Abstract

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One of the effects of broad social and political transformations has been the distrust of professional self-regulated work models and decisions; in medical care, an increasingly patient-centred perspective claims that patients should be listened to, informed and involved in the treatment thus requiring health care professionals to rethink their relationship to them.  This has been partly possible within the prevalent framework of evidence-based medicine (EBM), and especially in Anglophone countries, by the development of Medical Humanities (MH) (or Health Humanities – Crawford 2015) and through the practices of Narrative Medicine (NM).  However, a certain indistinction between these two types of approach still persists, notwithstanding very recent attempts at clarification (Hurwitz 2015, Charon 2016), suggesting the need for further interrogation and critical evaluation. Broadly and theoretically speaking Medical Humanities can be seen as drawing on interdisciplinarity within the arts, the social sciences and the humanities to offer new perspectives and a renewed approach to rethink past and present day healthcare, while Narrative Medicine focuses more directly on the use of narrative and communication to enhance today’s doctor-patient relationship in clinical practice and training. But, in fact, doctors, scholars and university programmes in both fields deal indiscriminately with diverse subjects / questions such as: the humanistic study of medicine: for example, history of medicine or the critical appraisal of medicine in literature; arts for health – arts in healthcare settings or arts activities with patients; arts therapies – using arts media within a psychotherapeutic framework (Bates, Bleakey and Goodman 2014); Narrative Medicine protocols – how doctors learn to diagnose and treat from exposure to patients’ stories (Montgomery & Hunter 1991, Charon 2006); enhancement of ethical questions through NM and MH approach to health care; narrative approaches to medical practice, through the understanding of complex and hybrid narrative and communicative structures / strategies (Carelli 2010, Cabral 2017); study of patients’ stories (as in socionarratology - Frank 2010, 2013) as avenues for a first-person experience and a fuller understanding of illness (Carel 2008); study of doctors’ narratives (for example, the use and importance of clinical case reports in history - Hurwitz 2017, or the use of the ‘parallel chart’ - Charon 2006); metanarratives – grand narratives on sociocultural understandings of the body in health and illness (for example, history of the body, the dichotomy of pain - Morris 1991). Based on this multiplicity of perspectives we invite participants in this panel to reflect on the boundaries, methods, objects, claims and impact of Medical Humanities and Narrative Medicine. More specifically we raise the following questions:

• What criterions should be taken into account to differentiate / relate these different areas? 

• Is there a tension between NM and MH or are they reconcilable?

• Should medicine and health subjects, studied from a humanistic or social sciences’ viewpoint, be clearly separated from the clinical practice training?

• Should MH encompass both humanistic approaches to healthcare and the social sciences’ protocols or should MH exclude the latter?

• What contributions can MH and / or NM give to the training of medical / nursing and other students and healthcare professionals?

• Should MH or NM intervene beyond compulsory medical education (Ma, PhD, other grades and diplomas) or from graduation level?

• Is NM’s triad – attention, representation and affiliation (Charon 2016) – a self-defining, exclusive feature of this area?

• Should narratives derived from social science research and from medical practice and patient encounters be seen as a source of evidence, beyond the gold standard of randomized controlled trials of EBM?

• Should art therapies be considered as a distinct area from those addressed by NM and MH?

 

Session organizer(s)

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Isabel Fernandes (PT) – is Professor of English at the School of Arts and Humanities of the University of Lisbon and Scientific Coordinator of the Narrative & Medicine interdisciplinary and international project. With a PhD in English Literature, she has published extensively on several British authors: D. H. Lawrence, Emily Brontë, Jane Austen, Joseph Conrad, A. S. Byatt and Ted Hughes, among others. Besides English literature, her areas of expertise include narratology and literary theory as well as inter-art studies (namely Literature and Painting). She has published the following books: Olhar a Escrita: Para uma Introdução ao Estudo da Literatura na Universidade (2004), Critical Dialogues: Slow Readings of English Literary Texts (2011) and Literatura: a (in)disciplina na intersecção dos saberes e das artes (2011). More recently she directed, edited and collaborated in the following volumes: Contar (com) a Medicina (2015, republ. 2016) and Creative Dialogues: Narrative and Medicine (2015).

 

Alda Maria Correia (PT) – is Assistant Professor at the Faculty of Social Sciences and Humanities of New University of Lisbon, where she has taught Comparative Literature and Literary Studies, and a researcher of the Project Narrative and Medicine: (con) texts and practices across disciplines. Her areas of study include short fiction history and theory, narratology, comparative literature, regionalist literature and narrative medicine. Some publications: A Quarta Dimensão do Instante - estudo comparativo da epifania nos contos de Virginia Woolf, Katherine Mansfield e Clarice Lispector, Lisboa, Universitária Editora, 2004; “Narrating to improve, narrating to survive” in Storytelling exploring the art and science of narrative, ed. Sara Shafer, Interdisciplinary Press, 2013, pp 135-143. Ebook; “Illness as Journey: Narrative Medicine in the Patient Quest” Cadernos de Literatura Comparada, 30 (Actas do Colóquio “De Idas e Regressos: Declinações da Viagem” 28-30 de Novembro 2013 F. Letras, Universidade do Porto), 2014, pp. 451-461; she co-edited and collaborated in the volume Contar (com) a Medicina (2015, republ. 2016) and Creative Dialogues: Narrative and Medicine (2015).

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