Poetry "Found" in Illness Narrative: A Feminist Approach to Patients' Ways of Knowing and the Concept of Relational Autonomy

Abstract

This project contributes to the improvement of the healing encounter between physician and patient and broadens the scope of medical ethics via application of a methodology that creatively communicates patient experience. Contemporary medical training and socialization can create emotional distance between patients and physicians, which has both positive and negative effects. A physician’s “detached concern” often renders patients’ ways of knowing irrelevant to their care. This has a negative effect on patient autonomy, trust, and the healing encounter in general. Herwaldt (2008) developed a pedagogical tool of distilling patient interviews in narrative form into “found poems,” in which the patient experience is expressed in verse; Herwaldt contends that the resulting poems hold the possibility of cultivating empathy in medical practitioners. My research extends Herwaldt’s work with a new set of ten patients currently in cancer treatment, translating their stories of illness into verse. The resulting poems have the potential to empower patients by legitimizing their narrative or experiential ways of knowing as complementary to physician perspectives and approaches to treatment. Clinical and feminist ethics are similar in their attention to case context, empathy, and legitimacy of narrative. However, there are aspects of feminist ethical theory that are not thoroughly delineated in clinical ethics—specifically, attention to power imbalances in medical structures and variations in ethical perspectives. When the poems are examined using a feminist bioethical framework, patients are empowered by expanding both the idea of justice and the principlist definition of autonomy to include the feminist conception of relational autonomy.