shrink)

Contemporary theorists critical of the current vogue for compassion might like to turn to Friedrich Nietzsche as an obvious ally in their opposition to the sentiment. Yet this essay argues that Nietzsche’s critique of compassion is not entirely critical, and that the endorsement of one’s sympathetic feelings is actually a natural outgrowth of Nietzsche’s immoralist ethics. Nietzsche understands the tendency to share in the suffering of their inferiors as a distinctive vulnerability of the spiritually strong and healthy. Their compassion, however, (...) is an essential element of the imaginative creativity that Nietzsche holds to be the goal of human existence. Although shared suffering may prove debilitating for some, great individuals must come to affirm their compassion as necessary in achieving accurate knowledge of the human condition. (shrink)

How Compassion can Transform our Politics, Economy, and Society draws together experts across disciplines - ranging from psychology to climate science, philosophy to economics, history to business - to explore the power of compassion to transform politics, our society, and our economy. The book shows that compassion can be used as the basis of a new political, economic, and social philosophy as well as a practical tool to address climate breakdown, inequality, homelessness, and more. Crucially, it also provides a detailed (...) plan for its execution. It marks the first time that the study of compassion has been applied across multiple disciplines. The book provides a template for the study of compassion on an interdisciplinary basis and will appeal to academics, professionals and the general reader searching for a fresh and inspiring approach to the seemingly intractable problems facing the world. (shrink)

In this empirical paper, we present a model of the dynamic legitimizing processes involved in the receiving and giving of compassion. We focus on the idea of being ‘worthy of compassion’ and show how ideas on giving and receiving compassion are highly contestable. Recognition of a worthy recipient or giver of compassion constitutes a socially recognized claim to privilege, which has ethical managerial and organizational implications. We offer a model that assists managers in fostering ethical strength in their performance by (...) encouraging reflection on the ethical complexity involved in compassion relations. The model emphasizes the dynamics of both the givers and receivers of compassion and so can also be used by organizations to both assess how others may view the legitimacy of their compassion relations and also to develop a positive organizational ethic of compassionate conduct. (shrink)

Background: Compassion-based practices in midwifery are the most important expression of the depth of care quality. This concept is insufficiently represented in literature, therefore, studies on this subject are of utmost importance. Objectives: This study aims to determine the levels of compassion of midwives working in the delivery room and the factors affecting these levels. The study was carried out in Kocaeli, Turkey. Methods: This descriptive study was carried out from 1 February to 15 April 2019 in delivery rooms of (...) six different hospitals located in the provincial centre of Kocaeli, Turkey, with 78 actively working midwives. Data were collected using a ‘Compassion Scale’ and analysed using the Mann–Whitney U test, the Kruskal–Wallis H test and the Spearman correlation test. Ethical considerations: This study was conducted according to ethical scientific guidelines. Results: The compassion score of the midwives were found to be 4.19 ± 0.39. The total compassion score was affected by professional factors such as number of patients, alternating shift work, number of traumatic births and work satisfaction. While the kindness subscores decreased depending on shift work and number of traumatic births, it was determined that the midwives who were satisfied with their work had higher kindness scores than those who were not. Also, as the age and professional experience of the midwives and the number of traumatic births increased, their indifference score also increased. Midwives who reported that they were not satisfied with their job had higher scores regarding separation and disengagement scores than those who were satisfied with their job. Conclusion: It was determined that the compassion levels of midwives were found to be negatively affected by factors such as age, professional experience, job satisfaction and number of monthly traumatic births in a month. They should be reminded that compassionate midwifery care for women is a basic human right. (shrink)