Emotionally Detached Concern or Empathic Care

Besides the value of health or wellbeing and the disvalue of disease or illness, as well as besides the normative ethical theories and the four principles that under gird contemporary bioethical principlism, modern medical knowledge and practice are influenced by two chief values that inform the ethical or moral stance or attitude of physicians—emotionally detached concern and empathic care. For the biomedical practitioner, the chief value is emotionally detached concern. “People enter medicine,” according to Manish Raiji, “out of concern for the sick and, for the more ambitious of them, the betterment of society as a whole” (2006, p. 295, emphasis added). Certainly the biomedical practitioner is concerned about the patient’s diseased state, but from a detached—particularly from the patient’s and physician’s—emotional state. Emotions are viewed as detrimental to the practice of scientific medicine, just as they are for the practice of natural science. For the humanistic or humane practitioner, however, scientific medicine is embedded within empathic care that includes the patient’s and the physician’s emotional state.

Warren Reich reconstructs the distinction between emotionally detached concern and empathic care in terms of two radically different meanings of care: “In the context of healthcare, the idea of care has two principal meanings: (1) taking care of the sick person, which emphasizes the delivery of technical care; and (2) caring for or caring about the sick person, which suggests a virtue of devotion and concern for the other as a person” (2004a, p. 361). “Taking care of” refers to the physician’s technical competence sans emotional engagement. It is a concern for the objective clinical data pertaining to the patient’s diseased state and is often reduced to a legal minimum of “due care” (Reich, 2004a). “Caring for,” however, includes an empathic or emotional engagement as a critical component of medical practice. It involves altruistic values and is part of the moral structure that under girds humanistic medical knowledge and practice (Reich, 2004a). In this chapter the emotionally detached concern of the biomedical model ( “taking care of”) is explored initially followed by contemporary challenges from humanistic practitioners in terms of empathic care (“caring for”), especially with respect to an ethic of care.