From Detached Concern to Empathy: Humanizing Medical Practice

Physicians recognize the importance of patients' emotions in healing yet believe their own emotional responses represent lapses in objectivity. Patients complain that physicians are too detached. Halpern argues that by empathizing with patients, rather than detaching, physicians can best help them. Yet there is no consistent view of what, precisely, clinical empathy involves. This book challenges the traditional assumption that empathy is either purely intellectual or an expression of sympathy. Sympathy, according to many physicians, involves over-identifying with patients, threatening objectivity and respect for patient autonomy.

How can doctors use empathy in diagnosing and treating patients rithout jeopardizing objectivity or projecting their values onto patients? Jodi Halpern, a psychiatrist, medical ethicist and philosopher, develops a groundbreaking account of emotional reasoning as the core of clinical empathy. She argues that empathy cannot be based on detached reasoning because it involves emotional skills, including associating with another person's images and spontaneously following another's mood shifts. Yet she argues that these emotional links need not lead to over-identifying with patients or other lapses in rationality but rather can inform medical judgement in ways that detached reasoning cannot. For reflective physicians and discerning patients, this book provides a road map for cultivating empathy in medical practice. For a more general audience, it addresses a basic human question: how can one person's emotions lead to an understanding of how another person is feeling?

"Jodi Halpern presents a scholarly and cogent exposition of the philosophic underpinnings of the concept of empathy may be rightly viewed as a seminal work in developing a scholarly understanding of the subject of empathy and will assist in the development of sound training and evaluation methods for imparting this skill to physicians." - Sharon K. Hull, MD JAMA

"I would recommend this book not as a manual, but as a vital reminder of how things should be, and as an insightful and philosophically educational analysis of how things probably are for the luckiest patients in our practice and hospitals." - Philip Berry, British Medical Journal

"This is a beautifully written and beautifully reasoned book. Physician-ethicist Jodi Halpern crafts one of the finest descriptions available of psychiatry's advance toward empathic involvement with patients. Intertwining psychiatry and ethics is no easy task. However in Halpern's hands, a blend of formal research, philosophical modeling, and straight talk shows how neatly psychiatry and ethics work together." - Philip Candilis, M.D., Psychiatric Services

"This is an important book. I recommend it to physicians and members of medical faculties for whom its subject matter is important. It is a serious essay on subjectivity, a topic about which we will be seeing more in the coming years. It repays the work of reading it." - Eric Cassell, M.D., The New England Journal of Medicine

"This lovely volume fixes on a profound truth in medicine: to the degree we are moved by our patients suffering we are better able to help them. The age of proteomics and genomics is the age of 'objective reality', yet for the patient it is all about humane empathetic care. Halpern in this scholarly and wonderful readable volume shows us that empathy is just as critical for the physician and without it healing cannot begin. This book is a must read for all of us with an interest in medical practice." - Abraham Verghese MD, author of CUTTING FOR STONE, Professor of Medicine, Stanford University

Jodi Halpern, M.D., Ph.D., is Associate Professor of Bioethics and Medical Humanities at the University of California, Berkeley. She received her B.A., M.D., and Ph.D. in philosophy from Yale University, did an internship at the UCLA/ Wadsworth VA Medical Centers, and completed a residency in psychiatry at the UCLA Neuropsychiatric Institute. She won the Louis Nahum Prize for her medical school thesis, and her Ph.D. thesis was awarded the Porter Prize, which is given to the outstanding dissertation at Yale of general interest across the disciplines.