Don’t “Put Yourself in Their Shoes”

This may sound completely wrong, but I have come to believe that one of our most instinctive ideas about empathy deserves to be challenged.

We are often told that empathy means “putting yourself in another person’s shoes.” It sounds compassionate and wise. But as both a patient and someone who has watched extraordinary caregivers up close, I increasingly wonder whether that approach can sometimes lead us astray.

I have seen how hard caregiving is. Not only through the selfless love my wife and family show me every day, but through the remarkable carers I have met in support groups. The amount of sacrifice, patience, and kindness people give to those they love is extraordinary, often without a second thought for themselves.

So this is not criticism. G-d forbid. It is simply a counterpoint worth considering.

The dictionary defines “put yourself in their shoes” as imagining yourself in another person’s situation in order to understand their feelings and perspective. But I think there is an important flaw in that idea.

Let me start with an innocuous analogy (that is how my brain sometimes works). My Wife’s Birthday Present – When I think about what to buy my wife for her birthday, I do not think about what I would want if I were her. I know she would not want that. I try instead to think about what she would want, based on who she is. I am sure most of us do the same – those of us still married that is.

That is a very different exercise.

The same applies to patients, especially those who can no longer communicate clearly. The real question is not:
“What would I want in this situation?”

It is:
“What would they want?”

Those are not the same thing.

Your loved one may adore you, trust you, and be deeply connected to you, but they are still a different person, with different fears, comforts, values, tolerances, and priorities. Loving someone does not mean they think like you. Back to my analogy – I would never have wanted to marry someone exactly like me – often opposites attract and whilst that is great for marriage it means we see things differently.

Interestingly, psychologists have studied this exact distinction. Researchers describe the difference between “imagine-self” and “imagine-other” perspective-taking. Studies suggest that when people imagine themselves in another person’s situation, they often end up projecting their own feelings and preferences. Those asked instead to focus on the other person’s known values and personality tend to make decisions more aligned with what that person actually wanted.

In other words, true empathy may not be about projecting yourself into someone else’s life. It may be about setting yourself aside.

This matters enormously in care decisions. Whether someone would prefer home or hospice. Conversation or quiet. Television or silence. Visitors or privacy. Hot or Cold. The thousand small decisions that together determine whether someone is living on their own terms or someone else’s.

Hospitals often struggle with this simply because they do not know the individual deeply enough. Families usually do know, but even families can disagree sincerely about what a loved one would have wanted.

That is why these conversations matter. It also has a critical role in End of Life Planning and Decision Making.

Before I go further, I want to be clear about something important. I am not speaking here about crossing ethical, legal, cultural, or religious boundaries. Every family and every faith tradition has its own framework for end-of-life decisions. As an Orthodox Jew, I prepared my own end-of-life guidance within the framework of Jewish law and with Rabbinic guidance. Those decisions belong to each individual, their beliefs, and the law of the country in which they live.

But within those frameworks, the principle still matters: ideally, the patient’s wishes should guide decisions wherever possible.

That is precisely why I prepared my own document for future care if I lose the ability to communicate. Without it, the people who love me most would all likely interpret my wishes differently, despite having the best intentions. I have seen how painful that uncertainty can become for families.

In my own document, discussed and shared with my wife and my appointed surrogate and filed with the Ministry of Health, I have set out my wishes as clearly as I can.

Interestingly, I have also tried to apply the same principle as a patient by trying to not put myself in my wife’s shoes. I state openly in the document that my wife’s needs should also carry enormous weight and are in fact Priority number 1 financially. If she wishes to care for me at home, support should be directed toward that. If hospice care would place less strain on her, then that should be the course of action. My request is simply to be treated with dignity, without attempts to extend life (where it is permitted by Jewish Law) and not to end up in hospital where a hospice or home is an option.

Research supports the value of the process of having conversations and being clear on these topics. A 2019 University of Nottingham study on end-of-life surrogate decision-making found that knowing a patient’s wishes helped reduce uncertainty and conflict for caregivers, while broader family discussions often helped avoid tension later on.

Which brings me to the most practical point in this piece.

If you are still able to communicate your wishes clearly, do not leave this for later.

Talk to the people who may one day care for you. Tell them what matters to you. Document it.

Not because your loved ones do not care, but because they care so much that they will desperately want to get it right.

And even people who love us deeply do not always guess correctly.

Empathy matters enormously. But perhaps there is an important distinction between imagining ourselves in another person’s position and genuinely trying to understand what they would want for themselves.

The question is not:
“What would I want?”

The question is:
“What would they want?”

That is a very different thing.