Professional Documents
Culture Documents
Narrative
You are a teenager and have cancer .
Your
physician says that chemotherapy and radiation therapy could be tried, but
(BMT) is your only chance of a cure. He tells you and your parents that you
could die as a result of complications
but without it you would only
live
one year.
You ask what
if the BMT fails, but your
physician and your family tell you that
you must
not think negative
thoughts. You do not ask more questions. The doctor gives your parents the
consent form
only your parents may sign it. The preparation
before the transplant is worse than you imagined
you experience painful
side effects You become fearful because some patients
went to the
PICU
and never came back you do not ask your
family if these patients died neither your family nor your doctor asks
what you would want done if you
need intensive care. One week after
BMT,
you
have trouble breathing.
it gets harder to
breathe and becomes difficult to speak more than two words at a time. You
feel so hungry for air.
A doctor tells you that you
will need help from a ventilator and
they must transfer you to the PICU. You ask
them please, do not send you to the PICU, because you do not want to die there .
You are transferred to the
PICU and are put into
sleep
You undergo a year of chemotherapy and after a brief return to normal life, you have a relapse.
a bone marrow
transplant
real
be expected to
You and your family discuss the alternatives and decide to have the transplant.
will happen
right now
both
any
necessary
had
grapevine,
also
it would be and
BMT
) this month
. Still,
and
ever
before the new marrow has even taken hold in your body,
the
start to
you
As your family watches you struggle to breathe, they become frightened as well.
soon
for this
You and
your parents look to your doctor, who is obviously worried. Your parents ask the doctor to save you; he says that the ventilator is your only chance.
a deep
, as the doctor promised, but eventually you wake up enough to realize that your fingers cannot move and your eyelids will not open. You cannot
speak, and even a grimace is impossible. You are groggy most of the time. The voices of family members, of certain nurses that you come to recognize, occasional music, a light stroking on your arm-these become the highlights of
After weeks
you are
awake
you cannot
move.
They promised you would be asleep. The air
goes into your lungs with so much force that you feel like your lungs are going to
burst, you are choking on the tube in your windpipe. The ulcerations in your mouth
and throat hurt continuously.
worse
is the
realization you are dying.
You want
more medicine to keep your pain and fear under
control. You want
to say goodbye to your family and go home to die, but you cannot move or speak
You die in the PICU
your existence. Time passes slowly and you lose track of the days.
some
Nobody told you that you might be awake but unable to move a muscle.
more
still
that
and
Even
to ask for
dawning
that
better
at all.
You hear the members of your family whisper to each other and they tell you how much they love you, but you cannot respond to them.
Framework
Normative debate in the form of absolutist ethics allow for
privileged debaters to never have to deal with the practical
implications of their arguments and performances. Vincent
Vincent, Christopher J. "Re-Conceptualizing Our Performances: Accountability in Lincoln-Douglas
Debate." VBriefly. N.p., 26 Oct. 2013. Web. <http://vbriefly.com/2013/10/26/201310re-conceptualizingour-performances-accountability-in-lincoln-douglas-debate/>.
We generate universal theories and assume they can be applied to anyone. These abstractions assume a conception of universality that never intended to account for the African American experience. This drowns out the
historically
cornerstone in Lincoln Douglas and in turn have been used to justify exclusion. That is why
bad, or even
for
, they
the debate to be about justifying why racism is bad ignores the reality of the bodies present in the room. Our justification of western philosophy has allowed us to remain disconnected from reality. Philosophy, as Mills argues, justifies
particular way of knowing under free and rational thought, through a universal way of knowing, believing, and discussing. We have embedded white ways of knowing as normative without ever challenging how it replicates
the gaming
of debate allows us to
speech can be disconnected from the
act.
The critical distinction is the
performance of that discourse. Its not what you say, but what you justify.
Debate is
itself a performance. To claim that it is not
is to be divorced from reality
We must evaluate what a debaters
performance does and justifies.
those with privilege in
debate, are never forced to have their performance attached to them but instead
their arguments are viewed as words on paper. They are taught to separate
themselves from ideologies and beliefs, and feel that there is no consequence to
what they say. It becomes the way in which they justify what is deemed as
rational and logical thought.
oppressive structures. The question then becomes how does our discourse justify what we believe? For many debaters it is
assume
aspect
that our
speech
that
The speech can be defined as the arguments that are placed on the flow,
and is evaluated in the context of what is the most logical and rational argument to win the round.
in and of
of what we do.
For white debaters it is easy to view the discourse as detached from the body. For
they
any
The argument sounds like it will be competitive so it is read but it is deemed as just an argument. Judges evaluate this as just a speech. This
becomes what I deem as a performance by the body, rather than a performance of the body.
It is no longer enough
. Students of color are being held to a higher threshold to better articulate why racism is bad, which is the problem in
we
must begin to evaluate the speech act itself. Debaters must be held accountable for
more than winning the debate. They must be held accountable for the implications
of that speech. As educators and adjudicators in debate
we have an ethical
obligation to foster an atmosphere of education.
a space that we deem to be educational. It is here where I shift my focus to a solution. Debaters must be held accountable for the words they say in the round. We should no longer evaluate the speech. Instead
the
space
also
It is not enough for judges to offer predispositions suggesting that they do not endorse racist,
sexist, homophobic discourse, or justify why they do not hold that belief, and still offer a rational reason why they voted for it. Judges have become complacent in voting on the discourse, if the other debater does not provide a clear
enough role of the ballot framing, or does not articulate well enough why the racist discourse should be rejected. Judges must be willing to foster a learning atmosphere by holding debaters accountable for what they say in the
Likewise, judges must be held accountable for what they vote for in the debate space.
If a judge is comfortable enough to vote for discourse that is racist, sexist, or homophobic, they must also be prepared to defend their actions. We as a community do not live in a vacuum and do not live isolated from the larger
society. That means that judges must defend their actions to the debaters, their coaches, and to the other judges in the room if it is a panel. Students of color should not have the burden of articulating why racist discourse must be
rejected, but should have the assurance that the educator with the ballot will protect them in those moments.
as objects of
knowledge, health and morals differ from physical phenomena
For
moral questions, as for questions about the care of patients, absolute or invariant
answers are unobtainable.
scientific reasoning or episteme is inappropriate in
fields like medicine, ethics
disciplines that are interpretive because they are
radically uncertain
Medicine and morals
call for phronesis or practical reasoning, the ability to determine the
best action to take in particular circumstances that cannot be distilled into
universally applicable solutions.
,
It is not that medicine and moral inquiry have no use for certainty or fixed and invariable answers: nothing would make physicians or moral reasoners happier. But
, law, or meteorology,
. Episteme belongs, instead, to stable physical phenomena that can be known through necessary and invariant laws.
(like
circumstances. It enables the reasoner to distinguish, in a given situation, the better choice from the worse. The former is law-like and generalizable to every similar instance, while the latter is inescapably particular and
interpretable, applicable to only a small set of more richly detailed circumstances.
Unlike analytic
philosophers who
work deductively
doctors are trained
beginning with the particular case and then seeking general medical
principles that might apply.
ethical
examination begins with the features of a particular case, then seeks to recall
similar paradigm cases that may shed enlightenment about the best resolution for
the case at hand
a narrative ethics in which the doctor must
work as coauthor with the patient
involves more than
simply recognising the patients autonomy
such a narrative practice is relational and requires the
doctor to be empathic
of the patients suffering
narrative ethics
recognises the primacy of the patients story but encourages multiple voices to be
heard and multiple stories to be brought forth by those whose lives will be involved
Hunters work on the narrative structure of medical knowledge has helped clarify some of the mental processes involved in medical education and practice.20
are trained to
to work in the
opposite direction,
Hunter argues that this practice is not inductive but abductive, as doctors tack back and forth between a particular case and the generalised realm of
scientific knowledge.20,23,24 This process is similar to the ethical practice of casuistry, which was revived and rehabilitated in an influential book by Jonsen and Toulmin. 25 In casuistry,
. Casuistry is, arguably, one form of narrative ethics. But narrative ethics has underlying assumptions that casuistry does not share. Foremost among them is a focus on the patient as
narrator of his or her own story, including the ethical choices that belong to that story. Brody has described
as author. Brody calls it a relational ethic.26 Kleinman27 and Frank28have written about it from differing
perspectives, the doctors and the patients respectively, but both agree that
an
witness
. In an ideal form,
29
in
the resolution of a case.30,31 Patient, doctor, family, nurse, friend, and social worker, for example, may all share their stories in a dialogical chorus32 that can offer the best chance of respecting all the persons involved in a case.33
fictional
unsuccessful
(JAMA)
16 an anonymous, presumably factual account by a doctor who had deliberately given a patient who was
a
states attorney took the journals editor to court to
try to force him to reveal the authors identity.
after Quill
published an eloquently written account of prescribing drugs for a patient who, he
knew, intended to use them to commit suicide he was brought before a grand jury
but was not indicted.
terminally ill with cancer an overdose of analgesics to speed her death,
Cook County
,17
Despite the general legal prohibition against physician assisted suicide in the United States, exemplified by the legal action taken against JAMA and Quill, doctors narratives
Contention One
Marginalizing and silencing bodies in academic spaces like
debate reinstitutionalizes violent hierarchies of oppression.
Brown and Strega
Brown, L., & Strega, S. (2005). Introduction: Transgressive Possibilities. In Research as Resistance:
Critical, Indigenous and Anti-Oppressive Approaches. Toronto, Ontario: Canadian Scholars'
Press/Women's Press.
Traditional
social science
research
silenced
, taking a deficit-
in
the academy, where,
, only certain conceptualizations of information are counted
as valid
subjugated knowledges
have been excluded or trivialized The search for research methodologies that are
capable of grasping the complexities of
the lives of those on the
margins, involves reclaiming these knowledges while
moving away from the
binary conceptualizations fostered under existing research paradigms
informed approach to explaining their lives and experiences. The histories, experiences, cultures, and languages (the ways of knowing) of those on the margins have historically been devalued, misinterpreted, and omitted
as noted
(objective and therefore authoritative) knowledge. In this process, many ways of knowing, which Foucault referred to as
messy
(1980),
simultaneously
in this book focus on racialized, gendered, differently abled, and classed experiences from a strengths-based focus and as sources of strength. Thus, it offers support for marginalized researchers attempting to cleave to the truth of
their own experience. It also offers research ideas for those who are not from the margins, or who occupy both marginal and privileged spaces, but who want to engage in research practices from a position of solidarity with the
there is
a move to
evidence based practice that reinscribes traditional
notions of how knowledge
should be created and assessed, in which what constitutes evidence is understood
securely within a positivist/Enlightenment (White, heterosexual, patriarchal)
framework
marginalized. Practitioners are being encouraged to embrace research as a core feature of practice. As previously noted, in social work at least
positivist
. We suggest that it is no accident that it is particularly the practice professions that are being pushed in this direction. As professions historically and currently dominated by women, they have long
struggled with and for issues of legitimacy. As female-dominated professions and as professions that work with those on the margins, we have been tempted (and have at times in the past) taken the position of proving ourselves
by subjecting ourselves as well as our research methodologies and processes to standards of legitimacy that are ultimately not in our own interests. Now we have a chance to step into the research space that has been opened up by
those on the margins. In acknowledging that previous efforts to develop a critical social science have largely failed to contribute to anti-oppressive practice or policy making, we must ask different questions about how to construct
and conduct our inquiries. This book is therefore for research practitioners in search of transgressive possibility
neutral and objective research has been used to justify the oppression
and genocide of the Other for the good of humankind
[t]he fact that
much research does not confront ideologies of oppression prevents the application
to research of critical knowledge regarding traditional culture, colonial history and
racist structure. This results in research which does not use appropriate concepts as
variables and defines ones culture using the cultural beliefs of another.
Throughout the world such
of accurate representations of Aboriginal peoples in almost every facet of popular culture leads us (Aboriginal peoples) to seek validation in one another. This is a two-edged sword; while Aboriginal peoples are extremely proud of
Aboriginal individuals who become famous in sports, politics, or the media, generalized representations of Aboriginal role models can negate the reality of oppression. A minority of Aboriginal peoples who have successfully
negotiated Western culture are too often held up as proof that the problems of oppression, racism, and inequity can be easily overcome or, worse, that the roots of these problems lie not within institutions or systems of governance
but within Aboriginal peoples themselves.
Is it possible that ethical action might depend less on analytical reasoning than on
responding to a dilemma as we might respond to a story?
By thinking
I mean, a process very different from the exclusive
operation of reason. Thought
involves reasoning, in addition to various forms of
"Thinking with stories" is a concept I borrow from sociologist Arthur W.
cognitive activity
but I want to emphasize that thinking involves a
crucial collaboration with feeling.
the
Western binary habit requires us to put
reason and emotion into separate words and unconnected categories is
a
neurological mistake, with
implications for ethics.
from memory to meditation,
also
In fact,
ancient
that
, I contend,
crucial
with recent discoveries in cognitive science?in order to escape the history of erroneous assumptions about thinking and about ethics, a history that I wish to challenge. The concept of thinking with stories is meant to oppose and mod
Thinking
step back,
ify (not replace) the institutionalized Western practice of thinking about stories. Thinking about stories conceives of narrative as an object. Thinker and object of thought are at least theoretically distinct.
childhood experience
take the
radical
almost a return to
Contention Two
Relying exclusively on universalized ethics to determine
correct action results in an ethical system that we does not
consider the perspectives of excluded Bodies. This justifies
exclusion and violence against non-normative bodies. Yancy
Yancy 5 George, Associate Professor of Philosophy at Duquesne University, Whiteness and the
Return of the Black Body, The Journal of Speculative Philosophy, 19(4), p. 215-216
presumes to speak for all of "us" without the slightest mention of [THEIR]
his or her "raced" identity. Self-consciously writing as a white male philosopher, Crispin Sartwell observes: Left to my own devices, I disappear as an author.
That is the "whiteness" of my authorship. This whiteness of authorship is, for us, a form of authority; to speak
(apparently) from nowhere, for everyone, is empowering, though one wields
power here only by becoming lost to oneself. But such an authorship and authority is also pleasurable: it yields the
pleasure of self-forgetting or [End Page 215] apparent transcendence of the mundane and the particular, and the pleasure of power expressed in the "comprehension" of a range of
materials.
What is key
is the idea that many different
readings of moral
situations and individual lives are possible .
narrativists focus less on trying to
reduce competing perspectives
and more on involving as many people as
possible in the dialogue.
any given situation.
voices and
And, generally,
Anne Hudson Jones summarises this view thus: In ideal form, narrative ethics recognises the primacy of the patients story but encourages multiple voices to be
heard and multiple stories to be brought forth by all those whose lives will be involved in the resolution of a case. Patient, physician, family, health professional, friend, and social workerfor example, may all share their stories in a
, for narrativists,
empathetic listening and support are privileged .
these virtues are
reworked to
accommodate the
view that,
difference is irreducible
dialogical chorus that can offer the best chance of respecting all the persons involved in a case (Hudson Jones A,20 p 222). In turn
acknowledge and
narrative
in some senses,
Howard Brody, for example, radically reconceives the moral demands of empathy in the following passage: In a culture that prizes autonomy and independence, we may fondly imagine that most people are whole and intact, unlike
those who suffer from disease. Charity tends to assume that I start off whole and remain whole while I offer aid to the suffering. Empathy and testimony require a full awareness of my own vulnerability and radical incompleteness;
to be with the suffering as a co-human presence will require that I change. Today I listen to the testimony of someones suffering; tomorrow that person (or someone else) will be listening to my testimony of my own. Today I help
to heal the sufferer by listening to and validating her story; tomorrow that sufferer will have helped to heal me, as her testimony becomes a model I can use to better make sense of and deal with my own suffering (Brody H,27 pp 21
require us to step into anothers shoes in order to understand their pain. It does not
.
mutual understanding.
offer patients the reassurance that they know and understand them, only the acknowledgement that they have listened and heard. On this view too, no health professional is untouched by a patients pain and vulnerability, there is
professional engagement, not detachment. What is refreshing about the account of narrative ethics outlined above is that it introduces the idea that the aim of ethics is not, necessarily, to reduce discord, disunity, and disagreement.
Where principlism is lauded because of its justificatory forcefor example, its supposed objective rules distinguishing between good and bad actions, and its theoretical consistency, by contrast narrative ethics, as we have seen,
slides toward relativism and diversity with seemingly wild abandon (MacIntyre excepted). Some might see this slide as good reason to abandon narrative ethics for the more stable and theoretically satisfying principlist position. What
if, however, one were to view the relativism of narrative ethics not as a failure of comprehensiveness or probity or insight, but rather, as pointing the way toward a reframing of what we understand the task of ethics to be?