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Health and the Rhetoric of Medicine

Judy Z. Segal

Publication Year: 2008

Assessing rhetorical principles of contemporary health issues


Hypochondriacs are vulnerable to media hype, anorexics are susceptible to public scrutiny, and mi­graine sufferers are tainted with the history of the “migraine personality,” maintains rhetorical theorist Judy Z. Segal. All are influenced by the power of per­suasion.


Health and the Rhetoric of Medicine explores per­sistent health conditions that resist conventional medical solutions. Using a range of rhetorical prin­ciples, Segal analyzes how patients and their illnesses are formed within the physician/patient relationship. The intractable problem of a patient’s rejection of a doctor’s advice, says Segal, can be considered a rhe­torical failure—a failure of persuasion.


Examining the discourse of medicine through case studies, applications, and analyses, Segal illus­trates how illnesses are described in ways that limit

patients’ choices and satisfaction. She also illuminates psychiatric conditions, infectious diseases, genetic testing, and cosmetic surgeries through the lens of rhetorical theory.


Health and the Rhetoric of Medicine bridges criti­cal analysis for scholarly, professional, and lay audi­ences. Segal highlights the persuasive element in di­agnosis, health policy, illness experience, and illness narratives. She also addresses questions of direct-to-consumer advertising of prescription drugs, the role of health information in creating the “worried well” and problems of trust and expertise in physician/patient relationships. A useful resource for critical common sense in everyday life, the text provides an effective examination of a society increasingly influ­enced by the rhetoric of health and medicine.


Published by: Southern Illinois University Press


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pp. c-ii

Title Page

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p. iii-iii

Copyright Page

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pp. iv-vi


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pp. vii-viii

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pp. ix-xii

Over the years of work that have gone into this book, I have had the support of the Social Sciences and Humanities Research Council of Canada and the Hampton Fund of the University of British Columbia. I have received funding from other sources as well: Riverview Hospital (Port...

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Introduction: The What, Why, and How of a Rhetoric of Medicine

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pp. 1-20

This book is for a range of readers: rhetorical theorists, rhetoricians of science, medical anthropologists, historians of medicine, and other scholars; health practitioners and health researchers with a special interest in the book’s topics (for example, migraine, health anxiety, end-of-life...

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1. A Kairology of Biomedicine

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pp. 21-36

Some sure evidence that biomedicine, notwithstanding its scientific basis, is subject to the vagaries—and the rhetoric—of situation is the instability of the nosology, the catalogue of illnesses. Both Edward Shorter and Elaine Showalter, for example, say that certain diseases, such as...

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2. Patient Audience: The Rhetorical Construction of the Migraineur

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pp. 37-58

The patient takes on certain new characteristics when regarded as a speaker and an audience involved in a rhetorical situation. In the physician’s office, the patient is not only an ill person or a person with a complaint; he or she is also an interlocutor in a persuasive encounter in...

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3. The Epideictic Rhetoric of Pathography

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pp. 59-73

In recent years, narrative has found a place in health research, not only among social science and humanities researchers but also among some medical researchers1 as the default opposite of biomedical discourse. Biomedicine is associated with a thinness in descriptions of patient experience,...

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4. Hypochondria as a Rhetorical Disorder

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pp. 74-90

If primary headache is the headache that is of interest in itself, not as a symptom of meningitis or brain tumor, then, on analogy, hypochondria is a kind of primary suffering, a suffering in itself, more complete because it takes place at a heightened level of awareness. Indeed, reflection...

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5. A Rhetoric of Death and Dying

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pp. 91-114

Some of what transpires between health professionals and patients or their family members in conversation at the end of life—and, indeed, some of what is taken to constitute “shared decision making” or to warrant “informed consent”—does not meet all of the conditions for rhetoric...

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6. Values, Metaphors, and Health Policy

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pp. 115-132

Metaphor is the most rhetorical of figures, and its ubiquity is the best evidence that we are, each of us, everyday rhetorical beings. Metaphor operates lavishly in health and medicine, but it operates, at the same time, somewhat under cover; such is the way of metaphor....

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7. The Problem of Patient “Noncompliance”: Paternalism, Expertise, and the Ethos of the Physician

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pp. 133-152

Billions of health-care dollars are spent each year because patients do not follow the instructions and advice of their doctors. One authority estimates the cost of medication noncompliance alone, in the United States alone, at $100 billion per annum (Gerbino). Medical and social-science...

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Conclusion: The Usefulness of a Rhetoric of Medicine

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pp. 153-160

Each of the foregoing chapters has used a rhetorical principle as a means of probing something puzzling or problematic in health and medicine. Each chapter was meant to be useful in a variety of ways and for a variety of readers. A historian, for example, might be interested in a rhetorical...


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pp. 161-186

Works Cited

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pp. 187-210


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pp. 211-217

Author Bio

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p. 218-218

Back Cover

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p. bc-bc

E-ISBN-13: 9780809386260
Print-ISBN-13: 9780809328666

Page Count: 232
Publication Year: 2008