Two Models of Compassion in the Therapy Cap Debate

Dec 27, 2013

Two Models of Compassion

          This year, AOTA’s new president marked her inauguration by discussing the importance of compassionate care. Since that time I have been contemplating how people with various perspectives conceptualize compassion. It would be worthwhile to explore the notion of compassion because I think that two competing views of compassion are actually influencing the debate over the therapy cap.  

         The first model is what can be called Compassion Action. Compassion Action uses an active and direct approach to helping those one believes should be helped. In this model, if someone is in need, you directly and actively take action to help them either through volunteering your time or donating your money. This is Compassion Action's fundamental feature: the direct contribution of one’s own time and one’s own money to the people in need.

          A competing form of compassion can be termed Confiscatory Compassion. This view of compassion posits that the way to help others is to support government policies that either directly or indirectly require the government to confiscate the money of some and distribute it to those one is claiming to have compassion for. Confiscatory Compassion is the model of compassion underpinning the movement for repealing the cap. Lobbying and advocacy that call for government money are at the heart of Confiscatory Compassion. In such a model one does not donate one’s money and time directly to help those one wants to help. Rather, one’s money is donated for lobbyists to use to persuade politicians and time is used to persuade politicians; the goal of all the persuasion through money and time is to get these politicians to pass more laws involving confiscation and redistribution. 

          In such a model of compassion the expectation is that people’s needs will be met by having the government confiscate whatever money is necessary to meet those needs, rather than looking for solutions through voluntary social interaction. It should be remembered, because it is so often forgotten, that the government can only pay for things by taking someone’s money, taking it either now or later, in one way or another.

          A compassion premised on one’s own voluntary contribution to help others directly will have a different set of dynamics than one premised on persuading politicians to pass laws promoting the forced confiscation and redistribution of money by the government.

          In practicing Compassion Action, one comes to recognize that there should be limits as to how much of one’s money and time should be devoted to meeting the needs of others. The concept of limits is important because our time is limited and our money is limited. And, we have the right to pursue joy and pleasure in our own lives. We have our own family and friends that we want to spend time with and use our money for. Failing to acknowledge this and saying that the needs of others have an unlimited claim on our time and money is to say that we should be the moral servants of the needy. Compassion Action seeks to help others directly with the understanding that we each have the right to pursue happiness in our own lives.

           The dynamics of Confiscatory Compassion (1) tend to ignore the importance of limits, (2) tend to be disrespectful of people’s right to their own lives and money, and (3) tend to lack the ability to put the needs of others in perspective. If someone is in need, the solution for Confiscatory Compassion is easy: call for even more confiscation. It also tends to give one an inflated sense of one’s compassion. The reason for this is that there is no cost to concluding that one is compassionate; all it takes is an opinion about a confiscatory public policy. In this form of compassion, the dynamic is to focus on problems in such a way that they can only be solved by the government. The tendency then is ignore the choices one makes when choosing to indulge in luxuries and conveniences versus spending one’s own time and money to create solutions directed at those we have compassion for.

          I believe these are the two paradigms of compassion at play in this discussion.