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Dignity and Narrative Medicine

Abstract

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.

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References

  1. Basta, L., and J. Tauth. 1996. High technology near the end of life: setting limits. Journal of the American College of Cardiology 28(6): 1623–1630.

  2. Beyleveld, D., and R. Brownsword. 2001. Human dignity in bioethics and biolaw. Oxford: Oxford University Press.

  3. Carel, H. 2008. Illness: The cry of the flesh, the art of living. Stocksfield: Acumen.

  4. Charon, R. 2001a. Narrative medicine: A model for empathy, reflection, profession and trust. JAMA 286(15): 1897–1902.

  5. Charon, R. 2001b. What narrative competence is for. The American journal of bioethics 1(1): 62–63.

  6. Charon, R. 2004. Narrative and medicine. New England journal of medecine 350(9): 862–864.

  7. Charon, R. 2006. Narrative medicine: Honoring the stories of illness. Oxford: Oxford University Press.

  8. Charon, R. 2008. The ethicality of narrative medicine. In Narrative research in health and illness, ed. B. Hurwitz, T. Greenhalgh, and V. Skultans. Oxford: Blackwell.

  9. Chochinov, H.M., T. Hack, T. Hassard, L.J. Kristjanson, S. McClement, and M. Harlos. 2005. Dignity therapy: A novel psychotherapeutic intervention for patients near the end of life. Journal of clinical oncology 23(24): 5520–5525.

  10. Concise Oxford Dictionary, The. 1999. Oxford: Oxford University Press.

  11. Conrad, P. 2007. The medicalization of society: On the transformation of human conditions into medical disorders. Baltimore: Johns Hopkins University Press.

  12. Coulehan, J. 2007. Dying with dignity: The story reveals. In Perspectives on human dignity: A conversation, ed. J. Malpas and N. Lickiss, 209–223. Dordrecht: Springer.

  13. Edgar, A. 2004. A response to Nordenfelt. Health care analysis 12(2): 81–97.

  14. Evans, H.M. 2008. Affirming the existential within medicine: Medical humanities, governance, and imaginative understanding. Journal of medical humanities 29: 55–59.

  15. Frank, A. 1995. The wounded storyteller. Chicago: The University of Chicago Press.

  16. Gallagher, A., S. Li, P. Wainwright, I. Jones, and D. Lee. 2008. Dignity in the care of older people—a review of the theoretical and empirical literature. BMC Nursing 7(1): 11.

  17. General Comment No. 14: The Right to the Highest Attainable Standard of Health (Article 12 of the International Covenant on Economic, Social and Cultural Rights). 2000. Adopted by the Committee on Economic, Social and Cultural Rights on 11 May 2000.

  18. Gordon, J. 2005. Medical humanities: To cure sometimes, to relieve often, to comfort always. Medical Journal of Australia 182(2): 5–8.

  19. Haslam, N. 2007. Humanising medical practice: The role of empathy. Medical journal of Australia 87(7): 381–382.

  20. Jacobson, N. 2007. Dignity and health: A review. Social science and medicine 64: 292–302.

  21. Jacobson, N. 2009. A taxonomy of dignity: A grounded theory study. BMC International health and human rights 9(3).

  22. Jaggar, A.M. 1998. Globalizing Feminist Ethics. Hypatia 13(2): 7–31.

  23. Kohlberg, L. 1973. The claim to moral adequacy of a highest stage of moral judgment. The journal of philosophy 70(18): 630–646.

  24. Lekan-Rutledge, D., and J. Colling. 2003. Urinary incontinence in the frail elderly: Even when it’s too late to prevent a problem, you can still slow its progress. American journal of nursing 103: 36–46.

  25. Little, J.M. 2002. Humanistic medicine or values-based medicine ... what’s in a name? Medical journal of Australia 177: 319–321.

  26. Mackenzie, C., and N. Stoljar (eds.). 2000. Relational autonomy: Feminist perspectives on automony, agency, and the social self. Oxford: Oxford University Press.

  27. Macklin, R. 2003. Dignity is a useless concept. BMJ 327(7429): 1419–1420.

  28. Maslow, A.H. 1970. Motivation and personality. New York: Harper & Row.

  29. Ministry of Health and Social Affairs, Sweden. 2001. Death everybody’s concern. Stockholm: Swedish Government Official Report.

  30. Nordenfelt, L. 2004. The varieties of dignity. Health care analysis 12(2): 69–81.

  31. Nussbaum, M.C. 1990. Love’s knowledge: Essays on philosophy and literature. New York: Oxford University Press.

  32. Nussbaum, M., and A. Sen. 1989. Internal criticism and Indian rationalist tradition. In Relativism: Interpretation and confrontation, ed. M. Krausz. Notre Dame: University of Notre Dame Press.

  33. Pullman, D. 2002. Human dignity and the ethics and aesthetics of pain and suffering. Theoretical medicine 23: 75–94.

  34. Rimmon-Kenan, S. 2006. What can narrative theory learn from illness narratives? Literature and medicine 25(2): 241–254.

  35. Sakalys, J.A. 2003. Restoring the patient’s voice: the therapeutics of illness narratives. Journal of holistic nursing 21: 228.

  36. Shell, S. M. 2008. Kant’s concept of human dignity as a resource for bioethics. In Human dignity and bioethics: Essays commissioned by the president’s council on bioethics, 333–349. Washington.

  37. Stepien, K., and A. Baernstein. 2006. Educating for empathy: A review. Journal of general and internal medicine 21: 524–530.

  38. Taylor, D. 2001. Tell me a story: The life-shaping power of our stories. St. Paul: Bog Walk Press.

  39. Toombs, S.K. 2004. Living and dying with dignity: Reflections on lived experience. Journal of palliative Care 20(3): 193–200.

  40. Zhang, X., and D.C. Grabowski. 2004. Nursing home staffing and quality under the nursing home reform act. The gerontologist 44(1): 13–23.

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Correspondence to Annie Parsons.

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Parsons, A., Hooker, C. Dignity and Narrative Medicine. Bioethical Inquiry 7, 345–351 (2010). https://doi.org/10.1007/s11673-010-9254-2

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Keywords

  • Dignity
  • Narrative medicine
  • Narrative ethics
  • Health care