sadness , and I myself experientially fill out the necessary details , Third , the explicated experience is given to me as the experience of another subject , and who thus is seen by me as a proper intentional object .” 3 As a phenomenologist , she believed that we could directly perceive the feelings of another as simply another phenomenon of that person .
Building on these ideas , ethicists and philosophers began to distinguish between two kinds or aspects of empathy . 4 One is termed Affective Empathy , denoting the capacity to emotionally perceive and respond to the other ’ s situation . 5 The other is termed Cognitive Empathy , the ability to mentally reconstruct the other ’ s experiential world , trying to imagine what it would be like to be in their situation , to , as it is said , walk a mile in their shoes . 6 One is emotional understanding , the other cognitive understanding .
Care Ethics
Later , in the 1980 ’ s the view known as Care Ethics was developed out of congruent views from feminist ethics , moral psychology and philosophical ethics . It placed care as its core concept . One important idea was that the traditional ethical principles of beneficence , non-maleficence , autonomy and justice were too abstract and nonrelational for the needs of healthcare practitioners . They wanted to add in the concept of care as an active , dynamic and interpersonal relationship ethic to add substance to ethical practice . 7
Care ethics is grounded on four aspects : One , it is relational ; it considers that care is necessarily an I and Thou relationship between carer and the recipient of that care . 8 Two , it has an epistemology , or theory of knowing , that places a high value on emotions and practical , tacit and embodied knowledge . 9 Third , it is a normative model of moral deliberation based on context and individuality , establishing a standard of behaviour based on those two characteristics . And four , it is political , in the sense that it is very aware of and responsive to the power dimensions in care . 10
Care ethicists are not interested in general principles as these cannot do justice to the richness and complexity of a particular moral situation . They are interested in first-person perspectives . In short , to be human means to be in caring relationships with other people .
Empathy in Care Ethics
What has care ethics then to say about empathy ? Given that care ethics is seen as relational , epistemic , normative and political , it is clear that care ethicists want to ask how empathy works in practice . The first question to ask , however , is can it work in practice ? And to answer that we first need to know more clearly what empathy actually is . Since the time of Stein , other thinkers have tried to define its characteristics more specifically .
First of all , there seems to be agreement that it is an innate human characteristic : we are all capable of it and recognise it when we experience it . 11 It is not , though , necessarily well-developed without thought and practice .
We next need to ask if empathy is inherently good or morally neutral . It is seen as one of our few ways of transcending ourselves and connecting with the inner world , thoughts and feelings of others . And this connection is not abstract or wholly objective but is such that it promotes the other ’ s well-being . That is , it motivates altruistic or helping behaviours ; we are motivated to act in response to others . This is important in care ethics with its emphasis on action and caring . I suggest it is equally important in Complementary Medicine . In nursing theory at least , empathy is understood to be a personal quality or virtue or disposition , which can be individually measured and trained . 12 If true , this is highly interesting and important for practitioner practice and education .
It can be seen as a form of moral perception , a form of moral imagination , and a form of moral emotion , as a criterion to determine whether an action is morally right . We can perhaps think of this emotion as working in tandem with our intuition or conscience ; if it feels right , maybe it is right . 1
If the above aspects of empathy are correct , then it is at least possible that empathy can work in practice . We have it as humans , we can develop it with experience and training and it can lead to good outcomes for the patient .
Concerns with Empathy
Nothing said so far has suggested that empathy might have its doubters . But those doubters are there , and they have some serious concerns about empathy as a foundation for ethical action , without due care at least .
Our first problem is that of empathetic accuracy ; is it really possible to acquire true or accurate knowledge of others using empathy ? 4 After all , we may be mistaken in what we think the recipient of our empathy is really experiencing . We may not be feeling what they feel at all . There may be a certain level of presumptuousness , even arrogance , in assuming we do , an arrogance that might feed into the power differential always at work in the healer / client relationship . How can we check or confirm the accuracy of our empathetic feelings ? Perhaps through continued dialogue and questioning , what Stein called the act of explication - an answer which asserts that empathy alone is not enough of a guide . We see this in the case study , where Maria may not be really in clear communion with her client at all , but only feels herself to be . The arrogance can be seen in the way she says she knows exactly what the client is feeling .
Our second problem is related to the first . Our empathic feelings may be superficial and thus misguided : we know their pain but not its depths . This is more likely if we ourselves have never experienced that level of pain or discouragement or depression or helplessness . This is a view that suggests that , while innate , empathy needs life experience for it to mature . Again , how
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