Challenging questions and ethical obligations: the ethics of everyday practice > 21 January 2015

Christine Lopes


Compassion: universal value or moral emotion?

Cases of gross neglect of care and blatant lack of compassion, such as those represented by the actions and omissions of Mid-Staffordshire and Winterbourne House staff, have generated thorough inquiries into the existing systems for ensuring quality of care, in general, and compassionate care, in particular. In the wake of the Francis Report, ministers have called for Health Education England to develop a values-based test to be use in the recruitment of nursing and care staff. Most nursing and care staff are already told to become well-acquainted with the NHS England three year vision entitled ‘Compassion in Practice – our culture of compassionate care’, which places compassion as one of the six core values of NHS healthcare practice [1]. Yet not all would agree that the problem with compassion is being addressed appropriately. In a recent masterclass debate held at the Southampton General Hospital on the relevance of compassion for the delivery of appropriate healthcare*, Dr. Rodney Gilbert** argued that compassion is neither a necessary nor a sufficient condition for proper healthcare to be delivered, and that, for this reason, only the creation of an institutional ethics based on universal values would ensure that compassion naturally flourishes in care practices. From this proposition Dr. Gilbert concluded that ethical initiatives which “simply tell” professionals to be compassionate are likely to be fruitless. Dr. Gilbert’s argument received a significant vote by the audience. The argument challenges the way in which both the coalition government, Trusts, and leading charities currently aim to implement the much needed changes around the education and training of the NHS healthcare workforce. In my talk I will briefly, and in simple and clear language, introduce the audience to a key aspect of compassion that contemporary psychologists and philosophers emphasise [2] [3] [4] [5] [6] and which makes it a challenge to implement it as a universal value at an institutional level. This key aspect is that compassion is a moral emotion rather than a universal reason to care for others. I will then briefly talk about how this key aspect of compassion has inspired me to design an empirical study of everyday nursing practice, with which I am professionally involved as a nurse. The study will investigate the ways in which nursing and care staff who care for older people with dementia in general and acute hospital wards understand what compassion is, and how their moral and emotional judgements about compassion inform their practice.

*   The masterclass was held on 17 October 2014, and the title was ‘This house proposes that compassion is not essential for the proper practice of medicine’.

** Dr Gilbert is a Consultant Paediatric Nephrologist at the Southampton University Hospitals NHS Trust



[1] The NHS Constitution, “Compassion in Practice Nursing, Midwifery and Care Staff Our Vision and Strategy,” 4 December 2012.
[2] Condon, P. and Feldman Barrett, L., “Conceptualizing and Experiencing Compassion,” vol. 13, no. 5, p. 817–821, 2013.
[3] Goetz, J. et al., “Compassion: An Evolutionary Analysis and Empirical Review,” vol. 136, no. 3, p. 351–374, 2010.
[4] Nussbaum, M. C., Upheavals of Thought: The Intelligence of Emotions, Cambridge University Press, 2001.
[5] Parfit, D., Reasons and Persons, Oxford: Oxford University Press, 1987.
[6] Toon, P., A Flourishing Practice?, Royal College of General Practitioners, 2014.



Dr. Christine Lopes is a Doctor of Philosophy and a Registered Mental Health Nurse.  As a philosopher, her interests are in ethics and applied ethics, phenomenology, philosophy of psychiatry, psychopathology, and in the critique of theories of mind that rely on the concept of rationality.  As a registered mental health nurse, her interests are in the psychology and phenomenology of mental disorders, and their impact on nursing in general.  She holds a joint appointment with Portsmouth Hospitals NHS Trust, Queen Alexandra Hospital (Medicine for Older Persons), and the University of Southampton, Faculty of Health Sciences.


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