Journalists are turning to militaristic language to describe the cancer progression of former President Jimmy Carter. Such rhetoric disappoints some end of life care advocates who view the media as portraying seriously ill patients as losing to a terminal disease that ultimately proves triumphant.
On Aug. 12, Carter announced that his cancer had spread throughout his body. He will soon begin treatments at Emory Healthcare in Atlanta. Immediately following his revelation, headlines using words such as “battle” and “fight” began appearing in newspapers, celebrity magazines and online news sites.
The Daily Mail, the world’s most popular English language news site, reports that Carter is “battling cancer” with humor and impatience. People magazine writes that Carter is “fighting his advanced cancer the same way he’s gone to battle against poverty, disease and injustice around the world.”
The day after his condition was made public, the Rev. Dr. Susan K. Smith wrote an article for The Huffington Post in which she referred to his cancer as “Goliath.” According to Smith:
Carter must attend to the battle which is warring within his body. There is no secretary of state to broker a deal. There is no summit which can be called to bring those disgusting cancer cells to a negotiating table, called to accountability by the yet-healthy cells of his body which stand to be de- stroyed as the cancer cells go on their quest of victory in this battle. The cancer cells are equipped, it seems, to handle the opposition; they seek death; the opposition seeks life and… peace. The warrior Jimmy Carter is on the battlefield. …It is a battle I for one wish he did not have to fight.
Such language creates a mentality of “winners” and “losers” that is often devoid of compassion for the patient, said Loretta Downs, a Life Matters Media contributor, hospice volunteer and past president of the Chicago End-of-Life Care Coalition. Patients hoping to forego aggressive treatments in favor of comfort measures may feel pressured to continue with chemotherapy or other costly and burdensome regimens to avoid letting down their family, doctors or societal expectations. Projecting the assumption of a “battle” that must be “fought” can rob patients of the autonomy to approach their diagnosis with a greater focus on comfort-seeking treatments.
“Cancer is not a war against an evil force, it is an opportunity for transformation, reconciliation and loving—like the time at the beginning of our lives,” Downs said, pointing out that he has the time and ability to make his care wishes known to his family and friends. “I suspect that President Carter is more prepared to have a gentle, high-quality death than are most of us are,” she added.
Craig Klugman, a bioethicist and chair of the Department of Health Sciences at DePaul University in Chicago, said the U.S. health care system often stigmatizes terminally ill patients with “war-like” language.
“Patients often find themselves abandoned by health care professionals who do not want to ‘waste their time’ working with patients who do not want to fight, who have given up, and who won’t take the fullest advantage of the provider’s expertise,” he told LMM. “How many more people might choose to allow a natural dying with a cancer diagnosis at an older age if battle language was avoided and if hospice was brought up as a true option and not simply a last resort? They are not ‘giving up.’ They are making a choice in line with their morals, experiences, and desires.”