Chapter 7 turns attention to the clinical dimension, chiefly the therapeutic relationship, to look at the experiences that the psychiatrists had with patients from South Asian cultures for two reasons. One was to learn more about the ways in which they were able to relate and address the socio-cultural needs as a way to think about the significance of the therapeutic dyad. Of especial relevance was the use of South Asian languages, the identification of idioms of distress, and somatization. It was equally important to learn about the various challenges faced in these relationships and the measures taken by professionals to ensure boundaries were respected both inside and outside the institution. The existential realities experienced by the psychiatrists of both generations increased their receptivity to the needs of other ethnic minorities. Some reported how colleagues would consult with them or refer patients from ethnic minorities to them in the belief that their understanding of displacement, isolation and cognate factors would be helpful in understanding their needs.

When we witness another person experiencing pain, be it emotional or physical, we have an empathic reaction. And even if we commit a harmful action against another person, we most of the time experience guilt in the aftermath, which prevents us from performing the same action in the future. Guilt and empathy are critical moral emotions that together usually prevent us from harming others. However, as this chapter shows, systematic processes of classification and dehumanization at play before a genocide can alter moral emotions towards another part of the population. Activity in empathy-related brain regions is generally reduced towards individuals that we consider as outgroup or towards dehumanized individuals. Neuroscience studies have further shown that when obeying orders to hurt another person, neural activity in empathy- and guilt-related brain regions is reduced compared to acting freely. Such results show how obeying orders diminishes our aversion to harming others.

Chapter 5 commences by retracing how, beginning in Nuremberg, the reasonable person entered the battlefield in the form of the reasonable military commander. Subsequently the chapter explores two challenges that confront the concept of the reasonable person on the battlefield and beyond. The first challenge consists in the fact that it is easier to empathise with people who are close to us. In the theatre of war, this raises the question whether the reasonable person, when acting as the reasonable military commander, can meaningfully balance the interests of civilians on opposite sides. The second challenge relates to the fact that it is more difficult for powerful people such as military commanders (or judges) to take the perspective of others and to empathise with them.

Chapter 2 focuses on the emergence of the modern concept of the reasonable person in nineteenth-century Britain. It argues that this development resulted from the legal and economic needs of the industrial revolution and was informed by the metaphysics of the Scottish sentimental Enlightenment. The chapter’s point of departure is the case known as Blyth v The Company of Proprietors of the Birmingham Waterworks, one of the first cases to discuss explicitly modern law’s reasonable person. Distinguishing between a rational Enlightenment and a sentimental Enlightenment, the chapter then shows that the underlying rationale of the reasonable person relies heavily on the sentimental Enlightenment, namely on David Hume’s and Adam Smith’s thought on the importance of empathy, judgement making in relation to the feelings of others, the incomplete understanding of morality that can be gained from objective reason, and the importance of a human common sense. The third section explains how the industrial revolution and the sentimental Enlightenment influenced the life of Baron Alderson, the judge who oversaw Mr Blyth’s case against the Birmingham Waterworks.

The Conclusion argues that the reasonable person possesses an essence that can be traced across time and across the different jurisdictions we encountered. This essence concerns the concept’s fundamental acceptance that ours is always just one perspective among many and that the best way to understand and assess what others think, do and feel is to empathise with those others. Since the standard is not always understood or applied in this manner, the Conclusion offers a restatement of the function and rationale of the common law’s most illustrious character; the aim is to contribute to the realisation of the concept’s potential and to make it easier to identify instances of misuse. The section unfolds in three parts, which correspond to the three steps of judgement making through empathetic perspective taking: the intention to take the reasonable person’s perspective; the assumption of the reasonable person’s perspective; and the making of a judgement by reference to the reasonable person’s perspective. Ultimately the Conclusion argues that the concept of the reasonable person has significant potential to facilitate the making of tolerant and humane judgements in a diverse, globalised and dynamic society, provided that one remembers that the reasonable person is always someone else.

The VitalTalk roadmap for talking about serious news is GUIDE (Get ready, Understand, Inform, Demonstrate empathy, and Equip patient for next steps). Getting ready includes planning the details of the meeting, including why and how the information is to be shared. The next step is understanding what the patient expects from the visit and what they have been told so far. Prior to giving information, the clinician should ask permission to share what they know. The news should be shared using a headline containing both data and what it means for the patient’s life. Afterwards, the clinician should demonstrate empathy by recognizing and responding to emotion. Equipping the patient includes discussing next steps, summarizing, and checking for shared understanding. There may also be challenges of patients receiving potentially too little or too much information when families say “don’t tell” or due to asynchronous electronic results delivery respectively. How much patients want to know and how and when they get information can be clarified through preparatory discussions. Finally, medical errors are another form of serious news that require an apology along with the headline.

Diplomacy skills matter, and the widespread perception that anyone with common sense can be trusted with a diplomatic position, even without proper qualifications, is misguided and dangerous. Diplomacy is a serious business. The matters that diplomats deal with are too important to be left to amateurs. There are careers that do not require a new hire to possess any special skills on day one; diplomacy is not such a profession. Diplomats must have most basic skills so that they can hit the ground running. In fact, they are expected to have them before joining a diplomatic service, because most governments do not provide much substantive training to new officers. Although different career tracks–political, economic, consular, management and public diplomacy–require some specialized knowledge and abilities, most diplomatic skill sets are universal. This chapter covers the key aspects of diplomatic tradecraft, on which the rest of the book will elaborate and expound.

What makes diplomatic negotiation different from other negotiations is that it takes place between or among nation-states through their representatives, and the stakes are usually higher than those in a domestic context. In addition, while other types of negotiation tend to be mostly transactional, negotiating in diplomacy cannot be isolated from the overall relationship with the other party. A truly successful diplomatic negotiation is one that not only resolves an immediate problem, but ensures that the state of relations with the other side will serve one’s interests in the long run. That does not mean that ties must necessarily be close or friendly, as long as they are civil and respectful, and the countries can work together in the future. Another feature of negotiation that is essential in diplomacy is its ability to build a basis for empathy. It helps to convey one’s own motivations and interests directly, which can reduce misunderstanding, and it provides insight into the other side’s motivations and perceptions.

The interaction between mental illness, some personality disorders, psychological and developmental problems and sexual behaviour is a complex area. This chapter focuses on sexually problematic behaviour displayed by adult patients in mental health inpatient settings. It discusses prevalence, definitions and a potential role for the criminal justice system. A clinical case illustrates potential difficulties and solutions in assessment and management which should be multi-faceted.