Stories Matter: The Role of Narrative in Medical Ethics

Narrative capacity seems to be an innate human ability. ¹ However natural a Part of the human equipment, narrative skill can be developed by exposure to environments rich in stories. Thus, even if people were all born with exactly the same narrative capacity, the narrative competence of adults would vary. Just as natural musical talent can be enhanced by the study and practice of music, narrative capacity can be enhanced by the study of literature and the interpretation of complex texts. One consequence of the increasing interest in narrative ethics is the need to think about the kind of training that can enhance the natural narrative capacities of those ethicists whose professional training has not been focused on the study of literature or narrative.

Before good answers can be offered as to how such training can be provided, the more basic question must be answered: What are the narrative skills that help clinicians and ethicists carry out their work? Narrative competence for clinical and ethical work includes at least the following skills: first, the reading and interpreting of complex texts; second, the writing and oral telling of complex clinical and ethical texts; third, the interpersonal relational and empathic capacities that depend upon mastery of the first and second set of skills; and fourth, the ability to think with stories.

Reading and interpreting complex texts requires learning to ask and answer such questions as: Who is the narrator? Is the narrator reliable? From what perspective or point of view is the story told? What does this perspective leave out? Who are the other potential narrators of this story? What might their perspectives add? How can differences between narrators’ stories be reconciled? What do individual readers bring to the story that influences their interpretations? How can differing interpretations be reconciled? If they can’t be reconciled, how should a reader handle such ambiguity? What patterns emerge from the accumulating

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