From Detached Concern to Empathy: Humanizing Medical Practice / Edition 1

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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?

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Editorial Reviews

Doody's Review Service
Reviewer: R. Waid Shelton, M.D.(University of Alabama at Birmingham)
Description: This book provides the philosophical and psychological basis for physicians' empathy with patients, instead of their previously held position of detached concern.
Purpose: The book's purpose is to present the argument that doctors can better understand and care for their patients if they are emotionally touched by those patients. The book provides a useful theoretical basis for the growing trend of physicians forming a relationship with patients, even before collecting data from them.
Audience: The audience includes those physicians who are interested in this theoretical basis, especially those whose interest is the doctor-patient relationship.
Features: The book takes the reader through the major historical positions regarding the doctor-patient relationship. A wide range of opinions are discussed. It concludes with support for the author's position that empathy with the patient improves the physician's understanding of the patient's response to his or her pathophysiology. Although two others are mentioned, the author returns frequently to one clinical case. Reference to more clinical material might have helped the reader see the author's argument from different perspectives.
Assessment: This book supplies the psychological and philosophical basis for physician empathy with the patient, a position in harmony with the recent trends of doctor-patient relationships. In doing so, it fills an important niche in our understanding of those relationships. The groundwork for the author's position is thoroughly laid out, and her arguments are convincing.

3 Stars from Doody
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Product Details

  • ISBN-13: 9780195111194
  • Publisher: Oxford University Press, USA
  • Publication date: 5/28/2001
  • Edition description: New Edition
  • Edition number: 1
  • Pages: 190
  • Product dimensions: 9.10 (w) x 6.00 (h) x 0.90 (d)

Meet the Author

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.

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Table of Contents

1 Failures of Emotional Communication in Medical Practice 1
2 Managing Emotions as a Professional Ideal 15
Detachment to Avoid the Errors of Sympathy 15
The Tradition of Sympathy 19
The Ideal of Objectivity 21
Avoiding Emotional Errors 26
Emotions and Cognition 29
3 Emotional Reasoning 39
Associational Linking 40
"Gut Feelings" 44
Emotional Inertia 49
Moods and Temperament 53
The Strategic Nature of Emotions 57
4 The Concept of Clinical Empathy 67
Clinical Empathy as Detached Insight 68
Aesthetics and the Origins of the Concept of Empathy 74
Psychoanalytic Views of Empathy as Affective Merging 77
A Model of Clinical Empathy as Emotional Reasoning 85
5 Respecting Patient Autonomy: From Non-Interference to Empathy 101
Respecting Autonomy: Beyond Non-Interference 102
Beyond Negative Autonomy: Kant on Deliberative Freedom 106
Autonomy versus Detachment 109
Suffering, Empathy, and the Interpersonal Basis of Autonomy 111
Kantian Theory and Positive Obligations to Share Ends 118
The Complex Relationship Between Empathy and Respecting Autonomy 123
6 Cultivating Empathy in Medical Practice 129
From Certainty to Curiosity 129
Emotional Irrationality Revisited: Finding the Therapeutic Opportunity 136
Regaining Mental Freedom 138
Non-Abandonment 141
Bibliography 149
Index 163
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Customer Reviews

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Sort by: Showing 1 Customer Reviews
  • Posted May 23, 2010

    Thought Provoking

    From Detached Concern to Empathy by Jodi Halpern is an excellent book that explores the impact that clinicians have on their patients' experiences. This is a thick read, with philosophical discussions around empathy, sympathy, and the role of the clinician in modern healthcare settings. Should we maintain a cold, clinical view of our patients in order to make sound judgements in their care? Should we try to change our patients' minds if their choice does not support continuing to fight for life? Or do we respectfully comply with their decision? This thought-provoking book would be a fantastic book for new clinicians, including medical and nursing students, or for the philosophical reader.

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