Katherine E. Rowan
Explanations designed to teach, rather than to support scientific claims in scholarly works, are essential in health and risk communication. Patients explain why they think their symptoms warrant medical attention. Clinicians elicit information from patients and explain diagnoses and treatments. Families and friends explain health and risk concerns to one another. In addition, there are websites, brochures, fact sheets, museum exhibits, health fairs, and news stories explaining health and risk to lay audiences. Unfortunately, research on this important discursive goal is less extensive than is research on persuasion, that is, efforts to gain agreement. One problem is that explanation-as-teaching has not been carefully conceptualized. Some confuse this communication goal and discursive type with its frequent verbal and visual features, such as simple wording or diagrams. Others believe explanation-as-teaching does not exist as a distinctive communication goal, maintaining that all communication is solely persuasive: that is, designed to gain agreement.
Explanation-as-teaching is a distinct and important health communication goal. Patient involvement in decision making requires that both clinicians and patients understand options underlying health-care choices. To explore types of explanation-as-teaching, research provides (a) several ways of categorizing health and risk explanations for lay audiences; (b) evidence that certain textual and graphic features overcome predictable confusions, and (c) illustrations of each explanation type. Additionally, explanation types succeed or fail in part because of the social or emotional conditions in which they are presented so it is important to note research on conditions that support patients, families, and clinicians in benefiting from explanations of health and risk complexities and curricula designed to enhance clinicians’ explanatory skill.
In the 1950s and 1960s, the U.S. Congress, with allies in the news media, created legislation that came to be known as the Freedom of Information Act (FOIA). It was designed to help hold the federal executive accountable to the public. It became law in 1966. Its significance can be understood in several contexts: (1) in connection with a special relationship of journalists to the operation of the FOIA; (2) in terms of arguments that transparency in government is necessary for citizens’ informed participation in democracy and that, on the other side, there are strong democratic arguments that transparency should be limited in the pursuit of other legitimate values, some of them recognized in the language of the FOIA itself that government agencies may deny a citizen's request for information on the grounds that honoring the request could endanger national security, personal privacy, the integrity of internal government deliberations, or other significant objectives; and (3) that freedom of information law are one institution within a wider web of institutions and practices dedicated to holding government accountable. In this regard, the U.S. Freedom of Information Act can also be seen in a broad context of a cultural shift toward “openness” and a political shift toward what has been called a “monitory” model of democracy.