Narrative medicine，which is popular worldwide，is replacing evidence-based medicine，and its philosophical basis is an important issue that urgently needs to be explored in the academic field. Charon puts forward that inter - subjectivity，as the core content of its philosophical foundation，would face three major difficulties that cannot be solved：the uncertainty of subject status，the paradox of inter-subjectivity itself，and the misinterpretation of the doctor-patient relationship as a result of the subjective abstraction of doctor-patient individual. Only by absorbing the intervitality of rationalism and irrationalism， and completing the transcendence of inter-subjectivity from Marx’s dialectical analysis of the natural and social attributes of life，is the core content of the philosophical foundation of narrative medicine in which doctors and patients empathize and make decisions together.