Narrative and Medicine: Premises, Practices, Pragmatism

Area of Science:

• Medical Humanities
• Narrative Medicine
• Philosophy of Medicine

Background:

• The term "narrative" is widely used in medical education, ethics, and practice.
• However, a singular definition for narrative in healthcare is lacking, leading to underappreciated pluralism in its conceptualization and application.
• Current broad categorizations like "medical humanities" or "narrative medicine" may obscure important distinctions in narrative theory and practice.

Purpose of the Study:

• To provide conceptual clarification of narrative in medicine.
• To distinguish between different conceptualizations and uses of narrative in healthcare.
• To address anxieties surrounding narrative in medicine by reframing them through a philosophical pragmatist lens.

Main Methods:

• Conceptual analysis and sorting of narrative conceptualizations.
• Categorization into "narrative premises" (descriptive/normative claims) and "narrative practices" (process, method, tool).
• Application of a philosophical pragmatist approach to re-evaluate narrative's role in medicine.

Main Results:

• Narrative conceptualizations can be systematically sorted into premises and practices.
• A pragmatist approach reframes concerns about narrative truth and fiction.
• Focus shifts to the justifiability of belief, inclusion of experience, and rationality of medical practices.

Conclusions:

• Clarifying narrative concepts in medicine is crucial for nuanced understanding and application.
• Distinguishing narrative premises from practices enhances theoretical and practical clarity.
• A pragmatist framework offers a productive way to address narrative complexities in healthcare, emphasizing revision and justifiability.