Morgan Alastair
Senior Lecturer, Division of Nursing, Midwifery and Social Work, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK.
Nurs Philos. 2017 Jul;18(3). doi: 10.1111/nup.12148. Epub 2016 Sep 27.
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.
在本文中，我认为近期医疗实践中对同情心的强调缺乏概念上的丰富性和清晰度。具体而言，我认为专注于一个更宽泛的同理心概念而非仅关注同情心会有所助益，并且同情心应被视为这个更宽泛同理心概念的一个组成部分。文章第一部分基于三个理由对当前关于同情心的论述进行了批判。这种论述使同情心自然化、个体化并使之具体化，导致对医疗实践中的失败形成一种脱离语境且简化的理解。第二部分运用现象学和当代道德哲学的资源构建了一个“混合”的同理心概念，该概念既包括前反思/直觉性成分，也包括认知/想象性成分。这种“混合”的同理心概念会让我们对他人痛苦的多种反应有更复杂的理解。我的结论是，对他人的痛苦不存在直接的规范性自然主义回应。我们不应将同情心概念化为一种自然主义冲动或基于性格特征的特质，而需要考虑我们对脆弱他人的同理心认知的复杂性。
