Empathy in patient care: from ‘Clinical Empathy’ to ‘Empathic Concern’

Clarissa Guidi; Chiara Traversa

doi:10.1007/s11019-021-10033-4

journal article Open Access Jul 01, 2021

Empathy in patient care: from ‘Clinical Empathy’ to ‘Empathic Concern’

Clarissa Guidi Chiara Traversa

Medicine, Health Care and Philosophy Vol. 24 No. 4 pp. 573-585 · Springer Science and Business Media LLC

View at Publisher Save 10.1007/s11019-021-10033-4

Abstract

AbstractAs empathy gains importance within academia, we propose this review as an attempt to bring clarity upon the diverse and widely debated definitions and conceptions of empathy within the medical field. In this paper, we first evaluate the limits of the Western mainstream medical culture and discuss the origins of phenomena such asdehumanizationanddetached concernas well as their impacts on patient care. We then pass on to a structured overview of the debate surrounding the notion of clinical empathy and its taxonomy in the medical setting. In particular, we present the dichotomous conception of clinical empathy that is articulated in the debate aroundcognitive empathyandaffective empathy. We thus consider the negative impacts that this categorization brings about. Finally, we advocate for a more encompassing, holistic conception of clinical empathy; one that gives value to a genuine interest in welcoming, acknowledging and responding to the emotions of those suffering. Following this line of reasoning, we advance the notion of ‘empathic concern’, a re-conceptualization of clinical empathy that finds its source in Halpern in Med Health Care Philos (2014) 17:301–311engaged curiosity. We ultimately advance Narrative Medicine as an approach to introduce, teach and promote such an attitude among medical trainees and practitioners.

Topics

No keywords indexed for this article. Browse by subject →

References

109

[1]

AAMC, P. 1998. Report II: Contemporary Issues in Medicine: Medical Informatics and Population Health. Washington, DC: Association of American Medical Colleges 25.

[2]

Alma, Hans A., and Adri Smaling. 2006. The meaning of empathy and imagination in health care and health studies. International Journal of Qualitative Studies on Health and Wellbeing 1, 195–211. http://www.ijqhw.net/index.php/qhw/article/view/4934. 10.1080/17482620600789438

[3]

Aring, Charles D. 1958. Sympathy and empathy. Journal of the American Medical Association 167 (4): 448–452. 10.1001/jama.1958.02990210034008

[4]

Astell, Ann W. 2004. Saintly mimesis, contagion, and empathy in the thought of Rene Girard, Edith Stein and Simone Weil. Shofar an International Journal of Jewish Studies 22 (2): 116–131. https://doi.org/10.1353/sho.2004.000. 10.1353/sho.2004.000

[5]

Avery, J. K. 1985. Lawyers tell what turns some patients litigious. Med Malpractice Rev, 2, pp. 35–37.

[6]

Beach, Mary Catherine, and Thomas Inui. 2006. Relationship-centered care. Journal of General Internal Medicine 21 (1): 3–8. 10.1111/j.1525-1497.2006.00302.x

[7]

Beckman, Howard B., Kathryn M. Markakis, Anthony L. Suchman, and Richard M. Frankel. 1994. The doctor-patient relationship and malpractice: lessons from plaintiff depositions. Archives of Internal Medicine 154 (12): 1365–1370. 10.1001/archinte.1994.00420120093010

[8]

Bellini, Lisa M., and Judy A. Shea. 2005. Mood change and empathy decline persist during three years of internal medicine training. Academic Medicine 80 (2): 164–167. 10.1097/00001888-200502000-00013

[9]

Bellini, Lisa M., Michael Baime, and Judy A. Shea. 2002. Variation of mood and empathy during internship. JAMA 287 (23): 3143–3146. 10.1001/jama.287.23.3143

[10]

Bertakis, Klea D., Debra Roter, and Sean M. Putnam. 1991. The relationship of physician medical interview style to patient satisfaction. Journal of Family Practice 32 (2): 175–181.

[11]

Bikker, Annemieke P., Stewart W. Mercer, and David Reilly . 2005. A pilot prospective study on the consultation and relational empathy, patient enablement, and health changes over 12 months in patients going to the Glasgow Homoeopathic Hospital. Journal of Alternative & Complementary Medicine 11 (4): 591–600. 10.1089/acm.2005.11.591

[12]

Bloom, Paul. 2017. Against empathy: The case for rational compassion. Random House.

[13]

Blumgart, Herrman L. 1964. Caring for the patient. New England Journal of Medicine 270 (9): 449–456. 10.1056/nejm196402272700906

[14]

Impact of communication training on physician expression of empathy in patient encounters

Kathleen A. Bonvicini, Michael J. Perlin, Carma L. Bylund et al.

Patient Education and Counseling 2009 10.1016/j.pec.2008.09.007

[15]

Boulton, Robert. 1987. People skills. Sydney, New South Wales, Australia: Simon & Schuster.

[16]

Broyard, Anatole. 1993. Intoxicated by my illness: and other writings on life and death. Fawcett Books.

[17]

Charon, Rita. 2001. Narrative medicine: A model for empathy, reflection, profession, and trust. JAMA 286 (15): 1897–1902. 10.1001/jama.286.15.1897

[18]

Charon, Rita. 2004. The ethicality of narrative medicine. Narrative Research in Health and Illness. https://doi.org/10.1002/9780470755167. 10.1002/9780470755167

[19]

Charon, Rita. 2006. Narrative medicine: Honoring the stories of illness. Oxford University Press. 10.1093/oso/9780195166750.001.0001

[20]

Charon, Rita. 2007. What to do with stories: The sciences of narrative medicine. Canadian Family Physician 53 (8): 1265–1267.

[21]

Chen, Daniel CR., Daniel S. Kirshenbaum, Jun Yan, Elaine Kirshenbaum, and Robert H. Aseltine. 2012. Characterizing changes in student empathy throughout medical school. Medical Teacher 34 (4): 305–311. 10.3109/0142159x.2012.644600

[22]

Coplan, Amy, and Peter Goldie, eds. 2011. Empathy: Philosophical and psychological perspectives. Oxford: Oxford University Press.

[23]

Coulehan, John L. 1995. Tenderness and steadiness: Emotions in medical practice. Literature and Medicine 14 (2): 222–236. 10.1353/lm.1995.0027

[24]

Coulehan, Jack. 2005. Today’s professionalism: engaging the mind but not the heart. Academic Medicine 80 (10): 892–898. 10.1097/00001888-200510000-00004

[25]

Coulehan, Jack, and Peter C. Williams. 2001. Vanquishing virtue: The impact of medical education. Academic Medicine 76 (6): 598–605. 10.1097/00001888-200106000-00008

[26]

Coulehan, John L., Frederic W. Platt, Barry Egener, Richard Frankel, Chen-Tan. Lin, Beth Lown, and William H. Salazar. 2001. “Let me see if I have this right…”: Words that help build empathy. Annals of Internal Medicine. 135: 221. 10.7326/0003-4819-135-3-200108070-00022

[27]

Coulehan, Jack. 2009a. Compassionate solidarity: Suffering, poetry, and medicine. Perspectives in Biology and Medicine 52: 585–603. 10.1353/pbm.0.0130

[28]

Coulehan, Jack. 2009b. Rescuing empathy. Literature, Arts, and Medicine Blog, Nov. 30. Retrieved from http://medhum.med.nyu.edu/blog.

[29]

Crandall, Sonia J., and Gail S. Marion. 2009. Commentary: Identifying attitudes towards empathy: An essential feature of professionalism. Academic Medicine 84 (9): 1174–1176. 10.1097/acm.0b013e3181b17b11

[30]

Cuff, Benjamin MP., Sarah J. Brown, Laura Taylor, and Douglas J. Howat. 2016. Empathy: A review of the concept. Emotion Review 8 (2): 144–153. 10.1177/1754073914558466

[31]

Decety, Jean. 2010. The neurodevelopment of empathy in humans. Developmental neuroscience, 32 (4), pp. 257–267. 10.1159/000317771

[32]

Decety, Jean. 2011. Dissecting the neural mechanisms mediating empathy. Emotion Review 3 (1): 92–108. 10.1177/1754073910374662

[33]

Human Empathy Through the Lens of Social Neuroscience

Jean Decety, Claus Lamm

The Scientific World JOURNAL 2006 10.1100/tsw.2006.221

[34]

Decety, Jean, and Meghan Meyer. 2008. From emotion resonance to empathic understanding: A social developmental neuroscience account. Development and Psychopathology 20 (4): 1053–1080. 10.1017/s0954579408000503

[35]

Derksen, Frans, Jozien Bensing, and Antoine Lagro-Janssen. 2013. Effectiveness of empathy in general practice: A systematic review. British Journal of General Practice 63 (606): e76–e84. 10.3399/bjgp13x660814

[36]

DiMatteo, M. Robin., Ron D. Hays, and Louise M. Prince. 1986. Relationship of physicians’ nonverbal communication skill to patient satisfaction, appointment noncompliance, and physician workload. Health Psychology 5 (6): 581. 10.1037/0278-6133.5.6.581

[37]

DiMatteo, M. Robin., Cathy Donald Sherbourne, Ron D. Hays, Lynn Ordway, Richard L. Kravitz, Elizabeth A. McGlynn, Sherrie Kaplan, and William H. Rogers. 1993. Physicians’ characteristics influence patients’ adherence to medical treatment: Results from the Medical Outcomes Study. Health Psychology 12 (2): 93. 10.1037/0278-6133.12.2.93

[38]

Diorio, Caroline, and Ma.łgorzata Nowaczyk. 2019. Half as sad: A plea for narrative medicine in pediatric residency training. Pediatrics 143 (1): e20183109. 10.1542/peds.2018-3109

[39]

Eide, Hilde, Richard Frankel, Anne Christine Bull. Haaversen, Kerstin Anine Vaupel, Peter K. Graugaard, and Arnstein Finset. 2004. Listening for feelings: Identifying and coding empathic and potential empathic opportunities in medical dialogues. Patient Education and Counseling 54 (3): 291–297. 10.1016/j.pec.2003.09.006

[40]

Eisenthal, Sherman, Robert Emery, Aaron Lazare, and Harriet Udin. 1979. “Adherence” and the negotiated approach to patienthood. Archives of General Psychiatry 36 (4): 393–398. 10.1001/archpsyc.1979.01780040035003

[41]

Ekman, Eve, and Michael Krasner. 2017. Empathy in medicine: Neuroscience, education and challenges. Medical Teacher 39 (2): 164–173. 10.1080/0142159x.2016.1248925

[42]

Figley, Charles R. 2002. Treating compassion fatigue. New York: Brunner-Routledge.

[43]

Finset, Arnstein. 2010. Conceptual explorations on person-centered medicine 2010: emotions, narratives and empathy in clinical communication. International Journal of Integrated Care. https://doi.org/10.5334/ijic.490. 10.5334/ijic.490

[44]

Flexner, Abraham. 1912. Medical education in Europe: A report to the Carnegie Foundation for the Advancement of Teaching 6. Carnegie Foundation for the advancement of teaching.

[45]

Fox, Fiona E., Karen J. Rodham, Michael F. Harris, Gordon J. Taylor, Jane Sutton, Jenny Scott, and Brian Robinson. 2009. Experiencing “the other side”: A study of empathy and empowerment in general practitioners who have been patients. Qualitative Health Research 19: 1580–1588. https://doi.org/10.1177/1049732309350732. 10.1177/1049732309350732

[46]

Francis, Vida, Barbara M. Korsch, and Marie J. Morris. 1969. Gaps in doctor-patient communication: Patients’ response to medical advice. New England Journal of Medicine 280 (10): 535–540. 10.1056/nejm196903062801004

[47]

Gair, Susan. 2012. Feeling their stories: Contemplating empathy, insider/outsider positionings, and enriching qualitative research. Qualitative Health Research 22 (1): 134–214. 10.1177/1049732311420580

[48]

Patients' and Physicians' Attitudes Regarding the Disclosure of Medical Errors

Thomas H. Gallagher, Amy D. Waterman, Alison G. Ebers et al.

JAMA 2003 10.1001/jama.289.8.1001

[49]

Garden, Rebecca. 2009. Expanding clinical empathy: An activist perspective. Journal of General Internal Medicine 24 (1): 122–125. 10.1007/s11606-008-0849-9

[50]

Geldard, David, and Kathryn Geldard. 2005. Basic personal counselling. Sydney, Australia: Pearson Education.

Showing 50 of 109 references

Cited By

119

A combined PBL and flipped classroom intervention enhances self-directed learning ability and empathy in ophthalmology undergraduates

Yu Yang, Jiarui Xue · 2026

Scientific Reports

ChatGPT-driven interactive virtual reality communication simulation in obstetric nursing: A mixed-methods study

Pao-Ju Chen, Wei-Kai Liou · 2025

Nurse Education in Practice

Metrics

119

Citations

109

References

Details

Published: Jul 01, 2021
Vol/Issue: 24(4)
Pages: 573-585
License: View

Authors

Cite This Article

Clarissa Guidi, Chiara Traversa (2021). Empathy in patient care: from ‘Clinical Empathy’ to ‘Empathic Concern’. Medicine, Health Care and Philosophy, 24(4), 573-585. https://doi.org/10.1007/s11019-021-10033-4

Empathy in patient care: from ‘Clinical Empathy’ to ‘Empathic Concern’

You May Also Like