The doctor-patient relationship is a crucial aspect of primary-care practice Research on associations between quality of care provision and burnout and empathy in a primary care setting could improve this relationship. Cross-sectional study of family physicians and nurses of twenty-two primary care centers in the health district of Lleida, Spain. Empathy and burnout were measured using the Jefferson Physician Empathy Scale and the Maslach Burnout Inventory, while quality of care delivery was evaluated using Quality Standard Indicator scores. JPSE and MBI (...) results were grouped into low, medium, and high scores to analyze associations with QSI scores and sociodemographic variables. The mean QSI score recorded for the family physicians and nurses was 665. Higher, albeit insignificant, QSI scores were observed for practitioners with high burnout. No differences were observed according to level of empathy. The differences with respect to sex, age, and area of practice were not significant. Practitioners with low empathy had higher QSI scores than those with high empathy while those with high burnout had higher scores than those with low burnout. Burnout and empathy did not significantly influence quality of care delivery scores in 22 primary care centers. More studies, however, are needed to investigate the unexpected trend observed that suggests that physicians and nurses with higher levels of burnout provide higher quality care. (shrink)

This paper addresses the issue of whether robots could substitute for human care, given the challenges in aged care induced by the demographic change. The use of robots to provide emotional care has raised ethical concerns, e.g., that people may be deceived and deprived of dignity. In this paper it is argued that these concerns might be mitigated and that it may be sufficient for robots to take part in caring when they behave *as if* they care.

This paper provides a series of reflections on making the case to senior leaders for the introduction of clinical ethics support services within a UK hospital Trust at a time when clinical ethics committees are dwindling in the UK. The paper provides key considerations for those building a case for clinical ethics support within hospitals by drawing upon published academic literature, and key reports from governmental and professional bodies. We also include extracts from documents relating to, and annual reports of, (...) existing clinical ethics support within UK hospitals, as well as extracts from our own proposal submitted to the Trust Board. We aim for this paper to support other ethicists and/or health care staff contemplating introducing clinical ethics support into hospitals, to facilitate the process of making the case for clinical ethics support, and to contribute to the key debates in the literature around clinical ethics support. We conclude that there is a real need for investment in clinical ethics in the UK in order to build the evidence base required to support the wider introduction of clinical ethics support into UK hospitals. Furthermore, our perceptions of the purpose of, and perceived needs met through, clinical ethics support needs to shift to one of hospitals investing in their staff. Finally, we raise concerns over the optional nature of clinical ethics support available to practitioners within UK hospitals. (shrink)

Medicine is not merely a job that requires technical expertise, but a profession concerned with making the best decisions and recommendations with reference to, and in consultation with, the patient. This means that the skill set required for healthcare professionals in order to provide good care is a combination of scientific knowledge, technical aptitude, and affective qualities or virtues such as compassion and empathy.

Efficiency is an important value for all publicly funded healthcare systems. Limited resources need to be used prudently and wisely in order to ensure best possible outcomes and waste avoidance. Since 2010, the drive for efficiency, in the UK, has acquired a new impetus, as the country embarked on an ‘age of austerity’ purportedly to balance its books and reduce national deficit. Although the NHS did not suffer any direct budget cuts, the austerity policies imposed on the welfare system, including (...) social and mental healthcare, have had a direct and detrimental impact on the healthcare service. This paper draws from a qualitative study conducted in three A&E Departments in England to explore the effects of austerity policies on the everyday experiences of doctors and nurses working in Emergency Departments. It discusses the operationalisation of efficiency in A&E, in a climate of austerity, and its effects on the experiences and practices of healthcare professionals. It uses the empirical data as a springboard to highlight the role of structures and regulations, in this case targets and protocols, in how core healthcare ethical values, such as empathy, are exercised in practice. It provides an analysis of the normative role structures and regulations can play on the perception and practice of professional duties and obligations in healthcare. (shrink)

This article is an examination of the doctor–woman patient encounter through a vulnerability lens. This relationship has been traditionally been critiqued as a paternalistic encounter in which the...

The goal of this paper is to propose a relational turn in healthcare professionalism, to improve the responsiveness of both healthcare professionals and organizations towards care of patients, but also professionals. To this end, it is important to stress the way in which difficult situations and vulnerability faced by professionals can have an impact on their performance of work. This article pursue two objectives. First, I focus on understanding and making visible shared vulnerability that arises in clinical settings from a (...) triple perspective: patient and family, health professionals, and institutions. Second, to address this challenge for professionalism, in this paper I articulate the term "relational centered-patient professionalism", which has two main axes. The relational approach means taking into account how the relationships among professionals, patients and institutions determine the constitution and evolution of those professional values. The focus on patient centered care is indispensable, because it is the ultimate goal pursued by the development of these professional values, and must always be at the center. (shrink)

Recently, novel lines of research have developed to study the influence of identity processes in sport-related behaviours. Yet, whereas emotions in sport are the result of a complex psychosocial process, little attention has been paid to examining the mechanisms that underlie how group membership influences athletes’ emotional experiences. The present narrative review aims at complementing the comprehensive review produced by Rees et al. (2015) on social identity in sport by reporting specific work on identity-based emotions in sport. To that end, (...) we firstly overview the different terminology currently used in the field of emotions in groups to clarify the distinct nature of emotions that result from an individual’s social identity. Secondly, we discuss key concepts of social identity to better understand the mechanisms underlying identity-based emotions. Thirdly, we address existing knowledge on identity-based emotions in sport. We close the present narrative review by suggesting future research perspectives based on existing meta-theories of social identity. Evidence from the social psychology literature is discussed alongside existing works from the sport literature to propose a crucial theoretical approach to better understand emotions in sport. (shrink)