First, I would like to say that this is a tremendous topic, and the compulsory reading was particularly compelling. The authors must be intelligent characters!
It is already widely acknowledged that the role of language is vital in sales/marketing, but the same is true in medicine. Certainly in my medical school there was a big push towards teaching us communication skills: not to sell cars, but to reduce litigation. I don’t know if anyone has heard of Neuro-Linguistic Programming (often used by sales people) which places an emphasis on many aspects of communication, including word usage.
Discourse analysis, in my understanding, can be used to analyse communication patterns. Analysis of pre-existing material can be undertaken, or new interviews (etc) can be carried out. Analysis can focus on communication at the 1:1 level, or the focus can be much wider eg. on societal values.
I found the ECT example interesting, because I know people can reason backwards. For example, a psychiatrist can see a depressed patient and decide that ECT is the best treatment option. THEN, once the decision has already been made to offer ECT, in their own mind they will start to see the person as being more depressed than they are. I think this is the mind’s way of reassuring itself that they have made the right decision. This seems to be linked to cognitive dissonance theory (by Festinger), but since Im rambling, I will not go on. My point is that, through discourse analysis it seems possible to identify changes in a person’s attitude over time. And this change may be driven by unconscious process.
The reason this topic interest me is because I have always thought that a doctor’s communication style can be consciously altered to bring about a certain response in a patient. Such techniques could easily be misused. However, there are subconscious influences on our choice of wording (and entire communication style). This paper I have chosen showed that (and it just happened to be nurses by the way- I am not suggesting that doctors don’t do this) when talking about efficacy of contraception, discourse centred on medico-statistical facts. However, side effects were described in lay terms that minimized their severity. This is a prime example of how we can present ideas to patients that ‘gives both sides of the argument’ to ensure that the patient has the ability to make an ‘informed-choice’ but we have already communicated in such a way that the person will choose a particular option.
