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Cognition and the compassion deficit: the social psychology of helping behaviour in nursing


  • John Paley MA

    Senior Lecturer, Corresponding author
    1. School of Nursing Midwifery and Health, University of Stirling, Stirling, UK
    • Correspondence: Mr John Paley, Senior Lecturer, School of Nursing, Midwifery and Health, University of Stirling, Stirling, FK9 4LA, UK. Tel.: + 44 1786 466399; fax: + 44 1786 466333; e-mail:

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This paper discusses compassion failure and compassion deficits in health care, using two major reports by Robert Francis in the UK as a point of reference. Francis enquired into events at the Mid Staffordshire Hospital between 2005 and 2009, events that unequivocally warrant the description ‘appalling care’. These events prompted an intense national debate, along with proposals for significant changes in the regulation of nursing and nurse education. The circumstances are specific to the UK, but the issues are international.

I suggest that social psychology provides numerous hints about the mechanisms that might have been involved at Mid Staffs and about the reasons why outsiders are blind to these mechanisms. However, there have been few references to social psychology in the post-Francis debate (the Francis Report itself makes no reference to it at all). It is an enormously valuable resource, and it has been overlooked.

Drawing on the social psychology literature, I express scepticism about the idea that there was a compassion deficit among the Mid Staff nurses – the assumption that the appalling care had something to do with the character, attitudes, and values of nurses – and argue that the Francis Report's emphasis on a ‘culture of compassion and caring in nurse recruitment, training and education’ is misconceived. It was not a ‘failure of compassion’ that led to the events in Mid Staffs but an interlocking set of contextual factors that are known to affect social cognition. These factors cannot be corrected or compensated for by teaching ethics, empathy, and compassion to student nurses.

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