Empathy can be characterized as a vicarious emotion that one person experiences when reflecting on the emotion of another. So characterized, empathy is sometimes regarded as a precondition on moral judgment. This seems to have been Hume's view. I review various ways in which empathy might be regarded as a precondition and argue against each of them: empathy is not a component, a necessary cause, a reliable epistemic guide, a foundation for justification, or the motivating force behind our moral judgments. (...) In fact, empathy is prone to biases that render it potentially harmful. Another construct—concern—fares somewhat better, but it is also of limited use. I argue that, instead of empathy, moral judgments involve emotions such as anger, disgust, guilt, and admiration. These, not empathy, provide the sentimental foundation for morality. (shrink)

Philoctetes was a good man and a good soldier. When he was on his way to Troy to fight alongside the Greeks, he had a terrible misfortune. By sheer accident he trespassed in a sacred precinct on the island of Lemnos. As punishment he was bitten on the foot by the serpent who guarded the shrine. His foot began to ooze with foul-smelling pus, and the pain made him cry out curses that spoiled the other soldiers' religious observances. They therefore (...) left him alone on the island, a lame man with no resources but his bow and arrows, no friends but the animals who were also his food. Ten years later, according to Sophocles' version of the story, they come to bring him back: for they have learned that they cannot win the war without him. The leaders of the expedition think of Philoctetes as a tool of their purposes; they plan to trick him into returning, with no empathy for his plight. The Chorus of soldiers, however, has a different response. Even before they see the man, they imagine vividly what it is like to be him– and they enter a protest against the callousness of the commanders: For my part, I pity him– thinking of how, with no living soul to care for him, seeing no friendly face, wretched, always alone, he suffers with a fierce affliction, and has no resources to meet his daily needs. How in the world does the poor man survive? (shrink)

Here is a thoroughly updated edition of a classic in palliative medicine. Two new chapters have been added to the 1991 edition, along with a new preface summarizing where progress has been made and where it has not in the area of pain management. This book addresses the timely issue of doctor-patient relationships arguing that the patient, not the disease, should be the central focus of medicine. Included are a number of compelling patient narratives. Praise for the first edition "Well (...) written. . .should be read by everyone in medical practice or considering a career in medicine."---JAMA. "Memorable passages, important ideas, and critical analysis. This is a book that clinicians and educators should read."---New England Journal of Medicine. (shrink)

Philoctetes was a good man and a good soldier. When he was on his way to Troy to fight alongside the Greeks, he had a terrible misfortune. By sheer accident he trespassed in a sacred precinct on the island of Lemnos. As punishment he was bitten on the foot by the serpent who guarded the shrine. His foot began to ooze with foul-smelling pus, and the pain made him cry out curses that spoiled the other soldiers' religious observances. They therefore (...) left him alone on the island, a lame man with no resources but his bow and arrows, no friends but the animals who were also his food. Ten years later, according to Sophocles' version of the story, they come to bring him back: for they have learned that they cannot win the war without him. The leaders of the expedition think of Philoctetes as a tool of their purposes; they plan to trick him into returning, with no empathy for his plight. The Chorus of soldiers, however, has a different response. Even before they see the man, they imagine vividly what it is like to be him– and they enter a protest against the callousness of the commanders: For my part, I pity him– thinking of how, with no living soul to care for him, seeing no friendly face, wretched, always alone, he suffers with a fierce affliction, and has no resources to meet his daily needs. How in the world does the poor man survive? (shrink)

The academic and medical literature highlights the positive effects of empathy for patient care. Yet, very little attention has been given to the impact of the requirement for empathy on the physicians themsel..

The distinctive aim of applied ethics is to provide guidance as to how we ought to act, as individuals and as shapers of social policies. In this essay, I argue that applied ethics as currently practiced is inadequate and ought to be transformed to incorporate what I shall call social moral epistemology. This is a branch of social epistemology, the study of the social practices and institutions that promote the formation, preservation, and transmission of true beliefs. For example, social epistemologists (...) critically evaluate the comparative advantages of adversarial versus inquisitorial criminal proceedings as mechanisms for the discovery of truth. (shrink)

This is a reply to Jesse Prinz and Paul Bloom’s skepticism about the moral importance of empathy. It concedes that empathy is spontaneously biased to individuals who are spatio-temporally close, as well as discriminatory in other ways, and incapable of accommodating large numbers of individuals. But it is argued that we could partly correct these shortcomings of empathy by a guidance of reason because empathy for others consists in imagining what they feel, and, importantly, such acts of imagination can be (...) voluntary – and, thus, under the influence of reflection – as well as automatic. Since empathizing with others motivates concern for their welfare, a reflectively justified empathy will lead to a likewise justified altruistic concern. In addition, we argue that such concern supports another central moral attitude, namely a sense of justice or fairness. (shrink)

BackgroundThe academic and medical literature highlights the positive effects of empathy for patient care. Yet, very little attention has been given to the impact of the requirement for empathy on the physicians themselves and on their emotional wellbeing.DiscussionThe medical profession requires doctors to be both clinically competent and empathetic towards the patients. In practice, accommodating both requirements can be difficult for physicians. The image of the technically skilful, rational, and emotionally detached doctor dominates the profession, and inhibits physicians from engaging (...) emotionally with their patients and their own feelings, which forms the basis for empathy. This inhibition has a negative impact not only on the patients but also on the physicians. The expression of emotions in medical practice is perceived as unprofessional and many doctors learn to supress and ignore their feelings. When facing stressful situations, these physicians are more likely to suffer from depression and burnout than those who engage with and reflect on their feelings. Physicians should be supported in their emotional work, which will help them develop empathy. Methods could include questionnaires that aid self-reflection, and discussion groups with peers and supervisors on emotional experiences. Yet, in order for these methods to work, the negative image associated with the expression of emotions should be questioned. Also, the work conditions of physicians should improve to allow them to make use of these tools.SummaryEmpathy should not only be expected from doctors but should be actively promoted, assisted and cultivated in the medical profession. (shrink)

Selected as a Financial Times Best Book of 2013Governments today in both Europe and the United States have succeeded in casting government spending as reckless wastefulness that has made the economy worse. In contrast, they have advanced a policy of draconian budget cuts--austerity--to solve the financial crisis. We are told that we have all lived beyond our means and now need to tighten our belts. This view conveniently forgets where all that debt came from. Not from an orgy of government (...) spending, but as the direct result of bailing out, recapitalizing, and adding liquidity to the broken banking system. Through these actions private debt was rechristened as government debt while those responsible for generating it walked away scot free, placing the blame on the state, and the burden on the taxpayer. That burden now takes the form of a global turn to austerity, the policy of reducing domestic wages and prices to restore competitiveness and balance the budget. The problem, according to political economist Mark Blyth, is that austerity is a very dangerous idea. First of all, it doesn't work. As the past four years and countless historical examples from the last 100 years show, while it makes sense for any one state to try and cut its way to growth, it simply cannot work when all states try it simultaneously: all we do is shrink the economy. In the worst case, austerity policies worsened the Great Depression and created the conditions for seizures of power by the forces responsible for the Second World War: the Nazis and the Japanese military establishment. As Blyth amply demonstrates, the arguments for austerity are tenuous and the evidence thin. Rather than expanding growth and opportunity, the repeated revival of this dead economic idea has almost always led to low growth along with increases in wealth and income inequality. Austerity demolishes the conventional wisdom, marshaling an army of facts to demand that we austerity for what it is, and what it costs us. (shrink)