Ethics Grand Rounds – St. Michael’s Hospital

Paul & Evelyn Higgins Conference Room, 2010 Bond

"What's the Story?: The ethical value of sharing patients' narratives as a team"
Presenter: Marnina Norys, PhD, Clinical and Organizational Ethics Fellow, Centre for Clinical Ethics
In this talk I'll be discussing narrative medicine and will aim to show how showing how patients’ narratives can support their autonomy by giving patients a say in the identity team members confer upon them. Secondly, I shall demonstrate, using examples from assertive community treatment team meetings I observed, how sharing stories can disrupt the entrenchment of biased or one-dimensional perceptions of patients and thereby contribute to better patient-centred care. Thirdly, I will show how sharing stories helps cultivate care for clients while also helping workers demonstrate this care to clients. In the end I shall address concerns that I am recommending workers spend time simply gossiping about patients by contrasting the type of storytelling I am endorsing with “triangling,” a way of communicating about others identified in psychotherapeutic literature that is dysfunctional (Bowen, 2012), and likely unethical.

Learning Objectives:

• Describe narrative medicine and understand how its proponents view patient narratives.
• Gain an understanding of how ACT teams (sometimes) treat narrative in practice.
• Begin to appreciate the ethical value of sharing patients’ narratives as a team.
• Appreciate the difference between sharing stories for a therapeutic purpose and dysfunctional ways of discussing others.