Theoretical Medicine

, Volume 7, Issue 2, pp 181–194 | Cite as

The practice of empathy as a prerequisite for informed consent

  • James E. Rosenberg
  • Bernard Towers


The patient-physician relationship, as formulated in the traditional biomedical model of medicine, is inherently flawed. In entering this relationship, most patients seek simply to be delivered from illness back to normal psychosocial functioning. The physician, however, almost invariably responds with a purely biologic approach to diagnosis and treatment that often does not effectively address the patient's needs. This precludes the opportunity for a consensus between them, and may in fact lead to the physician manipulating the patient's decisions about the course of therapy. The relationship should be reshaped within a new scientific model of patient care that combines the biomedical analysis of disease with an empathic understanding of the patient's illness experience. Truly informed consent is viewed as a natural outcome of the application of this more comprehensive framework.

Key words

Consent Sympathy Empathy 


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  1. [1]
    Aring, C. D.: 1958, ‘Sympathy and Empathy’, Journal of the American Medical Association 167, 448–452.Google Scholar
  2. [2]
    Altschule, M. D.: 1984, ‘The Doctor-Patient Relationship Through the Ages’, Alabama Journal of Medical Sciences 21, 435–439.Google Scholar
  3. [3]
    Baron, R. J.: 1981, ‘Bridging Clinical Distance: An Empathic Rediscovery of the Known’, Journal of Medicine and Philosophy 6, 5–23.Google Scholar
  4. [4]
    Barondess, J. A.: 1983, ‘The Clinical Transaction: Themes and Descants’, Perspectives in Biology and Medicine 27, 25–38.Google Scholar
  5. [5]
    Berger, D. M.: 1984, “On the way to Empathic Understanding’, American Journal of Psychotherapy 38, 111–120.Google Scholar
  6. [6]
    Bertman, S., Krant, M. J.: 1977, ‘To Know of Suffering and the Teaching of Empathy’, Social Science and Medicine 11, 639–644.Google Scholar
  7. [7]
    Blumgart, H. L.: 1964, ‘Caring for the Patient’, New England Journal of Medicine 270, 449–456.Google Scholar
  8. [8]
    Buber, M.: 1958, I-Thou (2nd Ed., trans. by Ronald Gregor Smith), Charles Scribner.Google Scholar
  9. [9]
    Buie, D. H.: 1981, ‘Empathy: Its Nature and Limitations’, Journal of the American Psychoanalytic Association 29, 281–307.Google Scholar
  10. [10]
    Bulger, R. J.: 1982, ‘Service as a Professional Sacrament’, Archives of Internal Medicine 142, 2289–2292.Google Scholar
  11. [11]
    Cannon, W. B.: 1932, 1963, The Wisdom of the Body, Norton, Inc. N.Y.Google Scholar
  12. [12]
    Cassel, E. J.: 1982, ‘The Nature of Suffering and the Goals of Medicine’, New England Journal of Medicine 306, 639–645.Google Scholar
  13. [13]
    Dorpat, T. L.: 1977, ‘On Neutrality’, International Journal of Psychoanalytic Psychotherapy 6, 39–64.Google Scholar
  14. [14]
    Engel, G. L.: 1978, ‘The Biopsychosocial Model and the Education of Health Professionals’, Annals New York Academy of Sciences 310, 169–181.Google Scholar
  15. [15]
    Engel, G. L.: 1980, ‘The Clinical Application of the Biopsychosocial Model’, American Journal of Psychiatry 137, 535–544.Google Scholar
  16. [16]
    Fabrega, H.: 1975, ‘The Need for an Ethnomedical Science, Science 189, 969–975.Google Scholar
  17. [17]
    Freud, S.: 1923, The Standard Edition of the Complete Psychological Works of Sigmund Freud, 18, Hogarth Press, London, p. 239.Google Scholar
  18. [18]
    Harris, W. H., Levey, J. S. (eds.): 1975, The New Columbia Encyclopedia, Columbia University Press, New York, p. 2754.Google Scholar
  19. [19]
    Hunsdahl, J. B.: 1967, ‘Concerning Einfühlung (Empathy): A Concept Analysis of Its Origin and Early Development’, Journal of the History of the Behavioral Sciences 3, 180–191.Google Scholar
  20. [20]
    Kimball, C. P.: 1977, ‘The Ethics of Personal Medicine’, Medical Clinics of North America 61, 866–877.Google Scholar
  21. [21]
    Lee, V., Anstruther-Thomson, C.: 1912, Beauty & Ugliness and Other Studies in Psychological Aesthetics, John Lane, London, p. 17.Google Scholar
  22. [22]
    Ibid, p. 20.Google Scholar
  23. [23]
    Ibid, p. 46.Google Scholar
  24. [24]
    Lee, V.: 1913, The Beautiful: An Introduction to Psychological Aesthetics, Cambridge University Press, London, p. 66.Google Scholar
  25. [25]
    Legg, L. G. W.: 1949, The Dictionary of National Biography, 1931–1940 (Supplement), Oxford University Press, London, p. 668.Google Scholar
  26. [26]
    Liddell, H. G., Scott, R.: 1978, A Greek-English Lexicon, Revised by Stuart Jones, Ninth Edition, Clarendon Press, Oxford, p. 542.Google Scholar
  27. [27]
    Ibid, p. 1285.Google Scholar
  28. [28]
    Ibid, p. 1680.Google Scholar
  29. [29]
    Lidz, C. W., et al.: 1983, ‘Barriers to Informed Consent’, Annals of Internal Medicine 99, 539–543.Google Scholar
  30. [30]
    Olinick, S. L.: 1977, ‘Empathy’, in B. B. Wolman (ed.), International Encyclopedia of Psychiatry, Psychology, Psychoanalysis & Neurology 4, Aesculapius Publishers, New York, 314.Google Scholar
  31. [31]
    Sykes, J. B. (ed.): 1976, The Concise Oxford Dictionary of Current English, Sixth Edition, Clarendon Press Oxford, 338.Google Scholar
  32. [32]
    Peabody, F. W.: 1927, ‘The Care of the Patient’, Journal of the American Medical Association 88, 877–882.Google Scholar
  33. [33]
    Thomasma, D. C.: 1983, ‘Beyond Medical Paternalism and Patient|Autonomy: A Model of Physician Conscience for the Physician-Patient Relationship’, Annals of Internal Medicine 98, 243–248.Google Scholar
  34. [34]
    Thomasma, D. C.: 1983, ‘Limitations of the Autonomy Model for the Doctor-Patient Relationship’, The Pharos 46, 2–5.Google Scholar
  35. [35]
    Towers, B.: 1982, ‘On the Practice of Teilhardian Principles: The Role of Empathy in Transdisciplinary Studies’, Teilhard Revue and Journal of Creative Evolution 17, 3–31.Google Scholar
  36. [36]
    Truax, C. B., Carkhuff, R. R.: 1967, Toward Effective Counseling and Psychotherapy: Training and Practice, Aldine Publishing Company, Chicago, p. 46.Google Scholar

Copyright information

© D. Reidel Publishing Company 1986

Authors and Affiliations

  • James E. Rosenberg
    • 1
  • Bernard Towers
    • 1
  1. 1.Department of AnatomyUCLA School of Medicine, Center for the Health SciencesLos AngelsU.S.A.

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