This chapter outlines ways in which narrative methods can be useful in guiding the critical first step in ethics consultation—constructing the description of the case. Knowing what information to gather, how to gather it, and how to interpret it are all essential parts of the skill and art of ethics consultation. Narrative methods, with their attention to issues of narrative frame, voice, and interpretative skill, can help ensure that information is gathered and interpreted in an appropriate and competent fashion. Narrative methods can sharpen our attunement to issues of how the narratives of a case or ethical dilemma are constructed, whose voices are given authority, which plot lines are considered relevant, and which possible resolutions are given consideration. And finally, narrative methods can provide the necessary foundation for the normative work that follows.
As I reflect on how I structure ethics consultations, I am struck by the powerful contribution narrative methods have made, and by how incomplete or problematic my consultations would have been without the steady influence of a narrative approach. 1 I am cognizant too that, while I make active use of narrative methods, I do not rely on them exclusively, particularly when it comes to engaging ethics committees in the hard work of normative reflection once the stories and stakeholders are gathered together in one room. From this experience I have learned that while narrative methods have much to contribute at the descriptive level of ethics consultation, their application at the normative level may be more limited. In what follows I will trace the influence narrative methods have had on my approach to ethics consultation and describe both the use to which narrative methods can be put and the resistance there may be to employing them.
My practice is structured according to the belief that ethics consultation is performed best when it is nested in an ongoing moral community dedicated to creating and holding open the moral space necessary for genuine reflection and discourse. 2 Rather than delegating the task of ethics consultation to a single “expert” or to a small group of dedicated individuals, 3 I advocate the model of a full, diverse, and broadly constituted ethics committee collaborating with an ethicist to do case consultations 4 using a thorough intake process and a deliberate