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.

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)

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)

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)

The purpose of this study was to illuminate the ethically difficult situations experienced by care providers working in a nursing home. Individual interviews using a narrative approach were conducted. A phenomenological-hermeneutic method developed for researching life experience was applied in the analysis. The findings showed that care providers experience ethical challenges in their everyday work. The informants in this study found the balance between the ideal, autonomy and dignity to be a daily problem. They defined the culture they work in (...) as not supportive. They also thought they were not being seen and heard in situations where they disagree with the basic values of the organization. The results are discussed in terms of Habermas’s understanding of modern society. Care settings for elderly people obviously present ethical challenges, particularly in the case of those suffering from dementia. The care provider participants in this study expressed frustration and feelings of powerlessness. It is possible to understand their experiences in terms of Habermas’s theory of modern society and the concept of the system’s colonization of the life world. (shrink)

What does it mean to get hooked by a work, whether a bestseller or a classic, a TV series or a painting in a museum? What is this aesthetic experience that makes us feel captivated? What do works of art do, and how, in particular, do they bind us to them? In "Hooked," Rita Felski builds an aesthetics premised on our attachments rather than our free agency and challenges the ethos of critical aloofness that is so much a part (...) of modern intellectuals' self-image. The result is sure to be as widely read, and as controversial, as Felski's 2015 book, "The Limits of Critique." Felski looks at several "attachment devices." One of these is "attunement"--those affinities and stirrings that often fall below the threshold of consciousness. Why, for example, are we drawn to a painting or piece of music in ways we struggle to explain, while being left cold by others whose merits we duly acknowledge? Another attachment device is "identification"--a widespread response to fiction that is often invoked by critics but usually treated as synonymous with either identity or empathy. But Felski shows that identifying has no neat fit with identity categories, and it can trigger ethical, political, or intellectual affinities that have little to do with co-feeling. What people most commonly identify with, Felski argues, are characters who are alluring, arresting, or alive, not in spite of their aesthetic qualities but because of them. This kind of identification is not limited to naïve readers or over-invested viewers, but is also a defining aspect of what scholars in the humanities do. Relatedly, academic "interpretation" emerges here as another circuit of connection: critics forge ties to the works they explicate, the methods they use, the disciplinary identities they inhabit. "Hooked" returns us to the fundamentals of aesthetic experience, showing that the social meanings of artworks do not lie encrypted in their depths, within reach only of expert critics, but are generated within the embrace of captivated audiences. (shrink)

Though âeoepejorationâe is an important notion for linguistic analysis and theory, there is still a lack of theoretical understanding and sound descriptive analysis. In this timely collection, the phenomenon of pejoration is studied from a number of angles. It contains studies from phonology, morphology, syntax, semantics and pragmatics, and deals with diverse languages and their variants. Thus, the collection will appeal to all those linguists with a genuine interest in locating pejoration at the grammar-pragmatics interface.

This book re-assesses the life and legacy of Swami Vivekananda from the vantage point of socially-engaged religion in a time of global dislocations and inequities. Due to the complexity of Vivekananda as a historical figure on the cusp of a new era, few works offer a nuanced, academic examination of his liberative vision and legacy.

Across two studies, a wide age range of participants was interviewed about the nature of death. All participants were living in rural Madagascar in a community where ancestral beliefs and practices are widespread. In Study 1, children (8–17 years) and adults (19–71 years) were asked whether bodily and mental processes continue after death. The death in question was presented in the context of a narrative that focused either on the corpse or on the ancestral practices associated with the afterlife. Participants (...) aged 8 years and older claimed that death brings an end to most bodily and mental processes. Nevertheless, particularly in the context of the religious narrative, they claimed that certain mental processes continue even after death. This assertion of an afterlife was more evident among adults than children, especially with respect to cognitive processes, such as knowing and remembering. In Study 2, 5‐ and 7‐year‐olds were asked similar questions in connection with the death of a bird and a person. Seven‐year‐olds consistently claimed that bodily and mental processes cease at death, whereas 5‐year‐olds were unsystematic in their replies. Together, the two studies replicate and extend findings obtained with Western children showing that, in the course of development, different conceptions of death are elaborated—a biological conception in which death terminates living processes and a religious conception in which death marks the beginning of a new form of spiritual existence. (shrink)

Digital technology is transforming life and is beginning to have a profound effect on individual psychic life and the wider social milieu. This article seeks to understand the nature of the new technology and its implications for personal life, culture, and education. The scene is set by comparing the introduction of printing to the revolution inaugurated by digital technology. This new age is often called “postmodern,” and some of the characteristics of the age suggested by Lyotard, Baudrillard, McLuhan, and others (...) are identified. The cultural impact of technology, according to Heidegger, is outlined, together with the interpretation in terms of digital technology proposed by Dreyfus and Spinosa. This is illustrated with examples and compared with the position of other thinkers. Finally, the consequences for education, including universities, are presented, and some proposals for approaches to education in terms of meaning, embodiment, and teacher-student relationship are considered. (shrink)