On the use of speech acts in medical practice

Introduction: The history of philosophy testifies to the applicability of rhetorical techniques to the content of therapeutic interlocution. Our methods of influencing people through processes of verbal interaction have developed over several hundred years, and this has also delivered a fruitful framework for evaluating these processes. The aim: To carry out an analysis of contemporary philosophical speech-act theories - viewed as elements of a form of therapeutic interlocution - and to interpret their efficiency in this regard.

Materials and methods: We examine the well-known speech-act theories of J.L. Austin and John Searle, but also - albeit indirectly - ideas stemming from Ludwig Wittgenstein. The conception of language they propose is similar to that of rhetoric: namely, viewing language as a tool for accomplishing something. In our case, the relevant goal is that of healing, or helping to heal, patients.

Preview: First of all, we outline what it could mean to "create reality" through making use of the power of words. Thus, we initially seek to outline the main points of Greek rhetoric, before then presenting the "speech act" theory of language: a model of language analogous to rhetoric that makes reference to Wittgenstein's conception of language games. After that, we illustrate the possibility of using speech-act utterances in doctor-patient interactions and, so to speak, in a kind of mode contrary to speech acts themselves, wherein the unintended expressing of something via words or sentences resembles the effects brought on by a placebo. Finally, in the last part of this article, we anatomize Plato's model of rhetorical utterance as something employed for the transmission of truth between doctor and patient. We will concentrate there, above all, on the question of what it means to be engaged in telling the patient the truth about his or her state of health.

Conclusions: On the one hand, the reference to speech-act theories provides a philosophical background for the use of words in some specific doctor-patient scenarios, while on the other it serves to exhibit the complex structures of our language itself: e.g. its interwovenness with actions such as touching, or its possible efficacy as a placebo, as in some instances of unintentional expressive utterance. Furthermore, using examples of different kinds of speech act, we can specify a number of truth-related and other conditions in force during doctor-patient interlocution.