It would be hard to deny progress in modern healthcare. Whether the metric is diagnostic precision or advances in therapeutics, medicine has advanced significantly in recent years.But, despite these advances, something is missing.The authors of a recent opinion piece in the British Medical Journal argue that modern healthcare is facing a moral emergency. They say healthcare has lost its human, moral and relational foundations and must reconnect with its core values to improve both patient and staff wellbeing. In order to reconnect healthcare with its mission and purpose it is time to restore kindness and compassion, experts from Imperial College Healthcare NHS Trust in London and the Institute for Healthcare Improvement in Boston argue. There is now a deep paradox whereby patients increasingly feel processed rather than cared for, staff report moral distress and loss of meaning, and the workforce is haemorrhaging people at an unsustainable rate.The core problem, they write, is we have accumulated extraordinary technical power while quietly losing the human, moral and relational foundations of care on which its effectiveness ultimately depends.Several powerful forces have helped create this imbalance, they say. For instance, in some countries the pursuit of profit has choked healthcare’s moral purpose, while across the globe modern healthcare has become an industrialised system that processes patients through standardised protocols in ways that risk disregarding the unique texture of individual lives.This has happened through an imbalanced emphasis on a “rational” lexicon (focused on measurement, targets and efficiency) over a “relational” one (concerned with feelings, kindness and human connection). Healthcare across the globe has lived almost entirely inside the rational lexicon for 30 years. Yet, re-establishing the relational balance is not a sentimental or “soft” approach; it is vital for quality and safety, they say.But does restoring the relational balance actually work?[ How Irish healthcare compares with other countries: you might be surprisedOpens in new window ]There is evidence that organisations where staff felt supported and valued had consistently lower patient death rates. And where conditions change to increasing joy in work – with clarity of purpose, psychological safety and feeling that what matters to you is actually valued – these changes are both achievable and measurable.Here in Ireland, work on restoring this balance to healthcare has already begun. I’m proud to say my alma mater is to the fore. The medical school at Trinity College Dublin (TCD) has just made love a graduate outcome that will be assessed for the first time next year. Claire Donohoe, senior lecturer in surgery and Colin Doherty, head of the school of medicine at TCD, have co-authored an article published in the Journal of Medical Education and Curricular Development arguing for love’s inclusion as a core concept in medical curricula.They see the new requirement as a need to be “a human with other humans”. Love in this context “calls on you to feel an emotional response to other people’s suffering or illness or ill health”, Donohoe told The Irish Times. “It’s being able to be comfortable sitting with the discomfort of watching other people suffer. Seeing other people going through difficult things and not losing the sense that they are people.”Machines may be able to “create a simulacrum of empathy and compassion”, says Doherty. “But in healthcare, when you bring love into it, you’re talking about actual clinicians stepping into the breach of the relationship and making a connection that is not going to be possible with a machine.”The argument he and Donohoe make is that treatment can go too far in the direction of cold, clinical logic.The BMJ authors say there is no need to wait for system reform for things to improve – every ward round and every consultation represents a small but powerful opportunity. “The evidence is clear: when healthcare systems invest in joy, kindness, compassionate leadership and asking four simple words ‘what matters to you?’ patients do better and staff thrive”, they conclude.mhouston@irishtimes.com
How healthcare must reconnect with its core values to improve patient and staff wellbeing
Dr Muiris Houston: It’s important to restore the balance between efficiency and concern with feelings, kindness and human connection















