Narrative Medicine, as defined by Charon, is primarily targeted at health care professionals, such as physicians, nurses and therapists. Narrative Medicine wishes to complement biomedical models and evidence-based medicine with concepts and methods from the humanities. Thus, close reading, that is the thorough attention to and interpretation of a text, and hermeneutic approaches more generally speaking are core methods of narrative medicine, as they foreground the meaning of a phenomenon. Such approaches seem to conflict with the action-oriented approaches and demands in medical practice. However, close attention to and the interpretation of the diverse meanings of a phenomenon like illness and suffering are also central and unavoidable tasks for patients and their practitioners. As Narrative Medicine argues, literature and art may contribute to a form of patient care that is not solely focused on biomedical paradigms and treatment guidelines and also takes into account that illness and suffering is informed by ambiguities, contradictions as well as psychological and socio-cultural dimensions of illness and health. Narrative Medicine can thus play an important role in the holistic orientation of medical action.
Narrative Medicine is also used as an instrument of self-care. The importance of self-care – especially in view of the alarming rates of burn-out, depression and suicide in the health care professions – has been recognized and included in the 2017 Declaration of Geneva by the World Medical Association. Narrative Medicine offers resources for practitioners to find and locate themselves in the complex meanings of their actions – for others as well as for themselves. Self-reflection, deceleration and a different perspective on language and medical issues more generally are some of the experiences that participants of narrative medicine workshops have described. Literature and art can play an important role in these and other aspects. Importantly, Narrative Medicine aims at creating a space in which the participants can decide which insights they take from their engagement with art. In this sense, the principles and practices of Narrative Medicine differ from approaches where a piece of art is used to promote specific learning objectives, such as a shift in perspective or empathy.
The use of art and literature in health care can also lead to problematic uses when, for example, the aim is to raise compassion rather than concern and (self-)critical questions. Therefore, a transparent, critical and self-critical reflection on the possibilities and limits of Narrative Medicine and similar initiatives in teaching, research and patient care is crucial. The German Network for Narrative Medicine is dedicated to contributing to this discourse.