Empathy or Etiquette

We have discussed the term empathy several times.
The most clarifying definition of empathy is based on viewing it as a process. This process of empathy consists of the following stages.

• The patient expresses feelings by way of verbal and non-verbal communication. Patients are not always aware of these expressions.
• The doctor also notices these emotions in himself more or less voluntary, more or less conscious. He or she coming aware of these feelings usually comes after the fact (affective empathy).
• Realizing these feelings as being from the patient is the cognitive empathy. Together with everything the doctor knows about the patient as a patient and as a person, he or she is coming to know the inner feelings of the patient(cognitive empathy).
• The doctor can now express these feelings for the patient or act on them for the patient(expressed empathy).
• The patient receives this empathy (received empathy).

Empathy or the ability to appreciate someone else’s emotions and express this emotional awareness is a capacity that differs amongst individuals. It’s clear that doctors who can communicate well with patients will be more effective. Communication is an important competence educated during med school. This is mostly about etiquette instead of empathy.

Etiquette enables people who are not in intimate relationships to interact without having to enter into each others’ subjective experiences, desires or values. Being polite may seem a very minimal requirement but, in fact, it is specifically with basic courtesy that doctors frequently struggle. ……… examples of failure of empathy: doctors do not meet the patient’s eye. They talk over and around the patient who feels that he has been badly treated. These people are being treated with a lack of courtesy that would be astonishing in any other circumstances.

Etiquette might be a more important topic during medical education than empathy per se. Doctors often have to do things that are socially taboo, so etiquette should be carefully structured around these complicated interactions. Waht do you think?

Smajdor, A., Stockl, A., & Salter, C. (2011). The limits of empathy: problems in medical education and practice Journal of Medical Ethics DOI: 10.1136/jme.2010.039628