“health and medical rhetoric infuses every aspect of healthcare” (Keranën 2014, p. 1173) from insurance forms, patient intake histories, and clinical notes through online support groups, digital health information, pharmaceutical advertisements, email exchanges between patients and providers, and mass‐mediated representations of illness. Scholarship in the rhetoric of health and medicine offers a humanistic perspective on the exigencies, functions, and impacts of health‐related discourse.
Stokes (2014) outlined four theoretical assumptions that – echoing the other frameworks in this chapter – demonstrate the commitment of rhetoricians as critics to keep close relationship with the discourses they critique. First, rhetoricians assume reality is constructed through language and culture is perpetuated through discourse. To that end, they are interested in both the measurable outcomes of a campaign and in the ways that campaign could shift cultural views, as demonstrated, for example, in campaign analyses of the use of humor in combating stigma about mental health in men (Mocarski and Butler 2016) and in the endorsement of personal responsibility for managing risks of infection (Brown 2019). Second, rhetoricians acknowledge that a neutral stance is both impossible and unethical, given that they bring their own ideologies and biases to bear when studying a particular phenomenon. Third, rhetoricians recognize that their perspective is selective. As such, any rhetorical act can be read in numerous ways, and audiences may take away different meanings from a particular health message. Finally, rhetoricians debate what constitutes an object of critique, noting that it could be one particular persuasive discourse or an assembly of texts and artifacts. As Lisa Keranën, an influential rhetorician of health and medicine, noted:
Rhetorical studies of health and medicine have increasingly embraced theoretical frameworks and methods that can account for the complexities of language as social action, shifting our focus from texts to the networks, ecologies, and activity systems that shape health‐related discourse and its effects. Many rhetoricians of health and medicine are looking beyond traditional rhetorical theory and methods – with their emphases on the persuasive moves of authors in texts – to explore other means of rhetorical inquiry… that foreground interconnectedness, materiality, and movement in health and medicine.
(Scott, Segal, and Keranën 2013, p. 3)
Indeed, Jensen (2015) positioned the articulation and tracing of health‐related arguments in and through time as a major objective of scholarship in rhetoric of health and medicine, and she offered two different but related orientations for engaging this approach. In the first, research focuses on the interaction of different kinds of rhetoric across a largely chronological timeline to constitute broader health landscapes. As an example, Jensen (2016) drew from doctor–patient correspondence, oral histories, and contemporary popular and scientific news coverage to trace the transformation of language surrounding infertility and the implications of those rhetorical constructions on individuals and the societies in which they live.
In the second approach, research demonstrates how historical arguments about health percolate up at distinct, chronologically disjointed moments: “The exploration of health as it was conceptualized in even the distant past can be understood… as a valuable contribution to delineating conceptualizations of health today that may not follow a linear or rational logic” (Jensen 2015, p. 524). To illustrate, consider the notable study on mothering, media, and medical expertise conducted by historian Bethany Johnson and health communication scholar Maggie Quinlan (2019). They engaged historical texts (e.g. doctors’ notes and family papers) and present‐day social media texts (e.g. comments and hashtags) to discover how such discourses have challenged and continue to challenge and create expertise and power relations in defining the good mother. Other studies have examined the rhetorical work of genres, such as Cole and Carmon’s (2019) analysis of addiction‐related obituaries, and the rhetoric of a particular area or topic, like Miller’s (2019) analysis of fat stigma as rhetorical disability or Alderton’s (2018) analysis of the aesthetics of self‐harm (i.e. visual rhetoric) in online communities.
Conclusion
Zoller and Kline (2008) defined the goal of interpretive, critical, and rhetorical health communication research as seeking “to better understand interpretation and the process of meaning making … [and] to provide in‐depth understanding of lived experience or a unique, well‐argued and defended interpretation of a discourse to impart some insight into the multiple ways in which communication fosters particular meanings” (p. 93). From these paradigms, grounded theory, narrative theorizing, autoethnography, and rhetoric of health and medicine intertwine theory and method to contribute a rich body of interdisciplinary scholarship in health‐related contexts.
Acknowledgment
Special thanks to Barbara Sharf for the insightful comments that prompted the creation of this chapter and the generous feedback provided as I wrote it.
References
1 Alderton, Z. (2018). The aesthetics of self‐harm: The visual rhetoric of online self‐harm communities. Abingdon, UK: Routledge.
2 Allen‐Collinson, J. (2013). Autoethnography as the engagement of self/other, self/culture, self/politics, and selves/futures. In S. Holman Jones, T. E. Adams, & C. Ellis (Eds.), Handbook of autoethnography (pp. 281–299). Walnut Creek: CA: Left Coast Press.
3 Anderson, L. (2006). Analytic autoethnography. Journal of Contemporary Ethnography, 35(4), 373–395. doi:10.1177/0891241605280449
4 Baglia, J. (2019). Beginning again: Diagnosis as breach, survival as a new normal. In L. W. Peterson & C. E. Kiesinger (Eds.), Narrating midlife: Crisis, transition, and transformation (pp. 107–130). Lanham, MD: Lexington Books.
5 Birk, L. B. (2013). Erasure of the credible subject: An autoethnographic account of chronic pain. Cultural Studies – Critical Methodologies, 13(5), 390–399. doi:10.1177/1532708613495799
6 Bochner, A. P. (2014). Coming to narrative: A personal history of paradigm change in the human sciences. New York, NY: Routledge.
7 Bochner, A. P., & Ellis, C. (2016a). The ICQI and the rise of autoethnography: Solidarity through community. International Review of Qualitative Research, 9(2), 208–217. doi:10.1525/irqr.2016.9.2.208
8 Bochner, A. P., & Ellis, C. (2016b). Evocative ethnography: Writing lives and telling stories. New York, NY: Routledge.
9 Brown, M. M. (2019). Don’t be the “fifth guy”: Risk, responsibility, and the rhetoric of handwashing campaigns. Journal of Medical Humanities, 40, 211–224. doi:10.1007/s10912‐017‐9470‐4
10 Bruner, J. (1990). Acts of meaning. Cambridge, MA: Harvard University Press.
11 Burke, K. (1984 [1935]). Permanence and change (3rd ed.). Berkeley, CA: University of California Press. (Original work published 1935).
12 Chang, H. (2016). Autoethnography in health research: Growing pains? Qualitative Health Research, 26(4), 443–451. doi:10.1177/1049732315627432
13 Charmaz, K. (2006). Constructing grounded theory: A practical guide through qualitative analysis. London: Sage.
14 Charon, R. (2006). Narrative medicine: Honoring the stories of illness. Oxford: Oxford University Press.
15 Charon, R. (2009). Narrative medicine as witness for the self‐telling body. Journal of Applied Communication Research, 37(2), 118–131. doi:10.1080/00909880902792248
16 Cole, K. L. (2020). The paradox of patient consent: A feminist account of illness and healthcare. Health Communication, 1–10. doi:10.1080/10410236.2020.1724645
17 Cole, K. L., & Carmon, A. F. (2019). Changing the face of the opioid epidemic: A generic rhetorical analysis of addiction obituaries. Rhetoric of Health & Medicine, 2(3), 291–320. doi:10.5744/rhm.2019.1014
18 Corbin, J. (2009). Taking an analytic journey. In J. M. Morse, P. N. Stern, J. Corbin, B. Bowers, K. Charmaz, & A. E. Clarke (Eds.), Developing grounded theory: The second generation (pp. 35–54).