Medical Discourse in Professional, Academic and Popular Settings (Language at Work, 1)

Thông tin sách: Medical Discourse in Professional, Academic and Popular Settings (Language at Work, 1) (Hardcover, 224 trang) – Multilingual Matters, 2016. Ngôn ngữ: Tiếng Anh.

This volume investigates the features and challenges of medical discourse between medical professionals as well as with patients and in the media. Based on corpus-driven studies, it includes a wide variety of approaches including cognitive, corpus and diachronic linguistics. Each chapter examines a different aspect of medical communication, including the use of metaphor referring to cancer, the importance of ethics in medical documents addressed to patients and the suitability of popular science articles for medical students. The book also features linguistic, textual and discourse-focused analysis of some fundamental medical genres. By combining sociological and linguistic research applied to the medical context, it illustrates how linguists and translation specialists can build bridges between health professionals and their patients.

Excerpt. © Reprinted by permission. All rights reserved. Medical Discourse in Professional, Academic and Popular SettingsBy Pilar Ordóñez-López, Nuria Edo-MarzáMultilingual MattersCopyright © 2016 Pilar Ordóñez-López, Nuria Edo-Marzá and the authors of individual chapters
All rights reserved.
ISBN: 978-1-78309-625-1
ContentsContributors,
1 Medical Discourse: Building Bridges between Medicine and Society Pilar Ordóñez-López and Nuria Edo-Marzá,
2 Variations in Medical Discourse for Academic Purposes Maurizio Gotti,
3 The Clinical Case Report as a Discourse Genre in the Context of Professional Training Vicent Salvador,
4 Popular Science Articles vs Scientific Articles: A Tool for Medical Education Begoña Bellés-Fortuño,
5 The Ethics of Informed Consent. An Applied Linguistics Perspective Morten Pilegaard,
6 Exploring the Links Between the Oral and the Written in Patient–Doctor Communication Vicent Montalt and Isabel García-Izquierdo,
7 Metaphorical Aspects in Cancer Discourse Ignasi Navarro i Ferrando,
8 Cancer Metaphors in Sports News: The Match that Must Be Won Martí Domínguez and Lucía Sapiña,
9 The Discourse of Mindfulness: What Language Reveals about the Mindfulness Experience Antonio-José Silvestre-López,
Index,


CHAPTER 1

Medical Discourse: Building Bridges between Medicine and Society

Pilar Ordóñez-López Nuria Edo-Marzá

Medical discourse not only allows medical professionals to communicate among each other, but it is also the link between the medical profession and the public, including patients. As pointed out by scholars such as Gotti and Salager-Meyer (2006: 10), medicine has always occupied a prominent place in all cultures and times, for the simple reason that it affects the health and lives of all human beings. Furthermore, as shown by the growing number of medical journals as well as non-medical journals devoted to the study of medical discourse, medical communication has become a cornerstone of our society. Access to specialised discourse is no longer restricted to the privileged few (Pilegaard, 2007) and, as Weingart (2002: 704) observes, by entering the public arena, knowledge, in this case medical knowledge, is subjected to the judgement and evaluation of society. The need to communicate, to take into consideration the other (the patient, the medical student, the general public, etc.), the need to be aware of the ethical implications involved and to become conscious of the factors which are decisive in order for communication to be successful – all of these are key aspects for the achievement of successful communication, for establishing a fruitful and dynamic dialogue between science, i.e. medicine, and society. On the other hand, these issues have no doubt contributed to the increasing interest in the study of medical discourse in a wide variety of settings and from a wide range of perspectives.

Another key issue in today's medical discourse, closely related to the aspects mentioned above, is popularisation, aimed at making specialised, medical knowledge accessible to the layman. According to Gotti (2014: 19), popularisation has greatly influenced the discourse of medicine, enhancing both new textual realisations (e.g. genres such as popular science articles) and new formats for the dissemination and sharing of knowledge (not only limited to specialised journals and forums, but also the media and other formats available and easily accessible to the general public). Gotti's (2014) work reveals the complexity of this phenomenon, which involves reformulation and recontextualisation, in order to guarantee that information is successfully transferred. These processes, in turn, favour certain linguistic, textual and cognitive mechanisms, such as the use of metaphors (Gotti, 2014: 28), aiming to facilitate the general public's understanding of the specialised (medical) content by constructing an informative and explanatory discourse. The popularisation of medical discourse, at the same time, implies paying attention to non-experts, e.g. the patient, leading to the analysis of the ethical issues arising from the access to and (mis)understanding of medical content by the public.

The shift of emphasis towards patient-centred healthcare has triggered interest in communication issues, which, as pointed out by Sarangi (2012: 13), has resulted in the incorporation of the teaching of communication skills within the medical training context. This new perspective has also brought about a shift in communication, as explained by Montalt and Shuttleworth (2012), from a monologic paradigm (in which the only voice worth listening to was the doctor's) to a dialogic one. Furthermore, the acknowledgement of the need to promote fruitful and dynamic interaction (doctor–patient) in order to successfully communicate has caused scholars to consider oral discourse a nuclear aspect, and it is the object of a significant amount of research in a wide range of contexts (e.g. Bowles, 2006; Candlin, 2006; Cordella, 2004; García-Izquierdo & Montalt, 2013).

Another trend that has shaped the discourse of medicine in recent years is the incorporation of complementary and alternative medicine (often referred to as CAM), which has become increasingly popular in Western societies in recent decades (cf., e.g. Gale & McHale, 2015; Salager-Meyer et al., 2006; Sharma, 2000). This is also an indication of the shifting focus in the medical context and has been reflected in the consideration of the notion of health from a more integrative, holistic and patient-oriented perspective. In sum, this is another example of how the present-day discourse of medicine is encouraging dialogue between diverse perspectives and is becoming an increasingly integrative area of knowledge, aware of the importance of meeting the needs of society.

The discourse of medicine is thus interactive and social, and as such it is critical for both the medical professional and the linguist to know how it is articulated and shaped to achieve successful communication, according to the different aims and settings involved. The study of medical discourse has gradually incorporated new perspectives resulting from the integration of input from other related fields, such as applied linguistics, sociology, corpus linguistics and cognitive linguistics. This has been possible thanks to the incorporation of some key theoretical perspectives, such as the study of genres and the use of corpora, as well as the focus on realia, i.e. the study of real cases, real contexts and real instances of medical communication, be it among medical professionals, doctors and patients, the media, etc.

This volume provides a multidisciplinary study of medical discourse based on corpus-driven investigations, carried out within different theoretical frameworks (e.g. sociology, corpus linguistics), applied both to individual case studies and more general linguistic, textual and discourse-specific analyses of medical communication. The contributions included in this book deal with key aspects of medical discourse, such as the use of metaphor referring to cancer, the importance of ethics in medical documents addressed to patients and the linguistic challenges involved, as well as the discourse analysis of some fundamental medical genres. Though diverse and wide-ranging, the contributions have in common that they adopt a comprehensive and up-to-date perspective, from which the rhetoric of medicine is examined in key settings (the media, academic and educational contexts, instances of real doctor–patient interaction, etc.) providing interesting new insights into the study of medical discourse.

Gotti presents a corpus-based study of variation in medical discourse for academic purposes, focusing on the relation between socioculturally oriented identity factors and textual variation. He reviews some current research projects devoted to the examination of identity-forming features linked to 'local' or disciplinary cultures through the analysis of specialised discourse in English in various academic domains by native and non-native speakers. He also discusses the results obtained in the CERLIS project, aimed at investigating to what extent the cultural allegiance of (native or non-native) anglophone discourse communities to their linguistic, professional, social or national reference groups is affected by the use of English as a lingua franca of international communication. This study shows the influence of factors such as the affiliation of writers to different professional, ideological or ethnic-geographic cultures on the realisation of medical discourse in academic settings.

The contributions by Salvador and Bellés-Fortuño deal with different medical genres, paying special attention to the training context, and they underline the importance of developing communication skills in the professionals of the future.

Salvador's chapter explores how the case study in medical and health settings (clinical case report [CCR]) is a regular section in some specialised academic periodicals, despite the controversy about its scientific nature. The author claims that the analysis of clinical cases as an actual instance of a therapeutic process is especially relevant in the study of communities of practice, a conceptual framework related to the sociology of professional training. According to Salvador, the prevalence of the narrative dimension in clinical cases has the potential to make the professional experience accessible and convey it to readers. The author explores the structure and content of CCRs, concluding that the CCR, as a medical narrative, contributes to the construction of the patient's identity. The inclusion of the CCR as a genre in medical journals counteracts the tendency towards a mere scientific biomedicine by providing a new perspective on more human-centred and personalised, yet scientific, health studies, capable of building bridges between science and the humanities.

Also with a focus on the educational context, Bellés-Fortuño provides a corpus-based analysis of two medical genres (scientific research articles and popular science articles), aiming to show the suitability of popular science articles for medical students. The author undertakes a contrastive study of the structure and use of evaluative language and linguistic features such as discourse markers in both genres, based on an ad hoc corpus of articles on the same topic (arthritis) extracted from the website Science Daily and the medical journal The Lancet. The results obtained allow the author to conclude that popular science articles, which tend to be simpler and shorter than scientific research articles, can be used as pedagogical tools to promote more intuitive learning and facilitate students' understanding of medical discourse, especially in their first years of education, when they tend to find the reading of research articles arduous.

Pilegaard's and Montalt & García-Izquierdo's chapters focus on textual genres addressed to patients with the aim of providing new insights into the ethicalness of informed consent documents (ICDs) and compare oral and written modes of communication, underlining the challenges posed by these genres for translators and writers of medical texts.

In his contribution, Pilegaard focuses on ethical issues involved in healthcare and claims that it is necessary to adopt a patient-centred approach and tailor communication to the patient's specific knowledge level and information needs. From an integrative perspective, Pilegaard advocates a model of analysis which builds on systemic functional linguistics (SFL) and incorporates aspects of other applied linguistics disciplines, such as genre theory, translation theory and discourse analysis, in order to cover all the dimensions that have an impact on ethicalness. The author carries out a multidimensional analysis of real ICDs, used to obtain consent for the participation in medical research in Denmark. The results obtained reveal a general lack of ethicalness: structural patterns are not always appropriate; the choice of lexical items shows a lack of consideration of the reader's knowledge level; the reader tends to be described as an object of investigation rather than an individual addressee; and the use of officialese and other expert language features creates distance between the expert and the layman (the addressee). All these aspects are detrimental to an ethical doctor–patient interaction and hinder fluent communication in the context of medical research.

Montalt and García-Izquierdo's chapter delves into oral and written modes from a holistic and comprehensive perspective and presents proposals that strengthen the links between the two modes of communication, so as to enhance doctor–patient interaction. The study departs from a translation studies perspective, the starting point being the recognition of the possible cultural and conceptual asymmetries between patients and doctors. The authors note that more progress has been made in the study and optimisation of oral than of written communication, focusing, in the final part, on the Calgary-Cambridge Guide (CCG). Arguing that some asymmetries may be better resolved through the written mode, the authors explore the convergences and divergences between the oral genre 'consultation' and contributions based on research on written communication.

Both Navarro and Domínguez & Sapiña deal with the use of metaphors for cancer in medical discourse: while Navarro provides a comparative analysis of the use of metaphor in three medical genres, Domínguez and Sapiña analyse the use of sports metaphors for this disease in the Spanish press.

Based on corpus containing texts belonging to three different genres that frequently deal with cancer issues, namely research papers, scientific news notices and press articles, Navarro's chapter tries to unravel certain aspects of the use of metaphors in medical discourse. With this aim, the author introduces different perspectives on the notion of metaphor, followed by a characterisation of types within Conceptual Metaphor Theory (CMT) in terms of correspondences between domains. The chapter proceeds by exploring and discussing cognitive functions of metaphor, such as categorisation and conceptualisation, as well as discourse communicative functions, such as deliberate and novel usage. Furthermore, the cognitive and communicative functions of conventional metaphors in a set of genres of medical discourse are illustrated and discussed. The author presents a characterisation of the three genres analysed in terms of metaphor usage and function, so as to determine the role of metaphorical models in scientific communication. The study suggests that metaphorical usage may be more or less conscious and deliberate depending on genre and it analyses the functions metaphors fulfil in each particular one.

Domínguez and Sapiña explore the use of metaphors in medical discourse on cancer in the Spanish press and how they contribute to the creation of a collective image of the illness. The authors examine the use of cancer metaphors in a corpus consisting of news items about three events related to celebrities of Futbol Club Barcelona, published in six of the most widely read general newspapers and four of the most popular sports journals, in order to determine which type of metaphor is most frequent. Domínguez and Sapiña claim that war metaphors convey a set of negative images, such as the inevitable need to fight a battle or the annihilation of the defeated, which to some extent underline the possibility of defeat and put pressure on the cancer patient. Nevertheless, as shown in this contribution, war metaphors prevail in the discourse about cancer in the press, even in the sports context, where we might expect sports metaphors to be more common. The authors advocate the replacement of war metaphors by sports metaphors, which create a more encouraging imagery for those affected by the disease.

Finally, Silvestre-López's contribution also underlines the relevance of metaphor in the discourse of mindfulness through the analysis of the linguistic production of a target group in order to identify more effective mindfulness teaching procedures. Mindfulness is a health-related area that has experienced a great expansion in recent times, especially in the fields of psychology, psychiatry and neuroscience. Mindfulness focuses on processes of attention and the perception of sensations, emotions and thoughts. Mindfulness meditation has become a fully accepted procedure in experimental and clinical psychology to treat a range of health conditions like stress, anxiety and depression. However, as the author points out, the linguistic dimension of mindfulness still requires an in-depth investigation; a first step in that direction is taken in this chapter with the study of metaphor as a necessary tool to apprehend, mentally represent and 'handle' the above-mentioned sensations, emotions and thoughts. Choosing a cognitive linguistic approach, Silvestre-López aims to establish what the analysis of 'mindfulness discourse' can reveal about the mental representations that underlie the mindfulness experience and practice. He encapsulates, from a linguistic perspective, the subjective experience associated with mindfulness by drawing on the linguistic production of the participants and practitioners of a series of mindfulness courses and identifying a series of conceptual metaphors and metonymic projections that are recurrently used in them. The study suggests that analysing this kind of discourse can lead to more effective mindfulness teaching procedures, including those of mindfulness-based psychotherapeutic programmes, and can become a rich source of data for further psychological experiments.

(Continues...)Excerpted from Medical Discourse in Professional, Academic and Popular Settings by Pilar Ordóñez-López, Nuria Edo-Marzá. Copyright © 2016 Pilar Ordóñez-López, Nuria Edo-Marzá and the authors of individual chapters. Excerpted by permission of Multilingual Matters.
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