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.

In this book, we come to understand the author's pedagogical thinking even better, through the critical seriousness, humanistic objectivity, and engaged ...

In At the Will of the Body , Arthur Frank told the story of his own illnesses, heart attack and cancer. That book ended by describing the existence of a "remission society," whose members all live with some form of illness or disability. The Wounded Storyteller is their collective portrait. Ill people are more than victims of disease or patients of medicine they are wounded storytellers. People tell stories to make sense of their suffering when they turn their diseases into (...) stories, they find healing. Drawing on the work of authors such as Oliver Sacks, Anatole Broyard, Norman Cousins, and Audre Lorde, as well as from people he met during the years he spent among different illness groups, Frank recounts a stirring collection of illness stories, ranging from the well-known--Gilda Radner's battle with ovarian cancer--to the private testimonials of people with cancer, chronic fatigue syndrome, and disabilties. Their stories are more than accounts of personal suffering: they abound with moral choices and point to a social ethic. Frank identifies three basic narratives of illness in restitution, chaos, and quest. Restitution narratives anticipate getting well again and give prominence to the technology of cure. In chaos narratives, illness seems to stretch on forever, with no respite or redeeming insights. Quest narratives are about finding that insight as illness is transformed into a means for the ill person to become someone new. (shrink)

ABSTRACT When hope is discussed in bioethics’ literature, it is most often in the context of ‘false hopes’ and/or how to maintain hope while breaking bad news to patients. Little or no time is generally devoted to the description of hope that supports these analyses. In this paper, I present a detailed description of hope, one designed primarily for the healthcare context. Noting that hope is an emotional attitude, four key aspects are explored. In particular, the function of imagination in (...) hope is discussed in depth. Through an examination of the relationship between hope and vulnerability, I demonstrate how adequately describing hope can broaden the normative inquiry into the role of hope in healthcare. Three ways in which persons with hope can be vulnerable are illustrated, and the challenge of how healthcare providers can attend in moral ways to the hopes of patients is identified. (shrink)

Naturalized bioethics represents a revolutionary change in how health care ethics is practised. It calls for bioethicists to give up their dependence on utilitarianism and other ideal moral theories and instead to move toward a self-reflexive, socially inquisitive, politically critical, and inclusive ethics. Wary of idealisations that bypass social realities, the naturalism in ethics that is developed in this volume is empirically nourished and acutely aware that ethical theory is the practice of particular people in particular times, places, cultures, and (...) professional environments. These essays situate the bioethicist within the clinical or research context, take seriously the web of relationships in which all human beings are nested, and explore a number of the different kinds of power relations that inform health care encounters. Naturalized Bioethics aims to help bioethicists, doctors, nurses, allied health professionals, disability studies scholars, medical researchers, and other health professionals address the ethical issues surrounding health care. (shrink)

Emotions shape the landscape of our mental and social lives. Like geological upheavals in a landscape, they mark our lives as uneven, uncertain and prone to reversal. Are they simply, as some have claimed, animal energies or impulses with no connection to our thoughts? Or are they rather suffused with intelligence and discernment, and thus a source of deep awareness and understanding? In this compelling book, Martha C. Nussbaum presents a powerful argument for treating emotions not as alien forces but (...) as highly discriminating responses to what is of value and importance. She explores and illuminates the structure of a wide range of emotions, in particular compassion and love, showing that there can be no adequate ethical theory without an adequate theory of the emotions. This involves understanding their cultural sources, their history in infancy and childhood, and their sometimes unpredictable and disorderly operations in our daily lives. (shrink)

First Published in 1993. Routledge is an imprint of Taylor & Francis, an informa company.

Paul Ricoeur has been hailed as one of the most important thinkers of the century. Oneself as Another, the clearest account of his "philosophical ethics," substantiates this position and lays the groundwork for a metaphysics of morals.

Hope is a central concept in nursing and other fields of health care. However, there is no consensus about the concept of hope. We argue that seeking consensus is futile given the multifaceted and multidimensional nature of the concept, but instead we encourage in‐depth studies of the assumptions behind talk about hope in specific contexts. Our approach to the ‘science of hope’ is inspired by philosophical pragmatism. We argue that hope is a concept that opens different rooms for action in (...) different contexts and that accordingly, all hope interventions are contextually sensitive. Careful attention to how the relative positions and power of nurses and patients influence what can be inferred from their different ways of talking about hope may make hopeful conversations more meaningful in health care relationships. (shrink)

Virtually all activities of health care are motivated at some level by hope. Patients hope for a cure; for relief from pain; for a return home. Physicians hope to prevent illness in their patients; to make the correct diagnosis when illness presents itself; that their prescribed treatments will be effective. Researchers hope to learn more about the causes of illness; to discover new and more effective treatments; to understand how treatments work. Ultimately, all who work in health care hope to (...) offer their patients hope. In this paper, I offer a brief analysis of hope, considering the definitions of Hobbes, Locke, Hume and Thomas Aquinas. I then differentiate shallow and deep hope and show how hope in health care can remain shallow. Next, I explore what a philosophy of deep hope in health care might look like, drawing important points from Ernst Bloch and Gabriel Marcel. Finally, I suggest some implications of this philosophy of hope for patients, physicians, and researchers. (shrink)