Tuesday, March 25, 2014

Respect, Acclaim, and Credibility: Subjective Phrasing in Case Reports

Case reports often taken on an official style in which the situation presented, that is the condition and treatment of a patient, is deescalated to a point where the medical professionals reading the report are desensitized from what is really happening to the patient and is instead offered an objective oriented view. This allows the authors to direct the reader’s attention on the efforts made and the outcomes that resulted. Ultimately, the focus shifts from the patient’s overall wellbeing to the efforts made by medical professionals who are responsible for the care of the patient. This signifies that the true purpose of such official writing is to further advance the acclaim and respect of the authors and medical professionals in the eyes of the rest of the professional medicine community. There are many ways in which this effect is achieved some of which include impersonal language, medical jargon, and subjective phrasing.  

            When referring to the patient, the authors do so passively in such a way that the focus is shifted from the patient to the efforts made to treat the patient. This can be seen through the use of “he” in reference to the patient and “the” instead of “his” in reference to something that belongs to the patient. “He has burns of variable thickness to the face, neck, chest, both arms, both thighs and the abdomen amounting to 33% total body surface area…” The lack of personal reference is due to ethical and professional standards that must be upheld while providing care for someone because of the confidential manner of the situation. In order to maintain an ethical standard of privacy and professionalism, medical professionals must not reveal any identifying information, such as the name, of a patient. This standard is expected among all medical professionals when they discuss or report about certain cases and signifies competency within their field. A subsequent effect that is often not readily noticed of this impersonal language is that besides upholding a professional standard, the case report is being focused on the authors themselves and their efforts.

            Once the focus is shifted to the authors’ efforts the authors must be able to maintain their credibility and respect which is often accomplished via the use of jargon relative to medical profession. The use of precise, formal language in relation to medicine is necessary to convey certain ideas that are being presented. This specific use of diction creates a type of shorthand which allows for communication amongst medical professionals to be clear and concise. Subsequently the authors are furthering their respect and acclaim through the lens which they are perceived by their peer professionals.

Purposefully or not the authors are putting themselves on a pedestal to showcase their efforts and knowledge. Impersonal language and medical jargon help the author establish credibility, respect, and acclaim which in turn allows them to phrase their report in a subjective manner. Case reports are phrased in a way which can allow the authors to take credit for but also avoid responsibility of the consequences of the information presented.

Should medical professionals’ findings on a type of treatment of a specific medical issue manifest into actually be detrimental to patients, then the medical professional will have wanted to word their report in such a way that they can go back and point out that they stated their uncertainty. Rather, they will want to be able to say that they were merely stating their findings without any proclamation of its significance. On the other hand, if their findings prove to further advance the care and quality of life of patients, then they will want to have worded the same report in a manner that portrays their discovery as an advancement in the future of medicine. An effective way through which this subjective phrasing is accomplished is the use of vague statements such as “we believe” or “we report” or even “may allow.”

Why would this be important? Why would a medical professional want to word their findings in such a way that, regardless of its practical significance and relation to the future of the medical field, would allow for subjective interpretation of their findings? The world, especially the world of medicine and science, is filled with uncertainty. What may be a groundbreaking finding today could end up being a false point tomorrow. Since the world is constantly changing and evolving, medical professionals want to be able to present their findings in such a way that they can take credit for its contributions to their field of study regardless if their findings prove to be accurate or are declared false. Essentially this is a win-win situation.

Upon recognizing this unique position that researchers put themselves in, their motives can be clearly reasoned. By wording their findings in a manner that allows for interpretation of their intent, the professionals are protecting themselves from backlash against others in their field. This protection of their reputation therefore allows for professionals to publish their findings without any negative drawbacks. For example, if their findings prove to be false they can simply say that they were reporting on what they had found and had not made any concrete conclusions about the significance of their publication. In this case their reputation is maintained and no true harm has been done. On the other hand if their findings do prove significant then their acclaim and reputation can only be boosted. Often times the purpose of this official style would be masked by professionals who say that they publish their findings to be used in collaboration amongst professionals rather than their own self-interest. This too is open for interpretation just as the phrasing of case reports are.
-James G. 

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