Herman Melville's account of Bartleby the scrivener has something to teach us about the interactive nature of refusal and the empathy necessary for an exchange of values in the setting of conscientious refusal.
The belief persists that patient satisfaction surveys are more responsive to friendliness and expensive facilities than clinician interaction, but there is evidence to the contrary.
Narrative ethics derives its ethical force from continually comparing and critiquing new narratives against existing narratives that guide the way we live.