Defense Date

4-8-2022

Graduation Date

Spring 5-13-2022

Availability

Immediate Access

Submission Type

dissertation

Degree Name

PhD

Department

Health Care Ethics

School

McAnulty College and Graduate School of Liberal Arts

Committee Chair

Joris Gielen

Committee Member

Gerard Magill

Committee Member

Peter Ikechukwu Osuji

Keywords

Narrative, medicine, ethics, storytelling, healthcare, global health, clinical ethics, Narrative Authority, Multicultural Ethics, Western biases

Abstract

Technological advances and globalization are transforming healthcare dramatically. But unfortunately, current medical practices remain blind to their multicultural patients’ varied worldviews and norms, especially in the West. As a result, patients often find themselves isolated, anxious, and resentful.

All the humanistic models in the current literature view the individual as a unique and autonomous being and, in turn, provide practices to access and recognize the patient’s personhood. These models—Narrative Medicine, Narrative Ethics, and Ethics of Care—attempt to catch sight of the individual, the person’s situation, and some semblance of the person’s story before diagnosing or offering prescriptions. However, all these models have been derived from predominantly White, Western, scholars and the models lack concrete directions or specific tools to respond to the patient’s humanness and the story-founded social nature of being in the service of providing good care.

The thesis presents a complementary, human-centric, narrative-driven model: Narrative Authority (NA). NA embraces components of the existing models and proposes a modified, integrated, and expanded version of the notions that ground Narrative Medicine, Narrative Ethics, and Ethics of Care. In addition, NA claims to be more attuned to the nature of human interactions, more culturally sensitive, and importantly provides specific application tools: Open Listening (not knowing), Storied Hearing (attention to), and Shared Healing (responding to). This dissertation aims to positively transform contemporary medicine via a perspective and a method that is thoroughly other-oriented, dialogue-based, culturally sensitive, nonjudgmental, and always story-dependent. The phenomenological investigation of NA presents a method to respond to the lived, experiential nature of illness, suffering, obligations, beliefs, norms, and responsibilities.

Further, the model proposed in the thesis is applied through examples ranging from the local to the global, from the interpersonal to organizational. This multifaceted applicability demonstrates the versatility of the NA. Such versatility is possible because the model is constructed on the foundational nature of human beings as relational and narrative based. The model is further applied to actual, current examples throughout the dissertation to show how components of NA can be implemented in different situations and among various populations. The dissertation intends to show how Narrative Authority offers an innovative model and complementary humanistic approach to care, and it provides an ethical justification of the importance of embracing Narrative in our care practices.

Language

English

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