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Compassion: hard to define, impossible to mandate

BMJ 2015; 351 doi: (Published 29 July 2015) Cite this as: BMJ 2015;351:h3991
  1. Raymond Chadwick, consultant clinical psychologist, Teesside University, School of Health and Social Care, Middlesbrough TS1 3BA, UK
  1. R.Chadwick{at}

Patients most likely want to interact with the person behind the professional, writes Raymond Chadwick, but it’s impossible to insist that staff connect emotionally with all patients

Since Robert Francis QC’s report of 2013 on the inquiry at Mid Staffordshire NHS Foundation Trust, the word “compassion” has taken on new significance. Its exact meaning may not be obvious, but clearly it’s a good thing, and we need more of it. Francis wrote that patients “must receive effective services from caring, compassionate and committed staff working within a common culture.”1

In relation to training nurses he called for “an increased focus . . . on the practical requirements of delivering compassionate care.” This, he opined, would require aptitude tests for compassion during selection, training supported by national standards in “fundamental aspects of compassionate care,” and “leadership which constantly reinforces . . . standards of compassionate care.”

So we now have “values based recruitment,”2 an e-learning programme called Compassion in Practice,3 and the “6 Cs”—care, compassion, competence, communication, courage, and commitment—as a vision for nurses, midwives, and care staff.4

What is compassion?

But what do we understand by compassion? The Francis report did …

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