Narrativity and medicine: some critical reflections
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(2019) 14:9
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Narrativity and medicine: some critical reflections Rolf Ahlzén
Abstract During the last three decades there has been a wave of interest in narrative and narrativity in the humanistic and the social sciences. This “narrative turn” has spilled over to medicine, where narrative medicine has gained a considerable influence. However, there have also appeared second thoughts on the role of narratives in our lives, as well as on what narratives may mean in relation to clinical medicine. This article presents some influential voices in this debate and scrutinizes the assumptions of narrative medicine in the light of these. It is concluded that there are sound reasons to tread this path with some caution and avoid the too far reaching ambitions on behalf of narrativity in relation to clinical medicine. However, narrative medicine should still be seen as a promising attempt within the broader scope of medical humanities to emphasize the importance of human subjectivity in clinical medicine. Keywords: Narrativity, Narrative, Narrative medicine, Empathy, Clinical encounter
Introduction Since at least thirty years, there has been a wave of interest in the meaning and role of narrative in human lives. Philosophers, literary theorists, sociologists and historians have increasingly claimed that narrative, and related notions like narrativity and narrative competence, are essential to our understanding of our personal lives, of the role of ethical values and of human suffering. Given such claims, it is not difficult to understand why narrative and narrativity soon became central to some of those who were striving to reform medicine, in order to contribute to its ability to reach its ethically defined goal of reducing suffering. Hence, Rita Charon launched her narrative medicine project with far ranging reform ambitions. The aim was to increase the narrative competence of physicians mainly by being in the company of literary texts, and also by bringing them “skills” to interpret texts and patient discourse. Narrative medicine has been influential and contributed to an almost unreserved belief in the central assumptions that underpin the “narrative movement”.
Correspondence: [email protected] Department of Historical, Cultural and Religious Studies, Psychiatric Open Care Unit, Region of Värmland, Karlstad University, Bryggaregatan 1, S-65340 Karlstad, Sweden
However, since a decade or more, there have been increasing doubts about several of the central assumptions of this narrative wave, which I will in the following call NW. These second thoughts have focused on both claims concerning the role of narrative in the lives of persons, and also on the question whether narrative competence really gives such a privileged access to the" first person perspective" as is often assumed. If this critique can be shown to be well founded, a substantial part of the foundation for the aspirations of narrative medicine would be undermined. It is therefore of great interest to the development of medica
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