Understanding empathy: why phenomenology and hermeneutics can help medical education and practice

Abstract

This article offers a critique and reformulation of the concept of empathy as it is currently used in the context of medicine and medical care. My argument is three pronged. First, that the instrumentalised notion of empathy that has been common within medicine erases the term's rich epistemological history as a special form of understanding, even a vehicle of social inquiry, and has instead substituted an account unsustainably structured according to the polarisations of modernity (subject/object, active/passive, knower/known, mind/body, doctor/patient). I suggest that understanding empathy by examining its origins within the phenomenological tradition, as a mode of intersubjective understanding, offers a different and profitable approach. Secondly, I argue that the appropriation of empathy in medicine means that, ironically, empathy can function as a technique of pastoral power, in which virtue, knowledge and authority remain with the doctor (Mayes in Bioeth Inq 6:483-493, doi: 10.1007/s11673-009-9195-9 , 2009). And thirdly, empathy is in danger of being resourced as a substitute for equity and funding within health systems. I conclude however with hope for the productive possibilities for empathy.

Keywords: Empathy; Medical humanities; Patient experience; Phenomenology; Sympathy; Understanding.