Speaking Truthfully: A Theological Analysis of Clinical Language and Physician Influence
Jacob Blythe, BA Baylor University, Pursuing an MA at Duke Divinity School
What does it mean for a physician to speak truthfully to a patient? On the predominant account, to speak truthfully is to give the patient all relevant information, so that the patient can make an informed decision. Relevant information, on this account, consists of accurate descriptions of pathophysiology, all available medical interventions, and the probabilities of the various possible outcomes. All of this information is conveyed using the language of science, or more specifically, the language of the clinic.
This frame for truth-telling has its strengths, particularly in the way that it supports patients in making informed, autonomous decisions. In recent years, however, both researchers and theorists have begun to note that the message received by the patient can be radically shaped and constrained by the way that the relevant scientific information is conveyed or framed, even when that information is “accurate,” and in a limited scientific sense, “truthful.”
This paper begins by critically considering the limits of clinical language for speaking truthfully to patients in the clinical encounter. In doing so, it briefly reviews studies that have examined how implicit value judgments on the physician’s part affect how he or she frames scientific information, and moreover, how this framing can influence patient decision-making.
Second, this paper notes the way that clinical language can cloak and evade truth that needs to be spoken, and can, therefore, become a means of speaking falsely, even when using “accurate” language. With respect to this cloaked form of speaking falsely, this paper considers particular clinical cases, in order to contrast clinical language with Christian theological language as differing methods of speaking “truthfully” to a patient.
Christian theological thinking calls into question several of the presuppositions that undergird the predominant account of physician truth-telling. In questioning these presuppositions and drawing on the Christian theological tradition, this paper finally attempts to constructively propose an alternative model of physician truth-telling.
This alternative model strives to avoid the reductive, individualistic, and tradition-blind assumptions of conventional clinical discourse in order to provide a model of physician truth-telling that is based in reasonable expectations for meaningful human relationships, a relational and communal understanding of human health, and the Christian theological tradition.
What does it mean for a physician to speak truthfully to a patient? On the predominant account, to speak truthfully is to give the patient all relevant information, so that the patient can make an informed decision. Relevant information, on this account, consists of accurate descriptions of pathophysiology, all available medical interventions, and the probabilities of the various possible outcomes. All of this information is conveyed using the language of science, or more specifically, the language of the clinic.
This frame for truth-telling has its strengths, particularly in the way that it supports patients in making informed, autonomous decisions. In recent years, however, both researchers and theorists have begun to note that the message received by the patient can be radically shaped and constrained by the way that the relevant scientific information is conveyed or framed, even when that information is “accurate,” and in a limited scientific sense, “truthful.”
This paper begins by critically considering the limits of clinical language for speaking truthfully to patients in the clinical encounter. In doing so, it briefly reviews studies that have examined how implicit value judgments on the physician’s part affect how he or she frames scientific information, and moreover, how this framing can influence patient decision-making.
Second, this paper notes the way that clinical language can cloak and evade truth that needs to be spoken, and can, therefore, become a means of speaking falsely, even when using “accurate” language. With respect to this cloaked form of speaking falsely, this paper considers particular clinical cases, in order to contrast clinical language with Christian theological language as differing methods of speaking “truthfully” to a patient.
Christian theological thinking calls into question several of the presuppositions that undergird the predominant account of physician truth-telling. In questioning these presuppositions and drawing on the Christian theological tradition, this paper finally attempts to constructively propose an alternative model of physician truth-telling.
This alternative model strives to avoid the reductive, individualistic, and tradition-blind assumptions of conventional clinical discourse in order to provide a model of physician truth-telling that is based in reasonable expectations for meaningful human relationships, a relational and communal understanding of human health, and the Christian theological tradition.