chapter  4
Language, harm and overdiagnosis – a case history
The real cancer paradox
ByOwen Dempsey
Pages 7

The intensification of anticipatory forms of healthcare, despite their collateral iatrogenic harms, are justified by an elite expert subjective neoliberal pragmatism that favours both an unregulated market and the thought impressions of elite expertise. Discourse shapes belief in the intended benefits and represses knowledge of harm, and makes this form of care publicly acceptable despite its harms.

The term or name ‘real’ cancer is shown to function and shape belief discursively, that is through expert rhetoric or discourse, to fix meaning to screen-diagnosed cancer as accurate, and to screening itself as ‘a good thing’.

Three examples from expert discourse are provided that show how meaning is fixed by language to align with neoliberal pragmatist ideals, and used as propaganda, by scientist-politicians. In these examples language is used to: a) impose particular beliefs about care; b) reinforce the idea that test results are always true and never false; and c) incite fear and urgent action.

Contemporary political ideology: neoliberalism, is shown to operate via discourse, and employs language in ways that shape conscious thought, beliefs and public opinion, and that there are important non-conscious factors at play in this process. This operative ‘unconscious’, then, introduces a different way of thinking about the human being’s subjectivity, that is, the way the individual makes sense of her self and social relations, as not necessarily being the commonly assumed ‘whole’ person, capable of autonomous thought and decision-making independent of social relations and cultural norms.