June 23, 2016
Source: Bigstock
The word “natural,” when used in association with breastfeeding, is “ideologically-loaded” language? Funny, I just thought it was a fact. And when facts get redefined as “ideological constructions,” look out, because that’s how the state and its lapdog scientists rationalize suppressing them. What fascinated me about Dr. Martucci’s reply was that she seemed rather shameless about essentially admitting “it’s an accurate term when I use it, but not when public health officials do so in the presence of patients.”
I decided a follow-up was needed.
Since a cornerstone of the anti-vaccine mentality is suspicion that the “medical establishment” is suppressing information, keeping “the truth” from the general public, can it be argued that by encouraging public health officials to avoid using what you acknowledge is a correct term for breastfeeding, you might actually be feeding the paranoia of the anti-vaccination crowd? I mean, if the end game here is to not provide encouragement to the anti-vaccine mindset, can it be argued that your paper inadvertently aids that mindset by feeding the “anti-vax” belief that health professionals are willing to be less-than-fully-truthful with the public in order to encourage parents to vaccinate? That, at the very least, they are willing to encourage doctors to be manipulative regarding the words they use in order to promote vaccinations, to the point of taking a factual description for breastfeeding and encouraging doctors not to use it when dealing with patients?
Her reply:
Advising health authorities to avoid using ideologically-loaded language that has no fixed meaning and does not communicate health information is completely different than advising health authorities to suppress health information. When we advise health authorities to avoid using an ideologically-loaded term like “natural” to promote breastfeeding we are absolutely not advising them to suppress actual information, and it would not be a reasonable interpretation of our paper to conclude that we are advising the suppression of information in any way.
So now the word “natural,” when used in association with breastfeeding, is not only “ideologically-loaded,” but also a word with “no fixed meaning.” Other than, you know, its age-old dictionary definition (“existing in nature and not made or caused by people”). Still, I felt as though Dr. Martucci was just not getting my point, so I sent a follow-up to my follow-up:
You describe the word “natural” in relation to breastfeeding as an “ideologically-loaded term” to be “avoided” by health authorities, yet you did not avoid using the word (in relation to breastfeeding) in the title of your own book. Some might interpret that to imply that you”re saying, “I, as a professional, can be trusted to use the word in an academic study, but you, as a patient, cannot be trusted to hear it from your doctor.” Certainly, people with a mistrust of the medical establishment”the very people who are most vulnerable to anti-vaccination rhetoric”might interpret your position in that manner.
And then it got tiresome:
David, I think there still might be some kind of misunderstanding here about who our paper is directed to, and what kind of argument we”re making. The paper is directed towards physicians and other clinicians who communicate with patients about breastfeeding, and towards people who design public health breastfeeding promotion campaigns…. My book is not communication about breastfeeding between a clinician and her patient, or communication from a public health agency to the public. These are two *very* different kinds of communication. My history book targets historians, health policy makers and members of the public who are interested in knowing how breastfeeding became seen as important again after falling out of practice by the mid-20th century. Our “Pediatrics” article is a public health ethics piece which targets clinicians and public health workers who promote breastfeeding. In that piece, we discuss the communication between clinicians/public health folks and their patients. These are two very different types of work, with different intended audiences.
Yes, that’s my point. And she’s just not getting it. My point is that she’s saying one thing in a book directed at “health policy makers,” while, at the same time, advising them to avoid saying that same thing to “patients” and “the public.” As she says, “different intended audiences.” It’s totally fine to say that breastfeeding is “natural,” as long as your audience is “historians” and “officials.” But the word must not be used when dealing with patients and the public. She understands that breastfeeding is “natural,” but she is asking doctors and public health officials to stop saying so in the presence of their patients, in order to promote an ideological agenda she deems more important than a factual dialogue between doctor and patient. Doctors have to stop speaking a truth so that patients will stop knowing a truth, and if that sits poorly with you, you”re a misogynist.
Welcome to “medical ethics” circa 2016.
Circling back to Shakespeare, in Hamlet, Polonius instructs Laertes:
This above all: to thine own self be true,
And it must follow, as the night the day,
Thou canst not then be false to any man.
Polonius obviously never read the collected works of Dr. Jessica Martucci.
