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centreformedicalhumanities.org | Article Link | by Emily T. Troscianko

We began our two days in Glasgow surrounded by hospital beds and medical skeletons, and had the chance to hear from four current medical students about their learning experiences. Their eloquent reflections on how they’ve been taught and how they’ve learned over the past four years raised some interesting questions, particularly about empathy: should a doctor be empathic towards his or her patient, and if so, how much? Can and should empathy be taught and learned, and how should it be expressed in a clinical setting? How much context-specificity does an empathic response require (can you ‘really’ empathise with someone three decades older than you, or with someone of the opposite sex, or with a cancer sufferer if you never have been…)? How do you convey sincerity in emotional response – and what is it anyway? Would simple politeness be a better way of thinking about what matters in all this?

There was quite a bit of scepticism expressed towards the whole existence and value of empathy, especially from our guide for the afternoon, Al Dowie (Senior University Teacher in Medical Ethics at the University of Glasgow), but maybe the controversy can be defused if we remember that there is no Platonic split between ‘reason’ and ‘emotion’, and therefore that the choice a doctor may seem to have to make between a ‘rational’ or ‘emotional’ appraisal of the person sitting in front of them is in fact a non-choice. All appraisal is a mixture of more and less emotional engagement with its object (e.g. Frijda 2007), and responses somewhere on an empathic spectrum from disconnect to identification are inevitable, especially when that object is another person. No one’s saying that empathy = identification; that is, we needn’t feel we actually are the other person, even temporarily. But trying to work out what’s wrong with someone is a profound act of social cognition, involving all the cognitive strategies at our disposal, including inferential ‘Theory of Mind’ practices (attributing a mental state to someone else through strategies of inference and prediction from their external state and behaviour), but also plenty of embodied interaction (accessing and responding to others’ consciousness directly, as it manifests itself through gesture and tone in a given interactive situation) (Gallagher 2011, 2012). There are different ways of empathising – imagining we are the other person – but some form of it is an inextricable part of being able to engage with other people at all.

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