When words make a difference in palliative care

Over my years of working in and teaching palliative care, I have often used the terms ‘empathy’, ‘sympathy’ and ‘pity’—in some cases, even interchangeably. While we could discuss the definitional differences among these three words, in this column, I intend not only to define them, but also to show the impact they have on communication with patients in their palliative care phase. The definitions I have chosen here are the ones I use when teaching, which are scenario rather than dictionary-based, to help illustrate these concepts visually.

While walking back to the office, busy on my smart phone, I fall into a deep muddy hole that workmen have dug to repair waterpipes, and I badly hurt my left knee. I am lying there and calling for help. Person 1 comes along, with his hand covering his mouth: ‘How awfully terrible, this chap is in an impossible predicament’. To me, this comment is pitying me, has not helped me and is not even directed at me. He has not noticed my hurt knee and he walks away.