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Understanding Patient Values Requires Communication, Not Empathy

Jean S. Kutner, MD
Arch Intern Med. 1996;156(14):1582-1586. doi:10.1001/archinte.1996.00440130132015.
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I am writing in response to the commentary "Empathy Revisited."1 Gianakos1 offers a convincing argument for the importance of empathy in the physician-patient relationship. I agree with the author that physicians "do not necessarily have the total answer to the patient perceived problem unless they understand the patient values and beliefs...."1 Empathy, however, is not synonymous with understanding patient values and beliefs. I would argue that the physician does not need empathy to truly help a patient. Physicians can understand patient values and beliefs without imagining that they are the patient. In fact, it may be arrogant to believe that we, as physicians, can truly empathize with a patient without having been in the patient's situation. Empathy does not guarantee that a physician is able to "determine whether the patients' opinions about what is best for them seems reasonable."1 If the physician were truly empathetic, he


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