Care and Compassion

By Steve Fouch

Read : Care and Compassion (Part 1) and Care and Compassion (Part 2)

Synthesis and Practice – Sydenham and Nightingale
This understanding of Christian compassion shaped the thinking of many of the pioneers of modern medicine and nursing. Space does not allow a detailed survey, so I will look very briefly at two of these pioneers.

Thomas Sydenham (1624 – 1689), called by some the ‘English Hippocrates’ due to his influence on the development of medicine in Britain, laid out four key principles for any godly physician:

It becomes every man who purposes to give himself to the care of others, seriously to consider the four following things:
First, that he must one day give an account to the Supreme Judge of all the lives entrusted to his care.’
Secondly,that all his skill, and knowledge and energy as they have been given him by God, so they should be exercised for his glory, and the good of mankind, and not for mere gain or ambition.
Thirdly, and not more beautifully than truly, let him reflect that he has undertaken the care of no mean creatire, for, in order that he may estimate the value, the greatness of the human race, the only begotten Son of God became himself a man, and thus ennobled it with his divine dignity, and for more than this, died to redeem it.
And fourthly, that the doctor being himself a mortal man, should be diligent and tender in relieving his suffering patients, inasmuch as he himself must one day be a like sufferer.44

This understanding of shared human frailty, shared human sinfulness and need for God’s grace, and a shared human dignity informed Sydenham’s view of compassion as a central component of good medicine. Sydenham also emphasised the notion of ‘vocation’ or calling. Medicine was not a career to advance one’s own interest, but a means of service to God and man.

Florence Nightingale (1820 – 1910), the founder of modern nursing, made it clear that being an effective nurse required compassion, but that this was a virtue to be worked at.

Nursing is an art: and if it is to be made an art, it requires an exclusive devotion as hard a preparation, as any painter’s or sculptor’s work; for what is the having to do with dead canvas or dead marble, compared with having to do with the living body, the temple of God’s spirit? It is one of the Fine Arts: I had almost said, the finest of the Fine Arts.45

However, she also understood that nursing was a science.46 It needed to be evidence-based and required technical skills, just as Sydenham understood medicine to be as much an art as a science, requiring diligence in compassion as much as in knowledge and technical skill. Both understandings are deeply informed by Christian faith as well as science, and I would argue that in Nightingale and Sydenham’s synthesis of both perspectives we can see that the care/cure split in Western though is largely an artifice. It also belies the popular view that higher levels of academic training in nurses and doctors necessarily mitigate against compassion. That many experience this to be the case suggests that the training process and wider professional and organisational culture of the health service and professions is failing to value compassion or to help people to acquire the skills and attitudes of mind necessary to develop it as a virtue.

Conclusion
Compassionate care is integral to good medicine and nursing, but our understanding of what compassion is and how it is developed have become confused. While there are innate qualities in our biology and character that can lead some people to show greater compassion than other, compassion is a virtue that can (and must!) be developed and nurtured in all who come into the professions.

Furthermore, a Christian understanding of compassion requires us to accept it as a virtue that is a gift from God, to be cultivated out if our on-going relationship with our Creator and in community with other believers. It requires us to respond to the needs of others, even those who we find difficult to care for or towards whom we are naturally unsympathetic or even antagonistic. Compassion is a practical response, not an emotional state or affection, but it starts from a quality of character and an attitude of mind.

Modern healthcare, from training institution to clinical monitoring and financial management, tends to devalue compassion, so if we are to nurture it in the nursing and medical professions there is a need for a change in values and culture. This comes from strong and visionary leadership that leads by example.47 We need to make sure that the professions and the health service as a whole become environments where compassion and the art of medicine and nursing are nurtured as much as scientific and technical excellent.

Steve Fouch is CMF Head of Allied Professions and a former nurse.

References

      44. Edmunds V, Scorer CG, (Eds) Ideals in Medicine. London: Tyndale Press, 1958:155
      45. Nightingale, Op cit
      46. Nightingale, Op cit
      Francis R. (2013) Op cit

Christian Medical Fellowship (CMF) Files No. 50, 2013