Narrative Medicine and Health Care Ethics: Religious and Literary Approaches to Patient Identity and Clinical Practice
Date of Award
Doctor of Philosophy (PhD)
This dissertation examines practices of narrative medicine and moral identity for end-of-life patients, with special attention given to Aristotle's Poetics and the work of Paul Ricoeur. While noting the genuine value of narrative medicine for clinicians, I examine the limits of self-narration for patients who are unable to offer a linear, coherent narrative of their lives due to cognitive deficits such as Alzheimer's disease. Nevertheless, the premise of narrative medicine, that being a close reader of texts can develop the ability to attend closely to patients, remains useful. When the sources used in narrative medicine are expanded to include those found in modern literature€”a genre known for disrupting language, character, plot, and the expectations of the reader€”the joint study of literature and medicine continues to be pedagogically viable for clinicians working with verbally or neurologically compromised patients. In Chapter Four, plays by Samuel Beckett, specifically Rockabye and Krapp's Last Tape, are approached as narrative case study to highlight the ways in which technology, structural space, attenuated relationships, difficult personalities, and limited verbal and cognitive ability come together to compound the challenges of approaching a patient with the assumption that they have a narrative arc.
For patients so challenged, I suggest that the practice of hospitality as it exists in the hospice model of care transcends the need for higher-level cognition commonly associated with narrative medicine. In the final chapter, I demonstrate how the hospice model of care recognizes both the value and the limits of narrative practices as they apply to end-of-life patients, and provides a treatment model for patients regardless of their verbal and cognitive abilities.
Flanagan Tracy, Tara, "Narrative Medicine and Health Care Ethics: Religious and Literary Approaches to Patient Identity and Clinical Practice" (2017). Dissertations. 2799.
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Copyright © 2017 Tara Flanagan Tracy