Empathy – the identification with and understanding of another person’s situation and feelings – may help patients with poor prognosis to cope with the situation and may as well lead them to follow the recommended treatment more closely. But empathy is not something that doctors are ready to offer when dealing with patients in their final stages of cancer, according to a study published in the Sept. 22 issue of Archives of Internal Medicine.

For the study, lead author Diane Morse, assistant professor of psychiatry and of medicine at the University of Rochester in New York and colleagues assessed transcripts of 20 audio recordings of consultations between men with lung cancer and surgeons or oncologists at a Veteran Affairs hospital. Overall, there were 384 opportunities for the doctors to show empathy towards their patients and yet only 10 percent or 39 doctors were able to offer it.

“Physicians only responded to 10 percent of empathic opportunities and, when patients raised existential concerns, physicians tended to shift more to biomedical responses. Physicians had trouble addressing the bulk of concerns, which were about patient fears, concerns about death or dying, or worsening conditions,” Dr. Morse said.

For example, in one case, a lung cancer patient was talking about the amount of time he expected to live: I don't know what the average person does in just two years, three years, a year?

Physician: I think that … you certainly could live two or three years. I think it would be very unlikely … But I would say that an average figure would be several months to a year to a little bit more.

According to previous studies, patients shown empathy are more satisfied with their medical encounters, which leads to a better understanding of their condition and lower anxiety. Sometimes a simple “I know that this is really scary,” or “I can imagine how difficult that is” or “It sounds like you are very concerned about that,” can make people feel much better, Dr. Morse said.

However, empathy is not something doctors can learn in school. It’s more like something that comes from inside and there are few people able to show it. Therefore, we can’t blame doctors for lacking empathy and for trying to change the subject when patients talk about their fears. Moreover, doctors might choose to avoid empathic opportunities, especially those about mortality, because they are difficult to address.

“This difficulty may be related to limited cure potential that results in a sense of failure and/or identification with the patient that is difficult for the physician to acknowledge or express and may raise within the physician awareness of his or her own vulnerability to illness and mortality,” the study concluded.

The study was funded by the Agency for Healthcare Research and Quality.