This document discusses the role of empathy in healthcare professionalism. It defines empathy as the ability to recognize and experience another person's feelings. Empathy is important for several reasons. It improves clinical outcomes for patients by reducing complications, improving control of conditions like diabetes, and reducing pain perceptions. It also increases patient satisfaction. However, empathy levels often decline during medical training as students are taught to be objective and not let emotions interfere. This can involve dehumanizing patients by reducing them to their illness or stripping away their uniqueness. The document argues empathy should be an essential part of professionalism in healthcare.

1. The Role of Empathy in
Healthcare Professionalism
PECH 1001: The Health Professional & Society
Dr. Farid F Youssef

2. Remember….
• Professionalism is the basis of
medicine’s social contract with society
• Professionalism demands placing the
interests of patients above those of the
physician, setting and maintaining
standards of competence and integrity,
and providing expert advice to society
on matters of health

3. EMPATHY: WHAT IS IT?

4. Status: Look at this Picture
• What is happening?
• What are you feeling?
• Are you have any motor responses?

5. Status: Look at these
Pictures
• What do you think is happening?
• What are you feeling?

6. Empathy: What is it?
• Empathy is the capacity to
recognize and experience
feelings that are being
experienced by another.
• “It is the intrapersonal
realization of another’s plight
that illuminates the potential
consequences of one’s own
actions on the lives of
others.” (Hollingsworth,
2003)

7. Empathy: What is it?
• “The essence of empathy is the ability to
stand in another’s shoes, to feel what it’s
like there and to care about making it better
if it hurts.”
– Szalavitz, M. & Perry, B.D. (2010). Born for love: Why
empathy is essential & endangered. New York: William
Morrow, (p. 12)

8. Empathy: What is it?
• Empathy is part of a
wider capacity of humans
which can be defined as
emotional intelligence
• the capacity to be aware
of, control, and express
one's emotions, and to
handle interpersonal
relationships judiciously
and empathetically.
• Often considered a
predictor of success

9. NEUROBIOLOGY OF
EMPATHY

10. Neurobiology of Empathy
• Do babies show empathy ???

11. Neurobiology of Empathy

12. Neurobiology of Empathy
• The discovery of mirror neurons

13. Neurobiology of Empathy
• Subjects empathy for
the pain of others only
elicits activity in ACC,
not somatosensory
cortex.

15. Neurobiology of Empathy
• Co-operation
• Giving to charity
• Fairness
• ALL activate the
reward centres of
the brain
• AND there is some
evidence to
suggest that giving
produces more
enduring pleasure
than receiving.

16. TYPES OF EMPATHY

17. Types of Empathy
• Cognitive
empathy
– The ability to
recognise the
emotions and
feelings of
others

18. Types of Empathy
• Affective or
Emotional
Empathy
– The ability to
experience the
feelings of
others

19. Types of Empathy
• Behavioural
Empathy
– Demonstrating
behaviours that
acknowledge
the emotional
state of others

20. Types of Empathy
• Moral Empathy
– The moral
responsibility to act
in accordance with
the other persons
emotional state
regardless of
personal feelings
– Considered highest
level of empathy

21. EMPATHY & HEALTH
PROFESSIONALISM

22. Empathy & the Health
Professions
• Empathy impacts on clinical
outcome in patients.
i. reduced metabolic complications
in a study of over 20000 diabetic
patients (Del Canalee et al,
2012)
ii. linked to better glycaemic control
(Hojat et al, 2011)
iii. reduced duration of the common
cold (Rakel et al, 2009)
iv. greater patient satisfaction and
empowerment. (Kim, Kaplowitz
& Johnston, 2004)

23. Empathy & the Health
Professions
• Empathy impacts on
clinical outcome in
patients.
iv. greater patient
satisfaction and
empowerment. (Kim,
Kaplowitz & Johnston,
2004)
v. Empathy reduces patients
perceptions to pain,
(Sarinpoulous, 2012)

24. But what we are taught in
school is akin to:
Alexithymia...
• “When it comes to patients, think
with your head, not with your
heart.”
• “Be objective when dealing with
patients and do not let your own
emotions interfere in the patient-
doctor relationship.”
• “Keep your own emotions at bay
lest you become too involved...”

25. Empathy & Health
Professional Training
Empirical data
suggests
empathy
scores decline
during training.

26. Empathy & Health
Professional Training
• Doctors show decreased
neuronal responses to painful
stimuli in patients and increased
activity in prefrontal cortex
• Theory suggests mental
processing recruits resources
away from emotional areas to
allows doctors to focus
• However new data now shows
doctors do not even appear to
perceive the pain response.

27. Why Empathy Erosion
• Response to
Authority
• The infamous
Miligram
Experiment, 1963

28. Why Empathy Erosion
• Dehumanization is the
denial of a distinctively
human mind to another
person (two facets
experience and agency)
• Used to justify slavery
and other crimes against
humanity
• Involved in the
objectification of women

29. Dehumanization in Medicine
– Patients stripped
of their
uniqueness
(stories,
personality,
culture) in service
to “objectivity”

30. Objective Subjective
How does the world work?
(Ontology)
There is only one reality. By
carefully dividing and studying
its parts, the whole can be
understood. (Realism)
There are mulitple realities,
being socio-psychological
constructions forming an
interconnected whole.
(Nominalism)
2. What is the relationship
between the knower and
what is known?
(Epistemology)
The knower can stand outside
of what is to be known. True
objectivity is possible.
(Positivism)
The knower and the known
are inter-dependent.
3 What role do values play
in understanding the world?
Values can be suspended in
order to understand.
Values mediate and shape
what is understood.
4 Are causal linkages
possible?
One event comes before
another and can be said to
cause that event.
Events shape each other.
There are multidirectional
relationships.
5 What is the possibility of
generalization?
Explanations from one time
and place can be generalized
to other times and places.
Only tentative explanations for
one time and place are
possible.

31. Dehumanization in Medicine
– Deindividuation”—
doctors as a sea of
white coats;
patients as half-
naked bodies in
smocks, identified
by their disease or
procedure (“the
gallbladder in
Room 38”)

32. Dehumanization in Medicine
– Mechanization
– Breaking the body
into organs and
systems for
training, diagnosis
and treatment

33. Dehumanization in Medicine
– Moral
disengagement:
some actions
require inflecting
suffering

34. Dehumanization in Medicine
– Impaired patient
agency
– medical staffs’
treatment of patients as
incapable of planning
their own care, which is
both infantilizing and
demoralizing.
– Dissimilarity
– the patient is ill; the
patient is labelled with
the illness; the power
dynamic

35. The Role of Empathy in
Healthcare Professionalism
PECH 1001: The Health Professional & Society
Dr. Farid F Youssef