Physicians’ empathy is generally regarded as important and attempts are made

to foster empathy. However, research indicates that the medical students’

empathy is often stunted during medical education, and our understanding of
how empathy is modulated during medical education is limited. This critical
review explores some relatively-neglected challenges in the literature on
empathy development in medical education. There is a lack of adequate attention
to physicians’ disciplinary matrix, the medico-scientific formation of physicians is
often neglected, the dichotomy between the science and the humanities lives on
and the ‘soft’ side is often presented as an appendix. This may contribute to
sustain a double-blinded, dichotomized clinical gaze – a clinical gaze that tends
to separate biomedical aspects from human experience and understanding and
to neglect existential aspects of both the physician and the patient. Empathy
training and the humanities should not be situated outside the hard core of
medicine, but rather foster critical discussions of the limits and strengths of
biomedical paradigms throughout medicine. In this way, the gap between
biomedicine and the humanities could be bridged, and empathy training could
contribute both in developing physicians’ general clinical perception and
judgement and in preventing the widespread stunting of empathy.
Uses the concept of cognitive scripts to present a comprehensive theory of how the development of
empathy forms the basis for the development of morality and prosocial behavior. The author
describes 5 types of moral encounters that encompass the prosocial moral domain, defined in terms
of the consequences of one's own actions for others: bystander, transgression, virtual transgression,
multiple claimant, and caring vs justice. These types share an empathic motive base—each features
empathic distress and the derived motives of sympathetic distress, empathic anger, empathic feeling
of injustice, and guilt. (PsycINFO Database Record (c) 2016 APA, all rights reserved)

This article presents a social work model of empathy that reflects the latest interdisciplinary research
findings on empathy. The model reflects the social work commitment to social justice. The three model
components are: 1) the affective response to another’s emotions and actions; 2) the cognitive
processing of one’s affective response and the other person’s perspective; and 3) the conscious
decision-making to take empathic action. Mirrored affective responses are involuntary, while cognitive
processing and conscious decision-making are voluntary. The affective component requires healthy,
neural pathways to function appropriately and accurately. The cognitive aspects of perspective-taking,
self-awareness, and emotion regulation can be practiced and cultivated, particularly through the use of
mindfulness techniques. Empathic action requires that we move beyond affective responses and
cognitive processing toward utilizing social work values and knowledge to inform our actions. By
introducing the proposed model of empathy, we hope it will serve as a catalyst for discussion and future
research and development of the model. Key Words: Empathy, Social Empathy, Social Cognitive
Neuroscience