Healthcare professionals are expected to have the right technical skills, medical knowledge and expertise, and to be empathetic, compassionate and trustworthy; and this is reflected in the training and education they receive. Yet numerous studies and reports demonstrate a decline in empathy among healthcare professionals.

Exercising empathy in healthcare depends on the individual healthcare practitioners and on the environment in which they work. It is, therefore, important to develop a broader account of healthcare-relevant empathy that encompasses healthcare systems and their role, in addition to the skill or virtue of the individual practitioner. In this paper, we develop and defend such an account by discussing: (1) Conditions for empathetic interaction between healthcare professionals and patients at the micro level. (2) Macro-level/ meso-level governing policies that allow healthcare professionals to develop and exercise empathy, and patients to benefit from it.


Broadening the definition of empathetic healthcare to include healthcare institutions and systems requires a broader understanding of what makes empathy possible at macro, meso and micro levels. Rather than centring on the individual healthcare professional, a multitiered view is needed and should be the focus of future work on empathy in healthcare systems.

To realise an empathic healthcare system requires a much broader scope of macro-level decisions that explicitly and coherently relate to empathy than what has been discussed in the literature thus far. Seen in relation to Buchanan's social moral epistemology, the shaping of empathic healthcare systems or institutions on such extensive terms would be expected to strengthen positive attitudes towards empathy in everyone involved in developing and upholding these systems or institutions. Moreover, an empathic healthcare system or institution can now be positively and in more detail described on ideal terms as involving policy decision regarding targeted training of empathy in healthcare professionals, ensuring conditions for cultivating empathy amonth healthcare professionals, delegating responsiblity for overseeing empathy in clinical work, as well as intending developing implementation and evaluation of empathy promoting policies across all phases of healthcare access and provision.

For the full article: Kerasidou A, et al. J Med Ethics 2020;0:1–5. doi:10.1136/medethics-2019-105921



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