Plusieurs aspects du modèle biopsychosocial promeuvent une approche humaniste en médecine. Cependant, Engel a explicitement rejeté un humanisme médical qui s’opposerait à la science. En adoptant une approche fondée sur la science des systèmes pour étudier les êtres humains, la santé et la maladie, Engel défend une approche scientifique pour améliorer la qualité des soins cliniques, ou autrement dit, une approche qui se prête à un examen scientifique de cette question.

Bioethics has begun to see the revaluation of affects in medical practice, but not all of them, and not necessarily in the sense of affects as we know them. Empathy has been accepted as important for good medical practice, but only in a way that strips it of its affectivity and thus prevents other affects, like sympathy, from being accepted. As part of a larger project that aims at revaluing the importance of affectivity in medical practice, the purpose of this (...) paper is to develop a clinical sympathy that can serve as a trainable skill for medical professionals. While everyday sympathy may be problematic as a professional skill for physicians, this does not imply that sympathy should be entirely rejected. As a natural part of our moral psychology, sympathy is an intersubjective affect that aids in our interactions with others and our decision-making abilities. I present here a theory of clinical sympathy as an affective response to patients, in which physicians are both attuned to their affective response and understand how their affects are influencing their beliefs and judgments. In this way, clinical sympathy serves as a trainable skill that can aid physicians in their interactions with their patients. (shrink)

According to Hugo Münsterberg, the direct application of experimental psychology to the practical problems of education, law, industry, and art belonged by definition to the domain of psychotechnics. Whether in the form of pedagogical prescription, interrogation technique, hiring practice, or aesthetic principle, the psychotechnical method implied bringing the psychological laboratory to bear on everyday life. There were, however, significant pitfalls to leaving behind the putative purity of the early psychological laboratory in pursuit of technological utility. In the Vocation Bureau, for (...) example, psychological instruments were often deemed too intimidating for a public unfamiliar with the inner workings of experimental science. Similarly, when psychotechnical means were employed by big business in screening job candidates, ethical red flags were raised about this new alliance between science and capital. This tension was particularly evident in Münsterberg's collaboration with the Paramount Pictures Corporation in 1916. In translating psychological tests into short experimental films, Münsterberg not only envisioned a new mass medium for the dissemination of psychotechnics, but a means by which to initiate the masses into the culture of experimental psychology. (shrink)

Recent studies have revealed a drop in the ability of physicians to empathize with their patients. It is argued that empathy training needs to be provided to both medical students and physicians in order to improve patient care. While it may be true that empathy would lead to better patient care, it is important that the right theory of empathy is being encouraged. This paper examines and critiques the prominent explanation of empathy being used in medicine. Focusing on the component (...) of empathy that allows us to understand others, it is argued that this understanding is accomplished through a simulation. However, simulation theory is not the best explanation of empathy for medicine, since it involves a limited perspective in which to understand the patient. In response to the limitations and objections to simulation theory, interaction theory is presented as a promising alternative. This theory explains the physicians understanding of patients from diverse backgrounds as an ability to learn and apply narratives. By explaining how we understand others, without limiting our ability to understand various others, interaction theory is more likely than simulation theory to provide better patient care, and therefore is a better theory of empathy for the medical field. (shrink)

ABSTRACTQuestions about how empathy should be conceptualized have long been a preoccupation of the field of empathy research. There are numerous definitions of empathy that have been proposed and that often overlap with other concepts such as sympathy and compassion. This makes communication between research groups or across disciplines difficult. Many researchers seem to see the diversity of definitions as a problem rather than a form of benign pluralism. Within this debate about conceptualization, researchers sometimes suggest that more neuroscientific evidence (...) will make the problem go away – that uncovering the processes underlying empathy will thereby also sort out conceptual difficulties. In this paper, I challenge this assumption by examining how neuroscientists studying empathy use concepts in practice – both in the development of their measures and in the interpretation of their data. I argue that this neuroscientific literature demonstrates that continuity and stability comes from the use of cert... (shrink)

In this article, I argue that the recent emphasis on compassion in healthcare practice lacks conceptual richness and clarity. In particular, I argue that it would be helpful to focus on a larger concept of empathy rather than compassion alone and that compassion should be thought of as a component of this larger concept of empathy. The first part of the article outlines a critique of the current discourse of compassion on three grounds. This discourse naturalizes, individualizes, and reifies compassion (...) leading to a decontextualized and simplified understanding of failures in healthcare practice. The second part uses resources from phenomenology and contemporary moral philosophy to construct a “hybrid” concept of empathy that includes both pre‐reflective/intuitive and cognitive/imaginative components. This “hybrid” concept of empathy leads to a more complex understanding of the multiple responses to others' distress. I conclude that there are no straightforward normative naturalistic responses to others' distress. Rather than conceptualizing compassion as a naturalistic impulse or a character‐based trait, we need to consider the complexity of our empathic recognition of vulnerable others. (shrink)

This dissertation contributes to the philosophy of empathy and biomedical ethics by drawing on phenomenological approaches to empathy, intersubjectivity, and affectivity in order to contest the primacy of the intersubjective aspect of empathy at the cost of its affective aspect. Both aspects need to be explained in order for empathy to be accurately understood in philosophical works, as well as practically useful for patient care in biomedical ethics. In the first chapter, I examine the current state of clinical empathy in (...) medicine including professional opinions about empathy, the dominant definition being employed, and the problems that arise from this definition. By trying to define empathy in a way that is useful to the current presuppositions in medicine, clinical empathy aligns with simulation theory, which has three problems: the discrepancy between the way empathy is defined and the way it is explained, the lack of diversity that this theory of empathy allows in our understanding of others, and the lack of affective understanding and affective engagement involved in the patient-physician interaction. These three problems are used to derive three questions that are important for any theory of empathy: (1) What is the phenomenon being explained? (2) What is the intersubjective context of empathy? (3) What is the affective dimension of empathy? The best theory of clinical empathy can be formulated by answering these three questions as they relate to phenomenological theories, which are more attuned to overcoming presuppositions. Chapters two and three each examine a different phenomenological approach to empathy from opposite extremes in their theories of intersubjectivity. Husserl and Stein begin from an isolated, transcendental subject that needs empathy to bridge the gap between itself and others, while Scheler begins from a primary intersubjectivity in which self and other are undifferentiated, making empathy a largely unnecessary skill. Despite their strongly opposed positions, and the acknowledgement that their theories of intersubjectivity necessitate their theories of empathy, I argue that both fail to understand the affective dimension of empathy. Husserl and Stein leave no room in empathy for it to be an affect, while Scheler prioritizes affects that reunite subjects, but leaves empathy itself as a non-affective skill. Chapter four explains Gallagher’s interaction theory as a more moderate approach to the relation between empathy and intersubjectivity. He draws on the insights of the other two theories, but conceives of empathy as a multi-leveled phenomenon that allows for an understanding of others. While this theory does aid in addressing the intersubjective context of empathy in a way that best solves the first two problems with clinical empathy, interaction theory still fails to fully address the affectivity of empathy, maintaining empathy as a largely cognitive ability. Gallagher does acknowledge the affective core of empathy, but he does not explain the way in which it is affective. In response to this problem, I explain Anya Daly’s application of Merleau-Ponty’s theory of reversibility to affectivity as a possible solution to the problematic gap in Gallagher’s theory. Chapter five focuses on theories of clinical empathy in order to address the neglected affective aspects of empathy, and respond to the problem of detached concern. The problems caused by detached concern are explained, as well as why the theories discussed in the middle chapters are still unable to solve them. This is done in two parts. In the first part, I explain the basis of this issue in the cognitive/feeling divide, as explained in the philosophy of emotion. Then, I give a brief overview of the phenomenology of affectivity to be used as a guide to the affectivity of empathy. In the second part, I examine three theories of clinical empathy that attempt to solve the problem of detached concern, noting their strengths and weaknesses based on their similarities to phenomenological approaches to empathy and affectivity. (shrink)

ABSTRACTEmpathy is commonly defined as the ability to feel another person’s emotion, and has previously received significant attention from various research communities. The third-person nature of...