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,...