Chapter One
Distributive Justice
Principle requiring that all persons be treated equally and fairly Ex: should get a disproportional share of society's resources or benefits
Compassion p.24
Profound awareness of and sympathy for another's suffering, pain, and try to make they feel better Dr. Peeno
Moral Value
Relative worth placed on some virtuous behavior
Buddhism p. 42
Religion and philosophy encompassing a variety of traditions, beliefs, and practices encourage one to do good, avoid evil, and purify the mind Informed about their health status to prepare spiritually and have side room
Fairness p.26
Requires each person to be objective, unbiased, dispassionate, impartial, and consistent with the principles of ethics Ability to make judgements free from discriminations, dishonesty, or one's own bias Be objective without being prejudice or bias Good in all and reward that good Healthcare: cheaper is not always better and providing care may not be enough
Utilitarianism
Seek happiness and avoid pain = our moral focus out to center on maximizing happiness and minimizing pain for the greatest number of people Both about what our goals should be and how to achieve them
Ethical Theories p.4
Seek to understand and to determine how human actions can be judged as right or wrong Ethical Judgements: based on our own experiences or based upon nature of or principles of reason Theories and principles of ethics Introduce order into the way people think about life Foundations of decision make process Help caregivers determine the outcome of alternative choices
Religious Ethics p.39
Serve a moral purpose by providing codes of conduct for appropriate behavior through revelations from a divine sources Enforced through fear of pain and suffering Tolerate the injustice in this life How to respond to patient Justify what otherwise could be unjustifiable behavior, political aspirations Spirituality implies that there is purpose and meaning to life Refers to faith in a higher being
Judaism p.42
Jewish law refers to the unchangeable that God gave the Jews Halakhah Torah Laws instituted by the rabbis Longstanding customs Monotheistic religion based on principles and ethics in the Hebrew Bible (Old Testament) Right or wrong is not so much an object of philosophical inquiry as an accpetance of divine revelation Caring for the dying, family members will normally want to present and prayers spoken Get rabbi
Virtue Ethics and Values
p.22
Truth Telling
Providing enough information so that a patient can make an informed decision about his or her health care ex: giving patient false hope Medical errors
Freedom p.30
Quality of being free to make choices for oneself within the boundaries of law Not recognized as a given
Taoism p.42
Reality is unknowable and unperceivable Lao Tzu Belief that the proper way of living involves being in tune with nature Compassion, frugality, and humility. Mediation in daily life.
Reasoning and Decision-making process p.45
Reasoning: process of forming conclusions, judgements, or inferences based on one's interpretation of facts or premises that help support conclusion Capacity for logical inference and ability to conduct inquiry, solve problems, etc Particular Reasoning Bias for or against a person based on one's relationship with that person Circular Reasoning Describes a person who has already made up her/his mind on a particular issue and sees no need for deliberation Consensus Building During the decision making process will occur when the parties involved can sit and reason together
Autonomy p.10
Recognizing the right of a person to make one's own decisions Greek --> auto = self or individual NOT an absolute principle One person must not infringe upon the rights of another Each person has right to own health decisions Refuse health care Respect to 14th ammendment They also have a concomitant right to know the risks, benefits, and alternatives to recommended procedures May be carried out through an advance directive and/or an appointed healthcare agent in the event of one's inability to make decisions
Intrinsic Value
Something that has value in and of itself (happiness)
Consequential Ethics p.6
"the philosophical search (within western philosophy) for right and wrong within controversial scenarios Application of normative theories to practical moral problems, such as abortion, euthanasia, and assisted suicide
Applied Ethics p.6
"the philosophical search (within western philosophy) for right and wrong within controversial scenarios Application of normative theories to practical moral problems, such as abortion, euthanasia, and assisted suicide -involves examining specific controversial issues, such as abortion, infanticide, animal rights, environmental concerns, homosexuality, capital punishment, or nuclear war. -depends on more general normative principles such as the right of self-rule and the right to life, which are litmus tests for determining the morality of that
Temperance p.24
Involves self-control and restraint Moderation in thoughts and actions Ability to control one's actions so that it doesn't get extreme Without ability to control = not virtuous person Stand out in crowd by actions and deeds
Integrity p.33
Involves steadfast adherence to a strict moral or ethical code and commitment not to compromise this code What you do when nobody else is around What you do and how you do it on a daily basis Consistency in actions, expectations, measures, methods, outcomes, principles, and values Our actions are honest and trustworthy May refuse treatment cause of beliefs Without it = lacks sincerity and moral conviction and may fail to act on professed moral beliefs
Medical Integrity and Patient Autonomy
Involves steadfast adherence to a strict moral or ethical code and commitment not to compromise this code What you do when nobody else is around What you do and how you do it on a daily basis Consistency in actions, expectations, measures, methods, outcomes, principles, and values Our actions are honest and trustworthy May refuse treatment cause of beliefs Without it = lacks sincerity and moral conviction and may fail to act on professed moral beliefs
Ethics p.2
Is the branch of philosophy that seeks to understand the nature, purposes, justification, and founding principles of moral rules and systems they compromise Ethics and morals are derivatives from the Greek and Latin terms roots for custom Etymology of them is derived from the roots ethos and mos = convey a meaning describing customs or habits Supports claims of anthropologist Ruth Benedict that all values are rooted in customs and habits of a culture Deals with values relating to human conduct Focuses on the rightness and wrongness of actions Goodness and badness of motives and ends Encompasses the decision making process of determining ultimate actions What should I do Is this the right thing to do Expression of how individs. Decide to live with one another within accepted boundaries and how they live in harmony with the environment as well with one another Concerned with human conduct as opposed to what it actually -science or morality
Atheism p.44
Rejection of belief in any god when no scientific evidence that can prove existence No objective moral standard for right and wrong and that ethics and morality are the product of culture and politics, subject to individual convictions
Kindness p.36
Quality of being considerate and sympathetic to another's needs
Systematic Approach
-Did I practice any virtues today? :habits of the heart -Did I do more good than harm today? Did I treat people with dignity and respect today? -Was I fair and just today? = Justice requires that we be fair in the way we distribute benefits and burdens
Thinking Ethically: A Framework for Moral Decision Making
-analyze moral issues. get facts -appeal to values 5 different approaches to values to deal with moral issues
What is Ethics?
-feelings tell me right or wrong -doing what the law requires -not a matter of one's feelings cause may recoil from doing what is right -not related with religion -well based standards of right and wrong that prescribe what humans it to don, rights, obligations, benefits to society, fairness, or specific virtues -study and development of one's ethical standards -continuous effect of studying our own moral beliefs and our moral conduct
Everyday Ethics
-more direct, persistent, and urgent -intimately bound up with that art, heart, and human relationships -right and wrong -make us who we are (characteristics) -most important problem after crime, healthcare, and jobs IS ethics -Ethic to Moral Leadership =take special responsibility for what is going on inside his or her own self, consciousness, lest the act of leadership create more harm than good
Justice and Emergency Care p.21
2 patients walk in should a caregiver: First patient who walks through the door? Age of the patients? Likelihood of survival? Ability of the patient to pay for services rendered? Condition of the patient? Patients should be treated equal but resources are scarce Principles of distributive justice raises numerous issues: How limited resources should be allocated
Macroethics
A more global view of right and wrong Solving dilemmas = micro and macro ethic perspective
Discernment p.28
Ability to make good decision without a personal biases, fears, and undue influences from others Wisdom to decide the best course of action there are many possible actions to choose from
Commitment p.24
Act of binding oneself intellectually and/or emotionally to a course of action Agreement or pledge to do someone Ongoing
Bioethics
Addresses a diversity of issues that include the nature of life and death What sort of live is worth living How we distinguish between assisted suicide and murder How we should treat people who are vulnerable Responsibility that we have toward other human beings Making better decisions when addressing diverse complex care issues with a wider variety of circumstances
Falun Gong p.42
Aka Falun Dafa Traditional Chinese spiritual discipline belonging to the Buddhist school of thought Moral teaching, meditation, four exercises that resemble tai chi and known in Chinese culture qigong Truthfulness, compassion, and forbearance/tolerance towards others
Normative Ethics and Assisted Suicide p. 5
Allows terminally ill state residents to end their lives through the voluntary self-administration of a lethal dose of medications prescribed by a physician
Injustice for the Insured p.20
Americans declared bankruptcy because of medical issues, struggle to pair or afford bills Insured used all benefits should hospital Withhold the money from the patient's wages? Place a lien on the patient's home? Arrest the patient? Block the patient from applying for the hundreds of millions of dollars in government fund designated to help pay for care for those who need it?
Micoethics
An individual' s view of what is right and wrong based on one's personal life teachings, traditions, and experiences
Consequentialism
Assets that determining the greatest good for the greatest number of people is a matter of measuring outcome, and so decisions about what is moral should depend on the potential or realized costs and benefits of a moral belief or action Largely determining how to attain our goals, which are taken to be self-evident
Respect p.36
Attitude of admiration or esteem Core ideal extending moral respect to things other than persons, including all things in nature Develop trust between patient and caregiver = improve health and healing
Deontological Ethics p.8
Attributed to German philosopher Immanuel Kant Doing the right thing is good, it might NOT always lead to or increase the good and right thing sought after Focuses on one's duties to others and other's rights Telling the truth and keeping your promises Duty-based ethics Ethical analysis = moral code or rules, religious or secular Deon: derived from Greek "duty" Differs from consequentialism in that consequences are not the determinant of what is right; therefore, doing the right thing may not always lead to an increase in what is good Heavy on obligation, that a person follows this ethical paradigm believes that the highest virtue comes from doing what you are supposed to do Following law, policies, doing your duty
Secular Ethics p.44
Based on codes developed by societies that have relied on customs to formulate their codes Code of Hammurabi Ruler proclaiming to his people an entire body of laws
Creating a Culture of Ethics p.47
Begins with governing body CEO must take leadership in role increasing and maintaining a culture of ethics
Paternalism p.13
Form of beneficence Ppl believe that they know what is best for antoehr and make decision s that they believe are in that person;s best interests Withholding information, believeing that the person would be better off that way Age, cognitive ability, and level of dependency
Employment-Related Paternalism p.14
Best is shared and cooperative style of management in which the employer recognizes and considers employee rights when making decisions in the workplace Paternalism Problem Employer's style of management becomes more authoritarian and arbitrary, and unpredictable. Discrimination Laws fail to provide uniform and consistent legal protection when an employer engages in applicant-specific paternalism- the practice of excluding an applicant Protect that person from job-related safety and/or health risks uniquely to his or her federally protected characteristics EEOC" rejects paternalism demanding that the applicant alone decide whether to pursue (and accept) a job that poses risks related to his or her sex, color, race, religion, or national origin
Descriptive Ethics p.5
Comparative ethics Study of what people believe to be right and wrong and why they believe it Describes how people act "and/or what sorts of moral standards they claim to follow" Normative Ethics: how people ought to act Both normative and descriptive ethical theories have application in the Oregon Act -describing how people behave and/or what sorts of moral standards they claim to follow -comparing ethics to past to present and one society to another -what do people claim as their moral norms? -how do people actually behave when it comes to moral problems?
Utilitarian Ethics p.7
Concept that the moral worth of an action is determined solely by its contribution to overall usefulness Doing the greatest good for the greatest number of people Moral worth of an action is determined by its outcome and ends justify the means Proper course of an action is one that maximizes utility Maximizing happiness and reducing suffering
Situational Ethics p.44
Concerned with the outcome or consequences of an action in which the ends can justify the means Those times when a person's beliefs and values can change as circumstances change
Honest/Trustworthiness, Truth Telling p.31
Confidence that a person will act with the right motives Assured reliance on the character, ability, strength, or truth of someone or
Religious Beliefs and Duty Conflict p.43
Conflict with saving lives Ex: Jehovah's Witness with blood transfusion
Cooperation and Teamwork p.37
Cooperation Process of working with others Caregivers work together to improve patient outcomes Failure: rippling effect Change = when players learn to cooperate for the common good
Courage as a Virtue p.23
Courage: mental or moral strength to persevere and withstand danger Strength of character necessary to continue in the face of fears and challenges in life Make good judgment and clear sense, evaluate danger, and right goal to achieve Help to defines one's character and offers the strength to stand up for what is good and right NOT exercised if so = foolish in actions
Non-consequential Ethics p.9
Denies that the consequences of an action are the only criteria for determining the morality of an action Rightness and wrongness of an action is based on properties intrinsic to the action, not on its consequences Believes right or wrong depends on the intention, not the outcome.
Principles
Describe responsibilities that do no specify what the required conduct should be Professionals need to make a judgement about what is desirable in a particular situation based on accepted principles
Beneficence p.12
Describes the principle of doing good, demonstrating kindness, showing compassion, and helping others Providing benefits and balancing benefits against risk Requires one to do good Knowledge of the beliefs, culture, values, and preferences of the patient What one person may believe to be good for a patient = could be harmful
Tuskegee Syphilis Experiment p.17
Designed to analyze the natural progression of untreated syphilis in African American men Believed they were receiving care and unknowingly suffered unnecessarily Requires all people to avoid causing harm Failure to alert those involved in the research study that a cure was available both ethically and legally wrong
Veracity
Devotion to and conformity with what is truthful
Scope of Healthcare Ethics
Encompasses numerous issues Right to choose or refuse treatment and the right to limit the suffering one will endure Advances in technology = extends life and quality of life But complicate the process of healthcare decision making NOT limited to philosophical issues But embraces economic, medical, political, social, and legal dilemmas
Justice part 2 p.17
Ethical issues involving in the rationing of health care Result of limited or scarce resources, limited access as a result of geographic remoteness, or a patients inability to pay for services combined with some physicians unwilling to accept patients who are perceived as "no pays" with high risks for legal suits Limited financial resources are challenging to the principle of justice Justice = equality Equal access to healthcare Education and prevention will improve the quality of life and life expectancy Unfailing quality patient care: a+ b +c+= D p. 19 Improving health of ppl on page 19 Not enoguh to merely have equipment, it must be high-quality equipment that improves patient outcomes Not enough to merely the "right" number of persons on staff; the individual staff members must also be competent enough to perform the assigned tasks. Not enough to have health facilities; they must be high quality facilities Resources are limited and scarce Justice requires the fair distribution of limited funds which are associated with the moral theories of utilitarianism and consequentialism
Nonmaleficence p.16
Ethical principle that requires caregivers to avoid causing patients harm Derives from the ancient maxim primum non nocere latin for "first, do not harm" Code of Hippocrates: pledging to do no harm Medical ethics requires healthcare providers to "first do no harm" Telling truth can cause harm Deviation from either can lead to unsatisfactory outcomes for both physicians and patients
Life or Death: The Right to Choose p.12
Executed a release requesting that no blood or its derivatives be administered during hospitalization
Virtue Ethics
Focuses on the inherent character of a person rather than on the specific actions they perform
Zen p.42
From Buddhism in Tibet Dharma practice and experiential wisdom based on learning through the reflection of doing, going behind Zazen: perform mediation to calm the body and the mind and experience insight into nature of existence and gain enlightenment
Pillars of Moral Strength p.23
Have courage to do right then we can be influence and compassionate Pillars of Moral Strength show a virtuous person Courage, wisdom, temperance, commitment, compassion, conscientiousness, discernment, fairness, fidelity, freedom, honesty, integrity, kindness, respect, hopefulness, tolerance
Moral Dilemmas p.4
Healthcare setting often arise when values, rights, duties, and loyalties conflict Best answer: Known wishes of the patient and other pertinent information such as living will that might be available when the patient is considered incompetent to make his or her own choices Right Answer: Often elusive when the patient is in coma, there are no known documents expressing a patient's wishes, and there are no living relatives
Why Study Ethics p. 2-3
Help caregivers make sound judgements, good decisions, and right choices Better choices Judgements guided by the Wisdom of Solomon to do good Doing right thing by applying the universal morals and values described in (10 Commandments) will help shield and protect all from harm
Ethical Relativism p.9
Holds that morality is relative to the norms of the culture where one lives Right or wrong depends on the moral norms of the society in which it is practiced Maybe morally right in one society or culture and wrong in another Caregivers must be away of cultural, religious, and legal issues that can affect the boundaries of what is acceptable and what is unacceptable practice, especially wen delivering health care to persons with other beliefs Not only grasp clinical skills of his or her profession but know the basic understanding of what is right and what is wrong from both a legal and ethical point of view -different cultures have different moral codes -ethics are relative to individuals, groups, and societies -resists universal moral norms ex: Eskimo cultures (infanticide) -Greeks/collations (eating the dead) -Criticism: -self-defeating: "there are absolutely no absolutes" -just cause some ppl believe something doesn't make it true -calls into question all moral program -How to get around it? -talk about shared values -some moral rules must be embraced by everyone for society to exist; honesty, prohibition of murder, etc.
Standards
Honesty, respect for others, conscientiousness Used to guide human conduct by stating desirable traits to be exhibited and undesirable ones (dishonesty, deceitfulness, self- interest) to be avoided
Morals p. 3
Ideas about what is right and what is wrong Ex: killing wrong and helping poor right Ingrained in culture and religion and are often part of its identity NOT religious or cultural habits or customs like religious Vary from nation, culture, and religion NO universal morality that is recognized by all people in all cultures at all times
Moral Judgement p.4
Judgements concerned with what an individual or group believes to be the right or proper behavior in a given situation Being able to select an option from among choices Assessing another person's moral character based on how they conforms to the moral convictions established by the individual and/or group Lack of conformity can result in moral disapproval and possibly ridicule or censure of one's character
Wisdom as a Virtue p.24
Judicious application of knowledge Begins first by learning from the failures and successes of those before Wisdom with good judgement
Detachment p.26
Lack of concern for the patient's needs, often translates into mistakes that result in patient injuries Those who have excessive emotional involvement in patient's care may be best suited to work in those settings where patients are most likely to recover and have good outcomes Comfortable balance between compassion and detachment
Morality Legislated p.4
Law Distinguish from morality by having explicit rules and penalties Created to set boundaries for societal behavior Every law and regulation that is proposed, passed, and enforced has inherent in it some idea of the good that it seeks to promote and preserve
Declining Trust in Healthcare System p.32
Nation's ability to deliver high-quality health care is evidence by a system caught up in the quagmire managed care companies Distrust in the nation's political leadership and the providers of healthcare
Absence of Moral Compass p.46
Nation's healthcare system is off course Trust declines when those provide health does unnecessary
Christianity p.43
New: describes Jesus as being God, taking the form of man Life, teachings, ministry, death, and resurrection of Jesus Golden Rule Anointing of the sick: Minster to be present like catholic priest
Morality p.3
News Clipping: how a deficiency in the morality of society can lead to a betrayal of humanity Lawlessness and heartless actions run rampant in a land void of courage and compassion Morality p. 3 Describes a class of rules held by society to govern the conduct of its individual members Implies the quality of being in accord with standards of right and good conduct Code of conduct Guide to behavior that all rational persons should put forward for governing their behavior Requires us to reach a decision as to the rightness and wrongness of an action
Justice p.17
Obligation to be fair in the distribution of benefits and risks Demands that persons in similar circumstances be treated similarly Treated justly when he or she recieves what is due is deserved, or can legitimately be claimed Involves how people are treated when their interests compete with one another
Hopefulness p. 37
Patient care setting involves looking forward to something with eh confidence of success Balance truthfulness while promoting hope
Conscientiousness p.27
Person is one who has moral integrity and a strict regard for doing what is considered the right thing to do If motivated to do what is right, believing it is the right thing to do Form of self-reflection on and judgement about whether one's actions are right or wrong, good or bad, Bad: painful feelings of remorse, guilt, shame if it is wrong
3 Distinct way for Ethics
Philosophical Ethics:inquiry about ways of life & rules of conduct General Pattern or Way of Life: religious ethics (Judeo-Christian) A set of Rules: conduct or "moral code" ex: professional codes of ethical behavior
Physicians and Paternalism p. 13
Physicians influence a patient's healthcare decision simply by selectively telling the patient what he or she prefers based on personal beliefs Violates patient autonomy Problem: conflict with autonomy and beneficence: viewed and weighed differently Patient's right to know and choose what course of treatment they wish to pursue without undue pressure
Medical Paternalism p.13
Physicians unwittingly making decision for patients who are capable of making their own choices
Hinduism p. 42
Polytheistic religion with many gods and goddesses God is everything and is infinite Reincarnation and that one's present condition is a reflection of one's virtuous behavior or lack thereof in previous lifetime Perform rituals, clothes removed, and wash body
Tolerance p.37
Positive tolerance Implies that a person accepts differences in others and that one does not expect others to believe, think, speak, or act as he or she does Free of prejudice and discrimination Negative Tolerance Implies that one will reluctantly put up with another's beliefs Tolerate the views of others Can be viewed as a virtue but NOT all tolerance is virtuous not all intolerances is wrong
Virtue
Positive trait of moral excellences Those characteristics that differentiate good people from bad people Courage, honesty, and just are abstract moral principles Morally: who does the good and right thing by habit not rules Virtuous person who naturally good as exhibited by unswerving good behavior and actions
Code of Conduct p. 4
Prescribes standards of conduct State principles expressing responsibilities Defines the rules expressing duties of professionals to whom they apply "set of rules outlining the social norms, religious rules and responsibilities of, and or proper practices for, an individual, party or organization. Related concepts include ethical, honor, moral codes, and religious laws" Require interpretation by caregivers as they apply to the specific circumstances surrounding each dilemma
Normative Ethics p. 5
Prescriptive in that is attempts to determine what moral standards should be followed so that human behavior and conduct morally right Establishing standards or norms for conduct and is more commonly associated with investigating how one out to act Critical study of major moral precepts, such as what things are right, good, and genuine Whether human actions to be judged right or wrong solely according to their consequences Prescribes how people out to act -takes on the task of arriving at moral standards that regulate right and wrong conduct -may involve articulating the good habits that we should acquire, the duties that we should follow -concerned with classifying actions as right and wrong without bias, as apposed to applied ethics
CPR and Paternalism in Nursing Home
Some have no-CPR policies, no resuscitation measures in the nursing home Memorandum Summary Initiation of CPR: EMS, nursing homes must provide basic life support and initiation of CPR. Facility CPR Policy: implemented facility-wide no CPR policies. Facilities must not establish and implement facility wide no CPR policies Surveyor Implications: should ascertain that facility policies related to emergency response require staff to initiate CPR as appropriate and that the records do not reflect instances where CPR was not initiated by staff even though the resident requested CPR or had not formulated advance directives
Intrinsic Mental Value
Something that helps to give value to something else (money is valuable for what it buys) Values change by needs like water, food, clothing etc. Give purpose in each life and make moral character Motivating power of a person's actions and necessary to survival Relationship between abstract virtues (principles) and values (practice)
Rules
Specify specific conduct They do NOT allow for individual professional judgement
Values
Standards of conduct Used for judging for goodness or badness of some action Standards by which we measure the goodness of our lives
Meta-Ethics p.5
Study of the origin and meaning of ethical concepts Explores as well as the connection between values, reasons for action, and human motivation, asking how it is that moral standards might provide us with reasons to do or refrain from doing as it demands, and it addresses many of the issues commonly bound up with the nature of freedom and its significance (or not) for moral responsibility Classification within western philosophy that attempts to discover the origin or cause of right and wrong Ex: how can we know what is right and wrong -investigates where our ethical principles come from, and what they mean -are they merely social inventions? -do they involve more than expressions or our individual emotions -nature and methodology of moral judgments and terms, relations between moral concepts, the correct ways of arguing about moral issues, similarities and difference between various normative systems like morality, religion, law, etiquette, aesthetics, the judgement of taste, etc.
Islam p.43
There is one god: Allah Received revelations from God and wrote different version of bible Submit to god's will and follow Islam Want to be with relative and die facing Mecca
Politics and Distrust p.33
Truthfulness is one measure of one's moral character Politicians do NOT always set good examples for the people they serve
Principles of Ethics p.10
Universal rules of conduct, derived from ethical theories that provide a practical basis for identifying what kinds of actions, intention, and motives are valued Assist caregivers in making choices based on moral principles that have been identified as standards considered meaningful when addressing health care-related ethical dilemmas Caregivers will find it difficult decisions often involve choices between conflicting ethical principles
Forgiveness p.38
Virtue and value Willingness to pardon someone who has wronged you in some way Form of mercy and loose the bonds of blame, cleansing souls of both
Fidelity p. 29
Virtue of faithfulness, being true to our commitments and obligations to others Truthful and honest Caregivers need to be faithful to their duties and obligations to provide quality patient care Perna v. Pirozzi : determined that a patient's consent form did not apply to the partners in a group practice Failure of a surgeon to perform a medical procedure after soliciting a patient's consent like the failure to operate on the appropriate part of a patient's body Patient to put his or her life in the hand of a well known and trusted medical doctor
Empathy p.24
Visceral feeling where a person sees another in pain and can place themselves in their shoes and feel that pain Action of understanding, being aware of, being sensitive to, and vicariously experiencing the feelings, thoughts, and experience of another of either the past or present without the feelings, thoughts, and experience fully communicated in an objectively explicit manner Jodi Halpern Physicians associate empathy with benevolent emotions and with developing a shared understanding with patients