The doctor patient relationship starts with a story. Doctors' notes, a patient's chart, the recommendations of ethics committees and insurance justifications all hinge on written and verbal narrative interaction. The "practice" of narrative profoundly affects decision making, patient health and treatment and the everyday practice of medicine. In this edited collection, the contributors provide conceptual foundations, practical guidelines and theoretical considerations central to the practice of narrative ethics.

This qualitative research study, a replication of a study published in 2002, investigated the qualities of a good nurse and the role ethics plays in decision making. After reviewing the limitations of the published work, the current study implemented modifications related to the research questions, sample selection, data collection, and use of software for data analysis. The original study identified seven categories that related to being a good nurse and doing the right thing. In the present study, the use of (...) relational analysis led to the recognition of four categories: (1) personal traits and attributes; (2) technical skills and management of care; (3) work environment and co-workers; and (4) caring and caring behaviors. To understand what it means to be a good nurse and do the right thing is a complex task; however, this research adds to the small amount of empirical data that exists to describe those characteristics. (shrink)

I have become curious about reciprocity within clinical practice. A vast topic that mobilizes considerations of money, knowledge, kinship, power, culture, and uses of the body, reciprocity is a strong means by which to achieve the egality required of just health care. Within health care, reciprocity might enable not only so‐called shared decision‐making and patient autonomy. It might open the door to mutual acknowledgement of the value of each participant's beliefs and habits. It might appear as a humble realization that (...) no one understands what health is and a concurrent welcoming curiosity about one another's conception of how the body and speech and mind work. From the intimate to the international levels of care, such forms of reciprocity may culminate in the radical and powerful state of reciprocal recognition.In this short essay, I will focus on one aspect of reciprocity in health care: the narrative and potentially reciprocal nature of attention in health care. A critical element in the development of therapeutic alliance, clinical accuracy, and effective practice, attention requires a donation of the self as a vessel into which can enter that which is perceived or, from the other side, a penetrating of that which is perceived so that one sees it from within its own vessel. (shrink)

The study of cases of illusory or unstable perception of some visual stimuli allows exploration of the psychology of perception of the surrounding world. The wired construction known as “Necker cube” is one such stimulus: it can be perceived as a cube whose front face is seen higher than the back face or vice versa. The switch can occur intentionally or spontaneously. The investigations were focused on switching parameters, relation of the switching to eye position, pre-history, and environment. Here we (...) define that the kernel of the problem is recognizing the 2D drawing as a 3D Necker cube. To this end, we have expanded Gestalt's psychology methods that allow us to recognize 2D figures in drawings for recognizing 3D figure in a flat drawing (including the Necker cube). The presented algorithm for recognizing the cube based on the imitation principle allowed the development of the model of switching between two possible perceptions of the Necker cube. The paper shows that the predictions are in conformity with previously available experimental data. The results confirm the imitation principle of perception, and suggest expanding our research on perception to a wider class of 3D figures, opening a window into the internal processes of perception. (shrink)

Abstract:Life-writing combines, collates, or colludes many lives into one text. No work of fiction, biography, poetry, drama, memoir, journaling, blogging, or autobiography—all of them life-writing—does not do this, either blatantly or surreptitiously. I am interested in forms in which authors do not own up to writing about themselves under the cover of writing about another. This essay will focus on the implications of this generic collusion in writing in health care. Health care professionals are given space within their professional journals (...) to write personal essays about their work. Typically, these essays include a patient portrait or vignette as a means to probe some aspect of clinical practice. Some, not all, of these journals provide guidelines for protecting the privacy/confidentiality of patients described in the essay, including instructions for how to “fictionalize” patients or families to render them non-identifiable, even to themselves. A clinician-author may adopt this genre to illuminate a moment in practice that bears reflection and provides insight into the world of care. Often, however, the essay’s tenor is the author, and the patient is pressed into service as but the vehicle for that examination. The genre may be adopted to confess an error, to lament a woe (generalizable to all readers), to critique the actions of colleagues or patients, or to boast of a successful clinical intervention. Perhaps these essays are all, or should all, be co-authored “duets” by patient and clinician. (shrink)

How do René Girard’s theories apply to a context of double colonization? Through a new interpretation of Alexis Wright’s novel Plains of Promise, this paper aims to show the crosscultural relevance of mimetic theory. The study will highlight the way in which the scapegoat mechanism is represented in the Australian colonial context. It also offers a Girardian analysis of the predicament of female characters of Aboriginal descent who are victims of sexual violence.

This essay is composed of five stories written by practicing physicians about their patients. Each clinical story describes a challenging ethical condition–potential abuse of medical power, gravely ill and probably over-treated newborns, iatrogenic narcotic addiction, deceived dying people. Rather than singling out one ethical conflict to resolve or adjudicate, the authors attempt, through literary methods, to grasp the singular experiences of their patients and to act according to the deep structures of their patients' lives. Examining these five stories with simple (...) literary tools–attention to narrative frames, time, plot, and desire–reveals the mechanisms through which acts of writing and reading contribute to clinical clarity and ethical actions. (shrink)

La notion d'audience n'apparaît que dans les années cinquante pour la presse écrite, soit tardivement. La méthodologie mise en oeuvre butte sur le nombre de titres, la diversité des situations de lecture, l'obligation de faire appel à la mémoire du lecteur. Les enquêtes s'opèrent par questionnaires sur de très vastes échantillons. L'amélioration de la procédure a permis d'élargir le champ des questions couvertes, d'accélérer et lisser les conditions de collecte, mais le nombre de titres étudiés reste forcément restreint, nécessairement limité (...) aux plus grosses diffusions . Il est significatif que les divisions entre quotidiens et magazines se soient manifestées très tôt sur l'étude d'audience, chaque forme de presse réalisant la sienne.The notion of readership did not appear in the Press until the 1950s which is very recently indeed! The methodology used has to deal with the large number of titles, a wide range of reading contexts and the need to appeal to the readers' memories. Surveys are carried out through questionnaires based on a wide range of samples. The improvement of this process has enabled us to extend the field of questions covered and speed up and improve data collection but the number of titles under study inevitably remains limited, and indeed tends to cover only those titles with the largest readership . It is important to note that since many publishers carry out their own readership surveys early in the life of a title, this has meant the division between daily papers and magazines also appeared very early. (shrink)

The progression of research and scholarly inquiry does not occur in isolation and is wholly dependent on accurate reporting of methods and results, and successful replication of prior work. Without mechanisms to correct the literature, much time and money is wasted on research based on a crumbling foundation. These guidelines serve to outline the respective responsibilities of researchers, institutions, agencies, and publishers or editors in maintaining the integrity of the research record. Delineating these complementary roles and proposing solutions for common (...) barriers provide a foundation for best practices. (shrink)

Mr. E. Courtney adopts Ellis's defence of repetitque, argues convincingly as a consequence that sed must be replaced by a verb, and claims: ‘That verb can hardly have been any other than stat.’ He continues : ‘This will mean that Charon's boat, having ferried across the young, does not remain tied up at the quay forgetful of the old, but goes back for them.’ The difficulty of que in the sense of sed in the line as reconstituted is defended (...) by a reference to Housman's note on Manilius, 1. 877. Still, the proposed line, non oblita tamen stat, repetitque senes, does not seem to be clear without a pause after stat, so that the reader will construe non with stat but not with repetit. This gives a very awkward rhythm indeed. (shrink)

In Rita Charon's account of narrative medicine, empathy seems to be an essential element of the clinical relationship. However, empathy has not received much attention, which I believe is problematic. First, I show that not only is there no clear definition of what empathy is, but that this conceptual gap creates ambiguity about its role in the practice of narrative medicine. Second, I argue that certain passages in Charon's work seem to implicitly characterize empathy as a combination of (...) cognitive empathy, affective empathy, and sympathy, and that its inclusion in the practice of narrative medicine can be problematic. Third, following Dan Zahavi, I argue that a phenomenological account of empathy not only seems most compatible with the practices, values, and theoretical framework of narrative medicine, but is also capable of resolving the problems posed by alternative definitions of empathy and the ambiguity about the role of empathy in narrative medicine. (shrink)

In this paper, I will explore the concept that healing activities shape the objects of therapy and seek to construct those objects through therapeutic activities. Objects of therapy are the persons, patients, human bodies, diseases, physiological processes and personal suffering—that which clinical medicine constructs through its distinctive formative processes, practices and knowledge. The rationale for choice of philosophical sources namely, Cassirer, Foucault, the anthropological perspective of Good and the sociological account of Frank will be discussed. The claim articulated by Good (...) will be examined and its relationship to culture, illness, medical knowledge, practice, truth, and science. I then focus on Frank's concepts of the patient and the body and how medical knowledge and practices affects it. The concept that the medicalization of the illness narrative silences the patient's voice requiring an ethic of listening will be emphasized, described and further supported by Charon's (2006, Narrative medicine: Honoring the stories of illness. New York, NY: Oxford University Press) and Cassell's (2015, The nature of suffering and the goals of medicine. New York, NY: Oxford University Press) thoughts on narrative of illness in clinical medicine. My position concludes that healing activities construct the objects of therapy: as the medical culture's way of seeking truth; as medicine's way of mediating and organizing forms of reality through culture and symbolic forms; and, as medicine's way of entering the body and constructing the disease. Lastly, I suggest that in spite of the remarkable progress in the control of disease, the failure to address the interpretation of illness meanings is a fundamental flaw in the work of “doctoring.” The experience and meanings of illness are at the centre of clinical practice and is a moral, political, ethical and professional obligation. The person is a cultural construct, a complex and culturally shaped way of experiencing self and other, and cultural “work” is required to constitute the person who is the object of medical attention and it also necessitates the ethic of listening. (shrink)