NARRATIVE ETHICS AND INSTITUTIONAL IMPACT
What effect might a narrative “turn” in ethics have upon health care institutions? While much more work needs to be done to define “narrative ethics,” I am interested in what Hilde Nelson has classified as telling, comparing, and invoking stories; that is, using narrative as part of moral reasoning, rather than merely as illustrative of moral conclusions derived from other methods of reasoning.1 Arthur Frank has succinctly characterized narrative reasoning as thinking with stories rather than thinking about stories.2 Regarding what narrative ethics is not, I shall adopt the blanket term principlist to refer to the most popular, non-narrative ways we have to approach medical-ethical decision-making today. Rita Charon, for one, has suggested that principlist and narrative ethics are ultimately complementary rather than competing.3 I would prefer to keep open the prospect that principlist ethics will be shown someday to have irreducibly narrative roots. But we need not resolve this question here.