The narrative epistemology and the clinical diagnosis practice

Abstract

This study aims to discuss the narrative epistemology contained in the medical practice. It was based upon a bibliographic review and a semiotic analysis of medical charts belonging to The Medical Genetic Center Jose Carlos Cabral de Almeida/Genetic Department/Fernandes Figueira Institute, a maternal-infant care unity of The Oswaldo Cruz Foundation. All the analysed charts referred to children diagnosed with Down syndrome that are being or were attended in the Down's Syndrome Outpatient of the above cited unity. The article appraises: the question concerning the possible opposition between narrative and science; a review of multiple authors and their works about narrative and medical knowledge; the narrative epistemology contained in the clinical discourse, using as example of such assumption one chart and one pedigree. The conclusion highlights how narrative is important to the process of diagnosis and treatment, and affirms the construction of a plot, by the physician, where biological, social and cultural interactions make themselves present.