Hildén Hanna-Mari, Honkasalo Marja-Liisa
University of Helsinki, Finland.
Commun Med. 2006;3(2):125-34. doi: 10.1515/CAM.2006.015.
We studied media discussions of end-of-life decision making to find out how the doctor-patient relationship is portrayed and what types of positions the media takes and how it is represented by other discussion participants in this context. The significance of the end-of-life decision making is related to the fact that it forms a contested site for the realization of patient autonomy. Our material consisted of two newspaper discussions and one television program. In all three samples, the consumerist physician-patient relationship model was promoted in the context of end-of-life decision making by the media representatives and the laypeople (patients, relatives, and a patient advocate). In the first, the media representatives make use of the romance narrative, which presents physicians as villains, and constructs patients as knowledgeable and competent 'ordinary heroes'. This justifies public scrutiny of healthcare. In the second sample, the relatives stress their competence but now by appealing to their knowledge and caring for the patient. This promotes their right to make decisions for patients. In the third sample, the journalist again pictures patients as 'ordinary heroes' who acquire their knowledge from the media. Patients are now empowered as consumers of healthcare. In conclusion, the consumerist doctor-patient relationship is promoted and the media's position as the source of information and as patient advocate is stabilized.
