Discourse Of Biomedicine Research Articles

Patient participation as discursive practice-A critical discourse analysis of Danish mental healthcare.

Patient participation is one of the most prevalent focus areas in the Danish healthcare debate. Patient participation is generally presented as a fundamental democratic right, and is stated in an objective language with legal requirements for healthcare professionals to ensure that patients systematically participate in their own courses of care and treatment. In the research literature, it is not clear what is meant by 'patient participation', and several discourses on patient participation exist side by side. This study explores how discourses of patient participation unfold and are at play in the articulations in official legal and political documents and patient records relating to a Danish psychiatric context. The documents and patient records have been analyzed using a Fairclough-inspired critical discourse approach which is concerned with how power is exercised through language. The research findings show that patient participation within Danish psychiatric healthcare is governed within a neoliberal discourse where underlying discourses; discourse of biomedicine, paternalism, management, evidence and ethics of care are embedded, and a discourse that seems to ascribe stigmatizing traits to mentally ill patients.

Breast cancer representations in Canadian news media: a critical discourse analysis of meanings and the implications for identity

ABSTRACTDespite the importance of critical media work, much is to be learned about breast cancer representations within media discourses and the implications for women’s identity construction. Building on research from Australia from a discursive perspective, this article used an eclectic approach to critical discourse analysis to explore the cultural construction of breast cancer in 25 detailed stories within Canada’s two national newspapers, The Globe and Mail and the National Post. Ten images accompanying stories and 17 advertisements/public service announcements were also analyzed to contextualize discourses and subject positions/identities within the stories. Analysis of this media affords the unique opportunity to explore taken for granted assumptions and prevailing meanings about breast cancer and the implications for subjectivity. Two primary discourses were identified: a discourse of biomedicine and a discourse of healthism. Subject positions identified included “breast cancer survivor,” “the good consumer,” and the “medical expert.” The psychological, social, political, and health promotion implications are discussed.

Desde la complejidad y la ética de la investigación: paradojas de los discursos biomédicos sobre la violencia de género en México

En este trabajo se exploran desde el método de la complejidad, la ética de la investigación y el feminismo crítico, los discursos universalistas, dicotómicos y ahistóricos que sobre violencia de género se han propagado en los sistemas de salud. Propone que tendríamos que re/pensar las paradojas que ha significado incluir en las investigaciones teóricas y la atención a la violencia de género el discurso "científico" de la biomedicina y derivado de esto, la vuelta a la apropiación del cuerpo de las mujeres a través de la medicalización de la problemática. Analiza con esta base teórica los discursos que a manera de simulacro pretenden "resolver" la violencia de género contra las mujeres mediante la implementación de estrategias simples, que para el caso de México han tendido al fracaso.

First Do No Harm? Female Hysteria, Trauma, and the (Bio)Logic of Violence in Iraq

In Iraq, women are frequently rushed to the hospital in severe anxiety, diagnosed by medical professionals in local hospitals as “hysterical.” The treatments proffered are often disturbingly violent in their own right, indicating the normalization of violence in the conflict zone and the rationalizing discourses of biomedicine to this end. Based on fieldwork in the northern Kurdish region, held to be a prosperous beacon of “postconflict” stability in an otherwise war-torn country, I consider the ways in which neoliberal interventionist agendas, medical technologies in the aftermath of war, and gendered narratives of the Kurdish nation coalesce to valorize particular forms of suffering while devaluing others as both inherently “feminine” and devoid of either agency or recuperative value. I argue that the violence of such biomedical beliefs forms a “natural” rationalized corollary of wider logics of violence in the war zone, and that both inscribe non-normative expressions of trauma in gendered terms.

(Re)considering Voice

This article considers some of complexities around a feminist imperative of `voice'. It is a reflective dialogue that follows the possibilities and problematics encountered in a social inquiry aimed at creating space for the women who participated to `give voice' as a collective. Our explorations about the ways that these women, diagnosed with a psychiatric disorder, come to experience their everyday worlds as they do, involved identifying the social processes and practices shaping their lived actualities. Speaking together and back to the discourses of biomedicine that work to position these women in fixed and universal ways was also central to our researching. That the woman's voice goes largely unheard when spoken from `madness' made such work more urgent. As our navigations of speaking together shows, however, this was not as straightforward as we had envisaged: because the circumstances that produce experiences of oppression are rarely simple, social change efforts to ameliorate inequities will necessarily need to be nuanced. This polyphonic discussion honours the respective contributions to our knowledge-making endeavours, and tells of a project cast in feminism's `with'.

Representations of people with HIV and hepatitis C in editorials of medical journals: Discourses and interdiscursive relations

HIV and hepatitis C are blood-borne viruses that cause chronic diseases and affect (in parts of the developed world) predominantly groups that are marginalized and discriminated against: gay men and injecting drug users, respectively. This paper compares the representation of people with HIV and hepatitis C in editorials of medical journals between 1989 and 2001. Analysis is informed by critical discourse analysis and systemic functional linguistics. Hepatitis C editorials draw almost exclusively on the discourse of biomedicine, and patients are either absent or objects in medical procedures. In HIV editorials, a variety of other discourses are integrated into the discourse of biomedicine, thereby creating multidimensional representations of people with HIV as patients and agents in medical procedures, involved in decision making, affected by economic factors, social and cultural issues. The paper discusses the role of the gay community in discursive change and argues that discursive diversity in the representation of people infected with HIV and hepatitis C in medical journals is necessary for health policy, the professional development of healthcare providers, and media reporting to the general public.

Doctoring the Spirit: Exploring the Use and Meaning of Mimicry and Parody at a Healing Centre in the North of England

The widespread increase of complementary and alternative medicine (CAM) in western societies has been well documented, yet biomedicine has not been significantly challenged by this resurgence. Even within the more esoteric practices such as spiritual and crystal healing, I show how the hegemonic discourse of biomedicine is reflected in the healing acts. Spiritual and crystal healers seemingly infuse their practice with some of the language and science of biomedicine. This throws into question the conventional biomedicine/alternative medicine interface, and offers some insight both into the common metaphorical basis of healing and medicine, and the continued influence of biomedicine. This article addresses this theme in relation to the empirical example of a healing centre in the North of England, where I conducted an ethnographic study.

Birth and the Postpartum in Northeast Thailand: Contesting Modernity and Tradition

Based upon ethnographic research in Northeast Thailand, this paper explores birthing and postpartum practice and discourses of modernity and tradition in a rural village. Although the majority of village women give birth in a hospital, they follow traditional postpartum practice within the village. Postpartum practice is both a health practice understood to ensure their strength and well‐being, and a rite of passage that asserts their ethnic and female identity. The village is a social space in which the definitions and practices imposed by the dominant biomedical discourse do not prevail. In birthing and the postpartum period, women move between the spatially separated domains of the hospital and the home and in doing so move between discursive frameworks: the first where discourses of biomedicine and state development prevail and the second where community discourses and meanings dominate.