Links between narrative and identity have intrigued scholars from many fields, particularly that of medical humanities. Recently, the call for a “narrativization of healthcare” and for paying attention to patients' narratives has had to face the limitations of the narrative form and the claim that one needs to go beyond narrative, even to free oneself from the impulse to narrativize, to grasp the fullness of illness and human experiences. In Ethics in the Conflicts of Modernity (2016), Alasdair MacIntyre addressed criticism that suggested he had exaggerated the role of narrative, beginning with the idea of “things going wrong” with someone's life. In this chapter, the author starts by discussing how this idea of “things going wrong” applies to experiences of illness in order to assess MacIntyre's response to his critics. This will make it possible to address the disputes within the critical medical humanities about limits and potentialities of narratives with an enriched vocabulary from moral philosophy.
We identify a particular action only by invoking two kinds of context, implicitly if not explicitly. We place the agent’s intentions…in causal and temporal order with reference to their role in his or her history; and we also place them with reference to their role in the history of the setting or settings to which they belong. In doing this, in determining what causal efficacy the agent’s intentions had in one or more directions, and how his short-term intentions succeeded or failed to be constructive of long-term intentions, we ourselves write a further part of these histories. Narrative history of a certain kind turns out to be the basic and essential genre for the characterization of human actions. (MacIntyre, 2007, p. 194)
Further on, this argument is completed with the idea that we do so because human action itself:
Has a basic historical character. It is because we live out narratives in our lives and because we understand our own lives in terms of the narratives we live out that the form of the narrative is so appropriate for understanding the action of others. Stories are lived before they are told – except in the case of fiction. (MacIntyre, 2007, p. 212)
It is not possible to explore in the present paper the full extent of the implications MacIntyre draws from these claims, but it is fair to say that they constitute the central nerve of his account of the “narrative unity of human life” and, therefore, of the importance he ascribes to the concept of narrative.
These ideas, of course, go well with Charles Taylor’s later arguments defending a similar role of narrative in human identity, just to name another broadly contemporary prominent and influential take on the topic:
Since we cannot do without an orientation to the good, and since we cannot be indifferent to our place relative to this good, and since this place is something that must always change and become, the issue of the direction of our lives must arise for us. . . . Now we see that this sense of the good has to be woven into my understanding of my life as an unfolding story. But this is to state another basic condition for making sense of ourselves, that we grasp our lives in a narrative. (Taylor, 1989, p. 47).
As it was for MacIntyre, it is the concept of narrative that illuminates the fact that human life is directed and directed toward the good, in Charles Taylor’s approach. Our lives are stories that we live out, stories that unfold as we live them out, and to see that is a necessary condition “for making sense of ourselves”, and a fortiori for making sense of others and for helping others make sense of ourselves.
The impact these and other authors—whose proposals are usually listed under the famous “narrative turn”1 tag—have had for the medical humanities, and particularly narrative medicine, is evident and I will just acknowledge it without discussion. Despite their significant and enduring influence, which continues up to this day to provoke and stimulate reflection, these theses about the relevance of narrative to human identity have been disputed.
One of their most vocal critics has been Galen Strawson, who famously argued that it is not true that all persons experience themselves narratively—which is taken to mean that there is no reason to say they have a narrative identity or a narrative unity in their identity—and that this type of narrative unity in human life is not a necessary condition for leading a happy, meaningful and fulfilling life and does not correspond to any kind of superior ethical stand or requirement. Strawson distinguished between what he called the descriptive empirical claim that people ordinarily and naturally “see or live or experience their lives as a narrative or story of some sort, or at least a collection of stories” (Strawson, 2004, p. 428), which he called “the psychological Narrativity thesis” (Strawson, 2004, p. 428), and the normative claim that “experiencing or conceiving one’s life as a narrative is a good thing; a richly Narrative outlook is essential to a well-lived life, to true or full personhood” (Strawson, 2004, p. 428), the “ethical Narrativity thesis” on his terms. According to Strawson, though essentially different and possible to combine in several ways, these theses are usually defended together, as a pair, and are both false: