COMPASSION: IS IT VOLUNTARY OR INVOLUNTARY BEHAVIORAL RESPONSE?

COMPASSION: IS IT VOLUNTARY OR INVOLUNTARY BEHAVIORAL RESPONSE?

Image result for what is the original source of compassion

In my view, Compassion is a natural, automated response generated in a person who truly experiences the feelings of grief and sorrow while actually witnessing a person or another living entity suffering on account of grief or sorrow. Compassion is neither learned nor acquired by exposure to educational experience or academic training. A professional actor can display a range of emotional responses including those of grief or sorrow. However, such enactment of behavioral response with features of grief or sorrow does not represent compassionate behavior.

In my analysis, a person who is insensitive to grief or sorrow often fails to respond in the natural, automatic manner to external stimuli. The insensitivity of the person can be attributed to his alienation, estrangement, separation, aloofness, ignorance, or distancing himself from his own true or real human nature.

To provide compassionate care or service, the person needs to discover his own true or real Self, the image in which God created man, giving or sharing with man His own Nature full of Grace, Mercy, and Compassion. To demonstrate Compassion, man has to get connected to the original source of Compassion

Image result for genesis 1:27 

Why I Spoke with the Dalai Lama About Compassion in Medicine

I distinctly recall the moment I decided to become a physician.  I was sitting on a bench in the hallway of Coney Island Hospital in Brooklyn, besides my aunt and older cousin, as we waited for the physicians to complete their examination of my beloved grandmother, in her early 90s, who was seriously ill.  She doted on all of her grandchildren, particularly me, as I was the youngest.  I loved my grandmother dearly.  I recall seeing the doctors, dressed in their white uniforms, emerge from her room, holding her life in their hands.  They eagerly reported what turned out to be good news, and thankfully, she lived over a year, and I entered the path to spend my life as a physician.  Clearly, what drove me into the field of medicine was the compassion these doctors exhibited—their sincere desire to care for and improve the lives of others.  

Amazingly, thirty-seven years later, I found myself as chancellor for health affairs at Duke University and dean of the Duke University School of Medicine where I oversaw the selection of our medical students.  The school was in an enviable position of having thousands of applicants with the highest academic standards for a class of 100 students.  While maintaining the most rigorous standards for scholastic achievement, we selected only those who convincingly demonstrated their compassion to serve the needs of others.  But, what has become apparent to me is that the sincere desire to deliver compassionate care—what drives most individuals to become physicians—is greatly challenged by the rigor and difficulties of medical education and even more so by the current practice of medicine.  Many factors are responsible for this, including the increasingly technical nature of medicine, the shortage of time available to engage with patients, and the ongoing bureaucratic issues needed for compliance.  However, the lack of focus on compassion, the basic emotion bringing physicians to medicine, has, in my view, greatly reduced the joy of practicing medicine and the benefits that physicians can bring to their patients.  Importantly, the lack of deep meaningful engagement between physicians and patients also greatly diminishes the value of care as patient behavior changes to achieve the best outcome is greatly dependent on the physician-patient relationship. 

Being committed to developing more effective, proactive, personalized models of care delivery, I have become increasingly interested in developing approaches to care that maximize compassionate interaction between the patient and their physician, while increasing the effectiveness and enjoyment of this engagement.  This being the case, I sought the opportunity to discuss compassion with the most recognized expert in compassion in the world, His Holiness the 14th Dalai Lama.  Join me in learning what resulted from this meeting and how compassion can be brought back to the practice of medicine in my recent Academic Medicine Invited Commentary.

By Ralph Snyderman, MD

R.S. is James B. Duke Professor of Medicine and Director, Center for Personalized Health Care, Duke University School of Medicine, and chancellor emeritus, Duke University, Durham, North Carolina.

Further Reading

Snyderman, R. Compassion and health care: A discussion with the Dalai Lama [published online ahead of print March 12, 2019]. Acad Med. doi: 10.1097/ACM.0000000000002709.

1 Comment
Rudra Narasimham Rebbapragada

What are the differences between voluntary actions and involuntary actions?
The article gives an incorrect impression about actions described as the delivery of compassionate care. The problem arises, as the author makes no distinction between voluntary actions and involuntary actions. The behavioral response characterized as compassionate care is always initiated as an involuntary response to an external environmental stimulus that evokes the feelings of sorrow, or grief. In other words, I cannot display any compassionate action in any given situation without experiencing grief or sorrow which acts as a trigger to elicit the response.

Published by Bhavanajagat

Whole Man - Whole Theory: "I am Consciousness, Therefore I am" is my proposition to examine the reality of Man and the World in which he exists.

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