June 19 2019
As the Australian Royal Commission into Aged Care Quality and safety rolls on, questions around the quality of health care in circumstances where consumers may have reduced capacity to communicate their needs have been highlighted.
How do doctors, nurses, allied health specialists and other care providers navigate communications in their day-to-day interactions with people, and how does that impact on health outcomes?
The University of South Australia will be putting issues of healthcare language, communication and meaning in the spotlight when it hosts the 17th International Conference on Communication, Medicine and Ethics June 26-28 (Comet Conference 2019 – Convene IT).
“When you have a health problem and enter the medical world, often having to consult specialists in different fields with different expertise, the only thing you have at your disposal to make sense of a diagnosis, prognosis, treatment, care, risk and recovery, is language,” he says.
“It becomes a huge influencer of how you get through. If you then mix in emotion and cultural differences, we have a very stressful melting pot which can impact on care outcomes.
“It’s no surprise that we are finding that in difficult areas such as care for people with dementia or with complex and manifold health needs, inadequate consideration of language and communication can detrimental to good care.
“Each field of health has its own language and words take on different layers of meaning in the different worlds of various health specialisations.
“We’ve seen huge shifts in language from a time when anyone who sought medical care was labelled a patient, to an era where everyone is a health consumer. In that shift alone, we have moved from understanding people as passive receivers of care, to seeing them as choosers of care options.
“At the conference we will be exploring the issue of language and its influence on good healthcare along with other issues of ethics and dignity in best practice medicine and healthcare.”
The conference will be held at UniSA’s City West campus and will feature keynotes from leading international researchers, including Professor Srikant Sarangi, Director of the Danish Institute of Humanities and Medicine (DIHM) at Aalborg University, Denmark; Professor Charlotte Rees
from Monash Centre for Scholarship in Health Education in Victoria; Professor Howard Waitzkin, Distinguished Professor Emeritus in the Department of Sociology at the University of New Mexico and adjunct Professor at the University of Illinois, Department of Medicine; and Professor Phyllis Butow, NHMRC Senior Principal Research Fellow in the School of Psychology at the University of Sydney.
Selected just recently to share his expertise with a panel at the Royal Commission into Aged Care Quality and Safety, Dr Crichton says recognising the language we are using, it’s labels, stigmas and other outfalls, and better training for the next generation of health professionals will make positive inroads into what has been a largely unmapped ethical area.
“History is full of examples where language can act to disempower, disregard and discriminate,” Dr Crichton says.
“Along with the aged care sector, I’ve been involved in researching linguistics in psychiatry and this is another area where layers of understanding and interpretation, and by both the patient and psychiatrist, play out in a space where language is also central to diagnosis, treatment and care.
“What we have traditionally found is that language is the ‘dark matter’ of health provision, profoundly influential but typically hard to capture.
“The upshot is that we know that experienced medical and health practitioners can become highly accomplished in their communicative expertise, but the language of health care is not yet taught widely.
“So, practitioners are typically left to learn it by experience.
“This is an emerging area we need to address if we are genuine about improving how health practitioners and health organisations help people get through the often life-changing experience of ill-health or the inevitable challenges of growing old.”