From method to hermeneutics: which epistemological framework for narrative medicine?
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The past 10 years have seen considerable developments in the use of narrative in medicine, primarily through the emergence of the so-called narrative medicine. In this article, I question narrative medicine’s self-understanding and contend that one of the most prominent issues is its lack of a clear epistemological framework. Drawing from Gadamer’s work on hermeneutics, I first show that narrative medicine is deeply linked with the hermeneutical field of knowledge. Then I try to identify which claims can be legitimately expected from narrative medicine, and which ones cannot be. I scrutinize in particular whether narrative medicine can legitimately grasp the patient’s lived experience of his or her illness. In the last section of this article, I begin to explore the potential usefulness of this epistemological clarification. This analysis allows for a further understanding of what is really at stake with narrative medicine, and thus to identify when it may be convenient, and when it may not. Furthermore, this clarification opens up promising new possibilities of dialogue with critics of the field. I conclude that narrative medicine finds its proper place as a possible tool available to mediate dialogue, which is at the heart of the clinical encounter in medical practice.
KeywordsNarrative medicine Hermeneutics Epistemology Gadamer Personalized medicine
The author would like to thank Sofia Lizza for her help in editing the initial manuscript and Daniel T. Kim for his helpful suggestions.
Compliance with ethical standards
Conflict of interest
The author declares that he has no conflict of interest.
This article does not rely on any studies with human participants or animals performed by the author.
- 1.Charon, Rita. 2006. Narrative medicine: Honoring the stories of illness. New York: Oxford University Press.Google Scholar
- 7.MacIntyre, Alasdair. 1981. After virtue: A study in moral theory. Notre Dame: University of Notre Dame Press.Google Scholar
- 11.Gadamer, Hans Georg. 2004. Truth and method. trans. Joel C. Weinsheimer and Donald G. Marshall. New York: Continuum.Google Scholar
- 15.Charon, Rita. 2007. What to do with stories: The sciences of narrative medicine. Canadian Family Physician 53: 1265–1267.Google Scholar
- 17.Husserl, Edmund. 1960. Cartesian meditations: An introduction to phenomenology. trans. Dorion Cairns. The Hague: M. Nijhoff.Google Scholar
- 25.Ricœur, Paul. 1991. From text to action. Evanston: Northwestern University Press.Google Scholar
- 26.Gadamer, Hans Georg. 1996. The enigma of health: The art of healing in a scientific age. trans. Jason Gaiger and Nicholas Walker. Stanford: Stanford University Press.Google Scholar