The dual role of empathy in clinical trial decisions

Mariam Chichua; Chiara Filipponi; Davide Mazzoni; Marco Marinucci; Marianna Masiero; Gabriella Pravettoni

doi:10.3389/fpsyg.2025.1397581

The dual role of empathy in clinical trial decisions

Front Psychol. 2025 Mar 19:16:1397581. doi: 10.3389/fpsyg.2025.1397581. eCollection 2025.

Authors

Mariam Chichua^#^{1

2}, Chiara Filipponi^#^{1

2}, Davide Mazzoni¹, Marco Marinucci³, Marianna Masiero^{1

2}, Gabriella Pravettoni^{1

2}

Affiliations

¹ Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy.
² Applied Research Division for Cognitive and Psychological Science, IEO European Institute of Oncology IRCCS, Milan, Italy.
³ Department of Psychology, University of Milano-Bicocca, Milan, Italy.

^# Contributed equally.

Abstract

Introduction: Empathy is a key driver of prosocial behaviors, including motivations to participate in clinical trials. Our study aimed to explore how individuals' levels of empathy influence their intention to participate in a trial, examining scenarios where participants envision the decision for themselves (Condition 1 - "Self") and when they consider a hypothetical person (Condition 2 - "Other"), who has to take that decision.

Methods: A between-subject design was conducted on 176 healthy participants (M_age = 31.98, SD = 10.14). All participants responded to socio-demographic questions and were assessed for empathy. They were randomly assigned to two conditions presenting a hypothetical cancer clinical trial and assessing the intention to partake in the trial.

Results: The moderation regression model was statistically significant [R ² = 0.10, F(7,167) = 2.04, p < 0.05]. Simple slopes analysis showed that for Condition 1, each unit increase in empathy was associated with 8.59 unit increase in intention to partake in a clinical trial [b = 8.59, SE = 4.04, 95% CI: 0.61, 16.6], whereas for Condition 2 each unit increase in empathy was associated with -9.77 unit decrease in intention [b = -9.77, SE = 3.78, 95% CI:-17.24, -2.3]. The slope of empathy on intention for condition 1 was significantly different than for condition 2 [Δ = 18.4, SE = 5.5, t (167) = 3.34, p < 0.001].

Discussion: Empathy acts as a facilitator for partaking in trials when imagining having been diagnosed with cancer, while it becomes a barrier when thinking about another person's participation. The reversed effect of empathy on intention shown in this study may guide future research and healthcare providers to discuss further before enrolment, involving both patients and caregivers in the decision-making process.

Keywords: clinical trials; decision-making; empathy; oncology; prosocial behavior.

Grants and funding

The author(s) declare financial support was received for the research and/or publication of this article. The Italian Ministry of Health partially supported this work with Ricerca Corrente and “5×1000” funds. CF and MC are PhD students in Medical Humanities at the European School of Molecular Medicine (SEMM) at the University of Milan, Italy.