Resumen: Todo hecho debe ser narrado para ser objeto de examen valorativo. Pero este examen depende, en parte, de cómo aquél sea narrado. Algunos autores han señalado el valor democrático que posee el enfoque narrativo, en la medida en que permite que una narración sea construida a partir de diferentes puntos de vista. El problema es que estos puntos de vista pueden conducir a soluciones alternativas o incluso antagónicas, fenómeno no infrecuente en una sociedad multicultural como la nuestra. Desde un (...) punto de vista estrictamente narrativo, el mejor relato es el más persuasivo. Pero esto nos aboca al relativismo, puesto que la eficacia de un relato está en función del auditorio ante el que se argumenta. En este trabajo se ha intentado poner de manifiesto que sólo se alcanza a comprender la verdadera contribución de la narrativa si nos situamos, no tanto en el plano de los hechos, como en el plano de la normatividad. La tesis que aquí se sostiene es que la utilidad del enfoque narrativo está en función del valor arquetípico del modelo o estándar de conducta que eventualmente contenga una determinada narración. Entronca así directamente con la noción de razón práctica, más allá de sus específicos puntos de conexión con algunas de las metodologías bioéticas más importantes. Abstract: Every fact must be narrated in order to be subject of value judgement. But this value judgement depends partly on how that fact is narrated. Some authors have highlighted the democratic value of the narrative approach, because of its admission of different points of view to construct a story. The problem is that these points of view can easily lead to alternative solutions o even opposing ones. This phenomenon is not rare in our multicultural society. From an strictly narrative point of view, the best story is the most persuasive. But this lead us to relativism, because the efficacy of an story relies on the audience towards the argumentation is developed. In this work we have tried to bring to light that the genuine contribution of the narrative approach is not achieved if we stay on the level of facts and we do not pass to the level of normativity. We suggest the thesis that the utility of narrative approach is a function of the archetypical standard of behavior that a story may content. So this approach, beyond its specific connections with some of the most prominent bioethical methodologies, become directly connected with the notion of practical reason. (shrink)

This paper provides a brief overview and critique of the dominant objectivist understanding and use of illness narrative in Enlightenment (scientific) medicine and ethics, as well as several revisionist accounts, which reflect the evolution of this approach. In light of certain limitations and difficulties endemic in the objectivist understanding of illness narrative, an alternative phronesis approach to medical ethics influenced by Charles Taylor’s account of the interpretive nature of human agency and language is examined. To this end, the account of (...) interpretive medical responsibility previously described by Schultz and Carnevale as "clinical phronesis" (based upon Taylor’s notion of "strong" or "radical evaluation") is reviewed and expanded. The thesis of this paper is that illness narrative has the ability to benefit patients as well as the potential to cause harm or iatrogenic effects. This benefit or harm is contingent upon how the story is told and understood. Consequently, these tales are not simply "nice stories," cathartic gestures, or mere supplements to scientific procedures and decision making, as suggested by the objectivist approach. Rather, they open the agent to meanings that provide a context for explanation and evaluation of illness episodes and therapeutic activities. This understanding provides indicators (guides) for right action. Hence, medical responsibility as clinical phronesis involves, first, the patient and provider’s coformulation and cointerpretation of what is going on in the patient’s illness narrative, and second, the patient and provider’s response to interpretation of the facts of illness and what they signify–not simply a response to the brute facts of illness, alone. The appeal to medical responsibility as clinical phronesis thus underscores the importance of getting the patient’s story of illness right. It is anticipated that further elaboration concerning the idea of clinical phronesis as interpretive illness narrative will provide a new foundation for medical ethics and decision making. (shrink)

Aesthetics is a vexed topic in philosophy, with a long history. For my purposes, an aesthetic experience is a foundational affective response to an object, to which terms such as “ugly”, “beautiful”, “pretty” or “harmonious” are applied. These terms are derived from a Discourse of aesthetics; some remain constant, others change from generation to generation. Aesthetics and ethics have been linked in Western thought since the days of Plato and Aristotle. This essay examines what is happening to that link in (...) contemporary experience. It emphasises the ways in which the popular media exploit aesthetic appeal to penetrate their market, and to exploit and frame intuitive responses to current and past events. Production values, the artfulness of editors and the financial interests of producers and directors thus do much to determine contemporary aesthetic and ethical judgements. That which is beautifully presented invites the ethical involvement of the audience. Events whose images are beautifully presented constitute “hyperevidence”, a pre-judged, reinforced and amplified illusion of reality and participation. Understanding how aesthetic excellence draws audiences into ethical relationship with what is presented becomes an important part of education in ethics, including bioethics. (shrink)

Both in the Netherlands and in Britain, practices of ‘life story work’ have emerged in nursing for persons with intellectual disabilities. The narrative approach to care and support may at the same time be considered as an attempt to compensate for the ‘disabled authorship’ of many persons with intellectual disabilities and as a sign of controversy with standard practices of diagnosis and treatment that tend to neglect the personal identities of both clients and care givers, their particular historical and relational (...) contexts and their spiritual needs. This paper argues that narrative ethics not only offers an appropriate moral framework for practices of life story work, but that these practices are a narrative ethics in action. Starting with an account of the concept of ‘life story work’ as it has been introduced in nursing practices in the field of intellectual disability, the paper explains its relationship with key characteristics of narrative ethics. The teleological dimension in narrative ethics and in practices of life story work sparks off a dialectic process of understanding of the client and self‐understanding of the care giver. It also invites a respect for life in its openness toward the future and presupposes an openness toward other possible versions of the life narrative. The phenomenological and hermeneutic‐interpretative methodologies in narrative ethics aim at a ‘sudden moment of intimacy’ in relationships of nurses and clients. The ‘epiphany’ of this essential moment of recognition, insight and engagement cannot, however, be brought about by methodology. (shrink)

Even though it is not a methodology on the level of principlism or casuistry, narrative bioethics nonetheless contributes to and guides decision-making in the field of biomedical ethics. However, unlike other methodologies, the narrative approach lacks a set of specific patterns and formal rules for doing so. This deficiency leaves this approach more vulnerable to the influence of historical factors; in fact, the vital history of a person is made up of thousands of scenes, which one must select and group (...) under different norms. Yet the historicity of narrative does not destroy its normative value; rather, it gives rise to a confluence of stories that contradict one another on the basis of their practical consequences. This problem is less severe in traditional cultures, where some stories take precedence over others according to the normative value conferred through the supposed authority of their sources. But it manifests in an intense manner within current multicultural societies. It is imperative to find the thread that leads outside the labyrinth of subjectivity. This paper shows that the end of this thread lies, paradoxically, not in actions but in the subject-actors that perform them—specifically when such subjects are conceived as dramaturgical characters in narrative. (shrink)

This paper is an attempt to examine issues and problemsraised by agricultural biotechnology by drawing on the richnessof contemporary ideas in ethical theory and thereby contribute tothe project of establishing new approaches to these problems. Thefundamental argument is that many of the negative aspects ofagricultural biotechnology are generated at the level of theunderlying conceptual frameworks that shape the technology''sinternal modes of organization, rather than the unintendedeffects of the application of an inherently benevolent set oftechniques. If ``food ethics'''' is to address (...) the adverse impacts ofagricultural biotechnology, it must ultimately challenge theseconceptual frames, which, I argue, emerge from Enlightenment,liberal, political, and economic theory.The translation of traditional bioethics (focusing on principlessuch as autonomy and rights, justice, and well being) into foodethics does not produce the critical tools that are ableadequately to challenge the harmful legacy of Enlightenmentthinking. What is needed are reorientations of ethics that arecapable of formulating concepts and approaches that to someextent break with the presuppositions that underpin biotechnologyat its foundation. This paper suggests that narrative andfeminist critiques of medical bioethics are a good place to startin this project. (shrink)

In recent years, there has been a growing interest in finding stronger means of securitising identity against the various risks presented by the mobile globalised world. Biometric technology has featured quite prominently on the policy and security agenda of many countries. It is being promoted as the solution du jour for protecting and managing the uniqueness of identity in order to combat identity theft and fraud, crime and terrorism, illegal work and employment, and to efficiently govern various domains and services (...) including asylum, immigration and social welfare. In this paper, I shall interrogate the ways in which biometrics is about the uniqueness of identity and what kind of identity biometrics is concerned with. I argue that in posing such questions at the outset, we can start delimiting the distinctive bioethical stakes of biometrics beyond the all-too-familiar concerns of privacy, data protection and the like. I take cue mostly from Cavarero’s Arendt-inspired distinction between the “what” and the “who” elements of a person, and from Ricoeur’s distinction between the “idem” and “ipse” versions of identity. By engaging with these philosophical distinctions and concepts, and with particular reference to the example of asylum policy, I seek to examine and emphasise an important ethical issue pertaining to the practice of biometric identification. This issue relates mainly to the paradigmatic shift from the biographical story (which for so long has been the means by which an asylum application is assessed) to bio-digital samples (that are now the basis for managing and controlling the identities of asylum applicants). The purging of identity from its narrative dimension lies at the core of biometric technology’s overzealous aspiration to accuracy, precision and objectivity, and raises one of the most pressing bioethical questions vis-à-vis the realm of identification. (shrink)