A narrative approach to the clinical reasoning process in pediatric intensive care: The story of Matthew

Michele A. Carter, Sally S. Robinson

Research output: Contribution to journalReview article

5 Scopus citations


This paper offers a narrative approach to understanding the process of clinical reasoning in complex cases involving medical uncertainty, moral ambiguity, and futility. We describe a clinical encounter in which the pediatric health care team experienced a great deal of conflict and distrust as a result of an ineffective process of interpretation and communication. We propose a systematic method for analyzing the technical, ethical, behavioral, and existential dimensions of the clinical reasoning process, and introduce the Clinical Reasoning Discussion Tool-a dialogical and interpretive device aimed at improving communication, understanding, empathy, and moral deliberation in the clinical setting.

Original languageEnglish (US)
Pages (from-to)173-194
Number of pages22
JournalJournal of Medical Humanities
Issue number3
StatePublished - Jan 1 2001



  • Critical care
  • Decision-making
  • Futility
  • Moral distress

ASJC Scopus subject areas

  • Health(social science)
  • Health Policy

Cite this