Patient stories, narratives of resistance and the ethics of humane care: a la recherche du temps perdu.
Over the past 20 years, the study of patient-physician relationships and the discourse of clinical encounters has become a major area of inquiry. Interest in these topics is closely linked to an ethic of humane care, reflecting widespread criticism of a technocratic approach to clinical practice. A narrow framing of this approach led to the neglect of a category of patients' socially grounded accounts of their illness and treatment experiences referred to as 'narratives of resistance'. The problem addressed in this article is the lack of connection, in research and practice, between an approach grounded in a humane care ethic and an ethic of social justice that addresses the impact of social and economic inequalities on rates of illness and access to health care. The aim is to open up a critical discussion among researchers, health care educators, practitioners and patients about relationships between ethical standpoints, clinical practice and research.
Mishler
Elliot G
EG
Harvard Medical School, MA 02139, USA. emishler@comcast.net
D003142:Communication; D005260:Female; D006801:Humans; D008297:Male; D033262:Narration; D017060:Patient Satisfaction; D010817:Physician-Patient Relations / Q000941:ethics*; D012935:Social Justice / Q000941:ethics*