Ethics & Empathy in Medicine: Cold Logic or Warm Heart?

[greghouse]

There are degrees of approaches to patient care: empathy, sympathy, objectivity and cruelty.

I think the character House tends to employ the latter when dealing with a patient’s emotional wellbeing, often resorting to sarcasm and contempt; but he uses objectivity when deciding which treatment would be most beneficial to their physical health.

Emotional wellbeing and physical health are inextricably linked, so it seems logical to appeal positively to both aspects of a patient’s welfare.

First, no way you can simply "degree" patient care like that. As pointed out before, empathy and sympathy are completely different. Objectivity is something (which Iv'e been trying to say all along) every doctor should try to achieve at the expence of empathy, which tends to compromise it.

Sure, but House isn't why I debate this, also as i pinpointed before.

Fake it man!

 

[baywax]

Might be true, but then exactly what are they doing that the other "not caring therefor stupid incompetent" doctor doesn't? And with that question I mean litterally do they visit the patient more often? Administer more drugs ( or placeboes) etc. Every type of action has to be broken down to its smallest parts, and then every doctor learns to do this, why he's doing it, and what effects it has if he doesn't do it. Problem solved.

Empathy in it self doesn't heal patients, it's its consequenses that up the odds. And these consequenses can be done without the empathy. QED

Compassion and empathy create the natural curiosity and motivation in a person to find the best solution to a situation. When a person/doctor is well trained in empathic observation the information gained from a patient or situation that goes toward understanding the conditions is of a far better quality and of such a specific nature that healing can take place faster and more effectively.

Don't mistake empathy with emotion. Empathy is the use of ones abilities to understand the basic effects of a situation on a patient's physical and psychological well being. When empathy delves into how the emotions of a patient feel, that is SYMPATHY which is not as constructive or as effective in treating a condition. Sympathy might be seen as a bottleneck in one's care of another because it causes one to pause, lament and feel as overwhelmed as one's subject in the face of what might be poor odds.

 

[baywax]

You can fake it without it being noticed. Many people for instance can't tell wheter someone has Aspergers or not. As you know, Aspergers is a milder form of autism, and the sufferers (blessed ones) don't have the empathy ability at all, or very little. Nevertheless they learn how to act, and though somewhat odd to their behaviour sometimes, it usually goes by unnoticed that they don't empathize.

To find these clues you have not only to look for them, but also know what you're looking for, which most people definately don't.

Fallacious attempts to paint every person experiencing Aspergers as lacking empathic abilities are... just that... fallacious and over-generalizing.

Empathy is a learned trait. If it has not been demonstrated well in early childhood, it will be more difficult to learn. But, one can train to be empathic... and to their advantage.

 

[greghouse]

Compassion and empathy create the natural curiosity and motivation in a person to find the best solution to a situation.

Don't mistake empathy with emotion. Empathy is the use of ones abilities to understand the basic effects of a situation on a patient's physical and psychological well being. When empathy delves into how the emotions of a patient feel, that is SYMPATHY which is not as constructive or as effective in treating a condition. Sympathy might be seen as a bottleneck in one's care of another because it causes one to pause, lament and feel as overwhelmed as one's subject in the face of what might be poor odds.

Nope it doesn't, it makes you want to be socially accepted by the person by interacting.

 

[greghouse]

Empathy is a learned trait. If it has not been demonstrated well in early childhood, it will be more difficult to learn. But, one can train to be empathic... and to their advantage.

OK this is just plain crap. What you speak of is sympathy. The difference between sympathy and empathy is that you learn sympathy, but you can't learn empathy. Sympathy is the ability to "suffer with someone" or "understand his/her feelings". This you do by getting experience, and then you can relate. Who do you think empathises best with getting your crouch crushed by a foot ball? Girls or boys? Obviously boys (and some genitally disfigured girls I suppose...) because most of them know how it feels, and then can sympathise.

Girls realize that the nearly castrated soprano boy is in pain, and empathizes (as do boy to, but to a lesser extent). But there's a HUGE difference.

And as goes for your idea about me generalizing, sure I do. As I generalize when I say that african-americans have GENERALLY darker skin...

 

[baywax]

OK this is just plain crap. What you speak of is sympathy. The difference between sympathy and empathy is that you learn sympathy, but you can't learn empathy.

Next you'll be BS'ing me that solving a math problem is a genetic trait.

Empathy is a learned ability.

The Study of Cognitive Empathy and Empathic Accuracy

Besides a growing interest in person perception among psychologists in the 1950's (e.g., Heider (1958)), researchers from the counseling and therapeutic milieu were keen on investigating empathic accuracy, since empathy was seen as being essential for successful therapy.

In conceiving of a client centered therapy, Rogers defines empathy early on as the ability to “ perceive the internal frame of reference of another with accuracy and with the emotional components and meanings which pertain thereto as if one were the person, but without ever losing the ‘as if’ conditions”

(emphasis added)

http://plato.stanford.edu/entries/empathy/cognitive.html

Empathy is highly dependent upon imagination and, as far as I know, imagination is something that must be exercised and trained before it becomes an ability like empathy.

Dymond's (1949) influential “scale for rating empathic ability” can be used to illustrate this fact. (For other methods of measuring empathic accuracy see Taft 1955, Davis and Kraus 1997)). Dymond defined empathy in the tradition of Rogers as the “imaginative transposing of oneself into the thinking, feeling, and acting of another person and so structuring the world as he does” (1949, 127).

Perhaps you are confusing the fact that having a brain is a genetically predetermined condition with the fact that you must use your brain to gain an empathic understanding of a subject.

 

[Giles]

First, no way you can simply "degree" patient care like that.

Sure you can. Some Drs are very empathetic in certain situations (due to having similar experiences), some can empathize a little (if they have a relatively minor understanding of the experience), some may feel varying degrees of sympathy (usually attributed to a natural tendency, I imagine), some are able to remain objective (whether they feel sympathy or not), and some are just pitiless and cruel (also probably due to a natural tendency, and greatly dependent on their dislike for a patient).

As pointed out before, empathy and sympathy are completely different.

And what about my post made you think I considered them the same thing?

Objectivity is something (which Iv'e been trying to say all along) every doctor should try to achieve at the expence of empathy, which tends to compromise it.

I disagree that objectivity is always the best approach when dealing with a patient's emotional wellbeing (i.e. particularly in the case of delivering bad news). Why would you say "fake it" if you don't think sympathy has a place in patient care to begin with? Wouldn't that be redundant?
By its very definition you can’t fake empathy. However, you can pretend to be sympathetic, but not everyone has the capacity to be convincing.

Regardless, empathy and sympathy can't be turned on and off like a tap. And just having these feelings doesn't automatically mean you cannot be objective about decisions regarding appropriate treatments. In fact, I'd argue that empathy and sympathy would predispose one to take the best option available...

By the way, when people decide to enter into medical school they often site there reasons for this decision as “I want to help people.”….

Which sounds suspiciously like they may be entertaining feelings of sympathy :)

 

[greghouse]

Next you'll be BS'ing me that solving a math problem is a genetic trait.

Empathy is highly dependent upon imagination and, as far as I know, imagination is something that must be exercised and trained before it becomes an ability like empathy.

Perhaps you are confusing the fact that having a brain is a genetically predetermined condition with the fact that you must use your brain to gain an empathic understanding of a subject.

No I won't, but your ability to do it better or worse, is mainly inherited, since men do it better than women.

I didn't see your linked article mension anywhere that empathy is a learned treat. Give me your differentiation between empathy and sympathy.

Besides, empathy has been linked to areas in the brain containg mirror-neurons. Women show more mirror-neural activity than men, and autist show even lower. Mirror neurons are active at birth, why macaque have been known to imitate behaviour at baby-age.

 

[Evo]

This thread is going nowhere. Closed.