Global Health and the Rhetoric of Interdisciplinarity
My dissertation examines the significance of public health messaging to perceptions ofresponsibility and risk. Central to this research is my view of public health campaigns asrhetorical texts—rhetoric being the art and study of persuasion—that employ discursivestrategies of various kinds to achieve their aims. As rhetorical texts, public health campaignsprovide a means of involving individuals in health promotion and disease prevention, whichmakes them a valuable resource amid growing concerns about rising healthcare costsworldwide. In four case studies, on hand hygiene, vaccination, antibiotic use, and “epidemic”obesity, I illuminate the persuasive means through which public health comes to beunderstood as, in the first instance, a matter of personal responsibility. Given that the rhetoric of personal responsibility places more of the onus for health on individuals than on systems, this rhetoric has long been criticized in health contexts as a form of “victim blaming.” Appeals to personal responsibility, for example, ignore the influence of context on health status. These appeals also induce cooperation among individuals by triggering feelings of anxiety, stigma, and blame. Some public health scholars celebrate these effects as essential to public health; I stress their potential to impede a society’s capacity to cope with infection. Throughout, I examine the relationship of the rhetoric of personal responsibility to neoliberalization—especially its advantages for the private sector, some of which come at the expense of public health. A political-economictheory, neoliberalism prioritizes privatization, deregulation, reduced spending on social welfare, and minimal government interference in the private sector. In each of my chapters, I critique public health’s neoliberalization by documentingconsequences or conflicts of interest arising from the rhetoric of personal responsibility. Onesuch conflict is the opportunity to profit from altered perceptions of risk and responsibility,an effect I demonstrate most emphatically in my chapters on hand hygiene and “epidemic”obesity. A rhetoric of personal responsibility also distracts from the reality that someproblems—for example, antibiotic-resistant infections (ARIs) and declining vaccinationrates—necessitate both societal and individual change.
This study answers the question “what is writing studies?” by answering the question, “who is writing studies?” This dissertation attempts a people’s history of writing studies in Canada insofar as it defines writing studies, gives shape to the people who work in it, and begins to offer an explicitly political account of working in this field. Chapter 1 covers the motivation and context for the study, the framing of the research through feminist standpoint theory and survey research informed by life writing, significance of the study, and an outline of the chapters. Chapter 2 provides a literature review and fleshes out the theoretical framework. Chapter 3 details the methodology and methods for a quantitative and qualitative surveyof writing studies professionals in Canada, defined here as subscribers to the list-servs of Canadian Association for the Study of Discourse and Writing (CASDW), the Canadian Association for the Study of Language and Learning (CASLL), the Canadian Writing Centres Association (CWCA), and the Canadian Society for the Study of Rhetoric (CSSR). Chapter 4 situates me as researcher through life writing about my journey into writing studies. Chapter 5 presents data to provide a definition of writing studies in terms of demographic information, institutional locations, and working conditions.Chapter 6 describes a collective identity for writing studies through respondents’ definitions and uses of the term, “writing studies,” their membership in and understanding of the scholarly organizations of writing studies, and their identities as in writing studies or not. Chapter 7 details respondents’ descriptions of their experiences in writing studies in terms of their routes into the field, their perceptions of change, their perceptions of tensions within their institutions as well as their aims to improve teaching and learning conditions. Chapter 8 gathers the data from Chapters 5-7 into a working definition of writing studies and discusses implications and limitations of the research as well as future directions.
This dissertation examines the relations between scientific work as it is performed at the benchtop and scientific work as it is represented in scientific prose, where “scientific prose” is defined broadly as instances of communication which point to the methods and objects of scientific research. The idea I expand upon is that scientists have historically been embodied knowers, moving through a physical context involving research objects, and that some forms of scientific communication have evolved to convey this material relation of scientists and their objects of study. Using concepts from phenomenology, such as intentionality, and Kenneth Burke’s theory of Dramatism, I develop and apply an “action-attention-language” triad model for examining how references to actions on research objects are represented. With this triad model as a heuristic tool, I examine various cases of representation in science. I look at experimental papers which attempt to introduce an apparatus into the community; the use of mice as research apparatus in neurobehavioral genetics; advertisements for research products placed in the journal Science; and two instances of what can be called “cyberscience”: websites selling research mice and services, and research involving “virtual” mice. The chapters of this dissertation progressively problematize the relation of physical and linguistic practices. In experimental papers describing an apparatus, the style of reporting tends to portray a direct correspondence between physical and linguistic research practices; when mice become research apparatus, language is both constrained by the mouse body and also used to surpass material limitations; advertisements for research products point to the automation of apparatus and the division of research work between those performing the experiments and those writing about experimentation. Furthermore, I observe that the digitization of research allows researchers to access mice and research services over the internet, while virtual biosimulations ask researchers to infer and describe material processes from digital representations. The contribution of this dissertation to knowledge in Science and Technology Studies is primarily evidential, as I attempt to show the relationships and transformations in research work which others have pointed at, but often in broad terms which call for further substantiation through specific textual examples.
This dissertation investigates scientific studies of complementary and alternative medicine (CAM) as episodes of scientific boundary work: these studies shift, and then seek to fix, the boundaries between what counts as proper medical science and what does not. Rhetoric scholars have mapped sites of boundary work both in science and in various CAM practices, but there is still some question of how biomedicine itself responds to challenges to its borders—and, by extension, challenges to its social and epistemic authority. This dissertation examines the rhetorical constituents of biomedical boundary work by analyzing a corpus of CAM-themed special issues of the journals of the American Medical Association from 1998, in which members of the medical profession consider the implications of including under biomedicine’s purview health practices formerly considered outside it. The project examines this corpus, and responses published in both medical and popular outlets, to illuminate some of the ways in which members of a culturally dominant profession evaluate medical therapies in the face of disciplinary unrest, both within and beyond the borders of their profession. The chapters move from contexts internal to medicine to those external, mapping, sequentially, the historical-professional, epistemological, clinical, and popular dimensions of biomedical boundary work. The project aims to provide a more nuanced, stratified account of the rhetorical negotiation of medical and scientific boundaries. Its main claim is that, despite the willingness of many medical researchers and practitioners to elide distinctions between mainstream and alternative medicine, this research on CAM, and its related activities (i.e., publication, clinical practice), ultimately strengthen those distinctions and expand science’s authority in medicine.
Detailed analysis of the inscriptions found upon the walls of The Thomas Jefferson Memorial (TJM), in Washington D.C. reveals an astonishing rhetorical secret, hidden in plain sight in the form of one of America’s most visited, and high-profile, national monuments. Upon the marbled interior of this Washingtonian pantheon, brass lettered quotations from Jefferson’s works, epistles, and legislation, purport to communicate an accurate and accessible facsimile version of the third president’s intellect, philosophy, and politics. Comparison of the quinquepartite panels to the original documents authored by Jefferson, however, exposes a systematic and purposeful series of textual and semantic alterations, giving rise to a highly manipulated form of US national history, presidential memorialization, and public understanding. This thesis moves in three parts: 1) to establish the existence and extent of these manipulations; 2) to interrogate the means and agents of Jefferson’s mediation; and 3) to assess the material and symbolic consequence of the TJM’s continued presence in extant form. In so doing, this thesis - informed by rhetorical theory, studies in public memory, and intensive archival research - finds that the inscriptions of the Jefferson Memorial were knowingly edited to function not only as a subjective commemoration of a national political hero, but also as an item of contemporary Progressive propaganda, communicating messages consistently sympathetic to Roosevelt’s New Deal and wartime agendas. Accordingly, the monument becomes an important locus for investigating the specific rhetorical formation and consequence of a single (and highly motivated) public memory space, whilst also providing a replicable case study methodology for a broader derivation of the workings of “technologies of memory” (as defined by Sturken, 1997), as they function at political mnemonic sites in the U.S. and beyond.
Healthcare information differs among the United States, Canada and England. Through a critical discourse analysis of fifteen websites on depression from these countries, this thesis reveals how linguistic differences and differences in the websites’ use of visual features persuade readers of the merits of different treatments. The analysis reveals that the trends are complex. However, England’s websites lean more towards talking therapy, the United States’ websites emphasize pharmaceutical intervention, and Canadian websites endorse the use of antidepressants where they mention treatment. These findings are illustrated through a comparison of vocabulary, grammatical, visual and ordering features (building from Fairclough’s 1989 framework). This thesis also reveals that patients from the United States, Canada and England are portrayed as in possession of differing levels of importance in the treatment-decision-making process with physicians. Of particular significance is the Canadian websites’ portrayal of patient deferral to expert physicians. By frequently referencing “your doctor,” using marked grammar for healthcare experts, and providing a reader with limited information on treatment options, Canada’s websites assert a traditional biomedical model of power relations. The patient is secondary to the physician. The United States’ privatized healthcare system indicates that websites from the United States would portray patient input as especially significant. However, it is England’s websites that suggest a high level of patient influence. Stressing patient involvement on England’s websites is perhaps indicative of the NHS’s 2012 constitution, which emphasizes that decision-making should be based on a model of concordance not compliance (Segal 2007). These findings highlight how the different healthcare models of each country might affect the information provided to patients. Above all, this research raises questions about the role of patient information websites, and about the different discursive strategies that subtly persuade a reader to view depression, treatment and their input in decision-making differently. England, United States and Canada all make use of the DSM IV-TR diagnostic criteria and operate under a biomedical model of medicine, but these websites suggest that potentially depressed patients are approached differently in each of these countries.
In a warming climate, policymakers require the best available information to develop the most effective responses. These responses could work to mitigate the worst consequences of climatic change or support adaption to the unavoidable ones. However, the challenges of communicating deeply uncertain information from statistical climatology to a non-technical audience are manifold. The complex uncertainties inherent in the development and study of General Circulation Models (GCMs), statistical climatology’s primary inferential tool, exacerbate these challenges. The Intergovernmental Panel on Climate Change (IPCC) is a U.N. body formed to solve this problem. Employing standardized sets of modal adverbials to indicate the certainty of a finding, the IPCC works to regularly communicate all policy-relevant uncertainties. The present thesis, analyzing the IPCC’s “Climate Change 2007: Synthesis Report” (SYR) and its attendant “Summary for Policymakers” (SPM), argues that the IPCC’s recently much-criticized treatment of uncertainty is a direct response to the combative politics of climate change. A comparison of the IPCC’s treatment of a few key findings to a number of independent analyses of the same highlights the problem. Through a linguistic and rhetorical analysis of the SYR and SPM, I argue that a number of problematic uncertainties are represented as if politically manageable. Independent literature on the reliability of long-term inference from GCMs cautions against such an interpretation. Partly motivating the IPCC’s practice (evidenced in IPCC-internal literature) is desire to control politically hostile and possibly inaccurate interpretations of the uncertainties. Nevertheless, forming adaptive policies on such highly uncertain findings could lead to ineffectual and economically wasteful infrastructure projects. Such policies could also distract from effective responses that might mitigate the worst climatic changes. Following recent sociological and historical work in the discipline of Science and Technology Studies, I argue that the IPCC’s problematic schema for the communication of uncertainty is best understood as a response to the contemporary democratic climate of distrust and distance. The IPCC’s modal adverbials, interpreted as a complex form of social and literary technology, are an attempt to erect a new and ambitious boundary around what constitutes a politically-stable scientific fact and what constitutes a scientific topic under deep investigation.
This thesis examines the remarkable ambivalence towards Cannabis sativa L. in Canada, evidenced in the high-stakes contest between competing public conceptions of, and private interests in, the drug-plant and cash crop. Official policy regarding the enigmatic substance over the first decade of the 21st century has been notably erratic, and during this period a number of dramatic shifts in Canada’s administrative and clinical approaches to cannabis have occurred. This has resulted in changes which stand out significantly in the history of the plant’s medicinal, recreational, and industrial use in this country. Despite the recent surge in acceptance and legitimacy of its medical use in a number of jurisdictions, the definition, classification, regulation, prescription, cultivation, marketing, and consumption of cannabis for therapeutic purposes continue to pose, for many groups and individuals in this country, a medico-legal dilemma—with the boundary between licit and illicit a blurry one in deed, and in word. The many lingering questions about proper ethical and practical conduct within (and parallel to) the framework of the MMAR have made it exceedingly difficult for many participants to arrive at a comfortable fit between the activities pursuant to their roles and the uncertain, unqualifiable, or unappreciated value (or risk) entailed by those roles. I intend not only to improve understanding of the rhetorical, linguistic, and socio-cognitive basis of a particular drug-policy problem, but also to demonstrate, in so doing, the broad analytical reach of rhetorical theory and criticism, and the usefulness of applying rhetorical and cognitive-linguistic methodologies together. Through analysis of suasive elements of key terms and conceptual structures in the discourse, and of differently motivated role-value connections assumed by participants therein, I forward the claim that marijuana has played the part of the scapegoat in medicine and, more broadly, among all drugs.