Language and ethics – being “let” to go overdue

The more I think about it the more I think that one issue bioethicists should play much closer attention to is the language used to describe things.

This isn’t a new thought, Kongzi (known as Confucius in the West) said:

Tsze-lu said, “The ruler of Wei has been waiting for you, in order with you to administer the government. What will you consider the first thing to be done?”
The Master replied, “What is necessary is to rectify names.” “So! indeed!” said Tsze-lu. “You are wide of the mark! Why must there be such rectification?”
The Master said, “How uncultivated you are, Yu! A superior man, in regard to what he does not know, shows a cautious reserve.
“If names be not correct, language is not in accordance with the truth of things. If language be not in accordance with the truth of things, affairs cannot be carried on to success.
“When affairs cannot be carried on to success, proprieties and music do not flourish. When proprieties and music do not flourish, punishments will not be properly awarded. When punishments are not properly awarded, the people do not know how to move hand or foot.
“Therefore a superior man considers it necessary that the names he uses may be spoken appropriately, and also that what he speaks may be carried out appropriately. What the superior man requires is just that in his words there may be nothing incorrect.”

From The Analects of Confucius, Book 13, Verse 3 (James R. Ware, translated in 1980.)

I’ll give an example to make my point clear.

One thing I remember vividly from my antenatal classes is a comment made by the teacher in response to one of the mothers in the class asking what would happen if she went overdue – she was told not to worry the doctors wouldn’t let her go more than two weeks overdue. Likewise my sister is now pregnant and slightly overdue, and I’ve heard her and others express the same sentiment, that she wouldn’t be let to go too overdue.

It is an interesting and revealing way of phrasing the situation – it seems to indicate that it is up to the doctors when the mother gives birth, and if she takes too long about it then she needs special permission from the doctor, otherwise they will make her give birth.

What a horrendously disempowering way of phrasing things, which implicitly passes control over the mothers body from her to the healthcare professionals involved. So much for the triumph of autonomy over paternalism…

It is better to say that if a mother goes more than two weeks overdue doctors will advise her to be induced – since it is her choice whether to be induced or not, and while it might be medically advisable to be induced no one can force her.

Are there other examples of where we need to tidy up our language in bioethics?

  • Keith Tayler

    Far too many to list – but ‘enhancement’ is particularly messy.

  • livingdonor101

    Refering to kidney transplants as 'life-saving'. Transplants are treatments, not cures, and especially in the case of kidneys, other treatments are available. The phrase 'saving a life' and any of its brethren serve to obfuscate the reality of living donation, and pad the prospective or current living donor's ego.

    Telling living kidney donors that their remaining kidney will 'grow' to compensate for the loss of the donated kidney. A kidney donor loses 50% of their nephrons, never to be regained. The remaining kidney hypertrophies, meaning the cells actually swell or increase in size. They do not replicate, as growth implies.

    In addition, the increased pressure of one kidney to handle 25% of the body's blood (as opposed to two) at any particular time causes hyperfiltration, a widening of the kidney's blood vessels, and greater plasma pressure as it pushes through the glomerules and nephrons. Consider what happens to a balloon when it is blown up.

    Hypertrophism can be a response to disease or dysfunction in the heart and is viewed unfavorably when occuring in other glands or organs. Hyperfiltration can be a symptom of diabetes or kidney disease, and can lead to glomerular damage and other renal problems (eg. proteinurie). Despite the transplant industry's assurances, these are compensatory adaptations, not proof of living kidney donation's safety.