Zaman Shahaduz, Whitelaw Alexander, Richards Naomi, Inbadas Hamilton, Clark David
School of Interdisciplinary Studies, University of Glasgow, Dumfries, UK.
Department of Global Health and Infection, Brighton Sussex Medical School, University of Sussex, Brighton, UK.
Med Humanit. 2018 Jun;44(2):140-143. doi: 10.1136/medhum-2017-011329. Epub 2018 Feb 10.
Compassion is an emotional response to the suffering of others. Once felt, it entails subsequent action to ameliorate their suffering. Recently, 'compassion' has become the flagship concept to be fostered in the delivery of end-of-life care, and a rallying call for social action and public health intervention. In this paper, we examine the emerging rhetorics of compassion as they relate to end-of-life care and offer a critique of the expanding discourse around it. We argue that, even where individuals 'possess' compassion or are 'trained' in it, there are difficulties for compassion to flow freely, particularly within Western society. This relates to specific sociopolitical structural factors that include the sense of privacy and individualism in modern industrialised countries, highly professionalised closed health systems, anxiety about litigation on health and safety grounds, and a context of suspicion and mistrust within the global political scenario. We must then ask ourselves whether compassion can be created intentionally, without paying attention to the structural aspects of society. One consequence of globalisation is that countries in the global South are rapidly trying to embrace the features of modernity adopted by the global North. We argue that unrealistic assumptions have been made about the role of compassion in end-of-life care and these idealist aspirations must be tempered by a more structural assessment of potential. Compassion that is not tied to to realistic action runs the risk of becoming empty rhetoric.
同情是对他人痛苦的一种情感反应。一旦产生，它就需要随后采取行动来减轻他人的痛苦。最近，“同情”已成为临终关怀中要培养的核心概念，也是社会行动和公共卫生干预的号召。在本文中，我们审视了与临终关怀相关的新兴同情话语，并对围绕它不断扩展的论述提出批评。我们认为，即使个人“拥有”同情或接受过相关“培训”，同情也难以自由流淌，尤其是在西方社会。这与特定的社会政治结构因素有关，包括现代工业化国家的隐私感和个人主义、高度专业化的封闭卫生系统、对基于健康和安全理由的诉讼的担忧，以及全球政治背景下的猜疑和不信任氛围。那么我们必须自问，在不关注社会结构层面的情况下，同情能否被有意地创造出来。全球化的一个后果是，全球南方的国家正迅速试图接纳全球北方所采用的现代性特征。我们认为，人们对同情在临终关怀中的作用做出了不切实际的假设，这些理想主义的愿望必须通过对潜力进行更具结构性的评估来加以调整。与实际行动脱节的同情有沦为空洞言辞的风险。
