On Compassion For Suffering & The Fight Against Ebola

December 18, 2014 Picture: UKDID/Flickr.

Compassion is unusual among feelings or emotions, in that the same English word is used for the feeling and for the corresponding virtue. That may be because it is generally thought good to feel compassion. As I’ll suggest below, that’s doubtful.

Unlike pity, compassion has no connotations of condescension or contempt. Empathy can be understood as a neutral understanding of the feelings of others. Compassion is closer to sympathy, understood in a strong form: a motivationally charged response to the suffering of others.

The most historically influential account of compassion has been that of Aristotle, in his Rhetoric, and this account has been updated and revised in more recent times by Martha Nussbaum, in her Upheavals of Thought (Cambridge University Press, 2003). Partly following Aristotle, Nussbaum puts three ‘cognitive requirements’ on compassion:

1. The suffering or ‘evil’ must be serious.

2. The evil must be undeserved.

3. The evil must be something the compassionate person considers part of her own scheme of goals.

I doubt all of these. First, I see no reason for a threshold for compassion. If you stub your toe then I can justifiably feel some compassion for you. Second, we can feel compassion for suffering even if we consider it deserved: consider the attitude of some prison visitors to the prisoners they visit. Finally, imagine someone who knows that she is close to death, to the point that she no longer has any substantial goals. Can she not feel compassion?

In preference to Nussbaum’s Aristotelian and Stoic ‘cognitivist’ account of compassion, I recommend a non-cognitive account, according to which what matters is pain or distress at the pain or distress of others. (If you’d like to see a statement of that in the history of philosophy, take a look at the opening words of Adam Smith’s Theory of Moral Sentiments).

What about compassion as a virtue? Here I think Aristotle can help. In his Nicomachean Ethics, Aristotle outlines his ‘doctrine of the mean’. The virtues are partly to do with feelings, and about these he says:

“To have them at the right time, about the right things, towards the right people, for the right end, and in the right way, is the mean and best; and this is the business of virtue. Similarly, there is an excess, a deficiency and a mean in actions. Virtue is concerned with feelings and actions, in which excess and deficiency constitute misses of the mark, while the mean is praised and on target, both of which are characteristics of virtue”. (2.6)

We should remember that virtue involves action as well, so the compassionate person, understood on Aristotle’s model, will act compassionately (that is, help others) as well as feel for them. On an Aristotelian account, then, the virtue of compassion will consist in feeling compassion, and acting to help others, at the right time, in relation to the right things and the right people, for the right end, and so on. The deficiency will consist in not feeling compassion and not acting compassionately when one should. We might call this callousness. But there is also an excess: feeling compassion and helping others when one shouldn’t. Consider someone who feels condescending and inappropriate pity for the disabled. This is a case of being ‘over-compassionate’. What I now want to suggest is that this excessive vice may be exemplified in some of the responses we have seen in recent months to Ebola.

Our main question is: when is it appropriate to feel compassion and to act on that compassion? Consider now three different conceptions of the virtue of compassion. The first I’m going to call agent-focused and partial (AFP). This is close to what one might see as the ‘traditional’ account of compassion. The person who is AFP-compassionate feels compassion in proportion to her connection with or relation to others. If one of her close relatives or friends is ill, for example, she may be deeply moved, and exert herself considerably to provide assistance. When it comes to those who are far away, in space (e.g. West Africa) or indeed time (future generations), her propensity to feel compassion and to act compassionately is less – often significantly less. But even here she will think it important that she does something. So rather than merely give a few pounds to an Oxfam appeal, she may spend a good deal of time organizing a bake-sale at one of her children’s school. So she is partial towards those close to her, and her agency is also deliberatively significant.

A second kind of compassion is agent-focused and impartial (AFI). This conception, in its pure form, places no normative weight on personal relationships, and is hence impartial. So if you ask an AFI-compassionate agent what matters to her, she will say that she wants to help other people – whoever they are – as much as she can, even if this puts her, and perhaps those close to her, at potentially serious risk. It is unlikely that any real human agent is entirely AFI-compassionate, but many people appear to demonstrate elements of this quality in their character. Consider Dr Kent Brantly, who contracted Ebola while engaged in missionary work in Ebola. It is clear that Dr Brantly does greatly value his family and his relationship with them. But he felt it more important to put his own life at risk to help those suffering from Ebola, even though they had no connection with him. And it mattered that it was he who was caring for his patients. My guess is that he never considered merely making a substantial financial donation as a substitute for his own medical assistance.

My final form of compassion is also impartial, but it puts no weight on the agent’s providing the help herself. Imagine someone who receives an unexpected inheritance of fifty thousand dollars. She might use that to help her niece through school (AFP-compassion). Or (if we assume she has the relevant skills) she might fund a trip for herself to West Africa to assist those dying from Ebola (AFI-compassion). Finally, she may do some research into the most effective charitable projects in the world, through organizations such as Giving What We Can. She may, for example, donate her inheritace to the Deworm the World Initiative, which encourages de-worming in school children in developing countries. This affects both health and educational outcomes, and is very cheap (about 50 cents per child per year). We might call this outcome-focused and impartial compassion (OFI).

Which conception of compassion is correct – that is, which one should we go for if we receive an unexpected inheritance? The morality we live by – so-called ‘common-sense morality’ – not only permits us to adopt any of the three conceptions, but will approve of each. But it is perhaps AFI-compassion which receives the greatest praise, especially if – as in the case of Dr Brantly – it involves risk to the agent and sits alongside a certain level of AFP-compassion as well. There are doubtless historical reasons for our sentiments’ having taken this shape, so we might want at this point to hold them up to the light. What matters to people who are suffering is that their suffering is relieved, and at bottom it doesn’t really matter by whom. Perhaps OFI-compassion, then, is the most plausible form, requiring the agent to provide as much impartial help to others as she can, even if that help is provided indirectly.