Commentary on “Creative Expressive Encounters in Health Ethics Education: Teaching Ethics as Relational Engagement”

The intriguing paper by Milligan and Woodley is presented as if it were about ethics education,1 but I read it as a reflection on what is at the heart of all of clinical practice—the rupture occasioned by the illness and the witnessing achieved by the clinician. Paramedic students were asked to write responses to paragraph-long clinical vignettes of patients in acute predicaments (miscarriage, plane crash, move to a nursing home, and the like). The students were instructed to frame their responses in the first person, taking on the perspectives of the patients, and they were given permission to write poems or prose or even to submit works of visual art that “spoke for” the patients in the vignettes. We learn that even students unsophisticated in reading or writing were able to create moving, affectively dense, surprising representations of how they imagined the patients in these situations to respond. The authors of this paper locate the ethics they are educating their students to practice squarely within the domains of human engagement and mutual recognition. Not interested in training “outside experts,” they hope to train their students to work in relation with singular individuals, not so much to apply pre-existing rules or laws but rather to attend to particular situations and to honor the lived experience of patients in their care.2 The authors, to my mind accurately, characterize much of mainstream bioethics and ethics education as exerting “pressure to dismiss potentially complicating details such as of subjective experience or contextual features” of human interaction (p. 2). The traditions they claim as influences on this work are phe-