How education must reawaken empathy

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Excerpt

Unless you are a visiting your local general practice clinic where you may be recognised by friends and neighbours, it is unlikely that you will come away from a modern health service with the feeling of having had a warm and empathic encounter with a nurse or doctor. As a patient in an outpatient clinic, one needs to endure time that undulates between long waiting times, with single, brief and hurried encounters with clinicians. There will be complex machinery, crowds of people – other patients, visitors and hospital staff – generating noise and making demands. The experience is likely to leave you feeling as though you were treated more like an object than a unique individual with personal and important concerns. To cope with this situation, and cope with its negative impacts, one needs to understand the peculiar mechanism of dehumanization that works sometimes as a blessing and a curse for medical workers (Haslam 2015).
Doctors and nurses learn through socialisation and role modelling that, to be a clear decision maker unencumbered by too many emotions, they are expected to treat people like they are cases, or collections of symptoms. You become desensitised to the many harrowing aspects of humanity seen every day. Care is often delivered to a body without acknowledgement that this is a body, a human being who has emotional and spiritual needs. Distance has the added benefit of allowing clinicians to continue to care for case after case, and to go home at the end of a shift feeling as though they have dispensed care reliably and efficiently.
Many healthcare workers think that to be professional and deliver high quality health care they need to be dispassionate and distanced. They misguidedly conclude that this is necessary to protect them from the distress they may suffer from their work. This is despite the evidence demonstrating the positive results for both patients and the healthcare professionals when empathy, a more passionate and engaged ontology, is communicated.
Studies have shown that, whilst empathy may be prevalent in medical students, for example, at the start of their programmes, it declines with exposure and interaction with patients in the clinical setting. Neumann et al. (2011) suggest that this could be due to the belief that to survive personally and professionally they need to treat patients objectively and dispassionately; however, they are objectifying people and dehumanising them. It is suggested that burnout and depression as students move through their programmes could contribute to this decline in empathy (Neumann et al. 2011).
The curse of dehumanization is that clinicians, having been trained so well to treat people without emotion, or sometimes with a false bonhomie, find it difficult to think and practice using both emotion and reason. Evidence for this is the many cases of institutional neglect such as observed in Mid‐Staffordshire in the UK (Francis 2010). More than 300 deaths were directly linked to this neglect. This was an extreme case but every day patients and their family and friends experience and witness acts of indifference and inattention such as those in the review recently conducted at a major teaching hospital in Australia that reported numerous issues where patients were left lying in dirty beds, given the wrong food or no food at all (http://www.watoday.com.au/wa-news/fiona-stanley-hospital-patients-injured-not-fed-left-in-dirty-beds-review-20150723-giisbo.html; retrieved 7 December 2016). Stereotyping of people who are older, have a disability, a mental illness or who act in ways considered deviant (such as those who self‐harm or overuse alcohol) is common among clinicians, and is an example of dehumanization. In more overt examples, clinicians have also been known to exploit, mock, deny people their right to liberty (http://www.news.com.
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