Euphemisms In Bad News Delivery To Critically-ill Patients From The Perspective Of Terror Management Theory

Doctor-patient communication has become a heated topic that nourishes not only public opinions but also academic discussions. Bad news delivery is crucial for building a smooth doctor-patient relationship. A great multitude of literature has examined protocols about how to disclose bad news so as to reach a balance between maintaining hope and being honest to patients, among which the western "SPIKES" has drawn considerable attention. Although no overriding guideline is given in these studies concerning bad news delivery, euphemism use is a prevalent phenomenon in prognosis disclosure especially to critically-ill patients.The thesis analyzes how the fear of death is ameliorated through strengthening the structure of cultural worldview and self-esteem. Since euphemism is an indispensable part of cultural communication, the thesis raises that the fear of death is ameliorated through the use of death and disease euphemism in the process of bad news delivery and in sensitive topics associated with mortality salience.The thesis explores the following questions:1) how Terror Management Theory (TMT) justifies euphemism use in doctor-patient communication;2) how death and disease euphemism facilitates bad news delivery;3) what are the strategies of applying death and disease euphemism in bad news prognosis.A thorough study earns the following findings:1) As TMT holds culture and self-esteem as the primary means to ameliorate the fear of death and euphemism is a cultural practice under mortality salience, doctors and patients in bad news delivery tend to confront the fear by avoiding the direct references of such "taboo" terms. Death and disease euphemism are thus utilized by doctors as a way to deny death and to keep themselves distanced from something distressing and painful and also as a soothing strategy for family or friends close to the dying patients.2) Doctors’disease euphemism is a process of prognosis communication in which direct references to sensitive topics are skillfully converted by multitude linguistic devices to achieve optimal prognosis delivery under mortality salience.3) There are semantic, lexical and grammatical devices for the creation of death and disease euphemism, which can be subcategorized into euphemism for bad news diagnosis term, euphemism for evaluating bad news, euphemism for expressing certainty about bad news, and euphemism for the recipient in bad news condition. The application of such devices enable doctors to further understand mechanisms of euphemism in prognosis.The study consists of five chapters. Chapter One introduces the general background, the significance and the texture of the thesis. Chapter Two does a literature review in euphemism study from different angles and elaborates on euphemism definition, classification, and its linguistic formation devices. Chapter Three brings in TMT as a theoretical basis for death and disease euphemism use in bad news delivery in the context of other justifications. Chapter Four is the main body of this thesis which demonstrates euphemism creation in details, starting from different sub-categories of death and disease euphemism through linguistic strategies of semantic, lexical and grammatical devices. Chapter Five concludes the study by a summary of its findings, limitations and suggestions for further study.