Saturday, 6 December 2014

Iona Heath on "the use and abuse of words"

Medicalsceptic is a rich source of interesting information. Well worth following. 

And this paper is worth being read thoroughly and thoughtfully:  


The allure and tyranny of certainty

Experts who “know” are wonderfully seductive. Whenever I attend a lecture by someone, usually a hospital specialist, who seems absolutely certain of the correct response to a patient in a particular situation, the temptation to take careful notes is enormous. Yet once I'm back in the consulting room the notes are never as useful as I had hoped they might be. Certainty seems to be born of pretending that things are very much simpler than they really are and in our consulting rooms things never seem simple. Yet there is a terrible certainty about much medical rhetoric and in much of what we say to patients.
Isaiah Berlin would recognise the expert who “knows”:
“Happy are those ... who have, by their own methods, arrived at clear unshakeable convictions about what to do and what to be that brook no possible doubt. I can only say that those who rest on such comfortable beds of dogma are victims of forms of self-induced myopia, blinkers that may make for contentment, but not for understanding of what it is to be human.”6
As would Jose Saramago:
“assuming he has been wise and prudent enough not to believe blindly in what he thinks he knows, because this rather than ignorance is the cause of the greatest blunders”.7
The pursuit of certainty–the desire for certainty–what Hans-Georg Gadamer calls “the reduction of truth to certainty”8 affects the way we use words and language. So I want to explore the use and abuse of words within the interaction between doctor and patient, and examine the normative basis of power in story, language, and knowledge. I hope to show how easy it is for doctors to use these dimensions of power to constrain and limit our patients' stories, consign many of them to stories of failure, and reduce their capacity to celebrate, or even recognise, achievement.9

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