Ricoeur’s hermeneutic arc and the “narrative turn” in the ethics of care

Abstract

Abstract“Patient-centred care” is the recent response to the malaise produced in the field of health care from the point of view both of a technical mentality and the paternalistic model. The interest in the story-telling approach shown by both the humanities and the social sciences has favoured a “narrative turn” in medicine too, where the new ethics of therapeutic relationship consider the hermeneutic method a means by which to integrate evidence and subjectivity, scientific data and patient experience. The aim of this paper is to show how Ricoeur’s theory of “threefold mimesis” makes a conceptual contribution to the use of narrative interviews in nursing and also be successfully transferred into and applied in the field of healthcare in general. First, the paper examines how this narrative approach might open up new possibilities for the acquisition of in-depth knowledge of patients’ life experiences, a condition indispensable for the improvement of the quality of care. Secondly, it highlights how this Ricoeurian method seems capable of provide an opportunity for healthcare professionals to review their own understanding of the caregiver-patient therapeutic relationship, beginning with their confrontation with the patient’s world as revealed by the narrative they provide.

An Unexpected Journey: The Lived Experiences of Patients with Long-Term Cognitive Sequelae After Recovering from COVID-19

“…Narratives of lived experience conveniently grasp the complexity of medical activity and the multidimensional reality of disease. This is essential when addressing health and healthcare, as they are non-linear phenomena which emerge from different components and clinical decisions, and need to be properly refined in order to accommodate the individual patients’ needs and circumstances ( Russo, 2021 ).…”

Public health nurses’ professional dignity: An interview study in Finland

“…Public health nurses acknowledge their professional dignity in mutual relationships with patients. This relational part of dignity, well emphasised in an ethics of care [64][65][66] and by various scholars, 67,68 deals with the social part of dignity. This describes dignity as the essence of relationships and human encounters.…”

Is the Mzungu phenomenon a help or hinderance?

“…The Three-fold Mimesis does not refer to an imitation of reality, rather; in the Aristotelian notion it describes the process by which narrative interpreters attain complete comprehension, obtained by revealing the traces of meaning hidden within a narrative transcript (Russo, 2021). Ricoeur's (1984) mimesis comprises three components of narrative theory, corresponding with his theory of interpretation; prefiguration (spontaneous and immediate relationship with the emotionally-experienced world), configuration (narrative construction and temporally organised narrative), and refiguration (return to the world of acting and of suffering, strengthened by previous experience and a new understanding of the world which have an impact at ethical level).…”

“…Mimesis 1 pertains to life as it is before being articulated into verbal or written narratives, constituted by existential conditions such as hope, fear, courage, spirit, unease and suffering (Missel & Birkelund, 2020;Russo, 2021). Corresponding with Husserl's conceptualisation of lifeworld, mimesis 1 refers to the everyday pre-scientific world encompassed by existential phenomena that influence the situation of the individual, in positive or negative ways (Missel & Birkelund, 2020).…”

“…109). Although distanciation is framed as objectifying the text, the interpretive hermeneutic ontology is maintained in that the "knower" is connected with the "known", within a process that seeks to allow broader interpretative scope to facilitate the "Refiguration" stage in Mimesis III (Geanellos, 2000;Russo, 2021;Charalambous et al, 2008).…”