Telling, Hearing, and Believing: A Critical Analysis of Narrative Bioethics

AbstractNarrative ethics taps into an inherent human need to tell our own stories centred on our own moral values and to have those stories heard and acknowledged. However, not everyone ’s words are afforded equal power. The use of narrative ethics in bioethical decision-making is problematized by a disparity in whose stories are told, whose stories are heard, and whose stories are believed. Here, I conduct an analysis of narrative ethics through a critical theory lens to show ho w entrenched patterns of narrative neglect in medicine are harming not only our capacity to make use of narrative ethics but also our capacity to deliver effective healthcare. To illustrate this point, I use three examples where the patient’s gender affects how their stories unfold: autism, weight , and pain management. From these, I argue that the use of narrative ethics without the application of a critical theory lens risks the exacerbation of what Miranda Fricker refers to as “testimonial injustice,” the prima facie harm experienced by individuals whose credibility is undermined by ot hers’ prejudices. Finally, I suggest that narrative ethics can be a powerful tool for mitigating oppressive practices in medicine if we couple it with critical analysis that enables us to understand the power dynamics at play in storytelling.
Source: Journal of Bioethical Inquiry - Category: Medical Ethics Source Type: research

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AbstractAutism spectrum disorder (ASD) is a neurodevelopmental disorder associated with many systemic comorbidities, including sensory dysfunctions. A growing body of literature explored patients ’ unusually intense reactions to innocuous sensory stimuli but very little is known about ASD patients’ response to noxious stimuli such as pain. Patients with ASD are thought to have low sensitivity to pain, but currently, there is no clear consensus on pain responsivity/sensitivity/expression in patients with ASD. Pain is likely a significant source of suffering for patients with ASD, but limited literature suggest t...
Source: Review Journal of Autism and Developmental Disorders - Category: Child Development Source Type: research
Authors: DENTAL SUPPLEMENT, Mummolo S, Sapio S, Falco A, Vittorini OL, Quinzi V Abstract The aim of this study is to evaluate the success of functional rehabilitation of one dental session in patients with severe disabilities such as severe autism, baby bottle syndrome and severe odontophobia, and to assess how patient compliance pre- and post-intervention changes in moderate sedation. Between the beginning of 2016 and the end of 2018, 20 pedodontic patients with severe odontophobia, severe autism and baby bottle syndrome who needed dental treatment came to our attention. Patients were aged between 3 and 12 years, ...
Source: Journal of Biological Regulators and Homeostatic Agents - Category: Biomedical Science Tags: J Biol Regul Homeost Agents Source Type: research
CASE: Thomas is a 13-year-old boy with autism spectrum disorder, attention deficit hyperactivity disorder (ADHD), generalized anxiety disorder, separation anxiety disorder, and major depressive disorder who presented for a follow-up to his developmental and behavioral pediatrician (DBP). His mother describes an increase in symptoms of anxiety and depression for the last 6 weeks, accompanied by suicidal ideation and thoughts of self-mutilation. Before this increase in symptoms, he had been doing well for the last several months with the exception of increasing weight gain, and Abilify was decreased from 5 mg to 2.5 mg at...
Source: Journal of Developmental and Behavioral Pediatrics - Category: Child Development Tags: Challenging Case Source Type: research
Allergic diseases are associated with central and peripheral nervous system diseases such as autism spectrum disorders and eosinophilic granulomatosis with polyangiitis, which frequently causes mononeuritis multiplex. Thus, it is possible that patients with an atopic constitution might develop multifocal inflammation in central and peripheral nervous system tissues. In a previous study in Japan, we reported a rare form of myelitis with persistent neuropathic pain (NeP) in patients with allergic disorders. However, the underlying mechanism of allergic inflammation-related NeP remains to be elucidated. First, we analyzed the...
Source: Frontiers in Neurology - Category: Neurology Source Type: research
In this paper, we conduct a literature survey about various virtual reality (VR) treatments in psychiatry. We collect 36 studies that made use of VR to provide clinical trials or therapies for patients with psychiatric disorders. In order to gain a better understanding of the management of pain and stress, we first investigate VR applications for patients to alleviate pain and stress during immersive activities in a virtual environment. Particularly for anxiety, VR exposure therapies are effective in provoking realistic reactions to feared stimuli. On top of that, the exposure therapies with simulated images are beneficial...
Source: Frontiers in Psychiatry - Category: Psychiatry Source Type: research
ConclusionsInjured children with ASD received fewer medications/injections than children with non-ASD developmental delays/disorders and more surgical treatments than general population children. Injury management was otherwise similar between groups. Understanding whether these results reflect child or injury characteristics or provider perceptions about behaviors and pain thresholds of children with ASD, and how these may influence care, requires further study.
Source: Research in Autism Spectrum Disorders - Category: Psychiatry Source Type: research
This study aimed to investigate a potential correlation between NGF serum levels and brain structural differences in schizophrenia. Furthermore, a potential overlap between the results of a whole brain correlation analysis between GMV and NGF serum levels and the results of GMV reductions in schizophrenia patients were identified in a conjunction analysis.Materials and MethodsSubjectsEighteen schizophrenia patients from the Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital RWTH Aachen, Aachen, Germany, and 19 gender- and age-matched healthy controls from the general population participated in ...
Source: Frontiers in Psychiatry - Category: Psychiatry Source Type: research
Conclusions: Almost one-third of ASD patients in our sample had at least one fGID. The presence of fGID was associated with ID, sleep problems and with behavioral problems (as measured by the prescription of psychotropic drugs). This subsample of ASD patients with fGID deserves particular attention in future research projects, focusing on specific phenotypic characteristics and overlapping biological markers that may underlie both pathologies. Introduction Autism spectrum disorder (ASD) is a pervasive neurodevelopmental disorder characterized by impairments in social communication and restricted, repetitive patterns ...
Source: Frontiers in Psychiatry - Category: Psychiatry Source Type: research
In a blog post last week, I shared an excerpt from the new book that Paul Cerrato and I just completed,The Transformative Power of Mobile Medicine. Here is a second excerpt from Chapter 3,  “Exploring the Strengths and Weaknesses of Mobile Health Apps.”Even patients who are fully engaged in their own care still need access to medical apps they can trust. The IQVIA Institute for Human Data Science has performed a detailed analysis of the clinical evidence supporting mobile health apps, rating their maturity and relative quality. Its rating scale places a single observational study near the bottom of th...
Source: Life as a Healthcare CIO - Category: Information Technology Source Type: blogs
A 15-year-old boy with autism and swallowing dysfunction presented with a 6-month history of fatigue, intermittent abdominal pain, and weight loss. He later became febrile and had multiple episodes of coffee ground emesis and melena stools. An upper endoscopy showed an esophageal mass, and a subsequent 18F-FDG PET/CT scan confirmed this finding. PET/CT also revealed metastatic disease in local lymph nodes, thus upstaging the patient and indicating poor prognosis. Consideration of these severe results and the patient’s quality of life helped guide decision making in patient management, with the ultimate decision to pu...
Source: Clinical Nuclear Medicine - Category: Nuclear Medicine Tags: Interesting Images Source Type: research
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