Practicing medicine in the real world: Challenges to empathy and respect for patients

Journal of Clinical Ethics

Volumn 14, Issue 4, 2003, Pages 298-307

  Halpern, Jodi ^a  

^a UNIVERSITY OF CALIFORNIA   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

CORRELATION ANALYSIS; EMOTION; EMPATHY; EMPIRICISM; HUMAN; MEDICAL ETHICS; MEDICAL PRACTICE; MEDICAL RESEARCH; PATIENT COMPLIANCE; PHILOSOPHY; PHYSICIAN; PSYCHOTHERAPY; REVIEW; SOCIAL PSYCHOLOGY; VIRTUAL REALITY;

PROFESSIONAL PATIENT RELATIONSHIP;

DECISION MAKING; EMPATHY; ETHICS, CLINICAL; FEAR; GUILT; HUMANS; MORALS; ORGANIZATIONAL CULTURE; PATERNALISM; PATIENT CARE TEAM; PERSONAL AUTONOMY; PHYSICIANS; TREATMENT REFUSAL;

EID: 2942567600     PISSN: 10467890     EISSN: None     Source Type: Journal    
DOI: None     Document Type: Review

References (28)

1. P. Goldie, The Emotions, A Philosophical Exploration (New York: Oxford University Press, 2000).
2. H. Brody, The Healer's Power (New Haven, Conn.: Yale University Press, 1992), 1; E. Cassel, "The Nature of Suffering and the Goals of Medicine," New England Journal of Medicine 306, no. 11 (1982): 639-45.
3. H. Brody, The Healer's Power (New Haven, Conn.: Yale University Press, 1992), 1; E. Cassel, "The Nature of Suffering and the Goals of Medicine," New England Journal of Medicine 306, no. 11 (1982): 639-45.
4. J. Halpern, From Detached Concern to Empathy: Humanizing Medical Practice (New York: Oxford University Press, 2001): 86-7.
5. On the other hand, a well-designed health-care organization should ensure continuity of care, so that even if primary care visits are brief, over time physicians could learn more and more about each patient.
6. A. Suchman et al., "A Model of Empathic Communication in the Medical Interview," Journal of the American Medical Association 277 (1997): 678-82.
7. I b i d.
8. I b i d.
9. A. Girgis and R.W. Sanson-Fisher, "Breaking Bad News 1: Current Advice for Clinicians," Behavioral Medicine 24 (1998): 53-9.
10. D. Roter et al., "Effectiveness of Interventions to Improve Patient Compliance: A Meta-Analysis," Medical Care 36, no. 8 (1998): 1138-61.
11. J. Coulehan et al., "Words that Help Build Empathy," Annals of Internal Medicine 135, no. 3 (2001): 221-7.
12. Coulehan et al. describe empathic listening as "a feedback loop." Ibid.
13. D.H. Buie, "Empathy: Its Nature and Limitations," Journal of the American Psychoanalytic Association 29 (1981): 281-307, p. 300.
14. J. Kayser-Jones, "A Case Study of the Death of an Older Woman in a Nursing Home: Are Nursing Practices in Compliance with Ethical Guidelines?" Journal of Gerontological Nursing (September 2000): 48-54.
15. Halpern, see note 3 above.
16. W.C. Williams, The Doctor Stories, compiled with an introduction by R. Coles (New York: New Directions, 1984).
17. M. Johnson, Moral Imagination: Implications of Cognitive Science for Ethics (Chicago: University of Chicago Press, 1993), 200.
18. Thank you to Norman Quist for challenging the picture of people as having transparent access to their own goals.
19. B. Herman, "Mutual Aid and Respect for Persons," The Practice of Moral Judgment (Cambridge, Mass.: Harvard University Press, 1993), 70.
20. N. Hauser and C. Kloesel, ed., The Essential Peirce, vol. 1 (Bloomington, Ind.: Indiana University Press, 1992), 139.
21. J. Katz, The Silent World of Doctor and Patient (New York: Free Press, 1984).
22. See for example, R. Dworkin, Life's Dominion (New York: Knopf, 1993).
23. I thank Norman Quist for raising important skeptical questions about the use of the term "capacity," both in some Kantian models (Dworkin) and in current practice.
24. This is an unfortunate phrase, but useful to philosophers interested in autonomy.
25. In brief, I agree, because I hold a deontological rather than utilitarian view of respect for autonomy. Physicians are not obligated to maximize autonomous acts, but rather to act according to a principle of respect for autonomy.
26. N. Badwher, commentary on "From Detached Concern to Empathy," at Author Meets Critic Panel, (American Philosophical Association Meeting, San Francisco, 2003).
27. A. Jaworska, "Respecting the Margins of Agency," Philosophy and Public Affairs 12, no. 2 (1999): 105-38.
28. I am grateful to Neera Badwher for challenging me on this point.