Towards an Inclusive Narrative Medicine: Reflections on the Limits and Opportunities of Narrative Medicine in Engaging with Diversity

Abstract

Over the past few decades, Narrative Medicine has emerged as a powerful response to the limitations of biomedicine, offering a more empathetic, individualised, and effective approach to healthcare by centering patients’ stories. While acknowledging its considerable benefits, this article critically examines the epistemological constraints and their resulting operational limitations of the narrative paradigm underpinning Narrative Medicine. Drawing on a conceptual analysis of the ambiguities embedded in the notion of “narrative”, it offers a previously unexplored framework to categorise and articulate the growing body of critical perspectives in the field.

The paper argues that the lack of critical scrutiny exposes Narrative Medicine to significant risks: implicit universalism, normative understandings of narrative, and forms of epistemic injustice that ultimately affect clinical practice. Within this framework, the article explores the relationship between narrative, power, and diversity, demonstrating how the current paradigm can marginalise minority groups and atypical subjectivities – including neurodivergent individuals and non-native speakers.

In conclusion, the article advocates for a critical and inclusive rethinking of Narrative Medicine. It calls for the integration of decolonial approaches, communicative pluralism, and the cultivation of narrative communities capable of confronting structural inequalities and broadening the communicative and decision-making rights of all actors within the healthcare process.