Elsevier

Journal of Aging Studies

Volume 34, August 2015, Pages 183-189
Journal of Aging Studies

Narrative ethics for narrative care

https://doi.org/10.1016/j.jaging.2015.02.014Get rights and content

Highlights

  • Narrative care requires a narrative ethics.

  • People construct their sense of self, communicate, and make decisions through narrative.

  • Other ethical theories do not allow for life's messiness, ambiguity, and indeterminacy.

  • Narrative ethics generates openness and is sensitive to narrative webs.

  • Narrative ethics generates alternatives to oppressive metanarratives.

Abstract

Narrative permeates health care—from patients' stories taken as medical histories to the development of health policy. The narrative approach to health care has involved the move from narratives in health care as objects of study to the lens through which health care is studied and, more recently, to narrative as a form of care. In this paper, I argue that narrative care requires a move in the field of ethics—from a position where narratives are used to inform ethical decision making to one in which narrative is the form and process of ethical decision making. In other words, I argue for a narrative ethics for narrative care. The argument is relatively straightforward. If, as I argue, humans are narrative beings who make sense of themselves, others, and the world in and through narrative, we need to see our actions as both narratively based and narratively contextual and thus understanding the nature, form, and content of the narratives of which we are a part, and the process of narrativity, provides an intersubjective basis for ethical action.

Section snippets

Narrative care

The concept of narrative care is only just starting to coalesce as a field of study and practice. While some narrative practices have been around for a while (e.g., narrative therapy, developed by White and Epston in the early 1990s), others are more recently formulated (see Bohlmeijer, Kenyon, & Randall, 2011), and while there is a sense that these approaches have something in common, it is probably too early to conduct a systematic concept analysis of the term “narrative care.” Having said

The narrative terrain of ethics

With the growth of interest in narrative, it is not surprising to find a developing literature on the subject of narrative and ethics. Broadly speaking, narrative is viewed as relevant to ethics in a number of ways. First, it is argued that stories can act as a means of moral education (see Murray, 1997) either through the lesson they teach or, as Gregory (2009) expounds, through engendering empathy and ethical sensitivity, as ethical issues can be experienced (albeit somewhat vicariously)

Common ethical theories and their limitations for guiding narrative care

Three normative ethical theories frequently guide decision making in health and social care: consequentialism, deontology, and principlism. I want to suggest that none of these align well with the concept of narrative care. Rather than embracing the richness, uniqueness, situatedness, and history of each ethical encounter between two or more people, they limit their focus to one narrow facet of ethical choice. All three can roughly be called prescriptive or normative ethical frameworks, meaning

Some contours of narrative ethics

If the above has gained any purchase as giving grounds to think that a narrative approach to ethics might have something more to offer to narrative care than other, more well-established frameworks, it is incumbent upon me to at least outline what such an ethics might involve. This outline cannot but be a general survey of the terrain, a mapping of contours, for to attempt to construct a detailed code with neatly outlined specifics would be to court the danger of establishing a totalizing

Concluding remarks

Narrative care is concerned with how people structure their stories and thus bring meaning and significance to their lives. It is also concerned with how people construct their identities in the face of life's vicissitudes, and how they characterize, and thus shape, their relationships with others and the world. Narrative care is thus personal, experiential, concrete, and communicative. On this basis, I have argued for an ethics that is also personal, experiential, concrete, and

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