Edwell Jennifer, Jack Jordynn
Department of English and Comparative Literature, University of North Carolina at Chapel Hill, 310 Greenlaw Hall CB#3520, Chapel Hill, NC, 27599, USA.
Department of English and Comparative Literature, University of North Carolina at Chapel Hill, 512 Greenlaw Hall CB#3520, Chapel Hill, NC, 27599, USA.
J Bioeth Inq. 2017 Mar;14(1):53-63. doi: 10.1007/s11673-016-9762-9. Epub 2016 Dec 22.
In this article, we investigate the role of scientific and patient narratives on perceptions of the medical debate around gestational diabetes (GDM) testing. Among medical scientists, we show that the narrative surrounding GDM testing affirms that future research and data will lead to medical consensus. We call this narrative trajectory the "deferred quest." For patients, however, diagnosis and their subsequent discovery that biomedicine does not speak in one voice ruptures their trust in medical authority. This new distrust creates space for patients to develop a Frankian quest narrative where they become the protagonist in their story. Additionally, across these different narratives, we observe how character is constructed and employed to negotiate trust. We conclude that healthcare providers should assess the narrative trajectory adopted by patients after diagnosis. Also, we suggest that providers acknowledge the lack of medical consensus to their patients. This veracity would foster women's sense of trust in their provider as well as allow women to be active interlocutors in a debate that ultimately plays out in their deliberation about their body, pregnancy, and risk.
在本文中，我们探究了科学叙事与患者叙事在围绕妊娠期糖尿病（GDM）检测的医学辩论认知中所起的作用。在医学科学家当中，我们发现围绕GDM检测的叙事肯定了未来的研究和数据将达成医学共识。我们将这种叙事轨迹称为“延迟探索”。然而，对于患者而言，诊断以及他们随后发现生物医学并非众口一词，这破坏了他们对医疗权威的信任。这种新的不信任为患者创造了空间，使他们能够形成一种弗兰肯式的探索叙事，在这种叙事中他们成为自己故事的主角。此外，在这些不同的叙事中，我们观察到角色是如何被构建和运用来协商信任的。我们得出结论，医疗保健提供者应该在诊断后评估患者所采用的叙事轨迹。同时，我们建议提供者向患者承认缺乏医学共识。这种真实性将增强女性对其提供者的信任感，也能让女性在这场最终在她们对自己的身体、怀孕和风险的思考中展开的辩论中成为积极的对话者。
