How The Fault in Our Stars illuminates four themes of the Adolescent End of Life Narrative

Med Humanit. 2019 Sep;45(3):240-246. doi: 10.1136/medhum-2017-011400. Epub 2018 May 26.


Adolescents who face life-limiting illness have unique developmental features and strong personal preferences around end of life (EOL) care. Understanding and documenting those preferences can be enhanced by practising narrative medicine. This paper aims to identify a new form of narrative, the Adolescent End of Life Narrative, and recognise four central themes. The Adolescent EOL Narrative can be observed in young adult fiction, The Fault in Our Stars, which elucidates the notion that terminally ill adolescents have authentic preferences about their life and death. Attaining narrative competence and appreciating the distinct perspective of the dying adolescent allows medical providers and parents to support the adolescent in achieving a good death. By thinking with the Adolescent EOL Narrative, adults can use Voicing my CHOiCES, an EOL planning guide designed for adolescents, to effectively capture the adolescent's preferences, and the adolescent can make use of this type of narrative to make sense of their lived experience.

Keywords: advance care planning; literature and medicine; narrative ethics; narrative medicine; paediatrics.

MeSH terms

  • Adolescent
  • Adolescent Behavior / psychology
  • Attitude to Death
  • Critical Illness / psychology*
  • Female
  • Humans
  • Literature, Modern*
  • Male
  • Medicine in Literature*
  • Terminal Care / psychology*