Communication Problems within Medically Assisted Procreation and Palliative Care: The Power of Words

In this paper, I seek to analyse communication problems between health caregivers and patients within Medically Assisted Procreation (MAP) and Palliative Care. These discursive and relational difficulties are revealed through social interactions in health frameworks, which are defined by transparency (to give all the clinical information to the patient and his family) and objective measures (the results of medical examinations or treatments and the application of standardized therapeutic protocols). For example, MPA protocols are standardization instruments, based on the success rate, which neutralize patients’ singularity and make it difficult to keep the communication between health caregivers and patients. Moreover, sometimes terminally ill patients and their families are unable to grasp the meaning of the medical discourse, i.e. the scope, depth and implications of what is transmitted on the diagnosis and prognosis. Communication is troubled by technical language poorly controlled or disease basic knowledge and beliefs. Communication issues that cross over institutional frameworks are a complex relational dimension because of communication problems, constraints of narrative exchanges in the medical context and understanding or empathy deficits between health caregivers and patients. Regarding ordinary situations encountered in health institutions, the difficult dimension of living together requires interpersonal and communication skills to transmit a diagnosis, prognosis or therapeutic that are not always possessed by caregivers by the lack of rules thus producing unintended drift of communication that result in disorders, misunderstandings and disagreements. I will try to demonstrate that communication is fundamental in complex and delicate situations, such as an infertility diagnosis or the stop of traditional cancer treatments (chemotherapy, radiotherapy, surgery) and referral to palliative care. Building upon my post-doctoral research on MAP techniques and a research project on palliative care, I will approach this problem theoretically and empirically through the analysis of field notes and in-depth interviews with health caregivers and patients.