1. The Role of Empathy in Healthcare Professionalism PECH 1001:
The Health Professional & Society Dr. Farid F Youssef
2. Remember. Professionalism is the basis of medicines social
contract with society Professionalism demands placing the interests
of patients above those of the physician, setting and maintaining
standards of competence and integrity, and providing expert advice
to society on matters of health
3. EMPATHY: WHAT IS IT?
4. Status: Look at this Picture What is happening? What are you
feeling? Are you have any motor responses?
5. Status: Look at these Pictures What do you think is
happening? What are you feeling?
6. Empathy: What is it? Empathy is the capacity to recognize
and experience feelings that are being experienced by another. It
is the intrapersonal realization of anothers plight that
illuminates the potential consequences of ones own actions on the
lives of others. (Hollingsworth, 2003)
7. Empathy: What is it? The essence of empathy is the ability
to stand in anothers shoes, to feel what its like there and to care
about making it better if it hurts. Szalavitz, M. & Perry, B.D.
(2010). Born for love: Why empathy is essential & endangered.
New York: William Morrow, (p. 12)
8. Empathy: What is it? Empathy is part of a wider capacity of
humans which can be defined as emotional intelligence the capacity
to be aware of, control, and express one's emotions, and to handle
interpersonal relationships judiciously and empathetically. Often
considered a predictor of success
9. NEUROBIOLOGY OF EMPATHY
10. Neurobiology of Empathy Do babies show empathy ???
11. Neurobiology of Empathy
12. Neurobiology of Empathy The discovery of mirror
neurons
13. Neurobiology of Empathy Subjects empathy for the pain of
others only elicits activity in ACC, not somatosensory cortex.
14. Neurobiology of Empathy Co-operation Giving to charity
Fairness ALL activate the reward centres of the brain AND there is
some evidence to suggest that giving produces more enduring
pleasure than receiving.
15. TYPES OF EMPATHY
16. Types of Empathy Cognitive empathy The ability to recognise
the emotions and feelings of others
17. Types of Empathy Affective or Emotional Empathy The ability
to experience the feelings of others
18. Types of Empathy Behavioural Empathy Demonstrating
behaviours that acknowledge the emotional state of others
19. Types of Empathy Moral Empathy The moral responsibility to
act in accordance with the other persons emotional state regardless
of personal feelings Considered highest level of empathy
20. EMPATHY & HEALTH PROFESSIONALISM
21. Empathy & the Health Professions Empathy impacts on
clinical outcome in patients. i. reduced metabolic complications in
a study of over 20000 diabetic patients (Del Canalee et al, 2012)
ii. linked to better glycaemic control (Hojat et al, 2011) iii.
reduced duration of the common cold (Rakel et al, 2009) iv. greater
patient satisfaction and empowerment. (Kim, Kaplowitz &
Johnston, 2004)
22. Empathy & the Health Professions Empathy impacts on
clinical outcome in patients. iv. greater patient satisfaction and
empowerment. (Kim, Kaplowitz & Johnston, 2004) v. Empathy
reduces patients perceptions to pain, (Sarinpoulous, 2012)
23. But what we are taught in school is akin to: Alexithymia...
When it comes to patients, think with your head, not with your
heart. Be objective when dealing with patients and do not let your
own emotions interfere in the patient- doctor relationship. Keep
your own emotions at bay lest you become too involved...
24. Empathy & Health Professional Training Empirical data
suggests empathy scores decline during training.
25. Empathy & Health Professional Training Doctors show
decreased neuronal responses to painful stimuli in patients and
increased activity in prefrontal cortex Theory suggests mental
processing recruits resources away from emotional areas to allows
doctors to focus However new data now shows doctors do not even
appear to perceive the pain response.
26. Why Empathy Erosion Response to Authority The infamous
Miligram Experiment, 1963
27. Why Empathy Erosion Dehumanization is the denial of a
distinctively human mind to another person (two facets experience
and agency) Used to justify slavery and other crimes against
humanity Involved in the objectification of women
28. Dehumanization in Medicine Patients stripped of their
uniqueness (stories, personality, culture) in service to
objectivity
29. Objective Subjective How does the world work? (Ontology)
There is only one reality. By carefully dividing and studying its
parts, the whole can be understood. (Realism) There are mulitple
realities, being socio-psychological constructions forming an
interconnected whole. (Nominalism) 2. What is the relationship
between the knower and what is known? (Epistemology) The knower can
stand outside of what is to be known. True objectivity is possible.
(Positivism) The knower and the known are inter-dependent. 3 What
role do values play in understanding the world? Values can be
suspended in order to understand. Values mediate and shape what is
understood. 4 Are causal linkages possible? One event comes before
another and can be said to cause that event. Events shape each
other. There are multidirectional relationships. 5 What is the
possibility of generalization? Explanations from one time and place
can be generalized to other times and places. Only tentative
explanations for one time and place are possible.
30. Dehumanization in Medicine Deindividuation doctors as a sea
of white coats; patients as half- naked bodies in smocks,
identified by their disease or procedure (the gallbladder in Room
38)
31. Dehumanization in Medicine Mechanization Breaking the body
into organs and systems for training, diagnosis and treatment
32. Dehumanization in Medicine Moral disengagement: some
actions require inflecting suffering
33. Dehumanization in Medicine Impaired patient agency medical
staffs treatment of patients as incapable of planning their own
care, which is both infantilizing and demoralizing. Dissimilarity
the patient is ill; the patient is labelled with the illness; the
power dynamic
34. The Role of Empathy in Healthcare Professionalism PECH
1001: The Health Professional & Society Dr. Farid F
Youssef