The Ethical Imperative of Narrative Care: The Necessity of Applying Narrative Skills to Clinical & Bioethical Practice

Abstract

Medicine and bioethics today are though as fields of pure logic, reasoning, and science, with physicians and ethicists trained to approach patients with an attitude of detatched rationality. In reality, neither medical care nor ethics can be practiced well without an acknowledgement for their deeply emotional, relational, and narrative qualities. Medical care and bioethics must both be practiced through a narrative lense in order to truly meet the humanity of both patients and practitioners. There are practical methods to integrate narrative skills into clinical practice, as well as tangible benefits to doing so. Practially, this is performed through narrative medicine: an approach to medical care that recognizes the stories as a critical component to healthcare; as well as narrative ethics: an awareness of the essential role of narrative in moral understanding. Using narrative as a tool to understanding illness and moral grounds the more abstract and universal aspects of both in practical, individual reality. There are many practical aspects of narratives when applied to bioethics, such as aquiring narrative skills, what happens when stories are shared, recognizing how narratives are built, how they convey knowledge, organize life, and provide meaning. Illness creates an isolation – for both patient and practitioner – and stories allow each to express their experience and be supported though the stories of others. Stories help brigdge the gap in experiences of illness between practioner and patient while helping pracitioners to maintin their empathy in the face of continual suffering. Narrative skills are also useful for practioners to bring awareness to the power dynamics that influence patient stories, such as the power of practitioner as co-creator, whose voice is given credibility, external and internal influences on a story, who determines the meaning of a story, and how the patient is characterized within the story. Narrative permeates every aspect of human life, including medical and ethical situations, and approaching both through a narrative lens is imperative for the development of true understanding, empathy, and compassion. Cultivating a narrative framework towards illness allows both practioners and patients to be cared for while also caring for the other, thus creating deep, meaningful connections.