Journal of Bioethical Inquiry

, Volume 7, Issue 4, pp 345–351 | Cite as

Dignity and Narrative Medicine

  • Annie ParsonsEmail author
  • Claire Hooker


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.


Dignity Narrative medicine Narrative ethics Health care 


  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.CrossRefPubMedGoogle Scholar
  2. Beyleveld, D., and R. Brownsword. 2001. Human dignity in bioethics and biolaw. Oxford: Oxford University Press.Google Scholar
  3. Carel, H. 2008. Illness: The cry of the flesh, the art of living. Stocksfield: Acumen.Google Scholar
  4. Charon, R. 2001a. Narrative medicine: A model for empathy, reflection, profession and trust. JAMA 286(15): 1897–1902.CrossRefPubMedGoogle Scholar
  5. Charon, R. 2001b. What narrative competence is for. The American journal of bioethics 1(1): 62–63.CrossRefPubMedGoogle Scholar
  6. Charon, R. 2004. Narrative and medicine. New England journal of medecine 350(9): 862–864.CrossRefGoogle Scholar
  7. Charon, R. 2006. Narrative medicine: Honoring the stories of illness. Oxford: Oxford University Press.Google Scholar
  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.Google Scholar
  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.CrossRefPubMedGoogle Scholar
  10. Concise Oxford Dictionary, The. 1999. Oxford: Oxford University Press.Google Scholar
  11. Conrad, P. 2007. The medicalization of society: On the transformation of human conditions into medical disorders. Baltimore: Johns Hopkins University Press.Google Scholar
  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.CrossRefGoogle Scholar
  13. Edgar, A. 2004. A response to Nordenfelt. Health care analysis 12(2): 81–97.CrossRefGoogle Scholar
  14. Evans, H.M. 2008. Affirming the existential within medicine: Medical humanities, governance, and imaginative understanding. Journal of medical humanities 29: 55–59.CrossRefPubMedGoogle Scholar
  15. Frank, A. 1995. The wounded storyteller. Chicago: The University of Chicago Press.Google Scholar
  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.CrossRefPubMedGoogle Scholar
  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.Google Scholar
  18. Gordon, J. 2005. Medical humanities: To cure sometimes, to relieve often, to comfort always. Medical Journal of Australia 182(2): 5–8.PubMedGoogle Scholar
  19. Haslam, N. 2007. Humanising medical practice: The role of empathy. Medical journal of Australia 87(7): 381–382.Google Scholar
  20. Jacobson, N. 2007. Dignity and health: A review. Social science and medicine 64: 292–302.CrossRefPubMedGoogle Scholar
  21. Jacobson, N. 2009. A taxonomy of dignity: A grounded theory study. BMC International health and human rights 9(3).Google Scholar
  22. Jaggar, A.M. 1998. Globalizing Feminist Ethics. Hypatia 13(2): 7–31.CrossRefGoogle Scholar
  23. Kohlberg, L. 1973. The claim to moral adequacy of a highest stage of moral judgment. The journal of philosophy 70(18): 630–646.CrossRefGoogle Scholar
  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.Google Scholar
  25. Little, J.M. 2002. Humanistic medicine or values-based medicine ... what’s in a name? Medical journal of Australia 177: 319–321.PubMedGoogle Scholar
  26. Mackenzie, C., and N. Stoljar (eds.). 2000. Relational autonomy: Feminist perspectives on automony, agency, and the social self. Oxford: Oxford University Press.Google Scholar
  27. Macklin, R. 2003. Dignity is a useless concept. BMJ 327(7429): 1419–1420.CrossRefPubMedGoogle Scholar
  28. Maslow, A.H. 1970. Motivation and personality. New York: Harper & Row.Google Scholar
  29. Ministry of Health and Social Affairs, Sweden. 2001. Death everybody’s concern. Stockholm: Swedish Government Official Report.Google Scholar
  30. Nordenfelt, L. 2004. The varieties of dignity. Health care analysis 12(2): 69–81.CrossRefPubMedGoogle Scholar
  31. Nussbaum, M.C. 1990. Love’s knowledge: Essays on philosophy and literature. New York: Oxford University Press.Google Scholar
  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.Google Scholar
  33. Pullman, D. 2002. Human dignity and the ethics and aesthetics of pain and suffering. Theoretical medicine 23: 75–94.CrossRefGoogle Scholar
  34. Rimmon-Kenan, S. 2006. What can narrative theory learn from illness narratives? Literature and medicine 25(2): 241–254.CrossRefPubMedGoogle Scholar
  35. Sakalys, J.A. 2003. Restoring the patient’s voice: the therapeutics of illness narratives. Journal of holistic nursing 21: 228.CrossRefPubMedGoogle Scholar
  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.Google Scholar
  37. Stepien, K., and A. Baernstein. 2006. Educating for empathy: A review. Journal of general and internal medicine 21: 524–530.CrossRefGoogle Scholar
  38. Taylor, D. 2001. Tell me a story: The life-shaping power of our stories. St. Paul: Bog Walk Press.Google Scholar
  39. Toombs, S.K. 2004. Living and dying with dignity: Reflections on lived experience. Journal of palliative Care 20(3): 193–200.PubMedGoogle Scholar
  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.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media B.V. 2010

Authors and Affiliations

  1. 1.Royal Prince Alfred Hospital, Clinical SchoolCamperdownAustralia
  2. 2.Centre for Values, Ethics and Law in MedicineUniversity of SydneySydneyAustralia

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