Abstract
The care perspective urges physicians not only to accept the significance of emotion but to face the challenge to work out “ways of dealing with one’s emotions.”1 With a renewed understanding of emotion arising from moral psychology, emotion theory, and the care perspective, physicians and ethicists are able to analyze the clinical situation from some fresh perspectives.
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Notes
Sherman, Nancy. “Emotions,” p. 667. On how emotion figures in deliberation, Sherman writes on page 670: “A simple matter of noticing a patient’s distress or displeasure, perhaps by attending to his or her facial expressions and bodily gestures, could figure importantly in assessing a case…. Again, emotions figure in deliberation of choices.”
Carse, Alisa. “Facing up to Moral Perils.” in Caregiving: Readings in Knowledge, Practice, and Politics, ed. Suzanne Gordon, Patricia Benner, and Nel Noddings. Philadelphia: University of Pennsylvania Press, 1996, p. 95.
Beauchamp, Tom and James Childress. Principles of Biomedical Ethics, 4th ed. New York: Oxford University Press, 1994, pp. 85–92.
Principles of Biomedical Ethics, 4th ed., p. 462.
As Nancy Sherman writes in “Emotions,” p. 670: “It is difficult to see how a thoroughgoing rejection of the emotions can be compatible with what is a human life.”
Halpern, Jodi. “Empathy: Using Resonance Emotion,” p. 161.
Lief, Harold and Renée Fox. “Training for ‘Detached Concern’ in Medical Students,” pp. 12-35.
“Training for ‘Detached Concern’ in Medical Students,” p. 24.
Sherman, Nancy. “Emotions,” p. 670.
Charon, Rita. “Let Me Take a Listen to Your Heart,” p. 302.
“Let Me Take a Listen to Your Heart,” pp. 292-293.
Ross, Judith Wilson. “Literature, Bioethics, and the Priestly Physician,” Hastings Center Report, vol. 24, No. 3, May-June, 1994, pp. 25–26.
Oxford English Dictionary, s. v. “detach.”
Gilligan, Carol. “Moral Orientation and Moral Development,” p. 43. Howard Spiro, in “Empathy, an Introduction,” in Empathy and the Practice of Medicine, p. 5, highlights the experiential problem of extreme and sustained detachment practiced by physicians when he charges that “imperturbability long practiced brings ‘alexithymia,’ a failure to recognize feelings when you have them.”
Carse, Alisa. “Facing up to Moral Perils.” p. 91.
“Facing up to Moral Perils.” p. 91-92.
“Facing up to Moral Perils.” p. 103.
“Facing up to Moral Perils.” p. 105.
Recall Julia Annas’ description (see p. 1) of virtue as a three part concept, including dispositions, affective concerns, and intellectual concerns.
Beiner, Ronald, Political Judgment, p. 115. Beiner notes further on page 163 that ‘The person of exemplary judgment possesses a certain detachment from the issues being judged, and thus is not swept up into the immediacy of passion and prejudice that often attends pressing political issues.”
Charon, Rita. “Let Me Take a Listen to Your Heart,” p. 299. Charon goes on to describe some ways physicians avoid some of the pain: “We take a detour to avoid walking by the ICU waiting room, because there are always strangers crying in the phone booths. It is too painful to be too close to such sadness every day, so we learn to get off the elevator one flight down and walk up a distant stairway” (p. 304).
Halpern, Jodi. “Empathy: Using Resonance Emotion,” pp. 161-166.
Lief, Harold and Renée Fox. ‘Training for ‘Detached Concern’ in Medical Students,” p. 12.
Landau, Richard. “…And the Least of These is Empathy,” p. 108.
“…And the Least of These is Empathy,” pp. 103-109.
Spiro, Howard. “Empathy: An Introduction,” pp. 1-2.
“Empathy: An Introduction,” pp. 1-3.
Spiro, Howard. “What is Empathy and Can It Be Taught?,” Annals of Internal Medicine, vol. 116, No. 10, May 15, 1992, p. 846.
Dearing, Bruce. Aequanimitas Revisited: Personal and Professional Styles of Physicians,” p. 147.
Percival, Thomas. PercivaVs Medical Ethics, p. 90.
Percival’s Medical Ethics, pp. 90-91.
Osler, William. A Way of Life and Selected Writings of Sir William Osler, 12 July 1849 to 29 December 1919. Introduction by G. L. Keynes. New York: Dover Publications, 1951, p. 244.
A Way of Life and Selected Writings of Sir William Osler, pp. 244-245.
A Way of Life and Selected Writings of Sir William Osler, p. 48.
Osler, William. Aequanimitas, p. 8.
Aequanimitas, p. 451.
Landau, Richard. “…And the Least of These is Empathy,” p. 106. If it were legitimate to attach such an adjective to equanimity, it should then be said that Osler supports a “connected equanimity.”
See Gilligan, for instance, in “Moral Orientation and Development,” p. 43 where she writes, “The potential error in care reasoning lies in the tendency to forget that one has terms, creating a tendency to enter into another’s perspective and to see oneself as’ selfless’ by defining oneself in other’s terms.”
Judith Wilson Ross in “Literature, Bioethics, and the Priestly Physician,” p. 26, summarizes the experiential difficulty of finding any balance through the idea of detached concern: “Anyone who has taught in a medical school hospital can attest to the lack of empathy and compassion. Suffering collects in hospitals, and treatment givers engender much of it. When I began teaching bioethics to medical students, a dean told me: ‘They come in like Francis of Assisi and they go out like Mafia hit men.’…I found that ‘detached concern’— an ideal widely subscribed to by medical educators and physicians generally—was realized thus: the students arrive with the concern, and medical school teaches them the detachment.”
As Rita Charon writes in “Let Me Take a Listen to Your Heart,” p. 305, for those who seek this balance—this temperance in the face of our emotions—there is a peacefulness that awaits: “There is a great satisfaction waiting for us all. Once we have found that peacefulness, that state of acceptance beyond the fear and beyond the need to protect, then we can help. Imagine, now, sitting in your little room with a patient, a patient in pain and confusion who mourns for his healthy self. You have the power to reach him, to make that massive movement out of yourself into his experience….Your words, your understanding will act as a comfort and a charge—a current of power. Your compassion can free your patient to understand the incomprehensible, to make sense of the tragic, to speak the unspeakable. You, together with your patient, will finally grasp the meaning of what takes place in our lives. Moved by suffering, you will ease that suffering.”
Carse, Alisa. “Facing up to Moral Perils.” p. 101.
Ibid.
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Carr, M.F. (2001). Emotion and the Care Ethic in Clinical Deliberation. In: Passionate Deliberation. Philosophical Studies in Contemporary Culture, vol 8. Springer, Dordrecht. https://doi.org/10.1007/978-94-010-0591-3_8
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