Negotiating Religious Beliefs in a Medical Setting
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This manuscript studies in detail, following a discourse analytical approach, medical consultations in which a patient’s religious belief does not allow blood transfusion to be administered. The patient is a young Jehovah's Witness suffering myeloid leukaemia who is being treated in a Catholic cancer hospital where the practice of blood transfusion forms part of the standard protocol to treat the disease. The consultations under analysis take place in a Chilean cancer clinic where mainly the oncologist and a Jehovah’s Witness Representative (JWR) present discuss and negotiate expert information on the substitute methods to be used. The exchange dynamics of the consultations differ from the usual visits where the medical knowledge and expertise is primarily in the hands of the medical practitioner. In these encounters, the JWR shares vital information with the oncologist providing the basis of the treatment to be used. This shifting of the balance of power—which could have been a cause of tension in the visit and a contributing factor in the disruption of communication—has instead brought light to the encounter where the negotiated treatment has been achieved with relative ease. The patient’s future is in the hands of the oncologist and the JWR, and their successful negotiation of treatment has made it possible to cater for the particular needs of a JW patient. Sharing different medical practices has not been an obstacle, but an opportunity to find out ways to deliver equity access and well-informed practices to a non-conventional patient.
KeywordsMedical communication Religious belief and medical treatment Discourse analysis Shifting of the balance of power Spanish discourse
The data collection for this project was made possible with the financial support of the Monash Small Grant Scheme. My special thanks go to Dr Pablo Bertín who unreservedly supported this project. His insights into oncology in Chile and elsewhere were pivotal to the realisation of this project.
I would like also to thank every colleague, at the clinic, who assisted me during the data collection. Last but not least, I take this opportunity to sincerely thank every one of the patients who gave their consent to be part of this study. The patients shared with me profound and intimate stories about their ordeal with the disease and the impact it had on their families, friends and their daily lives.
- Ainsworth-Vaughn, N. (1994). Negotiating genre and power: Questions in medical discourse. In B. L. Gunnarsson, P. Linell, & B. Nordstrom (Eds.), Text and talk in professional contexts (pp. 149–166). Uppsala, Sweden: Association Suédoise de Linguistique Appliquée.Google Scholar
- Ainsworth-Vaughn, N. (1998). Claiming power in doctor–patient talk. Oxford: Oxford University Press.Google Scholar
- Borges, S. (1986). A feminist critique of scientific ideology. In S. Fisher & A. D. Todd (Eds.), Discourse and institutional authority: Medicine, education and law (pp. 26–48). Norwood, NJ: Ablex.Google Scholar
- Cameron, D. (1992). ‘Respect, please!’: Investigating race, power and language. In D. Cameron, E. Fraser, P. Harvey, M. B. H. Rampton, & K. Richardson (Eds.), Researching language issues of power method (pp. 113–138). London: Routledge.Google Scholar
- Cassell, E., Skopek, L., & Fraser, B. (1976). A preliminary model for the examination of doctor–patient communication. Language Science, 43, 10–13.Google Scholar
- Cordella, M. (2004). The dynamic consultation: A discourse analytical study of doctor–patient communication. Amsterdam: Benjamins. Pragmatics and Beyond Series.Google Scholar
- Cordella, M. (2006). No, no I haven’t been taking it doctor’: Compliance, face threatening acts and politeness in medical consultations. In M. Placencia & C. García (Eds.), Linguistic politeness in the Spanish-speaking world. Mahwah, NJ: Lawrence Erlbaum Associates.Google Scholar
- Cordella, M. (2007). Unveiling stories to the oncologist: A matter of sharing and healing. Panacea@: Medicine and Translation, 9(26), 230–238.Google Scholar
- Cordella, M. (2008). Two experts and one patient: Managing medical practices and religious beliefs. Monash University Linguistics Papers, 6, 19–28.Google Scholar
- Fisher, S. (1993). Doctor talk/patient talk: How treatment decisions are negotiated in doctor–patient communication. In A. D. Todd & S. Fisher (Eds.), The social organization of doctor–patient communication (pp. 161–182). Norwood, NJ: Ablex.Google Scholar
- Puchalski, C. M. (2002). Spirituality and end of life care. In A. M. Berger, R. K. Portenoy, & D. E. Weissman (Eds.), Principles and practice of palliative and supportive oncology (2nd ed., pp. 799–812). Philadelphia, PA: Lippincott Williams and Wilkins.Google Scholar
- Tannen, D. (1987). Power through discourse. Norwood, NJ: Ablex.Google Scholar
- Todd, A. D. (1993). A diagnosis of doctor–patient discourse in the prescription of contraception. In S. Fisher & A. D. Todd (Eds.), The social organization of doctor–patient communication (pp. 183–212). Norwood, NJ: Ablex.Google Scholar
- Todd, A. D., & Fisher, S. (Eds.). (1988). Gender and discourse: The power of talk. Norwood, NJ: Ablex.Google Scholar
- Wardlaw, M. P. (2002, January 22). American medicine as religious practice: Care of the sick as a sacred obligation and the unholy descent into secularization. Journal of Religion and Health (online publication).Google Scholar
- Wodak, R. (Ed.). (1989). Language, power and ideology: Studies in political discourse. Amsterdam: John Benjamins.Google Scholar
- Wodak, R. (1996). Disorders of discourse. London: Longman.Google Scholar