In Peter D. Kramer’s New York Times piece published in the
‘Couch’ section on October 18, 2014 (Why
Doctors Need Stories) he affirms the experience of learners, educators, and
researchers in his arguments that a case vignette can provide a kind of
instruction that cannot be duplicated by data collection alone. While we do
still need evidence based material to assure safety and efficacy of treatments,
the case study offers contextual material that makes the evidence come to life.
As a Clinical Ethicist each clinical encounter is rich with
substantive information that is part of an individual or family story
intersecting with the healthcare setting. When invited to provide input,
support, or recommendations in any given case, the most informative elements of
any case are the story of the patient. What was before, what is now, and what
the future may require is different for each patient, and I am often awed by
the ‘before.’ The contextual landscape of each story is often where we come to
understand the psychosocial factors that weigh heavily in how a patient,
family, or community interacts with the healthcare community. Hard data is not
as useful as hearing the story that belongs to the patient.
Medical students must learn the complex labyrinth of
physician roles, hierarchies, and politics while learning to deliver good care
to patients. It is an exhausting, fascinating, and at times a discouraging
process that students must somehow find a way to navigate. Using case studies
to start the conversations about what learning medicine is like has been an
invaluable teaching tool at our institution.
The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.