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Theoretical Medicine and Bioethics

, Volume 29, Issue 6, pp 357–370 | Cite as

Medical explanations and lay conceptions of disease and illness in doctor–patient interaction

  • Halvor NordbyEmail author
Article

Abstract

Hilary Putnam’s influential analysis of the ‘division of linguistic labour’ has a striking application in the area of doctor–patient interaction: patients typically think of themselves as consumers of technical medical terms in the sense that they normally defer to health professionals’ explanations of meaning. It is at the same time well documented that patients tend to think they are entitled to understand lay health terms like ‘sickness’ and ‘illness’ in ways that do not necessarily correspond to health professionals’ understanding. Drawing on recent philosophical theories of concept possession, the article argues that this disparity between medical and lay vocabulary implies that it is, in an important range of cases, easier for doctors to create a communicative platform of shared concepts by using and explaining special medical expressions than by using common lay expressions. This conclusion is contrasted with the view that doctors and patients typically understand each other when they use lay vocabulary. Obviously, use of expressions like ‘sickness’ or ‘illness’ does not necessarily lead to poor communication, but it is important that doctors have an awareness of how patients interpret such terms.

Keywords

Doctor–patient interaction Communication Medical language Lay health beliefs 

Notes

Acknowledgements

I would like to thank anonymous referees for this journal for very helpful comments.

References

  1. 1.
    Ong, L., J. de Haes, A. Hoos, and F. Lammes. 1995. Doctor–patient communication: A review of the literature. Social Science and Medicine 40 (7): 903–918.CrossRefGoogle Scholar
  2. 2.
    Silverman, J., S. Kurtz, and J. Draper. 2004. Skills for communicating with patients. Oxford: Radcliffe Publishers.Google Scholar
  3. 3.
    Tate, P. 2007. The doctor’s communication handbook. Oxford: Radcliffe Publishers.Google Scholar
  4. 4.
    Davidson, D. 1984. Inquires into truth and interpretation. Oxford: Clarendon Press.Google Scholar
  5. 5.
    Nordenfelt, L., and A. Twaddle. 1993. Disease, illness and sickness. Three central concepts in the theory of health. Linköping: Linköping University Press.Google Scholar
  6. 6.
    Hofmann, B. 2001. Complexity of the concept of disease as shown through rival theoretical frameworks. Theoretical Medicine and Bioethics 22: 211–236.CrossRefGoogle Scholar
  7. 7.
    Nordenfelt, L. 2001. Health, science and ordinary language. Amsterdam: Rodopi.Google Scholar
  8. 8.
    Helman, C. 1984. Culture, health and illness. Oxford: Butterworth-Heinemann.Google Scholar
  9. 9.
    Lupton, D. 1994. Medicine as culture. London: Sage Publications.Google Scholar
  10. 10.
    Putnam, H. 1975. The meaning of “meaning.” Language, Mind and Knowledge: Minnesota Studies in the Philosophy of Science 7: 131–193.Google Scholar
  11. 11.
    Burge, T. 1979. Individualism and the mental. In Midwest studies in philosophy, ed. P. Uehling, 73–121. Minneapolis: Minneapolis University Press. Google Scholar
  12. 12.
    Peacocke, C. 1992. A study of concepts. Cambridge: MIT Press.Google Scholar
  13. 13.
    Radley, A. 1994. Making sense of illness. London: Sage Publications.Google Scholar
  14. 14.
    Nettleton, S. 1995. The sociology of health and illness. Cambridge: Polity Press.Google Scholar
  15. 15.
    Perloff, R., B. Blonder, G. Ray, E. Ray, and L. Siminoff. 2006. Doctor–patient communication, cultural competence and minority health. American Behavioral Scientist 49 (6): 835–852.CrossRefGoogle Scholar
  16. 16.
    Pessin, A., and S. Goldberg. 1996. The twin Earth chronicles: Twenty years of reflections on Hilary Putnam’s “The Meaning of ‘Meaning’.” New York: M.E. Sharpe.Google Scholar
  17. 17.
    Todd, A., and S. Fisher. 1993. The social organization of doctor–patient communication. Portsmouth: Greenwood.Google Scholar
  18. 18.
    Gannik, D., and L. Launso, eds. 2000. Disease, knowledge and society. Copenhagen: Samfundslitteratur.Google Scholar
  19. 19.
    Evans, G. 1982. The varieties of reference. Oxford: Clarendon Press.Google Scholar
  20. 20.
    Guttenplan, S., ed. 1996. A companion to the philosophy of mind. Oxford: Blackwell.Google Scholar
  21. 21.
    Putnam, H. 1981. Reason, truth and history. Cambridge: Cambridge University Press.Google Scholar
  22. 22.
    Wittgenstein, L. 1953. Philosophical investigations. Oxford: Blackwell.Google Scholar
  23. 23.
    Wittgenstein, L. 1967. On certainty. Oxford: Blackwell.Google Scholar
  24. 24.
    Worhall, J., and J. Worhall. 2001. Defining disease: Much ado about nothing? Analecta Husserliana 72: 33–55.Google Scholar
  25. 25.
    Nordby, H. 2006. Nurse–patient communication: Language mastery and concept possession. Nursing Inquiry 13 (1): 64–72.CrossRefGoogle Scholar
  26. 26.
    Fodor, J. 1998. Concepts. Oxford: Oxford University Press.Google Scholar
  27. 27.
    Villanueva, E. 1998. Concepts: Philosophical issues. Atascadero: Ridgeview Publishing Press.Google Scholar
  28. 28.
    Bezuidenhout, A. 1997. The communication of de re thoughts. Nous 31 (2): 197–225.CrossRefGoogle Scholar
  29. 29.
    Cappelen, H., and E. Lepore. 2005. Insensitive semantics. Oxford: Blackwell.Google Scholar
  30. 30.
    Nordby, H. 2004. Concept possession and incorrect understanding. Philosophical Explorations 7 (1): 55–72.CrossRefGoogle Scholar
  31. 31.
    Gadamer, H.G. 1975. Truth and method. New York: Continuum.Google Scholar
  32. 32.
    Crawford, P., B. Brown, and P. Nolan. 1998. Communicating care. Cheltenham: Stanley Thornes.Google Scholar
  33. 33.
    Pendleton, D., P. Tate, and T. Schofield. The new consultation: Developing doctor–patient communication. Oxford: Oxford University Press.Google Scholar
  34. 34.
    Downie, R., and J. Macnaughton. 2000. Clinical judgement: Evidence in practice. Oxford: Oxford University Press.Google Scholar
  35. 35.
    Nordenfelt, L. 1987. On the nature of health. Dordrecht: Klüwer Academic Publishers.Google Scholar
  36. 36.
    Nordby, H. 2006. The analytic-synthetic distinction and conceptual analyses of basic health concepts. Medicine, Health Care and Philosophy 9 (3): 169–180.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media B.V. 2008

Authors and Affiliations

  1. 1.Department of Health Management and Health Economics, Faculty of MedicineUniversity of OsloOsloNorway
  2. 2.Faculty of Health and Social WorkLillehammer University CollegeLillehammerNorway

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