Showing that Medical Ethics Cases Can Miss the Point: Rewriting Short Stories as Cases

I propose a new role for literature in medical ethics: rewriting short stories as ethics cases. This activity is instructive for its power to show that our standard ways of analyzing cases can overlook deeper ethical problems, such as those the short stories raise. To illustrate this claim, I begin by distilling Richard Selzer’s story “Fetishes” to an ethics case. Then, using principle-based ethics as a representative analytical framework, I argue that a typical principlist’s response to the “Fetishes” case misses the point, failing to address insidious issues like physician arrogance and patient mistrust. By comparing short story and case, we are led to wonder anew whether ethics cases that represent real events might also fail to probe to the heart of the matter. Thus, rewriting short stories as ethics cases can inculcate a healthy skepticism as to whether any case has succeeded in conveying what is most at stake.