The American medical humanities scholar Kathleen Powers questions the notion that the violence within hospitals or within medicine is tempered by metaphor and discretion. Rather, she considers the metaphoric language used in hospitals to be a language of violence, or a language of war. In a 2017 paper she outlined the militaristic and violent frameworks for the metaphoric descriptions of treatment and patient response. These descriptions include the notion that some therapies offer “a precise and targeted response to sites of disease … requiring ongoing surveillance to find new targets from a silent and hidden threat and interminable medical interventions.”[1] However, Powers suggests that the success or otherwise of these treatments is often attributed to the courage of the patient and their ability to fight the disease. Within this violent, militaristic metaphor, should the patient stop fighting they will almost certainly experience defeat; to transition to palliative care implies failure.
The crux of her paper is that violent, militaristic language and metaphor privileges the use of aggressive, violent treatments and is a means of passing responsibility for the success or otherwise on to the patient. Bizarrely, Powers has found these violent metaphors are now often applied to patients with Alzheimer’s and dementia, both of which are currently incurable. The agency of patients with Alzheimer’s or dementia is compromised and unlikely to affect the progression of the disease; however, the language used would still unfairly imply the patient had agency in the progression of their disease.
[1] Kathleen Powers. “The common use of words of violence in medicine”. Medicine and Violence Conference, the Program for the Medical Humanities. September 8, 2017. University of California, Berkeley. Center for Science, Technology, Medicine and Society.”
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