Palliative & Supportive Care


Empathy and the failure to treat pain

STEVEN D.  PASSIK  Ph.D. a1 , KAREN  BYERS  Psy.D. a1 and KENNETH L.  KIRSH  Ph.D. a2 c1
a1 Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York
a2 Pharmacy Practice and Science, University of Kentucky, Lexington, Kentucky

Article author query
passik sd   [PubMed][Google Scholar] 
byers k   [PubMed][Google Scholar] 
kirsh kl   [PubMed][Google Scholar] 


We set out to discuss the psychological barriers that exist in the treatment of pain. Specifically, we argue that clinicians have several innate mechanisms at play that can hinder their judgment and lead to erroneous assumptions about their patients. Issues are discussed from social psychological and psychodynamic perspectives. A focus is placed on the issue of empathy and how this, too, can act as a barrier to rational judgment when evaluating patients. In the face of growing scrutiny on pain management in the United States, it is important to understand the barriers to providing care that already exist on an intrinsic level. Through the exploration of these barriers, clinicians might be better able to reflect on their own practice. Ultimately, we hope to push forward an agenda of rational therapy in pain management that utilizes safeguards against abuse and addiction while also preserving treatment modalities for patients in need of services.

(Received August 31 2006)
(Accepted November 26 2006)

Key Words: Pain; Empathy; Undertreatment; Barriers.

c1 Corresponding author: Kenneth L. Kirsh, University of Kentucky, Pharmacy Practice and Science, 725 Rose Street, 201B, Lexington, KY 40536-0082, USA. E-mail: