Case Study: Physician Lacks Compassion

Compassion is one of the fundamental characteristics implemented into patient care by health care providers. Compassion signifies “a feeling of deep sympathy and sorrow for another who is stricken by misfortune, accompanied by a strong desire to alleviate the suffering” (Compassion, n.d.). Nurses and other health care providers provide selfless service, tireless dedication, compassion, and often neglect their personal needs, which

The American Medical Association (AMA) published a Code of Ethics for Physicians that includes a list of certain principles physicians should follow in order to be good physicians, practicing in an ethical fashion. This list, which was first adopted in June of 1957 and revised as recently as June of 2001, demonstrates some principles that are not universally accepted to be critical to the ethical practice of a physician. In particular, all physicians do not completely believe the claim that “A physician shall support access to medical care for all people” (Principles of Medical Ethics). Theorist, H. Tristam Engelhardt believes that the lack of access to care for some may be unfortunate, but it is not unfair and that this access does not need to be mandated, nor does believing it should be make you an ethical physician. In fact, Engelhardt supremely believes that by providing access of care to all, you will hurt certain patients that already have access to care, negating your function as a physician practicing beneficence. Engelhardt would retract this statement from the Principles of Ethics. However, this belief of and drive to implement access of care to all is critical to one’s job as a physician and it goes against core values of physicians to claim otherwise. Theorists such as Tom Beauchamp and Norman Daniels would agree that the universal access to health care is a critical component of the values physicians hold.

The resident physician violated beneficence, because he did not do good by respecting the patient’s autonomy and he was being uncivil.

Lisa Belkin is a women of her words. Ms. Belkin crammed all feelings imaginable into one book. Just as things seemed to be looking up for the patients involved she threw in a twist just within the next statement. This book is an emotional rollercoaster on all levels, but it was an abundant read. Lisa Belkin’s book is full of ethical dilemmas, provocative insights, indescribable doctor-patient/doctor-coworker relationships, and further more. “First, do no harm” is a principal in medical ethics its self. Medical staff are supposed to abide by the 4 principles of medical ethics, autonomy, beneficence, justice, and non-maleficence. Non-maleficence within its self means do no harm (which is the title of the book). The content of this book is based

Presence of a Duty of care: Physicians have a responsibility to treat people in a medically- appropriate manner.

When asked what trait a physician bears in the 21st century, most would agree with compassion. Pierre Elias author of the narrative essay, “Insensible Losses: When The Medical Community Forgets The Family”, argues that physicians may be compassionate when it comes to their patients, but “lack a systematic approach to communicating with families when a patient’s health deteriorates unexpectedly, requiring a change in care providers” (Elias 707). Pierre Elias is a medical student from Duke University. He is nearing the end of his clinical rotations when he is forced by his inner moral conscience to deliver difficult news to a patient’s family whom no other physician makes time for.

Health caregivers are the group of people mostly at risk of developing compassion fatigue. Most of the times, compassion fatigue may be as a result of the situations the care providers encountered and the pain they feel for their patients. One of the vital element of healthcare is providing a compassionate care. Compassion is defined as being aware of other people suffering, and desire to help to them reduce the suffering (Ruysschaert, 2009). Compassion fatigue is seen as a form of burnout that affect the health care provider which manifest itself as physical, emotional, and spiritual exhaustion (Lynch & Lobo, 2012). The four major factors that can lead to compassion fatigue are, giving others too much caring and not enough care to self, unresolved past trauma, inability to control stress at work, and lack of satisfaction in the work (Ruysschaert, 2009). Compassion fatigue occurs when the caregivers are milked of their sense of wellbeing, comfort, their purpose in life, strength and all the good qualities they have. It is important for those that caring for others to also pay attention to their own needs. Taking care of your own needs means that you will be healthy and therefore be more able to care for others. The caregiver needs to be able to recognize and discuss compassion in order to avoid it.

Traditionally, the physician was expected to use all of their talents and training in an effort to save the life of their patient, no matter the odds. More recently, the physician’s role has been redefined to preserve the autonomy of the patient. Now physicians must give life saving care only in so far and to the degree desirous of the competent patient.

Compassion represents an “acknowledgement of another’s suffering and is accompanied by the expression of a desire to ease or end that suffering.” (Van der Cingal, 2009, p. 124) This is a fundamental characteristic usually found in health care workers and nurses especially. In one twelve hour shift, a nurse’s job can change from taking vitals and administering medications to performing life saving measures

When graduates become doctors or a nurse, they take the doctor's oath, “I swear to fulfill, to the best of my ability and judgment, this covenant:...I will apply, for the benefit of the sick, all measures which are required, avoiding those twin traps of overtreatment and therapeutic nihilism….I will not be ashamed to say "I know not," nor will I fail to call in my colleagues when the skills of another are needed for a patient's recovery….I will respect the privacy of my patients….Most especially must I tread with care in matters of life and death. If it is given me to save a life, all thanks. But it may also be within my power to take a life; this awesome responsibility must be faced with great humility and awareness of my own frailty. Above all, I must not play at God….I will prevent disease whenever I can, for prevention is preferable to cure.” parts taken from the Hippocratic oath all doctors must take. Doctors should follow this oath; however, if their patient is suffering, they should do anything it takes to help him or her even if it results in death. Doctors need to overcome laws and do what is right, even if it makes them lose their job.

Compassion, or caring can be viewed as “nursing’s most precious asset” (Schantz, 2007), a fundamental element of nursing care (Dietze and Orb, 2000), and as one of the strengths of the profession. According to Torjuul et al (2007), it involves being close to patients and seeing their situation as more than a medical scenario and routine procedures. Compassion is to feel passion with someone, to enter sympathetically into their sorrow, suffering, pain or situation and desire and attempt to alleviate the sorrow, suffering, pain or need. Compassion knows when to be the shoulder to cry on and when to be the motivator for life changing health habits. Compassion is; treating not only the diagnosis but the person, the person with feelings, the person who is going to cry sometimes.

This can be read as a key ethical question to many healthcare case studies because of the errors and situations that occur. One of the explanations for this occurrence may be the overwhelming workload, chaotic environment and lack of individual attention prescribed to each patient. These issues can cause a disruption to the ethical principle of Beneficence. The principle of Beneficence calls to action the act of helping others and having compassion for the patients. This principle can be threatened when a doctor or caretaker is overworked and unable to effectively manage the series of patients and work they are assigned to take on. I believe that the admitting doctor did not initially catch the error of not calling for the specific drug need because he was more focused on getting Mr. Londborg stable and on the medication to treat his initial and present condition before worrying about the preventative medication. In addition, the doctor was so focused on helping everyone all at once that he was blind to the small details and loose ends that needed to be taken care

The creditability of our profession is undermined when we face the temptation to ignore our ethical responsibilities. The author of “Ethics & Critical Thinking” asserts the most common ethical fallacies rely on poor judgments, enormous stress, and conflict. Patient violations are committed everyday when our thoughts maintain “it’s not unethical even if our acts have caused harm as long as the person we harmed had it coming, provoked us, deserved it, was really asking for it, or practically forced us to do it—or, failing that, has not behaved perfectly, is in some way unlikable, or is acting unreasonably.” Integrity and values guide our behaviors and ethical commitment

Imagine you are injured or sick and have sought a doctor’s help. Although you trusted your doctor, something, something seemingly very in control of the doctor, went wrong. You are angry and confused, but also think of the commonality of medical malpractice. So, why do doctors, who are supposed to help, harm? Though many flaws influence it, malpractice can be, and often is unintentional. Most doctors aren’t trained to harm their patients. Inexperience and lack of medical discovery led to unintentional suffering of the patient. Personal flaws, like lack of willingness to abandon previous medical methods and shortcomings in communication also harm patients. Further reasons why doctors harm are socio-medical understandings that breed hate, prejudices stemming from a society’s belief about certain people, such as the medical practice under the Nazi regime. Additionally, displayed in the case of Ignác Semmelweis, judgement of one to oneself can be detrimental to any progress one’s ideas could make. We will examine these concepts through Jerome Groopman’s “Flesh-and-Blood Decision Making”, Sherwin Nuland’s The Doctors’ Plague and Barbara Bachrach’s “In the Name of Public Health”. Those who practice medicine are, unfortunately, unfree from the imperfections that plague all of humanity. Through these intimate and varied faults, doctors do harm.

I believe that the medical field needs to undergo a huge improvement in its ability to show compassion to their patients. Compassion and communication skills should be integrated into the education of all aspiring health care providers.