Empathy and Prevention – a reply to Paul Bloom

In the May 20, 2013 issue of the New Yorker Paul Bloom argues convincingly that policy should include more rational argument and less empathy. Empathy leads us to spend a million dollars to get a single little girl out of a well, and yet have to scrap over pennies for building a fence that keeps the girl out of the well in the first place. Empathy leads us to commit an outsized amount of research funds to a deadly disease that affects only a few people, while ignoring or underfunding research that would prevent diseases in the first place. Empathy leads us to worry about the effects of mitigation of global warming because of anecdotes about people who might be put out of business with greater regulatory efforts to reduce carbon emissions, while not being able to envision and prevent the effects on future generations (now a cliche).

Bloom is right about all of this. But he is wrong about his conclusion. He writes (his final paragraph):

Such are the paradoxes of empathy. The power of this faculty has something to do with its ability to bring our moral concern into a laser pointer of focussed attention. If a planet of billions is to survive, however, we’ll need to take into consideration the welfare of people not yet harmed—and, even more, of people not yet born. They have no names, faces, or stories to grip our conscience or stir our fellow-feeling. Their prospects call, rather, for deliberation and calculation. Our hearts will always go out to the baby in the well; it’s a measure of our humanity. But empathy will have to yield to reason if humanity is to have a future.

To state that “empathy will have to yield to reason” is to think only rationally. Yet policy is made because of both reason and anecdote, analysis and empathy. Empathy is a form of expression of moral accounts. And values are critical to policy decision-making. To claim that empathy has to yield to reason is to contradict how we think, deliberate, and act. Instead of his weak conclusion that is so contradictory, we need to take empathy into account during policy-making. How might we do this?

First, by finding our own anecdotes. We need to find human images and stories related to prevention issues that invoke empathic responses. We need to use “Mad Men” tactics to persuade policy-makers of the value of preventive actions not just with cost-benefit and cost-effectiveness analyses, but also with narrative and emotion-evoking explanations. In the policy world we generally have been bereft of such approaches. We even can be antagonistic to them; we believe that the facts and science will do our arguments for us. But as Bloom so poignantly shows us, facts don’t hold a candle to the little girl in the well.

Second, by acknowledging the need to include empathy in our studies – how do our reactions to information and circumstances influence our willingness to be influential with policy analysis and decision-making? After all, policy analysis is just that – taking data of various sorts and trying to figure out the impact of various actions to fix a problem. Two analysts can look at the same set of data and arrive at different conclusions and courses of action because values and empathic responses are so critical to the analytic method. Our greater or lesser sense of the effects and empathic responses to those effects may strongly color our conclusions and action recommendations.

So while Bloom analyzes the problem correctly, he concludes with the wrong action statement. Empathy doesn’t have to yield to reason, analysis has to take both empathy and reason (among many other things) into account on an equal footing. And more importantly how we sell our recommended courses of action needs to play on the empathic response he so wisely discusses in his article.

BTW, often the concepts of empathy and compassion are confused. Bloom defines empathy correctly in his article, but then sometimes uses it as if it were compassion, which incorporates a component of compulsion to action. If the reader is interested in a more definitive discussion of the “spectrum of beneficence” and how empathy plays in the clinical encounter model, take a look at my 2009 article, “Kindness, not Compassion, in Health Care,” Cambridge Quarterly of Healthcare Ethics, 18, 287–299 DOI: 10.1017/S0963180109090458.

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