This paper examines definitions and uses of reflective and creative writing in health care education classrooms and professional development settings. A review of articles related to writing in health care reveals that when teaching narrative competence is the goal, creative writing may produce the best outcomes. Ultimately, the paper describes the importance of defining literary creative writing as a distinct form of writing and recommends scholars interested in using literary creative writing to teach narrative competence study pedagogy of the field.

Many medical interventions have both negative and positive effects. When health care professionals cannot achieve a particular desired good result without bringing about some bad effects also they often rely on double-effect reasoning to justify their decisions. The principle of double effect is therefore an important guide for ethical decision-making in medicine. At the same time, however, it is a very controversial tool for resolving complex ethical problems that has been criticized by many authors. For these reasons, I examine in (...) this paper whether the principle of double effect can serve as a basis for ethical decisions in medicine. The conclusion reached in this article is that even though this principle has desirable effects on clinical conduct, it is only an unreliable guide and physicians and nurses cannot feel secure in continuing to use this principle for ethical guidance. (shrink)