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Published in: Medicine, Health Care and Philosophy 2/2014

01-05-2014 | Scientific Contribution

Empathy as a necessary condition of phronesis: a line of thought for medical ethics

Author: Fredrik Svenaeus

Published in: Medicine, Health Care and Philosophy | Issue 2/2014

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Abstract

Empathy is a thing constantly asked for and stressed as a central skill and character trait of the good physician and nurse. To be a good doctor or a good nurse one needs to be empathic—one needs to be able to feel and understand the needs and wishes of patients in order to help them in the best possible way, in a medical, as well as in an ethical sense. The problem with most studies of empathy in medicine is that empathy is poorly defined and tends to overlap with other related things, such as emotional contagion, sympathy, or a caring personality in general. It is far from clear how empathy fits into the general picture of medical ethics and the framework of norms that are most often stressed there, such as respect for autonomy and beneficience. How are we to look upon the role and importance of empathy in medical ethics? Is empathy an affective and/or cognitive phenomenon only, or does it carry moral significance in itself as a skill and/or virtue? How does empathy attain moral importance for medicine? In this paper I will attempt to show that a comparison with the Aristotelian concept of phronesis makes it easier to see what empathy is and how it fits into the general picture of medical ethics. I will argue that empathy is a basic condition and source of moral knowledge by being the feeling component of phronesis, and, by the same power, it is also a motivation for acting in a good way.
Footnotes
1
How to translate Aristotle’s terminology into modern English is a constant debate that is not only related to research on Ancient Greek culture and language, but also to what philosophical use can and should be made of his philosophy today. The translation by Christopher Rowe of the Nicomachean Ethics that I am referring to in this paper is by no means undisputed in comparison with earlier ones and my translations of key concepts represents a compromise that also take other translations into account (regarding these matters, see Kraut 2006).
 
2
Exactly which moral excellences should be listed as necessary and sufficient to be morally good is not clear from Aristotle’s own writings. He mentions courageousness (andreia), moderation (sophrosyne), generosity, munificience (megaloprepia), great-souledness (megalopsychia), mildness, shamefulness, self control, righteousness, reasonableness and friendliness (philia). Later virtue theorists have made many changes and additions to his tentative list of possible virtues in human life, see Hursthouse 1999.
 
3
Regarding “theory theory” and “simulation” definitions of empathy, see Coplan and Goldie 2011.
 
4
Beauchamp and Childress, who are most often cited as the primary source for standard contemporary medical ethics in the form of principles to be balanced in forming sound ethical judgments in a dilemma, indirectly acknowledge this role for phronesis and empathy themselves by adding chapters about moral character and professional-patient relationships in the later editions of their main work Principles of Biomedical Ethics (Beauchamp and Childress 2009).
 
Literature
go back to reference Agosta, L. 2010. Empathy in the context of philosophy. New York: Palgrave Macmillan.CrossRef Agosta, L. 2010. Empathy in the context of philosophy. New York: Palgrave Macmillan.CrossRef
go back to reference Agosta, L. 2014. A Rumor of empathy...in Heidegger. Medicine, Health Care and Philosophy (this issue). Agosta, L. 2014. A Rumor of empathy...in Heidegger. Medicine, Health Care and Philosophy (this issue).
go back to reference Aristotle. 2002. Nicomachean ethics. Translated by C. Rowe. Oxford: Oxford University Press. Aristotle. 2002. Nicomachean ethics. Translated by C. Rowe. Oxford: Oxford University Press.
go back to reference Battaly, H.D. 2011. Is empathy a virtue? In Empathy: Philosophical and psychological perspectives, ed. A. Coplan, and P. Goldie. Oxford: Oxford University Press. Battaly, H.D. 2011. Is empathy a virtue? In Empathy: Philosophical and psychological perspectives, ed. A. Coplan, and P. Goldie. Oxford: Oxford University Press.
go back to reference Beauchamp, T.L., and J.F. Childress. 1979. Principles of biomedical ethics, 1st ed. New York: Oxford University Press. Beauchamp, T.L., and J.F. Childress. 1979. Principles of biomedical ethics, 1st ed. New York: Oxford University Press.
go back to reference Beauchamp, T.L., and J.F. Childress. 2009. Principles of biomedical ethics, 6th ed. New York: Oxford University Press. Beauchamp, T.L., and J.F. Childress. 2009. Principles of biomedical ethics, 6th ed. New York: Oxford University Press.
go back to reference Bornemark, J. 2014. The Genesis of empathy in human development: A phenomenological reconstruction. Medicine, Health Care and Philosophy (this issue). Bornemark, J. 2014. The Genesis of empathy in human development: A phenomenological reconstruction. Medicine, Health Care and Philosophy (this issue).
go back to reference Coplan, A., and P. Goldie. 2011. Introduction. In Empathy: Philosophical and psychological perspectives, ed. A. Coplan, and P. Goldie. Oxford: Oxford University Press.CrossRef Coplan, A., and P. Goldie. 2011. Introduction. In Empathy: Philosophical and psychological perspectives, ed. A. Coplan, and P. Goldie. Oxford: Oxford University Press.CrossRef
go back to reference Gadamer, H.-G. 1990. Wahrheit und Methode: Grundzüge einer philosophischen Hermeneutik, 6th ed. Tübingen: J. C. B. Mohr. Gadamer, H.-G. 1990. Wahrheit und Methode: Grundzüge einer philosophischen Hermeneutik, 6th ed. Tübingen: J. C. B. Mohr.
go back to reference Gadamer, H.-G. 1993. Über die Verborgenheit der Gesundheit. Frankfurt am Main: Suhrkamp Verlag. Gadamer, H.-G. 1993. Über die Verborgenheit der Gesundheit. Frankfurt am Main: Suhrkamp Verlag.
go back to reference Halpern, J. 2001. From detached concern to empathy: Humanizing medical practice. Oxford: Oxford University Press. Halpern, J. 2001. From detached concern to empathy: Humanizing medical practice. Oxford: Oxford University Press.
go back to reference Halpern, J. 2014. Clinical empathy and emotional distress. Medicine, Health Care and Philosophy (this issue). Halpern, J. 2014. Clinical empathy and emotional distress. Medicine, Health Care and Philosophy (this issue).
go back to reference Heidegger, M. 1986. Sein und Zeit, 16th ed. Tübingen: Max Niemeyer Verlag. Heidegger, M. 1986. Sein und Zeit, 16th ed. Tübingen: Max Niemeyer Verlag.
go back to reference Hursthouse, R. 1999. On virtue ethics. Oxford: Oxford University Press. Hursthouse, R. 1999. On virtue ethics. Oxford: Oxford University Press.
go back to reference Kraut, R. (ed.). 2006. The Blackwell guide to Aristotle’s Nikomachean ethics. London: Blackwell Publishing. Kraut, R. (ed.). 2006. The Blackwell guide to Aristotle’s Nikomachean ethics. London: Blackwell Publishing.
go back to reference Nussbaum, M. 1990a. The discernment of perception: An Aristotelian conception of private and public rationality. In: Love’s knowledge: Essays on philosophy and literature. Oxford: Oxford University Press. Nussbaum, M. 1990a. The discernment of perception: An Aristotelian conception of private and public rationality. In: Love’s knowledge: Essays on philosophy and literature. Oxford: Oxford University Press.
go back to reference Nussbaum, M. 1990b. Reading for life. In: Love’s knowledge: Essays on philosophy and literature. Oxford: Oxford University Press. Nussbaum, M. 1990b. Reading for life. In: Love’s knowledge: Essays on philosophy and literature. Oxford: Oxford University Press.
go back to reference Pedersen, R. 2010. Empathy in medicine: A philosophical hermeneutic reflection. Oslo: University of Oslo, Faculty of Medicine. Pedersen, R. 2010. Empathy in medicine: A philosophical hermeneutic reflection. Oslo: University of Oslo, Faculty of Medicine.
go back to reference Pellegrino, E.D., and D.C. Thomasma. 1993. The virtues in medical practice. Oxford: Oxford University Press. Pellegrino, E.D., and D.C. Thomasma. 1993. The virtues in medical practice. Oxford: Oxford University Press.
go back to reference Prinz, J.J. 2011. Is empathy necessary for morality? In Empathy: Philosophical and psychological perspectives, ed. A. Coplan, and P. Goldie. Oxford: Oxford University Press. Prinz, J.J. 2011. Is empathy necessary for morality? In Empathy: Philosophical and psychological perspectives, ed. A. Coplan, and P. Goldie. Oxford: Oxford University Press.
go back to reference Rizzolatti, G., et al. 1996. Premotor cortex and the recognition of motor action. Cognitive Brain Research 3: 131–141.PubMedCrossRef Rizzolatti, G., et al. 1996. Premotor cortex and the recognition of motor action. Cognitive Brain Research 3: 131–141.PubMedCrossRef
go back to reference Slote, M. 2007. The ethics of care and empathy. London: Routledge. Slote, M. 2007. The ethics of care and empathy. London: Routledge.
go back to reference Svenaeus, F. 2000. The hermeneutics of medicine and the phenomenology of health: Steps towards a philosophy of medical practice. Dordrecht: Kluwer.CrossRef Svenaeus, F. 2000. The hermeneutics of medicine and the phenomenology of health: Steps towards a philosophy of medical practice. Dordrecht: Kluwer.CrossRef
go back to reference Svenaeus, F. 2003. Hermeneutics of medicine in the wake of Gadamer: The issue of phronesis. Theoretical Medicine and Bioethics 24: 407–431.PubMedCrossRef Svenaeus, F. 2003. Hermeneutics of medicine in the wake of Gadamer: The issue of phronesis. Theoretical Medicine and Bioethics 24: 407–431.PubMedCrossRef
go back to reference Zahavi, D., and S. Overgaard. 2012. Empathy without isomorphism: A phenomenological account. In Empathy: From bench to bedside, ed. J. Decety. Cambridge, Mass: MIT Press. Zahavi, D., and S. Overgaard. 2012. Empathy without isomorphism: A phenomenological account. In Empathy: From bench to bedside, ed. J. Decety. Cambridge, Mass: MIT Press.
Metadata
Title
Empathy as a necessary condition of phronesis: a line of thought for medical ethics
Author
Fredrik Svenaeus
Publication date
01-05-2014
Publisher
Springer Netherlands
Published in
Medicine, Health Care and Philosophy / Issue 2/2014
Print ISSN: 1386-7423
Electronic ISSN: 1572-8633
DOI
https://doi.org/10.1007/s11019-013-9487-z

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