Une médecine plus humaniste serait une médecine où les professionnels de santé feraient preuve de plus d’empathie envers leurs patients. Or s’il est difficile d’attester un déclin de l’empathie en médecine en l’attribuant au modèle biomédical, l’empathie n’est pas sans défaut. Cela ne signifie pas la mort de l’humanisme médical. Il est possible de le faire reposer sur un concept minimal de compassion et de lui intégrer une approche basée sur les systèmes de santé. L’humanisme ainsi défendu n’est plus empathique, (...) mais il est aussi plus convaincant. (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)

This paper presents a phenomenological account of empathy inspired by the proposal put forward by Edith Stein in her book On the Problem of Empathy, published originally 1917. By way of explicating Stein’s views, the paper aims to present a characterization of empathy that is in some aspects similar to, but yet essentially different from contemporary simulationist theories of empathy. An attempt is made to show that Stein’s proposal articulates the essential ingredients and steps involved in empathy and that her (...) proposal can be made even more comprehensive and elucidating by stressing the emotional aspect of the empathy process. Empathy, according to such a phenomenological proposal, is to be understood as a perceptual-imaginative feeling towards and with the other person’s experiences made possible by affective bodily schemas and being enhanced by a personal concern for her. To experience empathy does not necessarily or only mean to experience the same type of feeling as the target does; it means feeling alongside the feeling of the target in imagining and explicating a rich understanding of the experiences of the very person one is facing. (shrink)

This paper presents and explicates the theory of empathy found in Edith Stein’s early philosophy, notably in the book On the Problem of Empathy, published in 1917, but also by proceeding from complementary thoughts on bodily intentionality and intersubjectivity found in Philosophy of Psychology and the Humanities published in 1922. In these works Stein puts forward an innovative and detailed theory of empathy, which is developed in the framework of a philosophical anthropology involving questions of psychophysical causality, social ontology and (...) moral philosophy. Empathy, according to Stein, is a feeling-based experience of another person’s feeling that develops throughout three successive steps on two interrelated levels. The key to understanding the empathy process á la Stein is to explicate how the steps of empathy are attuned in nature, since the affective qualities provide the energy and logic by way of which the empathy process is not only inaugurated but also proceeds through the three steps and carries meaning on two different levels corresponding to two different types of empathy: sensual and emotional empathy. Stein’s theory has great potential for better understanding and moving beyond some major disagreements found in the contemporary empathy debate regarding, for instance, the relation between perception and simulation, the distinction between what is called low-level and high-level empathy, and the issue of how and in what sense it may be possible to share feelings in the empathy process. (shrink)

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)

This paper presents and explicates the theory of empathy found in Edith Stein’s early philosophy, notably in the book On the Problem of Empathy, published in 1917, but also by proceeding from complementary thoughts on bodily intentionality and intersubjectivity found in Philosophy of Psychology and the Humanities published in 1922. In these works Stein puts forward an innovative and detailed theory of empathy, which is developed in the framework of a philosophical anthropology involving questions of psychophysical causality, social ontology and (...) moral philosophy. Empathy, according to Stein, is a feeling-based experience of another person’s feeling that develops throughout three successive steps on two interrelated levels. The key to understanding the empathy process á la Stein is to explicate how the steps of empathy are attuned in nature, since the affective qualities provide the energy and logic by way of which the empathy process is not only inaugurated but also proceeds through the three steps and carries meaning on two different levels corresponding to two different types of empathy: sensual and emotional empathy. Stein’s theory has great potential for better understanding and moving beyond some major disagreements found in the contemporary empathy debate regarding, for instance, the relation between perception and simulation, the distinction between what is called low-level and high-level empathy, and the issue of how and in what sense it may be possible to share feelings in the empathy process. (shrink)