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.
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Notes
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).
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.
Regarding “theory theory” and “simulation” definitions of empathy, see Coplan and Goldie 2011.
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).
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Svenaeus, F. Empathy as a necessary condition of phronesis: a line of thought for medical ethics. Med Health Care and Philos 17, 293–299 (2014). https://doi.org/10.1007/s11019-013-9487-z
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DOI: https://doi.org/10.1007/s11019-013-9487-z