Empathy signifies the ability to understand the world from someone else’s perspective, and requires the engagement of both cognitive and emotive abilities [
27,
28]. The cognitive side of empathy denotes the ability to comprehend another person’s experiences, and the emotional component refers to the ability to join in another’s feelings. The empathetic engagement with another can lead to the desire to alleviate the other’s suffering, that is compassion [
29]. Empathy, therefore, can be the precursor to compassion, as it can bring about the desire to help someone and address their needs. Conversely, compassion requires empathy, as it is through empathy that one understands another’s situation and predicament, and feels motivated to act [
30,
31]. At this point, it would be useful to briefly introduce the concept of sympathy, only to distinguish it from those of empathy and compassion. Sympathy is ‘an instance of
feeling another individual’s predicament …leading to emotional identification between the two individuals’ [
32], rather than understanding of another’s situation that is empathy, or being motivated to help that is compassion. In recent years empathy has been critiqued [
33‐
35]. Bloom [
33], for example, argues that empathy can lead to immoral actions, and advocates for rational and distanced compassion instead. Persson and Savulescu [
36] challenge Bloom’s thesis on the grounds that he wrongly defines empathy as
feeling someone else’s emotions rather than
understanding them, and on mistakenly juxtaposing reason (as a function of rationality) with empathy (as a function of intuition). They conclude that ‘reason is not an
alternative to empathy: it needs empathy as a motivator, and empathy needs reason for its motivational force to be properly directed and encompassing’. What both Bloom and his critics, however, agree upon is that empathy motivates action, including compassionate action.
In healthcare, for the past few decades there has been a distinct and sustained movement away from a paternalistic model of care, where the healthcare professional dominates the decision-making process, towards a shared decision-making model that puts the patient in the centre of the therapeutic relationship [
37‐
39]. In this patient-centred care model, empathy is fundamental [
40]. Doctors and nurses are expected to not only provide competent treatment but also care, in an empathetic and compassionate way, to their patients. However, empathy does not come without costs. Listening and engaging with patients’ experiences and feelings requires time, and studies have shown that doctors who spent more time with patients are perceived by them as being more empathetic [
41]. The emotional labour of empathy also requires material support. Time and resources are needed to allow healthcare professionals to process and reflect on their own feelings as a way of enhancing and maintain their ability to empathise [
42]. Institutional structures, system priorities and the underlying ethical principles on which healthcare systems are built also impact on the healthcare professionals’ motivation and ability to perform their duties [
43].
A number of studies have explored the impact of austerity on care provision [
44‐
46] and on healthcare professionals themselves [
47‐
49]. However, there has been no specific analysis of the relationship between efficiency and empathy in healthcare at times of austerity. This paper uses data collected as part of an empirical bioethics project on the effects of austerity on everyday experiences and professional duties [
50]. It focuses on the practical and normative implications of the renewed drive for efficiency on the everyday practice of healthcare professionals, and on the professional and ethical character of the medical and nursing professions as a whole.