How to Navigate the Ethical Challenges of Storytelling in Health PR

Human stories are among the most powerful tools in health PR and are nearly always a cornerstone of the most successful campaigns. They bridge clinical facts and emotional truth, helping audiences connect with complex health issues in ways that data and facts alone cannot. From awareness campaigns to behaviour change initiatives, storytelling taps into our natural tendency to learn and act through narrative.

Storytelling in health communications can take many forms - from real patient testimonials to composite characters based on multiple voices and brought to life with the help of AI. Each approach comes with its own ethical considerations, and PR professionals must tread carefully to ensure that storytelling remains accurate, compelling and inclusive.

For example, using a real person’s story can bring unmatched authenticity and emotional impact. Yet, it also raises questions around consent, accuracy, and unintended consequences. As Glässel et al. (2022) highlight, patient stories must be used in ways that empower individuals without exploiting their vulnerability. Informed consent must go beyond a signature on a form. It must mean fully understanding how, where, and for how long the story will be used and the possible repercussions, particularly when the topic is stigmatised or divisive.

Even anonymised stories can pose risks. Unique personal details may still render someone identifiable to their community. Ethical storytelling must protect identity while preserving the authenticity and emotional power of the narrative.

Alternatively, fictional or composite narratives offer a solution, but they must be clearly framed as such. Research by Massey et al. (2025) on fictional storytelling about HPV vaccination warns against blurring the line between fact and fiction, particularly in public health education. Transparency is key: audiences should understand that the story is representative, not real. This allows PR professionals to protect individuals while still evoking empathy, provided they also ensure all medical references are evidence-based and peer-reviewed.

Importantly, narratives should reflect the diversity of real-world experiences. As Brooks et al. (2022) propose, successful storytelling requires a framework that includes narrative transportation (being emotionally and cognitively immersed), homophily (identification with the storyteller), and perceived realism. These elements drive audience engagement and behaviour change - but they must not be used manipulatively. Emotional resonance should inspire reflection and discussion, not override informed decision-making.

Health PR campaigns must also avoid defaulting to a ‘heroic patient’ archetype that fits neatly into narrative expectations. This risks erasing less comfortable or more complex realities. As PR professionals, it’s our responsibility to seek out and include underrepresented voices, and challenge assumptions about what makes a story ‘compelling’. Content should be reviewed not only by clinical experts, but also by patients and advocacy groups to ensure stories reflect a true spectrum of experience.

Ultimately, ethical storytelling in health PR is about balance - between impact and accuracy, emotion and evidence, individual story and collective responsibility. Done right, it has the power to educate, to dismantle stigma, and to bring unheard voices to the forefront. But it must always begin with respect - for the people behind the story, and for those listening to it.

References

Glässel, A., Tyebally Fang, M., Hendriks, M.J., Biller-Andorno, N., The Swiss DIPEx Research Group. (2022). Using Narratives to Improve Health Literacy – An Ethical and Public Health Perspective. In: Barrett, D.H., Ortmann, L.W., Larson, S.A. (eds) Narrative Ethics in Public Health: The Value of Stories. Public Health Ethics Analysis, vol 7. Springer, Cham. https://doi.org/10.1007/978-3-030-92080-7_12 

Brooks, S.P., Zimmermann, G.L., Lang, M. et al. A framework to guide storytelling as a knowledge translation intervention for health-promoting behaviour change. Implement Sci Commun 3, 35 (2022). https://doi.org/10.1186/s43058-022-00282-6

Philip M. Massey, Regan M. Murray, Kelli Kostizak, Wen-Juo Lo, Michael Yudell,

Exploring the ethics of using fictional stories for health education on social media to share information and emotions about the HPV vaccine: A cross-sectional study with interdisciplinary health experts, Vaccine, Volume 46, 2025, 126575,

ISSN 0264-410X, https://doi.org/10.1016/j.vaccine.2024.126575.