Why Narrative Matters (But Not Exclusively) in Bioethics Education
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Why Narrative Matters (But Not Exclusively) in Bioethics Education Comment on “Shanachie and Norm” by Malcolm Parker Eleanor Milligan
Received: 17 June 2012 / Accepted: 27 August 2012 / Published online: 12 October 2012 # Springer Science+Business Media B.V. 2012
Keywords Narrative . Ethics . Education The universe is made up of stories, not atoms. —Muriel Ruketser The conversation played out in Parker’s (2012) depiction of two bioethicists/educators invites us to consider the fundamental question at the heart of their problem, which is: “What is the purpose of including ‘ethics’ in the curriculum of tertiary health care education?” Do we teach ethics because we feel that health care has become too skewed toward the scientific or economic at the expense of the humanistic? Maybe we suspect health practitioners are at risk of becoming ethically detached and in need of a morality inoculation before they join the workforce? Perhaps it is an acknowledgment that “harm” at the hands of a health carer can occur in the simplest form—a distracted look, a thoughtless comment, or a hasty dismissal—rather than simply physical harm? Maybe we believe that moral sensitivity can actually be “taught” to the adult students who come to their training with a diverse range of preexisting values, expectations, beliefs, and ethical norms? Or perhaps we see it as providing a protective
The original article by Malcolm Parker, published in the Journal of Bioethical Inquiry, 9(2): 215–216, can be located at DOI 10.1007/s11673-012-9356-0. E. Milligan (*) School of Medicine, Griffith University, Brisbane, Australia e-mail: [email protected]
framework that will help young health professionals make sense of their professional role as they face daily reminders of the fragility of life and the inevitability of death? Our responses to these questions will shape how we respond to the practical educational challenges considered by Shanachie and Norm. It is only once we are clear on why we are teaching ethics in health professional programs that we can begin to focus on what to teach and how to teach it. As Edmund Pellegrino writes: “Medicine being simultaneously the scientific and humanistic study of man cannot escape being based in an explicit or implicit philosophy of human nature” (2003, 10). When patients enter the health care system, and the care of individual professionals within, they do so (mostly) at times of uncertainty, trauma, and vulnerability. Illness is not only a physical threat to the body, it also threatens and fractures a person’s sense of identity—of who they are, how others regard them, their possible futures, and their present capabilities. It is through this veil of vulnerability and uncertainty that the ill person tries to make meaning and sense of his or her situation. And it is at this time that health practitioners most need to grasp the “human nature” part of medicine to which Pellegrino refers—for the well-being of their patient, but also for their own well-being. It is this very vulnerability—that
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