The ethical and epistemic roles of narrative in person-centred healthcare

Mary Jean Walker* (Corresponding Author), Wendy A. Rogers, Vikki A. Entwistle

*Corresponding author for this work

Research output: Contribution to journalArticle

Abstract

Positive claims about narrative approaches to healthcare suggest they could have many benefits, including supporting person-centred healthcare (PCH). Narrative approaches have also been criticised, however, on both theoretical and practical
grounds. In this paper we draw on epistemological work on narrative and knowledge to develop a conception of narrative that responds to these concerns. We make a case for understanding narratives as accounts of events in which the way each event is described as influenced by the ways other events in the narrative are described. This view of narratives recognises that they can contribute knowledge of different kinds of connections between events: not just causal, and not just of patient’s perspectives. Additionally, narratives can add further epistemic value by suggesting potentially useful lines of inquiry. We take narrative approaches to healthcare to include clinicians considering both patients’ informational offerings and their own professional understandings as narratives. On this understanding, our account is able to overcome the major
theoretical and practical criticisms that have been levelled against the use of narrative approaches in healthcare, and can help to explain why and how narrative approaches are consistent with PCH.
Original languageEnglish
JournalEuropean Journal for Person Centered Healthcare
Volume8
Issue number3
Publication statusAccepted/In press - 17 Nov 2019

Keywords

  • biomedical model
  • causality
  • communication
  • diagnosis
  • empathy
  • epistemology
  • ethics
  • illness experience
  • interpretation
  • listening skills
  • narrative
  • objectivity
  • person-centered care
  • subjectivity
  • understanding

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