Can't agree, Jenny. I WOULD fault biomedical texts for using such jargon.
There are times when discussing deep issues in some areas of 'biomedicine'
where jargon is inevitable, but good medical writing should have a degree of
clarity such that a reasonably educated person can grasp the meaning. There
is an awful lot of bad medical writing, however that should not stand as an
exemplar to other disciplines.
As you are aware within the Collaboration, much emphasis is placed on making
reviews readable. If they were written in the style of Filc they would be
useless. The baby would be heaved out with the bathwater before the first
page was finished.
Mike Bennett
Thanks for your clarity, Mike. Just quickly, there is often a sense that
social science literature should somehow be open to all, within and outside
of the field. However, no one would fault biomedical texts for using
'jargon' that is only comprehensible to those within the field. Social
science, broadly speaking, is likewise a learned space, where jargon is
sometimes used to get across complex thought, where simplistic language
(that everyone and anyone could understand without having the necessary
skills and background) sometimes just won't do. I'll leave it at that,
thanks again,
Jenny
Mike Bennett <[log in to unmask]> wrote:
>
>
>
>
>
>
>
> To comment on the discussion so far concerning this
> paper, I suspect there is something of value in what both Eric and
Roy on
> the one hand, and Jenny on the other have to say. It is largely a
matter of
> emphasis.
>
> Filc is correct to point out that EBM and indeed,
> medicine in general should attach more importance to the social context in
which
> it operates. There is increasing discussion within the Cochrane
Collaboration
> (to take an example of a fairly pure culture of EMB), concerning social
> relevance of their reviews, and particularly how conclusions about
effectiveness
> need to be interpreted in the light of different societies or sub-cultures
> within a society. At it crudest, for example, cost-effectiveness may be
quite
> different in different settings. Many of us could list a number of more
subtle
> social and cultural influences on effectiveness. This is not 'anti-EBM',
nor
> 'anti-biomedicine'.
>
> Filc also highlights the tendency to medicalise
> social or cultural problems - the recent controversy in my field
concerning the
> appropriateness of medical examinations in order to declare an individual
'Fit
> for Diving' is an example. No human being is fit to dive, and pretending a
> medical practitioner can make the distinction is not logical. What is
really
> required is for an individual to be offered an informed risk assessment of
a
> social activity - and this assessment might well involve medical,
physical
> ability and equipment issues best addressed by a number of individuals,
> including an appropriate physician.
>
> Having said that, the tone of this article makes it
> quite clear where the author is coming from, and that is largely
anti-medical
> doctor and thereby anti-EBM and anti-'biomedicine'. (The latter is an
> interesting term of itself. I am not sure there can be any meaningful
medicine
> which is not 'bio'.) Filc is drawing the link between 'physican
medicine'
> if I may use that term, as the dominant paradigm in Israeli society,
with
> the social and political forces that dominate the state of Israel. I
find
> the argument quite interesting, if rather beyond my limited comprehension
at
> times. Certainly, Filc believes 'we' have it wrong in regards to EBM, a
process
> which Filc states critically 'holds scientific research to be
the
> means for knowing the truth'.. There is also apparently something
> reprehensible about a medical journal containing predominantly articles
about
> medicine 'a telling commentary on the priorities of the medical
> profession'. Well, yes I guess so.
>
> Some of the text does approach (but not
> quite reach) the meaningless post-modernist stuff Roy and I discussed in
this
> group some time ago. While much of the text is comprehensible, there are a
> number of passages that seem to have been deliberately written in a way to
> obscure rather than enlighten. For example: "Medicalization implies the
> desocialization and reification of disease and illness and the explanation
of
> social problems in biomedical terms. The affirmation of current
relationships of
> domination implies the acritical internalization of those relationships
into the
> medical discourse." I think I know what it means, but it is a struggle for
> me to keep such passages straight in my mind. I am willing to accept the
fault
> may be mine, but surely there is a better way to write this stuff?
>
> Filc is particularly critical of the apparent
> inability of medicine to see the social dimension of illness, and this is
a view
> with which I sympathise. Again, it is a matter of emphasis whether members
of
> this list would accept, concerning chronic fatigue syndrome (CFS), '(the
> authors) do not ask whether thirty-something women's chronic fatigue is
caused
> because gender division in our society makes women work twice (earning a
living
> and doing home tasks). This omission ignores gender oppression.' If Filc
> mearly wishes to state that a lot of medical research is poor, I'm sure
many on
> this list would agree, but he/she seems determined to see this as an
indication
> that medicine is a tool of oppression in some way. Indeed, we are most
useful:
> 'By calming the patient, the physician becomes functional to the hegemonic
> project.'
>
> There is much more of interest in this article, and
> I urge those interested to read it. My conclusion is that Filc has
made
> some good points in what is a dense and at at times nearly
incomprehensible text
> that is ultimately misdirected. If EBM is guilty of ignoring society, Filc
is
> guilty of the overuse of jargon and circumlocution.
>
> Mike BennettDept of Diving and Hyperbaric
> MedicinePrince of Wales Hospital and University of
> NSW
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