Empathic concern is essential to our social lives because it motivates helping behavior. It has, however, well-known shortcomings such as its limitation in scope. Here, we highlight a further shortcoming of empathic concern: it contributes little to understanding the relevant features of complex social situations (e.g. the causes of somebody’s distress), and unaided by further cognitive inputs, likely fails to produce effective helping. We then elaborate on the conditions needed for an accurate assessment of others’ situations: the ability to pay attention and try to understand others for their own sake. We explain that when combining these abilities with the valuing aspect of empathic concern, we obtain “availability”, an understudied mental state which plays a crucial role in helping motivation. We provide a detailed definition of that notion and show how availability can be trained and exercised by health professionals in order to improve their care and relationships with patients.
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Methodological note: in order to develop the model of availability presented in this paper, we used an empirically and phenomenologically informed approach, complemented with conceptual analysis. We started by identifying the problem, namely the cognitive limit of empathic concern as discussed in the empirical literature. We set the goal of finding what attitude could be more conductive to appropriate helping behavior. We found a possible candidate, availability, in the work of Gabriel Marcel. We explored how this notion is understood in his work and in the broader phenomenological and existential literature. We observed incoherencies and lack of precisions. We then applied the method of conceptual analysis to the notion of availability in order to make it more precise, more workable, and to elaborate on the distinctions between empathic concern and availability. What we present here is the resulting model. We hope that future empirical research will confirm our theoretical results.
There is no agreement between disciplines (bioethics, psychology, philosophy) on how to label the different other-oriented affective phenomena. Most agree, however, that there is a difference between emotional identification (feeling what someone else feels) and concern for another (feeling sorry for, concerned about, afraid for, etc.) (Batson 2011; Darwall 1998; Gelhaus 2012). While many philosophers call the latter “sympathy” (Darwall 1998; Slote 2007; Maibom 2017; de Vignemont and Singer 2006; Simmons 2014; Keen 2007), we use Batson’s term “empathic concern”.
From 1978 to 1996, Batson and his team conducted numerous experiments to test whether empathic concern could motivate helping behavior and to differentiate it from egoistic motives. The results of these experiments consistently verified Batson’s hypothesis.
In his book Empathy and Moral Development, Implications for Caring and Justice, Martin Hoffman (2001) explains how the development of empathic concern, sympathetic distress as he calls it, is an important stage in the moral development of children.
For instance, in one of Batson’s experiments, subjects had to assign two tasks, one with negative consequences, to two individuals. The subjects in whom empathic concern was induced tended to assign the negative-consequence task to the individual they had not empathized with, whereas subjects in the control condition used an impartial method to choose, such as flipping a coin (Batson et al. 1995).
For a detailed discussion of the downside of empathic concern, see Batson et al. (2016).
We may even qualify this mental state as a “mental action” because, as it will be explained later, it involves a cognitive effort.
In the last section, we will discuss in more detail this ideal degree of availability i.e. the degrees to which each component is realized.
Emotional contagion, sharing the other’s emotion without being aware of picking up on the other’s emotion, and personal distress, feeling distressed (for oneself) as a result of witnessing someone else’s suffering are not considered here because they are not other-oriented and thus play a completely different role than affective empathy and empathic concern.
Note that paying attention to the patient and trying to understand her does not necessarily mean listening to the patient talking about herself. There are other ways of learning about someone which are especially important if the patient is unable to express herself. For example, one can learn about someone through her close ones or through a written document such as advanced directives.
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We would like to thank Florian Cova and Ralf Jox as well as the reviewers for their helpful comments.
This work was supported by the Swiss National Science Foundation under Grant doc.ch P0FRP1_162009.
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The authors declare that they have no conflict of interest.
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Malbois, E., Clavien, C. Overcoming the limits of empathic concern: the case for availability and its application to the medical domain. Med Health Care and Philos 23, 191–203 (2020). https://doi.org/10.1007/s11019-019-09935-1
- Cognitive empathy
- Medical attitude
- Doctor–patient relationship
- Affective empathy
- Empathic concern