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Empathy can be thought of as standing in the patient's shoes or trying to imagine the patient's perspective. Empathy involves reframing the clinical encounter by recognizing emotion and occupying the emotional space rather than defaulting to a biomedical or factual stance.


This guide provides a brief conceptual framework for empathy in patient care and provides examples of difficult situations or phrases and suggested responses. Each vignette is a mere snapshot of situations that commonly arise in medical practice. We propose “traditional” responses in the left column and “empathic” responses in the right column.

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Guide Layout

Traditional Approach

Empathic or Exploratory Approach

Difficult patient encounter as depicted by scenario or “patient quote.”

An example of a traditional response to the scenario by the provider.

An example of the preferred empathic response by the provider.

All clinicians should adapt the responses in this guide to their own style and use words and phrases that feel genuine to them. “Traditional” approaches listed in this document are often appropriate in the right context.


KEY CONCEPT 1: The challenging conversations described in this guide are born of strong emotions that are experienced by all vulnerable patients and their families. Those emotions include fear, helplessness, desperation, frustration, sadness, grief, and anxiety.

KEY CONCEPT 2: Rather than trying to fix the unfixable, empathic responses like those listed in this guide help us to connect with patients and families in a healing way.

KEY CONCEPT 3: Exploratory questions, like, “tell me more…,” create more empathic opportunities.

KEY CONCEPT 4: Empathic responses often fit into one of the following categories (NURSE): Name the emotion, Understand, Respect, Support, Explore (Pollak, Journal of Clinical Oncology 2007).

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Examples of Empathic Continuer Statements to Stimulate Expression

Name (the emotion)

I can imagine you are feeling sad/nervous/angry…

Understand (validate)

  • I can/can't imagine…

  • …how difficult this must be for you and your family.

  • …how you're feeling.

  • I don't blame you for feeling…


I respect your:

  • fighting spirit.

  • love for your family.

  • courage.

  • strong faith. Faith is powerful medicine.

  • independence.

  • resilience.


  • We will be here for you throughout this process no matter what happens.

  • You are not alone.


Tell me more…

  • about what you meant when you said…

  • about how you and your family are coping…

I wish…

  • …things were different.

  • …we had better treatments for you.

  • …I could fully relieve your symptoms...


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Traditional Approach

Empathic ...

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