Ethical Considerations of Hedging and Expressions of Certainty in the Integrative Treatment of Fibromyalgia Syndrome

Ethical Considerations of Hedging and Expressions of Certainty in the Integrative Treatment of Fibromyalgia Syndrome  

Alexis Martin

Building on studies of hedging and evidentials in medical discourse, this paper examines the relationship between the use of hedging and expressions of certainty in the text of integrative medicine clinic websites aimed at attracting patients with fibromyalgia syndrome (FMS). Analyzing the differences in the use of these expressions aids in answering questions regarding how providers manage patient expectations, the ethics of making claims about treatment efficacy to attract patients to clinics, and the role of integrative medicine clinics in western society and the biomedical community. To answer these questions, the text of seven integrative medicine clinic websites advertising to individuals with FMS or providing information on FMS were analyzed to identify phrases containing hedging or expressions of certainty, and further to identify the different ways in which these phrases rely on biomedical data or conventions as evidence in support of these phrases. Analysis provided insight into the ways in which these clinics attract patients through expressions of certainty while, in some cases simultaneously, managing patient expectations using hedging. Both types of expressions relied on biomedical data or conventions as evidence to support their claims, but websites utilizing expressions of certainty more heavily tended to refute this evidence while websites utilizing higher proportions of hedging tended to agree and build upon this evidence. Ultimately, the use of hedging and expressions of certainty combined with the use of biomedical evidence demonstrates the various ways integrative medicine clinics balance attracting patients with the ethics of promising effective treatment in a society dominated by biomedical practices.