The Emerging Issue of Digital Empathy

Christopher Terry, PharmD; Jeff Cain, EdD, MS


Am J Pharm Educ. 2016;80(4):58 

In This Article

Online Disinhibition Effect

Which personal thoughts and attitudes are communicated to others and the manner in which they are expressed may be different in digital vs traditional face-to-face settings. Some individuals may exhibit unusual acts of compassion in online settings, while others may devolve into sarcasm, harsh language, uncouth criticisms, and even cyber bullying.[10–12] It is not uncommon to read vitriol-filled remarks on social media applications or in the comments section of online news sites. Disrespect and thus a lack of empathetic concern for others is all too evident in contemporary online discussions.[13] In many instances, those unsavory comments are unprovoked and unwarranted.

While there may be other influences, the online disinhibition effect[14] describes several subtle, but powerful underlying factors that contribute to the nature of communication via digital devices. These factors may help explain the sometimes toxic and aggressive nature of online communications.[15] First, the anonymity associated with computer-mediated communication may permit people to possess an alternate online identity and essentially hide behind a nonidentifying pseudonym or username. This form of dissociative anonymity allows people to separate from in-person identity and moral agency, thereby freeing them to express hostility and criticism without any effect to the psyche. Similarly, online users may dissociate those at the other end of the communication by subconsciously viewing them merely as avatars or usernames instead of actual persons.

Second, as online communication can be asynchronous, individuals do not have to manage immediate reactions to online conversations and can remove themselves from the repercussions of online discussions, even avoiding ownership for hostile and intimidating comments. Third, even in a completely nonanonymous environment (ie, computerized medical record, e-mail correspondence, blogs), the nature of online communications is such that individuals are physically invisible to others, permitting them to disregard any type of eye contact or physical reaction of the other person(s). A significant portion of traditional face-to-face communications tends to be nonverbal (eg, body language, tone of voice), and without these cues, online conversations lack an essential element of understanding.[16]

Overt negativity toward others manifested in online communications should not be attributed merely to character flaws. The online disinhibition effect applies to all individuals regardless of ethical and moral character. Even those of high moral judgment and character can subconsciously devolve into a more pernicious state when they psychologically disconnect their words from their actual being. In essence, the subconscious psychological factors associated with the online disinhibition effect negatively impact the likelihood that empathy will be expressed in digital environments. In fact, a contributor to declining empathy is the "rising prominence of personal technology and media use in everyday life."[17] Thus, interpersonal dynamics are altered by the use of technology as a communication tool.[17] As the provision of health care services becomes more entwined with a technological world, we must elevate the construct of digital empathy into the collective consciousness of both educators and trainees in the medical community and seek to prepare future health care providers to exhibit empathy in digital venues.