Comment about Musk from a college classmate: "Musk’s comment in his interview by Seth Rogan: “The fundamental weakness of Western civilization is empathy.”  Says all you need to know about him. "

Reply by another college classmate: "But see Paul Bloom’s book Against Empathy: The Case for Rational Compassion.

From the back cover, courtesy of Amazon.com:

A controversial call to arms by one of the world’s leading psychologists, Against Empathy reveals how the natural impulse to share the feelings of others leads to cruel and irrational behavior on both the world stage and at home. With precision and wit, Paul Bloom demonstrates how empathy distorts our judgment in every aspect of our lives, from philanthropy and charity to the justice system; from medical care and education to parenting and marriage. Without empathy, Bloom insists, our decisions would be clearer, fairer, and—yes—ultimately more moral.

I have to push back on the use of Bloom's book as an argument against empathy.

His book came out about a year after I had retired from my medical practice and stopped teaching/mentoring family practice residents and medical students. Although I found his arguments interesting and mostly internally consistent, my overall reaction was ‘meh'.

My personal bias is that empathy is a critical characteristic of high-quality patient-centered care and an essential attribute for primary care clinicians. I found nothing in his book (or the interviews and articles I've seen since) to contradict my belief in the importance of empathy in dealing with both people as individuals and society as a whole.

I have some specific criticisms of his book, and of the use of his book to attack empathy.

First, he takes an all or nothing approach when he argues that acting with empathy means our actions are driven by emotion, biased, not constrained by reason, and based narrowly on what we think another person *feels* without any broader context. To me, that's like saying a cake baked with only flour would be inedible so flour is bad. There is a monumental gap between informing one's actions with empathy and acting based on empathy alone.

Second, his approach to empathy is limited to *feeling* what others feel and completely ignores what psychologists call cognitive empathy: *understanding* what another person is experiencing. These two aspects of empathy (affective and cognitive) overlap and usually exist in various combinations. In primary care (and, I suspect, in many other care fields), understanding the context of the patient is essential.  I see both aspects of empathy as potentially problematic in isolation: the psychopath is loaded with cognitive empathy but has no affective empathy (he gets you and then guts you) while the person with only affective empathy will generate terrible unintended consequences. In teaching family practice residents, I tried to help them identify, balance, and use both kinds of empathy. In general, I found it easier to help residents gain skill in cognitive empathy to balance their affective empathy than the reverse.

Third, Bloom seems to be unaware of the concept of moral imagination, where one extends one's self beyond the constraints of one's limited personal experiences and the current moment. The ability to visualize and relate to more than our limited self, and to see the world through multiple lenses, is both personally and socially adaptive. To some degree, all art forms (and perhaps especially theater) depend on this. Art (moral imagination) saves us from dying of reality (with apologies to Nietzsche.)

Fourth, Bloom doesn't spend much time or effort criticizing pity or sympathy, which I personally find much more destructive than empathy.

If Bloom had been more explicit in limiting his critique to the problems of basing policy decisions purely on affective empathy, I would have no argument with him. For me, whether it is practicing medicine, dealing with friends and acquaintances, or making policy decisions, one needs a combination of some affective and considerable cognitive empathy integrated with rational decision making. I think of this as intelligent kindness or compassion.  Many people who cite Bloom seem to argue that rational compassion does not need and should not include any affective empathy. I think they are wrong and I suspect Bloom would agree with me.