Social Justice and Compassion in Medicine

Compassion, health disparities and social justice in health care are topics that have been discussed for decades and both have been examined from the lens of public health policies and education as well as ethics. Compassion is defined as the “sensitivity to suffering in self and others with a commitment to try to alleviate and prevent it (Sinclair et al, 2016, pg.193).” The importance of compassion may not be fully understood by some doctors who think that their job is to be strictly professional with patients and any matters pertaining to patients.

Today, social justice in the health care is lacking. There are multiple inequalities in our healthcare system that are avoidable and unjust. More than 30 percent of direct medical cost faced by Blacks, Hispanics and Asian Americans can be tied to health inequalities (Wharton University of Pennsylvania, 2019). Due to the inequitable access to care and other health-promoting resources, these populations are often sicker when end with higher medical costs. Medicine is so much more than a textbook coming to life, it is about the fragility of life, the inevitability of death and everything in between.

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It is both fascinating and terrifying that we can easily lose sight of how compassion is at the very core of what it means to be human. While there is no way to choose our patients’ outcomes, we can certainly choose to be empathetic and compassionate regardless of their outcomes. Medicine without empathy and compassion is not medicine at all. By providing adequate training to healthcare professionals, we may be able to propose an effective way of ensuring that nurses and doctors treat their patients with compassion and empathy only if it is followed by specific measures and policies that will nurture and develop such attitudes.

I believe that being an exceptional clinician and a compassionate human being are by no means mutually exclusive rather, they are intertwined. Compassion is a learned behavior. It is not a personality trait that you either have or you don’t. It is a set of behaviors and actions that can be learned and practiced, and even perfected, for those willing to take action.

Over several decades, scientific progress has expanded our ability to improve human health, and many regions of the world have achieved significant health gains. Yet extreme deprivation in health is still widespread. Resolving this predicament of major health improvement in the midst of deprivation is one of the greatest global challenges of the new millennium. The Center for Disease Control and Prevention defines health disparities as “preventable differences in the burden of disease, injury, violence, or opportunities to achieve optimal health that are experienced by socially disadvantaged populations.” There are many things that factor into health disparities and some of them include race or ethnicity, gender, education or income, disability, geographic location, or sexual orientation. Many of the health disparities faced by minority groups can be associated with lack obtaining or understanding basic health information and services needed to make appropriate health decisions. During the past 2 decades, one of Healthy People’s overarching goals has focused on disparities. In Healthy People 2000, it was to reduce health disparities among Americans. In Healthy People 2010, it was to eliminate, not just reduce, health disparities. In Healthy People 2020, that goal was expanded even further: to achieve health equity, eliminate disparities, and improve the health of all groups (Anserdon et al, 2009, pg. 289).

Social justice in health care and health disparities work hand in hand because studies have shown that clinicians tend to have more negative attitudes toward people of color, and unconscious racial bias among clinicians has been shown to lead to poorer communication and lower quality of care. A popular misperception among health care practitioners is that poor patients are more likely to file medical malpractice claims. During the 1990s, obstetricians and gynecologists reported performing a higher number of cesarean sections among a poorer patient population primarily because of a perceived heightened willingness for this group to file suit (Burkle, 2001, pg. 330). Poor does not automatically equate to filling for lawsuit for money. It is important to understand recognize that lawsuit cost money and they require time and patience, so we should not be quick to state that people who are poor are looking for an easy way out. Social justice is a matter of life and death. It affects the way people live, their consequent chance of illness, and their risk of premature death. We watch in wonder as life expectancy and good health continue to increase in parts of the world and in alarm as they fail to improve in others. One of the elements of critical social justice that is grounded in different disciplinary knowledges is to be able to move between the individual and the social to make visible the mutually constitutive social processes that shape individual experience. We ought to identify indicators-or ways of assessing-whether or not we are moving toward socially just healthcare. This we believe is a necessary next step for a practice profession, requiring more theoretical and empirical work to explore the relationships and influences between actions and outcomes at all levels.

There is abundant data in the medical literature showing that we have a compassion crisis in health care. Survey data shows that nearly half of Americans believe that the U.S. health care system is not compassionate. Nearly half of Americans believe that health care providers are not compassionate. This is coupled with evidence that physicians, specifically, miss 60% to 90% of opportunities to respond to patients with compassion. More survey data shows that two-thirds of Americans have had a meaningful health care experience with a striking lack of compassion. There is a lot of research that shows that when patients are treated with compassion, they perceive the health care provider to be more competent. Clearly, you’re going to have trouble building a practice if people don’t think you’re competent and this goes to show why compassion is important. There is notion that society has come with that hospitals cannot be lively. Each time we go the hospital, we rarely laugh or make jokes. Trzeciak who is the chief of medicine at Cooper as well as chair of medicine at Cooper Medical School at Rowan University, joined the Wharton School of Medicine on their radio show on SiriusXM to talk about bringing more compassion into the practice of medicine. Trzeciak was asked “How does compassion factor into Cooper and your role there?” and he answered “as a leader in the organization and chief of medicine, and after curating all the data and putting it together in this book, I am aware every day of how much compassion matters, not only in meaningful ways, but also measurable ways. We are now taking a new approach and looking at that in every aspect of what we do.” I believe that compassionate behaviors can, in fact, be taught and learned. It plays such a vital part in medicine and needs to be introduce in medical schools.

The healthcare system in the united states undergoes many changes due to politics, policies and healthcare budget. Social medicine places an equal level of focus on the social conditions and structural inequalities that generate and cause health problems. These include social stigmatization and discrimination, social injustice and adverse physical factors in certain environments such as inadequate diets and low income. Providing adequate training to healthcare professionals proposed to remedy poor care and neglect may be an effective way of ensuring that nurses and doctors treat their patients with compassion and empathy only if it is followed by specific measures and policies that will nurture and develop such attitudes. In order to successfully achieve this, we must acknowledge the lack of compassion in health care and the roles that social inequality and health disparities contribute to our health care system.