Truth and belief in narrative feedback

In the latter part of 2025, I had the great honour of visiting our colleagues at Care Opinion Australia. While there, I had a wonderful conversation with Ellen McGovern-Greco, Moderation and Reporting Officer, that has stayed with me ever since. Ellen talked about how her Philosophy studies shape the way she thinks about Care Opinion, she put words to the very human side of our work in a way that felt honest, deeply insightful and held some very interesting truths. I remember thinking at the time that more people should hear the reflections she was sharing!

This blog is the first of two pieces Ellen has kindly offered us, and it explores ideas of truth, belief and lived experience through a philosophical lens. Her writing invites us to pause, to listen with care, and to reflect on the meaning behind the stories people choose to share.

I am delighted to introduce this piece and grateful to Ellen for bringing such depth and humanity to our shared work. Enjoy!

Care Opinion Australia recently received a letter of thanks from a patient who told their healthcare experience over the phone. The patient’s negative experience was compounded by the sense that no one seemed to take their version of events seriously. This was at the crux of their distress: they felt like no one believed them. After listening to this patient, I began to think about an omnipresent concern we deal with in narrative feedback:

        What if a patient isn't telling the truth?

Insights on truth

Many modern-day discussions on truth centre around twentieth-century philosopher Hannah Arendt who distinguished truth as having two forms; rational truths and factual truths:

• Rational truths: these truths are both self-evident and universally provable, such as those found in mathematics or geometry. In an Arendtian sense, there are no stories on Care Opinion that would be considered rational truths.
• Factual truths: these are truths about what occurred, such as historical events. They are about what actually happened in the world and are grounded in events and realities that can be documented or witnessed.

(And yes, for those keen-eyed philosophers – these distinctions are eerily parallel to Kant’s a priori and a posteriori descriptions. However, his work was grounded in epistemology, whereas Arendt’s is rooted in politics - hence the difference.)

For Hannah Arendt, factual truths are not just another kind of personal story or opinion. They are anchored in the world of events and what has actually happened. Unlike feelings or interpretations, factual truths can be checked against evidence and testimony. Neil Armstrong’s 1969 Moon landing is one such truth, confirmed by records and witnesses. Factual truths do not express opinion; they state, simply and irrevocably: this happened.

Care Opinion also deals with accounts of ‘what happened,’ but in a very different way. Patient stories are not straightforward paths to factual truth in Arendt’s sense. They do more than state “this happened” and are shaped by subjectivity and personal perspective rather than verifiable evidence. This raises a difficult question:

        If a story is not ‘factually’ true, what use is the story then?

Not every experience is a factual truth (nor does it need to be)

The reason it is useful to bring in Arendt’s idea of factual truth is to show what patient stories are not. Health services should not approach every account as though it must be an Arendtian ‘factual truth.’ To do so would impose an unrealistic rigidity on people’s experiences, and risk dismissing stories that still hold great value.

Patient stories are not always fact-checked records of events; they are not court depositions where unbiased fact reigns supreme. We don’t ask services to prove every detail, nor to accept stories as legal truth. People often remember and describe events in different ways, and it is only natural for our personal accounts to sometimes be incomplete, emphasised, or shaped by perception. This is what makes us human. Our storytelling is shaped by our emotions, perspective, and the small details we choose to emphasise.

The question then becomes: can patient stories still hold value, even if they are not verified facts, and don’t meet the standard of Arendtian factual truths? Where is a story’s value if not in its factual accuracy?

Perhaps a story’s value should instead be found in our belief in it: the recognition that while details can shift, this is how care was felt, lived and how it shaped someone’s life. This kind of value does not depend on every detail being verified, but on the recognition that stories communicate something true about the human experience of care.

        This is where belief becomes essential.

Belief as the antidote

While Arendt doesn’t speak to belief as a framework, we can utilise this concept as a way to approach patient stories regardless of their claim to truth. Believing isn’t necessarily about stating the story as an Arendtian factual truth; believing can be as simple as saying yes, I believe that this is your experience, I believe that this is how you felt. The core experience of feeling ignored, hurt, cared for, empowered, or afraid – that part is real. It deserves to be listened to with care. The challenge for healthcare is therefore to not conflate believing the patient with asserting their experience as an Arendtian factual truth. Believing isn’t about affirming the accuracy of an event; instead, it is affirming that this is how the experience was felt. 

So, why believe?

First, because it validates the innate humanness of storytelling. To believe is to acknowledge that their voice matters, that their perception is real to them, and that it deserves attention. Their story cannot be told any other way; it is a reflection of them, spoken in their own voice. We do not only tell stories to report events, we tell them to share meaning, connect with others, and to be heard. In this sense, the value of a patient’s story lies less in its factual precision and more in its role as a deeply human act. To believe a story is to recognise that the act of telling itself is an expression of this humanity.

Second, belief creates the conditions in which facts, where they exist, can come forward. When stories are met with disbelief or dismissal, whatever factual insights they contain are lost. Belief keeps stories open, usable and capable of shaping understanding and service improvement. Experiences are thus worth examining not because they are automatically true, but because dismissing them outright risks losing the space where truth might be found. Believing someone’s experience protects the possibility of discovering truth.

By prioritising spaces where patients’ voices are heard, believed, and valued, we create conditions that not only acknowledge the humanness of storytelling but also allow truths to emerge and be meaningfully addressed.

We can believe first – not to declare what is true, but to make truth possible.