This paper1 aims to develop a model of practitioner narrative competence specifically for mental health care. I begin by considering the status of narratives as a form of evidence. Following Rita Charon and Cheryl Misak, I claim that there is no distinction to be made between evidence-based medicine and narrative medicine. I then explore Charon’s model of practitioner narrative competence, and suggest that it can be fruitfully adapted for mental health care contexts, a project for (...) which I employ Jennifer Radden and John Z. Sadler’s psychiatric ethics. This project brings together two independently promising accounts to develop what I refer to as the adapted model of... (shrink)

Democratic school systems are expected to equip students with the knowledge, abilities, and attitudes needed for life as citizens, particularly through social science education. Disciplinary knowledge, derived from the academic counterparts to school subjects, is essential in developing these skills. However, research has also emphasized the importance of life-world perspectives, where students’ experiences are included and taken seriously in teaching. This study suggests that the theory of (civic) narrative competence can function as a bridge between the disciplinary domain (...) and the life-world domain in its focus on how students’ civic reasoning can be developed through teaching. The article uses narrative theory to explore how the students’ civic narratives changed and became more nuanced after a teaching segment focusing on social and political trust. In the article, we demonstrate how the students’ personal experiences colored their interpretations and orientations before the teaching segment and how their civic narratives were developed through the implemented teaching, which provided them with concepts, a theoretical model, and empirical examples. We found that the students did not discard previous perceptions after the teaching segment, but integrated them into their new knowledge and orientations, thus integrating the life-world and disciplinary domains. (shrink)

This article examines the discourse competence of high-functioning children with autistic spectrum disorders to participate in narrative introduction sequences with family members. The analysis illuminates the children’s own efforts to launch narratives, as well as their ability to build upon the contributions of others. Ethnographic, discourse analytic methodology is integrated with the theory of discourse organization and the weak central coherence account of autism. Introductions of both personal experience narratives as well as fictional narratives are examined. The children (...) were especially competent in the use of stable introductory practices when launching fictional narratives, pre-organized by the media of expression. Their challenge was not in the introduction, but in the narrative co-telling, which often was not globally organized over an extended course of propositions. The heterogeneity of the ASD children’s discourse competence and its implications for discourse analysis are discussed. (shrink)

Relying on a powerful collective narrative through which political, legal and social decision-making is guided in the name of science, the authority of scientific experts reaches beyond the boundaries of their certified knowledge base. Therefore, expertise constitutes and is constituted by transgressive competence. The author argues that (1) changes in the decision-making structure of liberal Western democracies and changes in the knowledge production system diminish the authority of scientific expertise while increasing the context-dependency of expertise - thereby altering (...) the nature of its predictive claims; (2) the societal distribution of expertise, while displaying emancipatory features of empowerment of citizens, also raises issues of quality control; and (3) in order to regain a balance between public and private, i.e. individual-based societally distributed expertise, future expert systems will need to adopt a longer time-perspective. The author also reflects on directions in which future expert systems might evolve. (shrink)

In 1948, Bertrand Russell and Frederick Copleston entertained us with a radiophonic debate, on the BBC, concerning the rational proofs of God’s existence. This debate is primarily a product of Authors’ mindset. In this sense, every argument on each side presupposes a universal reason from which human intellect can grasp a certain degree of truth. Therefore, we would expect that the debate 75 years old to be outdated. Or maybe, Russell’s agnostic position could, at first sight, seem to be more (...) aligned with a contemporary post-modern mindset than Copleston’s theism. However, we disagree with the aforementioned thesis. We will not argue that Copleston won the debate by means of reason alone. We will rather show that both positions emerge from different ontologies. And these ones are intertwined with specific narratives and its respective ways of life. For that matter, the Russell-Copleston debate substantiates the thesis of Radical Orthodoxy. Deep down, John Milbank’s “ontology of peace,” as opposed to the Nietzschean nihilism, emerges from this debate. In this sense, while Copleston’s argumentation grounds this narrative on an ontology of peace, Russell tends to follow in a nihilism capable of destroying the communion between different persons. In this sense, the debate is still up to date. (shrink)

ULRICH DUCHROW AND FRANZ HINKELAMMERT'S PROPOSALS AGAINST private property contain a structural weakness analogous to that of which they accuse John Locke: an inability to attribute agency to their opponents. Analysis of antineoliberal and neoliberal narratives of economic history shows that they are mirror images of each other in what they consider fixed or changeable in life. The likelihood that each narrative contains partial truths means that faithful Christian economic ethics are best grounded in a theology according agency to (...) all, acknowledging the universality of sin, and proclaiming transcendent hope. (shrink)

Smythe and Murray presented the basic ethical issues in narrative research in a comprehensive, well-reasoned, and direct manner. In this critique, we highlight 3 issues. Two matters appear to challenge the internal inconsistency of the assumptions of NR: privileging some voices over others and a potential inherent conflict of interest for some researchers. We also examine some issues regarding the protection of research participants and conclude with modest recommendations.

This paper provides a defense of the ethical/political dimensions of Kant’s liberalism by gauging the strength of the critique of one of its most acerbic contemporary critics, Richard Rorty. Rorty’s dissatisfaction with Kant’s position can be traced back to a narrative of the coming to age of our culture, which bears surprising similarities to Kant’s account of the Enlightenment. Yet, in Rorty’s version of the story, Kant’s philosophy is mistakenly assimilated to a form of “Platonism.” This is due, I (...) argue, to the fact that Rorty confuses the “transcendental” with the “transcendent” in Kant. To set the score straight, I present a “de-Platonized” reading of Kant’s 1784 Enlightenment essay, whose goal is to protect the achievements of liberalism against Rorty’s poetic excesses. (shrink)

In this article, using the recent work by Charles Taylor in A Secular Age as my point of departure, I will argue that Jean-Luc Nancy enables us to think past the competing binary of atheistic and religious experience and allows us to surpass the present narratives of secularism. In A Secular Age, Taylor himself seeks a middle ground between atheism and religion, arguing that it is possible to open ourselves to the cross-pressures of modern existence that find us caught between (...) scientific atheism and a need for spiritual and religious guidance. Here, Taylor finds a way of picturing ourselves within a secular age, remaining faithful to scientific rationalism, but still open to religion and a sense of a higher good. However, as I shall demonstrate, in his thesis Taylor misrepresents the Continental philosophical tradition (particularly Nietzsche and post-structuralism) that has itself sought to understand these cross-pressures of existence. Taking this misrepresentation, and specifically his reductive and colloquial analysis of Nietzsche, Camus, and Derrida, as my point of departure, I provide an alternative manner of thinking through the work of these writers, one that leads to a detailed analysis of Jean-Luc Nancy and his project the deconstruction of Christianity. In this analysis I argue that Nancy provides a manner of thinking that remains open and allows an experience of freedom, without seeking to close that sense of openness with explanation, nor maintaining that sense of openness with a conception of the divine. (shrink)

This essay describes the emergence of the 9/11 attacks on the World Trade Center and Pentagon as an object of conspiratorial intrigue and imagination, offering a snapshot of the “9/11 truth movement” and its various theories as they began to reach full bloom. Theories about the attacks have come to constitute the dominant conspiratorial present – a present that looks remarkably like the mid- and late-twentieth-century past, despite significant changes in information technology and the continuing institutionalization and ironization of conspiracy (...) theory as an influential form of popular politics. In addition to the 9/11 conspiracy community, the essay considers the battle over the 9/11 Commission’s review of the government’s failure to anticipate the terrorist attacks. The Commission engaged in knowing and savvy efforts to respond to conspiracy theories and to preempt popular belief in them, offering an authoritative narrative (or, more precisely, set of narratives) to explain what occurred. Meanwhile, the 9/11 truth movement made equally knowing and savvy efforts to critique the official account, responding with its own efforts to reinterpret and re-narrate the attacks, their causes, and what they signify about the contemporary world. While the 9/11 Commission may have criticized the federal government and its intelligence services for their failures of imagination prior to the attacks, the truth movement criticized the Commission either for a failure of imagination – an explanation for the attacks that could see through the “official” account – or for a quite imaginative cover-up of the hidden truths of 9/11. By considering the clash between official authorities and an active conspiracy community, this essay considers how the movement attempted to form a collective political and scholarly community, producing a blizzard of texts offering narratives that compete with the ones told by the Commission that seek the impossible grail of conspiracy theory: the truth. The essay also considers the effects, if any, of the state’s attempt to preempt and respond to conspiracy theories. (shrink)

An important consideration which runs through the adjudication process in each dimension is that of insight vs. blindness. Whether it is a question of deciding if one description is a persuasive critique of another, or which of two rivals is more adequate empirically, or which is a more plausible and convincing narrative, one is always involved in assessing how far and how much each of the accounts permits us to see. The centrality of this notion certifies the inescapably hermeneutical (...) character of social description adjudication. It precludes the possibility of a decision-procedure, but not of rationality. The alternative to a canonical method of description adjudication is not relativism but hermeneutics. ;My argument for a hermeneutical approach to social description adjudication is made largely via consideration of a series of examples. I look at a collection of rival accounts of the same portion of social reality and at the process of choosing between them. I consider the sorts of reasons and arguments that might be advanced for preferring one to another and I evaluate them. The descriptions I look at are accounts of the French Revolution of 1848 and they include Karl Marx's Eighteenth Brumaire of Louis-Bonaparte, Victor Hugo's Napoleon the Little, Gustave Flaubert's Sentimental Education and the works of two recent twentieth century social historians. ;I show that these descriptions are complexes of at least three analytically distinct components: critical, empirical and narrative. I show, therefore, that the choice between them can be made from at least three corresponding standpoints. But I also argue that these three dimensions are not independent of one another; each, rather, presupposes the others and none is foundational with respect to the others. Adjudicating between competing social descriptions, then, turns out to be a complex non-canonical process of weighing the relative merits within each dimension. ;I counterpose to the decision-procedure model of social description adjudication a hermeneutical model. I show that good and convincing reasons for preferring one social description or historical interpretation to another need not be strictly derivable from or translatable into a set of universal rules capable of being formulated independently of and in advance of the consideration of the particular case. I show, rather, that rational adjudication between competing social descriptions consists in creative rule-transcending judgment akin to Aristotelian phronesis or Kantian reflective judgment. ;It is often presupposed that choices between competing theories, interpretations, actions or whatever qualify as rational just in case they result from the application of some decision-procedure. I take issue with this assumption when what is at stake is choosing between competing descriptions of social reality. I argue that there is not and cannot be a decision-procedure governing such choices, but that such choices may nonetheless be rational and intersubjectively defensible. (shrink)

This study investigates the developmental pattern and relationships between oral narrative textual skills, spelling, and written narrative textual skills in monolingual and bilingual language-minority children, L1-Chinese and L2-Italian. The aims were to investigate in monolingual and BLM children: the developmental patterns of oral and writing skills across primary school years; the pattern of relationships between oral narrative textual competence, spelling skills, and written narrative textual competence with age and socio-economic status taken under control. In (...) total, 141 primary school children from grades 2 to 5 in Central Italy aged between 7 and 11 years obtained scores for oral and written narrative textual competence, spelling accuracy in dictation, and written texts. One-way ANOVA and ANOVA with robust method analyses and Bonferroni’s correction showed that BLM children had poorer spelling skills in dictation and written narrative textual competence than their monolingual peers. After preliminary correlation analysis, the results of hierarchical regression showed that the relationship between oral and written narrative textual competence is completely mediated by spelling accuracy in BLM children. These results suggest that adequate performance in written narrative textual competence depends on adequate spelling accuracy in writing stories. The Sobel test verified the power of this mediation. In monolinguals, the strongest predictor of written narrative textual competence is oral narrative textual competence. This relation is stronger in older children whose spelling skills are automatized. The identified pattern of relationships shows a complex network of oral and written processes. The scarce spelling skills characterizing BLM children may explain why spelling skills determine a low written narrative textual level. Scarce spelling skills absorb cognitive resources, hindering high-level cognitive processes that regulate narrative production. In monolinguals, the medium of writing does not impact narrative textual competence. Children’s oral narrative textual competence easily transfers into their written narrative productions. These findings have implications for the assessment and instruction of literacy skills in young BLM children and their monolingual peers. (shrink)

The author of “How Bioethics and Case Law Diverge in Assessments of Mental Capacity: An Argument for a Narrative Coherence Standard” (2020) arrives at a reasonable conclusion; however, it is far le...

Shifts in the national cultural identity of the US have been reflected in shifts in the US’ dominant constitutional narratives. For the United States, “inter-legality” has been less a matter of dealing with alternative non-state legal narratives than of contending with constantly arising and competing narratives about the “correct” nature of the “official” legal order of the state. The US Supreme Court has claimed to have the “last word” in resolving these arguments but because that Court is so often sharply (...) divided and because the Court membership and the nature of its “last words” changes so often, where a significant element of the society seeks to advance its ideas and interests, it will often do so in legal and constitutional terms. As the national culture undergoes changes, a competing constitutional narrative may gain ground and even ultimately prevail, at least for a time, and achieve Supreme Court “endorsement” for its claims. (shrink)

High-quality education has been considered important for social justice, although what good education means is contested. A project aimed at identifying varieties of conceptions of ethical competence was presented as well as another that focused on a fiction-based approach to ethics education. A multidimensional ethical competence mediated through a multitude of narratives was shown as a strong contribution to EE. The aim was to discuss as to what extent such a multidimensional ethical competence mediated through a multitude (...) of narratives could be understood as powerful knowledge. Sweden, where national tests lately have been understood as a tool to increase achievements, but where an unclear understanding of desired knowledge in EE exists, was the setting. Methodologically, the article drew on Michael Young’s definition of powerful knowledge, a hermeneutic meta-study on the findings of EthiCo concerning conceptions of ethical competence, as well as Mark Tappan’s sociocultural perspective on moral development. These perspectives were brought together to discuss powerful knowledge in EE as a contribution to education for social justice. Whether a multidimensional ethical competence mediated through a multitude of narratives could be understood as powerful knowledge was shown to be dependent on the definition. Whilst Young’s powerful knowledge is restricted to an academic language, Tappan stresses vernacular language as characteristic for a functional moral discourse. One conclusion was the centrality of fiction in EE for the development of moral discourses that transcend reality and shape ‘knowledge of possibilities’ – powerful in the shaping of societal justice. (shrink)

The Narrative Practice Hypothesis (NPH) is a recently conceived, late entrant into the contest of trying to understand the basis of our mature folk psychological abilities, those involving our capacity to explain ourselves and comprehend others in terms of reasons. This paper aims to clarify its content, importance and scientific plausibility by: distinguishing its conceptual features from those of its rivals, articulating its philosophical significance, and commenting on its empirical prospects. I begin by clarifying the NPH's target explanandum and (...) the challenge it presents to theory theory (TT), simulation theory (ST) and hybrid combinations of these theories. The NPH competes with them directly for the same explanatory space insofar as these theories purport to explain the core structural basis of our folk psychological (FP)-competence (those of the sort famously but not exclusively deployed in acts of third-personal mindreading). (shrink)

Bioethics, and indeed much ethicalwriting generally, makes its point throughnarratives. The religious parable no less thanthe medical teaching case uses a simple storyto describe appropriate action or theapplication of a critical principle. Whilepowerful, the telling story has limits. In thispaper the authors describe a simple teachingcase on ``end-of-life'' decision making that wasill received by its audience. The authors ill-receivedexample, involving the disconnection ofventilation in a patient with ALS (Lou Gherig'sDisease) was critiqued by audience members withlong-term experience as ventilation users. Inthis (...) case, the supposedly simple narrative ofthe presenters conflicted with the lifehistories of the audience. The lessons of thisstory, and the conflict that resulted, speakcritically to the limits of simple teachingcases as well as the strengths of narrativeanalysis as a tool for the exploration ofbioethical case histories. (shrink)

Decoupling a modestly construed Narrative Self Shaping Hypothesis from Strong Narrativism this paper attempts to motivate devoting our intellectual energies to the former. Section one briefly introduces the notions of self-shaping and rehearses reasons for thinking that self-shaping, in a suitably tame form, is, at least to some extent, simply unavoidable for reflective beings. It is against this background that the basic commitments of a modest Narrative Self-Shaping Hypothesis are articulated. Section two identifies a foundational commitment—the central tenet—of (...) all Strong Narrativist proposals, those that posit a necessary link between narrative self-shaping and narrative self-experience. As will be shown, in the hands of Strong Narrativists the latter notion is unpacked in stronger or weaker ways by appeal to the notion of implicit Narrativizing. Section three reminds the reader of Strawson’s challenge to Strong Narrativism. It is revealed that Strawson’s objections are most effective if they target Strong Narrativism’s central tenet construed as a phenomenological revelation about what is necessary for self-experience and not merely the psychological Narrativity thesis, construed as an empirical hypothesis about typical Narrativizing proclivities. Having set the stage, section four critically examines two different strategies, pursued by Rudd and Schechtman respectively, for escaping the horns Strawson’s dilemma poses for Strong Narrativism. In the end both strategies invoke the notion of implicit Narrativizing at a crucial juncture. Section five reveals that a substantive proposal about what implicit Narrativizing might be is lacking, hence we have no reason to believe that it actually occurs. It is concluded that, as things stand, Strong Narrativism has no way of avoiding the horns of Strawson’s dilemma. Brief concluding remarks in the final section are a reminder why, despite their modesty, softer versions of the NSSH—when coupled with a developmental proposal about the narrative basis of our folk psychological competence—are non-trivial and worthy of further development and investigation. (shrink)

Surely since the Enlightenment, if not before, the study of mind has centered principally on how man achieves a “true” knowledge of the world. Emphasis in this pursuit has varied, of course: empiricists have concentrated on the mind’s interplay with an external world of nature, hoping to find the key in the association of sensations and ideas, while rationalists have looked inward to the powers of mind itself for the principles of right reason. The objective, in either case, has been (...) to discover how we achieve “reality,” that is to say, how we get a reliable fix on the world, a world that is, as it were, assumed to be immutable and, as it were, “there to be observed.”This quest has, of course, had a profound effect on the development of psychology, and the empiricist and rationalist traditions have dominated our conceptions of how the mind grows and how it gets its grasp on the “real world.” Indeed, at midcentury Gestalt theory represented the rationalist wing of this enterprise and American learning theory the empiricist. Both gave accounts of mental development as proceeding in some more or less linear and uniform fashion from an initial incompetence in grasping reality to a final competence, in one case attributing it to the work out of internal processes or mental organization, and in the other to some unspecified principle of reflection by which—whether through reinforcement, association, or conditioning—we came to respond to the world “as it is.” There have always been dissidents who challenged these views, but conjectures about human mental development have been influenced far more by majoritarian rationalism and empiricism than by these dissident voices. Jerome Bruner is research professor of psychology at New York University, where he is also serving as Meyer Visiting Professor of Law. His most recent book, Acts of Meaning, appeared in 1990. In 1987 he received the Balzan Prize for “a lifetime contribution to the study of human psychology.”. (shrink)

This article intends to review the relationship between European organization and diversity. Europe lives in the legacy of division of nation and ethnicity as its main source dating from the ninete...

Bayesian models of legal arguments generally aim to produce a single integrated model, combining each of the legal arguments under consideration. This combined approach implicitly assumes that variables and their relationships can be represented without any contradiction or misalignment, and in a way that makes sense with respect to the competing argument narratives. This paper describes a novel approach to compare and ‘average’ Bayesian models of legal arguments that have been built independently and with no attempt to make them consistent (...) in terms of variables, causal assumptions or parameterization. The approach involves assessing whether competing models of legal arguments are explained or predict facts uncovered before or during the trial process. Those models that are more heavily disconfirmed by the facts are given lower weight, as model plausibility measures, in the Bayesian model comparison and averaging framework adopted. In this way a plurality of arguments is allowed yet a single judgement based on all arguments is possible and rational. (shrink)

The relation between narratives and agency can be sometimes considered as mutually constitutive. There are cases in which telling a story expresses higher degrees of agency, and respectively, agency is shaped as a narrative that expresses the agent’s reasons. From henceforth, I will contend that a narrative theory, beyond the personal identity problem, can also enlighten how the agent attains giving reasons for the action by making sense of sequences of events. In order to explain how agency is (...) constituted from understanding and control, we must assume a primitive competence for narratives. Agency supposes an ordering that cannot be reduced to temporality, but expresses a certain sense of accomplishment that can be narratively constituted. In this context, I will examine Welleman’s theory of emotions as an ordering framework of the events in structures of means-ends. A possible objection to his explanation of the agential narratives is that emotions themselves need to be understood as narrative processes. I suggest then that an enactivist approach would be a way of explaining the narrative constitution of agency. One virtue of this approach is that it harmonizes the biological and cultural components of the agency from the most basic layers to the ordinary folk-psychological narratives. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy and Literature 25.2 (2001) 233-250 [Access article in PDF] Narrative Theory and Function: Why Evolution Matters Michelle Scalise Sugiyama I It may seem a strange proposition that the study of human evolution is integral to the study of literature, yet that is exactly what this paper proposes. The reasons for this are twofold. Firstly, the practice of storytelling is ancient, pre-dating not only the advent of writing, (...) but of agriculture and permanent settlement as well. Secondly, narrative is ultimately a product of the mind, which in turn is the product of a long history of evolution by natural selection. Thus, an understanding of why and how humans create and consume narrative requires an understanding of (1) features of ancestral environments and (2) features of the mind that made the emergence of this phenomenon possible.There can be little doubt that narrative emerged in human prehistory. Language, an obvious prerequisite for storytelling, is likely to have emerged by at least 50,000 and possibly 250,000 years ago, depending upon whether one places one's trust in archaeological or anatomical evidence. 1 The most reasonable estimate is offered by Geoffrey Miller, who points out that, given its universality, the language faculty must have emerged by the time ancestral Homo sapiens began migrating out of Africa approximately 100,000 years ago. 2 Although the oldest known written narrative (The Epic of Gilgamesh) dates back only 5,000 years, the written literary traditions of many ancient cultures are known to be rooted in longstanding oral traditions. 3 The fact that many modern foraging peoples have rich and complex oral traditions further suggests that the emergence of narrative is not linked to the development of agriculture 10,000 years ago. Moreover, other forms of symbolic expression, such as the cave paintings, Venus figurines, and engraved bone [End Page 233] and antler that have been found at various sites throughout Europe, date back approximately 30,000 years, and rock paintings in Australia may date back even farther. 4 Since humans were physiologically capable of speech long before they began producing these artifacts, storytelling is likely to be at least as ancient as these other representational forms. Indeed, one scholar situates the "dawn of the oral tradition" within this period (Pfeiffer, p. 189). Given, then, that modern humans (Homo sapiens sapiens) have been in existence for approximately 100,000 years 5 and are the only hominid species or subspecies known for certain to exhibit storytelling behavior, we can safely say that oral narrative is a product of our hunting-and-gathering past, likely to have emerged between 30,000 and 100,000 years ago.The universality of narrative is further testimony to its being an ancient cognitive phenomenon. Literate or not, all known cultures, past and present, practice storytelling. 6 Moreover, all normally developing humans acquire the ability to process and generate stories: studies of Western children indicate that the ability to tell stories emerges spontaneously between the ages of two-and-a-half and three, and children as young as thirty months can distinguish between narrative and non-narrative uses of language. 7 In contrast to reading, writing, and arithmetic, no special education is required for narrative competence to develop, nor is there any evidence that oral literacy is acquired through contact with other cultures; although subject matter is often exchanged between groups, the practice of storytelling itself arises independently among even the most isolated peoples. Nor does any type of culture have a monopoly on narrative sophistication: the stories of hunter-horticulturalist societies are no less observant, insightful, or artful than those of agrarian or industrial societies.As with language, narrative takes the same basic form across cultures, which David Bordwell and Kristin Thompson define as "a chain of events in cause-effect relationship occurring in time." Given the preponderance of human agents in narrative, most narrative theorists would probably modify this barebones description to include character (usually understood to have a human psychology), goal-oriented action, and resolution. Frank Kermode, for example, defines the "proprieties" of narrative as "connexity, closure, and character," and John... (shrink)

Patient competence, defined as the ability to reason, appreciate, understand, and express a choice is rarely discussed in patients with obsessive compulsive disorder, and coercive measures are seldom used. Nevertheless, a psychiatrist of psychologist may doubt whether OCD patients who refuse treatment understand their disease and the consequences of not being treated, which could result in tension between respecting the patient’s autonomy and beneficence. The purpose of this article is to develop a notion of competence that is grounded (...) in clinical practice and corresponds with the experiences of patients with obsessions and/or compulsions. We present a naturalistic case study giving both the patient’s and the therapist’s perspective based on in-depth interviews and a narrative analysis. The case study shows that competence is not merely an assessment by a therapist, but also a co-constructed reality shaped by the experiences and stories of patient and therapist. The patient, a medical student, initially told her story in a restitution narrative, focusing on cognitive rationality. Reconstructing the history of her disease, her story changed into a quest narrative where there was room for emotions, values and moral learning. This fitted well with the therapist’s approach, who used motivational interventions with a view to appealing to the patient’s responsibility to deal with her condition. We conclude that in practice both the patient and therapist used a quest narrative, approaching competence as the potential for practical reasoning to incorporate values and emotions. (shrink)

This article discusses an epistemological problem faced by causal explanations of action and a proposed solution. The problem is to justify why one particular reason rather than another is specified as causally efficacious. It is argued that the problem arises independently of one’s preferred conception of singular causal claims, psychological and psychophysical generalizations, and our folk-psychological competence. The proposed fallibilist solution involves the supplementation of the reason given by narratives that contextualize it and provide additional criteria for justifying the (...) causal claim. It is argued that narratives have a distinctive structure that can afford the justification of causal attributions without sui generis powers of narrative explanation having to be invoked. (shrink)

This essay proposes an expansion of the concept of narrative competence, beyond close reading, to include two more skills: the collaborative construction and compelling performance of stories. To show how this enhanced form of narrative competence can be attained, the essay describes Off Script, a cocurricular medical storytelling program with three phases: 1) creative writing workshop, 2) dress rehearsal, and 3) public performance of stories. In these phases, Off Script combines literary studies, creative writing, reflective practice, (...) collegial feedback, and drama. With increased narrative competence, Off Script participants are likely better equipped to engage in more impactful health advocacy and partner with patients more effectively. (shrink)

Aryeh Goldberg compellingly argues for a Narrative Coherence Standard (NCS) to bolster existing methods of assessing patients' mental capacity. But his account fails to distinguish between the cognitive abilities of children and adults; consequently, worries may be raised about the scope of the NCS, in particular when we consider child patients. In this article, I argue the NCS cannot plausibly apply to children. Since children's self-conception does not arrive fully formed — but rather is a product of both incomplete (...) cognitive development and socializing factors — I claim children may not possess a sufficiently intimate knowledge of self, and therefore a sufficiently coherent sense of self, as Goldberg demands. Therefore, we should either revise the NCS to accommodate children, adopt an incremental view of consent, or revert to the relevant form of the MacArthur competence criteria to establish children’s capacity to consent. (shrink)

The slogan that ‘the virus doesn’t discriminate’ has been belied by the emergence of stark and persistent disparities in rates of infection, hospitalisation, and death from Covid-19 between various social groups. I focus on two groups that have been disproportionately affected, and that have been constructed or designated as particularly ‘at-risk’ during the Covid-19 pandemic: racial or ethnic minorities and fat people. I trace the range of narratives that have arisen in the context of explaining these disparities, in both the (...) scientific literature and wider expert and public discourse. I show that the scientific and public narratives around these groups have differed significantly, revealing contested and competing conceptions of the basis of these categories themselves. These different conceptions have important impacts on the kinds of interventions that become possible or desirable. I show that in the case of racial or ethnic disparities, genetic narratives have been combatted by a strong focus on structural racism as a driver of pandemic inequalities. However, in the case of fatness, individualising and stigmatising narratives have dominated discussions. I suggest that, given racial or ethnic differences in prevalence of fatness, and scholarship casting anti-fatness as historically racialised, the stigmatisation of fatness disproportionately affects racial or ethnic minorities in terms of placing individual blame or responsibility for the increased burden of Covid-19 on these groups. Despite widespread acknowledgement of the role of structural racism in driving racial inequalities in the burden of Covid-19, anti-obesity rhetoric and research provides a ‘backdoor’ to placing blame on individuals from racial minorities. (shrink)

Method in ethics consultation has at least three distinguishable components: a canon – that is, the rules that guide actions, cognitions, judgments, and perceptions involved in performing an ethics consultation; a discipline – that is, a mastery, or at least possession, of the specific types of actions and intentions of ethics consultation which are guided by the rules that are embodied in the actions of competent ethics consultants; and a history – that is, the narrative of, and critical reflection (...) on, the actions, including the analyses, assessments, and communications undertaken in the course of the consultation, including the reasoning about the practical issues and the steps toward resolving the ethical question or issues that arose. As a doing, then, ethics consultation consists in actions and intentions that constitute a distinctive set of meanings in the clinical space of patient care in which the meanings brought to patient care through the actions and communications of the ethics consultation help shape, to some extent, the way that the case develops and is understood, which is further reflected in how the case is represented. In this sense, statements about ethics consultation methodology, and theories of ethics consultation, are secondary to the actual practice itself. The analysis and interpretation of actions and communications of those involved in the clinical care of the patient represents a complex process that blends the meaning of ethical concepts, principles, and theories with the constructed and uncovered clinical and value meanings of the case. (shrink)

In this paper we develop a hermeneutic approach to the concept of competence. Patient competence, according to a hermeneutic approach, is not primarily a matter of being able to reason, but of being able to interpret the world and respond to it. Capacity should then not be seen as theoretical, but as practical. From the perspective of practical rationality, competence and capacity are two sides of the same coin. If a person has the capacity to understand the (...) world and give meaning to the situation, he or she is able to make decisions, and is thus competent. People can fail in the area of practical rationality. They can feel ill at ease, uncomfortable or not at home in the situation. Under such conditions, they appear as incompetent, and urge caregivers to respond in such a way that their competence can be raised. The issue is not how to measure their incompetence, but how to help them to become more competent, that is to get a practical grip on their situation and to be able to live out their lives in such a way that they develop their identity in relations with others. From a hermeneutic point of view, assessing a patient's capacity implies focusing on the patient's way of meaning making and regarding her behavior from the perspective of practical rationality. The focus should not be on the assessment as a matter of fact, but on improving capacity. This requires allowing the patient to experience the world meaningfully and affording her, in the context of a supportive and trustful institutional environment, the possibility of developing a personal narrative where her choices are expressed verbally or non-verbally. (shrink)

Per Aage Brandt, commenting on a passage from Merlin Donald, suggests that there is ‘a narrative aesthetics built into our mind.’ In Donald, one can find an evolutionary account of this narrative aesthetics. If there is something like an innate narrative disposition, it is also surely the case that there is a process of development involved in narrative practice. In this paper I will assume something closer to the developmental account provided by Jerome Bruner in various (...) works, and Dan Hutto's account of how we learn narrative practices, and I'll refer to this narrative aesthetics as a narrative competency that we come to have through a developmental process. I will take narrative in a wide sense, to include oral and written communications and self-reports on experience. In this regard narrative is more basic than story, and not necessarily characterized by the formal plot structure of a story. A story may be told in many different ways, but always via narrative discourse. Also, having narrative competency includes not just abilities for understanding narratives, but also for narrative understanding, which allows us to form narratives about things, events and other people. To be capable of narrative understanding means to be capable of seeing events in a narrative framework. (shrink)

Virtue, Narrative, and Self connects two philosophical areas of study that have long been treated as distinct: virtue theory and narrative accounts of personal identity. Chapters address several important issues and neglected themes at the intersection of these research areas. Specific examples include the role of narrative in the identification, differentiation, and cultivation of virtue, the nature of practical reasoning and moral competence, and the influence of life's narrative structure on our conceptions of what it (...) means to live and act well. This volume demonstrates how recent work from the philosophy of mind and action concerning narrativity and our understanding of the self can shed new light on questions about the nature of virtue, practical wisdom, and human flourishing. This book will be of interest to scholars and advanced students working in virtue theory, moral philosophy, philosophy of mind and action, and moral education. (shrink)

‘Narrativity and Hermeneutics’ is not an obvious subject to mark the fifth anniversary of a centre devoted to applied ethics. Narrative tradition and the interpretation of texts are not the main concern of handbooks on biomedical ethics, engineering ethics, business ethics or ecological ethics. The reasons are evident; most practitioners of applied ethics see their area of research as a functionally differentiated discipline, a carefully circumscribed field wherein only specialists are competent. In their textbooks they adopt the view of (...) ethical expertise as defended by Theo van Willingenburg in his noteworthy thesis Inside the Ethical Expert. According to this view, practitioners of applied ethics are experts possessing a body of specialized knowledge and skill within a given domain acquired through a substantial amount of study and training. Besides being able to clarify problems and analyze concepts and arguments, they are, as experts, also able to apply specific skills of moral reasoning to reach a substantiated evaluation of values and norms, with the ultimate purpose of offering suitable ethical advice.The acquisition of a certain amount of expertise is doubtless important. The practice of applied ethics is more than probing for a good moral intention. They primarily pursue the right moral choice, i.e. the action that in a given, often complex situation, is objectively suitable to express a good moral intention. A right moral choice is impossible without a thorough clarification of the complex reality about which a moral judgment must be made.Yet emphasizing ethical expertise does not say everything. Is it correct to position ethicists as experts parallel to the medical, economic or technical experts with whom they deal? Does applied ethics, because of its functionally differentiated approach, not run the risk of either reducing itself to a professional deontology with a limited view of responsibility or enclosing itself with other experts in an iron cage of technocratic, bureaucratic or instrumental rationality? When forming an ethical judgment, is it possible to exclude completely all influence arising from personal convictions? (shrink)

Cognitive and rational assessments of competence do not fully capture the way in which individuals normally make decisions. Human beings have always used stories to explain their experiences and values. Narrative ethics should be used to understand the perspective in context of a patient whose competence is in question, and so avoid a destructive clash. Psychiatry and professionals within it also have a narrative that may join with that of science, but there is no special privilege (...) for these narratives unless survival is at stake. The narrative approach should be used to try to make different stories compatible. This article examines the background to this approach, and indicates some ways in which it could be used in the specific cases addressed in the series. (shrink)

The complex relations between Christianity and science seem to present a critical point in evolutionary theory, especially for the challenges it poses to the doctrine of original sin. I investigate the precise senses in which evolution threatens the Augustinian/Reformed formulation of original sin, analyzing each of the six tenets of the doctrine vis a vis nine evolutionary claims, as well as the supposed clash between the narratives of evolution and Christianity. I show that the threat is less impressive than it (...) is usually assumed, and I highlight where the conflict really lies. I defend that it is possible to remain faithful to the core of the doctrine of original sin and to accept the reliability of evolution as a scientific theory. I present three scenarios for “Adam and Eve” and interpret them using two different models. I favor the understanding of Adam and Eve as the whole initial human bottleneck viewed through the lens of a multilevel model. (shrink)

Critiques of the dehumanising aspects of contemporary medical practice have generated increasing interest in the ways in which health care can foster a holistic sense of wellbeing. We examine the relationship between two areas of this humanistic endeavour: narrative and dignity. This paper makes two simple arguments that are intuitive but have not yet been explored in detail: that narrative competence of carers is required for maintaining or recreating dignity, and that dignity promotion in health care practice (...) is primarily narrative in form. The multiple meanings that dignity has in a person’s life are what give the concept power and can only be captured by narrative. This has implications for health care practice where narrative work will be increasingly required to support patient dignity in under-resourced and over-subscribed health care systems. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:How Narrative Counts in Phenomenological Models of SchizophreniaThe author reports no conflicts of interest.Rosanna Wannberg (2024) offers an intriguing and novel critique of the predominant phenomenological model of schizophrenia, the ipseity disturbance hypothesis. According to this model, which was initially proposed by Sass and Parnas (2003), schizophrenia is best understood as arising from a disturbance or instability of minimal or basic self-hood, the sense of being present to (...) oneself and one's experiences (Henriksen, 2022). This disturbance appears as various experiential anomalies, sometimes termed "anomalous self (or world) experiences" or "self disorders," which include such phenomena as alienation from subjective processes, doubt in the existence of the world or one's own existence, fluidity of boundaries between self and others or self and world, and many other phenomena. Many of these have been captured in the Examination of Anomalous Self Experience (Parnas et al., 2005) and the Examination of Anomalous World Experience (Sass et al., 2017).At the same time, some research reveals the presence of self disorders in nonpsychotic conditions like panic disorder (Madeira et al., 2017) and depersonalization/derealization disorder (Sass et al., 2013). There are also competing phenomenological models that posit schizophrenia instead as a disturbance of dialogical self (Lysaker & Lysaker, 2002) or as a disruption of automatic perceptual processing (Uhlhaas & Mishara, 2007). Such works contain implicit critiques of the ipseity disturbance hypothesis that focus on the specificity of self disorders, or else on the specific nature of the underlying disturbance in schizophrenia.Wannberg's critique is distinct from these others: by considering the validity and function of recovery narratives, she raises crucial epistemological and ethical questions about the phenomenological approach to psychopathology, asking not only whose narrative counts, but how narrative counts. In particular, Wannberg questions a phenomenology that, she suggests, might find any ongoing symptoms as evidence of continued alterations of subjectivity, and that would then be dismissive of recovery narratives—a phenomenology that would prioritize the authority [End Page 71] of consciousness, as Wannberg puts it, over the authority of the person.It is worth stating here that the standard phenomenological response would not be to distrust or dismiss accounts of recovery. Ideally, phenomenological models, along with their ongoing theoretical developments and empirical work, are based on a deep respect for patients' experience and self-descriptions, striving to attend to experiences as they are lived without imposing pre-defined constructs that would limit or alter the experiences in a fundamental way (Nordgaard et al., 2013).Questions about the nature of recovery might be addressed within phenomenology by considering the difference between minimal (or basic) self and narrative (or extended) self, a more complex self-understanding or self-interpretation that is founded on the more basic, pre-reflective sense of being alive in the world (Gallagher, 2000; Parnas, 2007). According to proponents of the ipseity disturbance hypothesis, disturbances of basic self-hood can contribute to disturbances of narrative self, such as confusion about one's future goals or difficulties making sense of one's life history, though it is unlikely for disruptions that originate in the narrative self to trickle down to the minimal self (Henriksen, 2022). Such a view might similarly suggest that it would be unlikely for work on the level of the narrative self to lead to improvements in minimal self. Recovery, according to this approach, might best be viewed as an understanding of and compensation for alterations in basic self-hood, such that a person can develop a relatively solid narrative self that accounts for and manages disturbances of minimal self—while the minimal self may also grow more solid through various therapeutic interventions (Skodlar & Henriksen, 2019).Wannberg finds a more transformative possibility in Wittgenstein's grammatical approach, which is concerned with the function and rules of discourse. According to her grammar of recovery, recovery narratives are not only the product of a process of meaning-making and self-understanding, but they can create meaning and new realities. Furthermore, this process, according to Wannberg, has an inherently social and normative quality to it: the self-work that occurs in recovery and the recovery narrative involves the development of agency, autonomy, and responsibility in a social world... (shrink)

The present research paper focuses its objective on clarifying the arguments for establishing the Competency to use the knowledge as the intensively required criteria of knowledge in the present global scenario. For a clear and precise understanding, the present paper has three objectives. The first objective of the present paper is set to deal with definition of the competency of knowledge in general and reflect upon the theories of Competency as given in Indian and Western Philosophy. The second aim of (...) the research paper will be to examine how far the criteria of Competency includes all vital criterion of knowledge truth like universality, certainty and necessity leading towards the objectivity fulfilling the verification and falsification criteria in the process of competent performance and use of knowledge by the performer or user. And lastly the concluding part of present research paper, we shall make an attempt to exhibit how Competency is quintessential requirement in all the field-for example narrative form of knowledge, in the process achieving higher level experience and introspection based knowledge in Yoga and Meditation. (shrink)

We argue that theory-of-mind (ToM) approaches, such as “theory theory” and “simulation theory”, are both problematic and not needed. They account for neither our primary and pervasive way of engaging with others nor the true basis of our folk psychological understanding, even when narrowly construed. Developmental evidence shows that young infants are capable of grasping the purposeful intentions of others through the perception of bodily movements, gestures, facial expressions etc. Trevarthen’s notion of primary intersubjectivity can provide a theoretical framework for (...) understanding these capabilities and his notion of secondary intersubjectivity shows the importance of pragmatic contexts for infants starting around one year of age. The recent neuroscience of resonance systems (i.e., mirror neurons, shared representations) also supports this view. These ideas are worked out in the context of an embodied “Interaction Theory” of social cognition. Still, for more sophisticated intersubjective interactions in older children and adults, one might argue that some form of ToM is required. This thought is defused by appeal to narrative competency and the Narrative Practice Hypothesis (or NPH). We propose that repeated encounters with narratives of a distinctive kind is the normal route through which children acquire an understanding of the forms and norms that enable them to make sense of actions in terms of reasons. A potential objection to this hypothesis is that it presupposes ToM abilities. Interaction Theory is deployed once again to answer this by providing an alternative approach to understanding basic narrative competency and its development. (shrink)

Understanding social cognition referring to narratives without relying on mindreading skills has been the main aim of the Narrative Practice Hypothesis proposed by Daniel Hutto and Shaun Gallagher. In this paper, I offer a semiotic reformulation of the NPH, expanding the notion of narrative beyond its conventional common-sense understanding and claiming that the kind of social cognition that operates in implicit false belief task competency is developed out of the narrative logic of interaction. I will try to (...) show how experience is shaped through meaning by the structure of narrativity and the way this can account for how narrative competencies do not just depend on language acquisition, but permeate the interactive competencies of pre-linguistic children and some social non-human animals. Developing during primary and secondary intersubjectivity and rooted in the semiotic ability to deceive and manipulate others, semiotic narrativity is the key bridge that leads us to mind and beliefs starting from basic perceptions, emotions and embodied enactive interactions. I will test my Narrative Practice Semiotic Hypothesis on Autism spectrum disorders, where social cognition skills don’t work properly, connecting NPSH to the Social Motivation Theory of Autism. I will finally answer some criticisms towards the original NPH, connecting its semiotic reformulation to early mindreading in infants and to some very recent experiments by Krupeneye et al. and Buttelmann et al. about false beliefs understanding in primates. (shrink)

Cultural appropriateness has become an important conceptual tool for health care professionals serving diverse patient populations. Physicians and other health care providers working in urban communities are increasingly challenged to provide care that is responsive to the health needs and beliefs of immigrants, refugees and other newcomers to mainstream health services. This paper argues that notions of cultural 'sensitivity' or 'competency' help health practitioners acknowledge professional and biomedical biases, but also risk dehistoricizing and hence disempowering newcomers by failing to recognize (...) culture as a dynamic process. Without attention to the ways in which newcomers actively produce culture and make sense of illness experience, health care workers ignore the contexts in which people. become ill and hence cannot act as healers. By presenting the case of one newcomer to the Canadian health care system, I argue that narratives provide a valuable tool for health practitioners to understand how newcomers actively engage and come to terms with illness, without defining them as determined by a set of cultural beliefs or practices. (shrink)