A growing field of research focused on the mental-emotional impact of medical diagnoses argues for more empathetic patient-provider relationships.
The emotional impact of diagnoses can alter a patient’s ability to maintain their cognitive autonomy due to increased levels of stress and anxiety, according to a paper by UC Berkeley professor of bioethics Dr. Jodi Halpern, who is also a part of the UCB-UCSF Joint Medical Program.
In this paper, Halpern draws on her experience working with a patient, whom she refers to as Ms. G, who began refusing lifesaving treatment. Ms. G also suffered an inability to make decisions around her treatment after an above-the-knee amputation, according to Halpern.
“The medical team thought they were respecting her autonomy by just basically helping her end her life quickly,” Halpern said. “No one had the training or education in how people’s capacity to make autonomous decisions is different in contexts where they’re treated without empathy.”
Halpern’s study, published in the Journal of Evaluation in Clinical Practice on May 31 aims to provide a framework for healthcare professionals when interacting with patients experiencing impaired decision-making due to psychological distress.
According to Halpern, this framework relies on medical professionals’ empathetic curiosity and active reinforcement of patient autonomy.
“The concept of empathic curiosity is to realize that we make assumptions about other people,” Halpern said. “We never know about another person’s world and don’t know what other people feel. The worst thing we can say to somebody else is, ‘I know how you feel.’”
Halpern described empathetic curiosity as an attitude that rejects assumptions about other people’s experiences and promotes doctors and nurses working from a place of genuine interest. She added that allowing patients to own their experiences can empower them to make their own decisions on medical treatments.
Working from a place of empathy encourages an emotional connection between patient and provider and challenges past standards of “emotionally detached” patient-doctor relationships, Halpern said. According to Halpern, an emotional connection on some level is central to medical practices and past standards ignore an individual’s implicit biases.
Haplern said she became interested in the necessity of forming an emotional bond with patients during her time in medical school when she observed the impact that a terminally ill mother’s diagnosis had on her daughter.
“She was sobbing, the woman was probably in her 20s, (and) my heart broke for her,” Halpern said. “I said to the team that we want to talk about the emotions involved and they very much felt, at that time, it was unprofessional to even get involved with patients’ emotions.”
Halpern noted that recently there’s been an increased emphasis on the emotional aspects of medical care and students are being trained on how to connect with patients through modules, films and clinical work.