Metaphors and Decision Making in Parental Blogs About Their Children with Life-Limiting Diseases: Who’s Afraid of the War Metaphor?

Article Summary by Veronica Neefjes

When we use war metaphors we think of a particular situation as a fight. War metaphors are widely used to spur people into action; ‘fight climate change’ and ‘war on drugs’ are just two examples. In healthcare war metaphors have a poor reputation because many fear that thinking of especially serious illness as a fight might lead patients and their families 1) to continue medical treatment cure is no longer possible and 2) to blame the patient when they ‘lose the fight’ implying they die because they haven’t fought hard enough. For that reason, for example UK healthcare professionals in childhood cancer discourage the use of war metaphors. However, the precise effects of the use of war metaphors in medical decision making for seriously ill children has not been investigated.

By analysing 15 blogs written by Dutch, German and English & Welsh parents about their ill child I investigated 1) which metaphors parents use for their child suffering from an incurable disease, 2) how their metaphors influence their decision making about medical treatment and 3) how the parents describe the death of their child.

All parents talk about their child in terms of war metaphors, i.e, ’fighter’, ’hero’ or ’trooper’ and describe their disease as an enemy, i.e. ‘assassin’ or ‘sniper’ which is fought on a daily basis. They also often also describe their family’s daily life with the child’s disease as a struggle. However, whilst ‘fighting the disease’ is important to parents, when making decisions about medical treatment parents weigh the importance of fighting against making sure that their child lives a ‘good’ life. For that reason, the use of war metaphors does not increase a tendency to treat when benefit is unlikely in the 167 treatment decisions made. Neither is the child blamed when they ‘lose the fight’ because parents interpret their death as the child ‘having fought enough’. Rather than their use of war metaphors having a negative effect, parents use war metaphors both as a way to express their love for and pride in their child and as a tool to empower their child and family to manage their incurable illness.

Read the full article on the Medical Humanities journal website.


Portrait of Veronica NeefjesVeronica Neefjes is a Consultant in Paediatric Palliative Medicine and currently working on a PhD about decision making and conflict in the medical treatment of seriously ill children.

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