Table 2.

Exemplars of Empathic Responses in Palliative Care Encounters

	Empathic response type [rating level]	Excerpts from transcripts
		Context from discussion	Clinician empathic response
High-empathy responses	Shared experience [6]	Patient: I mean that's been my fight all along is… my opinion is discarded, my thoughts about what's going on with me and when things started [have] been ignored. And I've had [physicians] pat my hand… ‘well, you're just going through a tough time.’ It's like no I'm not going through a tough time- I can't breathe!	It's so difficult. I've worked in cancer for so long and like the oncologists are excellent right? They are committed to understanding the various types of treatments that can keep your cancer at bay… [but] you are the expert in your body and what your body feels like in the midst of all that and it sucks to advocate and be the advocate [when] no one knows what's going on internally… you know, they only look at scans
	Confirmation [5]	Patient: I feel real fuzzy and stupid	Really fuzzy and stupid? Yeah. Well, I think it's pretty exhausting to deal with these things right and on top of that we're giving you medicines and, you know, the energy it takes to get up and go have a bowel movement…that's exhausting
	Acknowledgment with pursuit [4]	Patient: I miss the daily contact cause I can't… right now being with people is very exhausting so…	I'm wondering, how have the two of you… tackled visits from the community? Cause it seems like you've impacted a lot of people like…have you been open about your cancer experience?
	Acknowledgment without pursuit [3]	Family caregiver: So I'm a little frustrated to see her leaning	Leaning…leaning to the side there
Low-empathy responses	Implicit recognition [2]	Patient: Yeah [it's upsetting]… cause… the alternative to this is dying	Well, I mean if we can't give you chemotherapy to control your cancer, we know that… the cancer is going to take over… and take your life, but the question is, is during this time if we can't give you chemotherapy, how do we best take care of you?
	Perfunctory recognition [1]	Family caregiver: He needs [new strategies to transfer in and out of bed]. We're having a really hard time	Tell me how you're transferring [him]
	Denial of perspective [0]	Patient: Well the diagnosis yesterday was very shocking to me. I mean I knew I was going to die at some point but not two days, you know, that's what he said…	Do you have children?