11/4. Guest Lecture—“Medical authority, autonomy and reactance.” Prof. David H. Lee (Communication/Humanities)

Please watch Dr. Lee’s lecture in its entirety.

Then, make two posts below according to the following instructions. These comments are due before the following class period (i.e. before 4:00pm on Tuesday, 11/9).

The first one is your own individual thoughts and response to the lecture. This post should be at least 75 words long. You should interact with main ideas, although what you say is up to you. You may want to criticize an idea, agree with something, or offer further insight or thoughts about some topic discussed by our guest. Or, you may want to pose a question for others about the lecture. I expect the post to interact with the content of the actual lecture, and not just the day’s topic or other thoughts you may be having.

The second post is an interactive comment, posted as a response to another student’s comment. There is no length requirement on this post.

56 thoughts on “11/4. Guest Lecture—“Medical authority, autonomy and reactance.” Prof. David H. Lee (Communication/Humanities)”

  1. This lecture was lengthy but it wasn’t dense; my first thought after watching this lecture. I liked the explanation on Psychological Reactance. I can relate to not wanting to do something because I had been told to do it. This has kept me from doing chores and things that I probably was supposed to do. Its nice to know there is a psychological term for it and that I am not just being petty.
    In this lecture, Dr. Lee spoke of Kant and idea of duty. I think this related to Kant’s categorical imperative because if we acted and lived in the opposite of reactance the world might be a better place. It is a way to be responsible for one another and act as if what you are doing is making a difference for another; paying it forward. It was also interesting learning on ways to manipulate situations to gain what we want, by adding in ‘because’ to increase our chances. I will be using this in the near future.

    1. Hi Krystal,

      I found psychological resistance very interesting as well. I liked how you spoke from a personal level and related Professor Lee’s lecture back to the idea of the categorical imperative. I find myself in these situations when I am about to start a chore and someone reminds me to do it, and I suddenly lose interest.

      1. Hi, Jordyn. What you and Krystal mentioned about chores is similar to instances I thought of while Professor Lee explained psychological reactance. It’s funny how at times when people say things to encourage us to do something it has the opposite effect.

    2. Hi Krystal,
      I agree Psychological Reactance was very interesting. I enjoyed learning about why people react when asked to do certain things. I like your analogy of not doing your chores because you felt like it would take away from doing something else.

    3. Hi Krystal,

      Thanks for your comments. I like that description of the categorical imperative as the opposite of reactance. If only everybody acted as if the rest of humanity would follow in their footsteps. It would be a way of acting in the right way, not because I expect to get anything in return, but just because its the right thing to do.

  2. After watching Professor Lee’s lecture, I have grasped a deeper understanding of autonomy. He brought up many slogans, such as “Be fit,” “No pain, no gain,” and “Eat better, feel better,” that are all associated with maintaining a healthy lifestyle. However, these health promotions impose on autonomy. Public health communications, like posters, and society both expect people to be healthy, and these promotions are almost seen as a form of control. Instead of focusing on society’s expectations, Professor Lee explained how they are many social determinants that affect one’s health. These include economic stability, education, neighborhood and environment, and healthcare. These social determinants and lifestyle factors may affect one’s quality of life, based on the healthcare they receive.

    1. Hi Jordyn,

      I also have a better understanding of autonomy. He gave examples that relate to everyday life. I like how you mention that “social determinants and lifestyle factors may affect one’s quality of life”. It sums up the whole lecture.

    2. I agree the health ads we see tend to use words as we perceive as telling us what to do rather than encouraging us to eat healthy. We all have self autonomy and guilty being oppose to information we received whether its positive or negative.

    3. I agree, and that is why advertisement affect people negatively cause people believe if they’re not working out they’re automatically not healthy. Health doesn’t have to do with appearance or how many times you go to a gym. It’s deeper than that, there are many other factors! Yes working out can help with keeping you healthy, but there are other things us individuals should take in consideration.

    4. I agree and I also have a better understanding of how these health campaigns can impinge upon a person’s autonomy, I never really thought about it that way. I’ve always taken these public health campaigns just to be reminders that quitting cigarettes, having protected sex, not drinking and driving and staying off drugs is just what is best for me as an individual and what is best for society. Since learning about autonomy and understanding the reasons for certain language, I can understand how these campaigns can be viewed as a form of control.

    5. Hi Jordyn,

      I’m glad you pointed out the social determinants of health perspective. Often health promotion messages are aimed at changing individual behaviors. For example, eat better, exercise more. But not everybody is in the same position to make those changes. Let’s say you live in the suburbs in an apartment complex. You can’t afford a car. So you can’t go to the grocery store to get fresh fruits and veggies. You end up going to the McDonalds across the street, mostly, because it’s close by. That’s a hypothetical example, but I bet there are people out there in a similar position. The idea of “food deserts” is areas where nutritious food is not nearby.

      See: https://www.dosomething.org/us/facts/11-facts-about-food-deserts

  3. In this lecture, Dr. Lee incorporated things we learned from PHIL 2203ID. He mentioned the Principles of Biomedical Ethics and focused on autonomy (The right to be free and self-directed). He mentioned environmental factors and gave an example of two different environments in one place.
    There is some rule to individual behavior, which takes up to 40% of our health. Which makes individual health a major factor in our lifestyle. For example, how can we control our lifestyle and the environment around us.
    He is also Canadian like Dr. MacDougall 🙂

    1. Great connections, Leila! When we have guest lecturers, I always wonder whether students are able to see the connections. Apparently, you were.

      Individual behavior is a huge part of our health outcomes. Individual behavior and environmental factors need not be mutually exclusive. I might behave in certain ways partially because it is easier for me to do so than alternatives (my environment encourages me to do something, for example), even though I have a real choice about how to behave.

  4. Professor Lee’s lecture emphasis on health communication is very accurate in that most medical error in healthcare comes from poor communication, and I have experienced that as well in my dental care field. Most of the time, the patient would always nod their head as if they understood the instructions and then call back to the office to ask what they have to do. Apparently, they did not understood anything at all, so to make sure they understood, I had to make them explain to me what they have to do next before they leave. In another case, my friend had a misdiagnosis from a dermatology visit in which the dermatologist did not listen and take in a lot of consideration of the symptoms and condition of the skin disease she had. Until after the third visit, another dermatologist, took a better consideration and heeded better attention the my friends complaint and found the right diagnosis of the skin condition. So I absolutely agree with Professor Lee’s emphasis on health communication on being the third leading cause of death in medical error.

    1. I agree with your post Benny, I like how you used your own personal experience. It is very important to understand medical errors and where they come from which is lack of communication. Professor Lee did a great job on emphasizing the importance of health communication so it doesn’t lead to medical errors.

    2. I totally agree with you Benny, poor communication in the medical field is a big problem, and glad that Professor Lee emphasized this topic. What are things that can be done in the future to improve communication skills?

    3. I agree with you Benny, I work in radiology facilities where we do biopsy for breast and chemoport. I have go over many times with my pt’s if they understand post procedures instructions. Poor communication can make a person confused after a procedure which lead to made errors

    4. Hi Benny,

      Thanks for your comment. The claim that medical error is the third leading cause of death comes from Makaray and Daniel (2016) in BMJ.


      Note it is a disputed estimate:


      see also


      But even if that statistic is questioned, medical errors resulting from miscommunication are preventable, in principle, provided people communicate better.

      “to make sure they understood, I had to make them explain to me what they have to do next before they leave” –That’s right. It’s called “the teach back method” and it’s not rocket surgery. Ask them to explain back to you what you just explained to them.

  5. David Lee spoke about medical authority, autonomy and reactance. He speaks about health communication which is the science and art of using communication to enhance the health and well-being of people. David Lee breaks it up into two campaigns, health and patient provider campaigns. I enjoyed how he broke down different categories that affect the health and care that a person can receive, he broke it down into different categories under social determinants of health. I like when he spoke about speech acts, which he described as the ability to do things by saying something. He used the example, ‘the professor says class dismissed.’ The professor has the authority to make this call using a description of the situation as well as a command for people to disperse. Using one speech act that serves two different functions.

    1. Hi Allie,

      Thanks for your comment. What I meant to say was that health communication has two major areas of focus. The first is provider-patient communication, which takes place in the doctor’s office. The second is public health campaigns, which happen outside of the privacy of the examination room. I’m glad you mentioned speech acts. I am fascinated with how words can create a new reality. For instance, the Professor says class is dismissed. How does he know? It isn’t that she is describing the situation as it is. She makes it the case that the class is dismissed because of the words uttered.

  6. Mr. Lee explained the topics of autonomy and psychological reactance. He spoke about topics we covered in class such as beneficence as well as non maleficence. Mr. Lee also talks about how the science of communication plays a role in improving the overall health of people. The ideas that Mr. Lee talked about such as “Be fit” does actually play a role in helping someone understand how their health should be prioritized. I found it very insightful when Mr. Lee was talking about how people cannot quit drugs cold turkey. He speaks about how it plays a role in redefining health options for addicts.

    1. Hi Tashin, thanks for your comment. Sometimes, if someone has a bad habit, like smoking or drugs, people ask them, “why don’t you quit?” But as you note, the problem with addiction is that the person has lost the power of self-control. They rely on a chemical (such as nicotine or oxycodone) and their body tells them to take it even when they know it isn’t good for them. I just got through watching the series “Dopesick” on Hulu. I recommend it. But it is a tragic situation of the opiate epidemic.

  7. Dr. Lee lecture on health communication shed some light into how people perceive information and respond to such information. He talks about autonomy in which people have their own rights to decide on what to do with the information giving. For example being told what to do and reacting towards the message by not doing so. It was interesting to learn about the reactance theory and how when peoples autonomy are threaten they react in opposition rather then understanding the bigger picture. A perfect example would be smoking. Smoking has negative health effects and second hand smoke can affect those around you. But people still smoke and be mindful of others because its their own choice to smoke.

    1. Smoking is indeed a good example of how intruding on our freedoms can be offensive to us and can really make you think about how a simple action has an important factor in our daily lives. It really is interesting how human behavior tends to have a sense of autonomy and that they are likely more satisfied to be this way.

    2. Yes, smoking is an individual choice. I feel like, if you want to do that to yourself, go ahead. As long as you are not hurting anybody. But the thing is, what about the people who live with the smoker? They have to breathe that toxic cloud and they don’t have any choice in the matter.

  8. I never heard of healthism before but it sounds like a good principle to uphold for oneself. When talking about health some people don’t realize how much social determinants play a role. Often genetics and behaviors are discussed. Also, it was mentioned that to an extent the environment isn’t out of one’s control which I believe is important to note. What I found interesting is that the word “because” aids in compliance. You would think please is highly effective. It makes sense, however, if you present a good reason then it’s more likely that you’ll get your desired outcome.

    1. Hi, Tara cherry
      I agree with you that people usually don’t realize that social determinants play a big role in their lives. As well as It may effect their rights or taking their own decisions and force their autonomy to do decision that society wants, thinking that this will make their life better.

    2. Yes, I find that a lot of health promotion messages are worded that way. They tell you what to do, and then give you a reason why. Or sometimes it is the other way around. First, they provide the reason, then they ask you do do it. I think the term “healthism” is a negative term. It suggests that one’s entire life is geared towards being healthy. Getting up early and jogging. Eating egg whites with no butter on a single low carb cracker. Having a strict bedtime of 9:30 pm. Yes, those people may live longer, but do they miss out on some enjoyment along the way?

  9. I like how Dr.Lee’s lecture had some topics that related to what we’ve been introduced to in this class. The question of “If everybody in America acted like you do, would the country be better or worse?” I always believed that we all think if everyone was like us, everything would be better, but no. There are many factors that affected us as individuals. Maybe in our heads we think we’re good because well when we do things its for the better or we do the best based on what we were taught. I found the examples given by Dr.Lee interesting.

  10. Psychological reactance was the topic that interested me the most. Reactance theory is how people act when their freedom is threatened, the threat is used as motivation to restore freedom. Reactance can cause people to think differently then they normally do and can cause a lot of anger and single mindedness. The relation to psychological reactance and the current pandemic is a connection to what is going on in the world. Many people feel threatened that their freedom was taken away due to government mandated lockdowns and mandatory masks which in turn caused them to lash out.

    1. Hello Jaggernath,
      I too was interested in the theory of psychological reactance, as many of us reacted the same when our parents told us not to do something. And yes, due to the pandemic a lot of regulations and policies were enacted that did threaten society’s freedoms, but for a purpose of COVID-19. However, because the U.S. is known for freedoms for all, any restraint on our individual behavior seems to always cause an uproar to parts of our society.

    2. Hi Jaggernath,

      You have a great name! I like your description of reactance theory. I think it can help explain the situations you describe, such as lockdowns, anti-mask, etc. The theory is that people don’t like being told what to do, so they lash out. I had a student who said she was going into the grocery store with her mom. Her mom was reaching for the mask when a worker at the store said “Masks on!” The mom didn’t like the worker’s tone, so she went mask free in the store! Even though she had no problem wearing a mask before the worker said that.

  11. I find this topic to be the most interesting out of the guest lectures so far. Dr. Lee’s lecture made me think twice about how I present my sentences to the general public and made me consider how they perceive them. The one that caught my attention the most was his discussion of “reactance theory” and how our sense of freedom is actually more important to us than I generally thought. The fact that a threat to it can garner a negative emotional response to quickly regain that control back is quite confirming for me. The example he provided about COVID I thought was a good example to convey this point. Knowing this, I have more awareness now about how I direct myself towards people, and giving them choices to have that perception of liberation can help garner a more positive response.

    1. Thanks for the comment, Paul. Happy to hear you got something out of this lecture. I know growing up I was a rebel and I always had to do things differently. I wanted to stand out from the crowd. I think I was so reactionary that I missed out on a lot of lessons. It takes a lot more energy to constantly be trying to duck and dodge and be unique. This sounds weird, but it was when I started doing what I was told and being more obedient that things really starting happening for me! Take school, for instance. The teachers have tasks they need you to complete as directed. Now that I’m a professor I really appreciate it when a student follows instructions! Lol.

  12. Since I started my major, Health Services Administration, I’ve taken a real interest in public health so Dr. Lee’s lecture was especially interesting to me. He defined Health Communication to be both a science and an art of using communication to advance the health and well-being of people and populations. Dr. Lee also went on to talk about the two areas of health communication: health campaigns and patient provider information. His talk about how health promotion imposes on autonomy was a bit surprising and made me think about what we’re going through with the current pandemic. For example, are all the radio ads to go get vaccinated impinging on my autonomy? I agree with Dr. Lee’s viewpoint that while we do have control over many of our behavioral risk factors, concentrating on or over emphasizing this fact can certainly lead to ignoring other social determinants of health that many of us can not control. I believe the over emphasis of this fact allows for an ignorance by society that we can not really afford.

    1. Hi Shabon,

      Thanks for these thoughtful remarks. I am interested in public health as well. In general, I think it is an excellent thing. But health campaigns can have negative unintended consequences. An article that I teach in my Health Communication class talks about 11 unintended consequences of health campaigns, including “boomerang effects.” That is when the campaign backfires and has a counter-persuasive effect. The article is called Unintended Effects of Health Communication Campaigns by Hyunyi Cho & Charles T. Salmon. https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1460-2466.2007.00344.x?casa_token=gvdcjmt1zekAAAAA:JeC2CrkagkCiAjGTUqcvyAChj7duMXj0A2uc8_-y5k9IJFATQvHAOA9Ggo2QgE6cblNu1h-NajT_zhX6

  13. After watching the guest lecture I thought of different things and concepts of health ethics and how there are social determination and effectiveness over personal health. Mr. Lee explained that five social factors affect health. Which are economic stability, social communication,neighborhood or environment, healthcare ,and education . He also talked about how society is kind of get over the ethics of autonomy which they do health campaigns like signs of no smoking or quiet smoking, as well as signs of eat better ,feel better. He discussed that by these health campaigns being healthy is not type of an option,but it’s the opposite of ethical autonomy which giving the people the right to make their own decisions to themselves because it’s a way society telling people that they have to be health and they forcing their decisions by telling them that you can’t be fat or eating what ever you want or you can’t smoke because you have to be healthy.

  14. Professor Lee’s lecture really targeted/ focused on health communications which was very on point due to most medical errors coming from poor communication. For example, I work in a pharmacy and I always explain to the patients which medication is which and what it’s being used for so the instructions are clear for them. Then, once they get home they call the pharmacy and ask which medicine is which and what are the indications. So, I always wonder who’s in the error for not communicating properly with the patient in order to avoid this in the future visits.

    1. Hi Emerson, I’m glad you explain carefully to patients. But as you point out, communication is a two way street. Drug interactions are a big problem, and pharmacists and pharmacy tech are supposed to check carefully for these. However, you can provide the best, clearest explanation, but if the other person isn’t listening then the communication is not effective. I believe that patients bear a lot of the responsibility for miscommunication in medicine. However, look at the power differential between providers and patients. The provider has all the expertise, and the patient’s knowledge is discounted if they are not medically trained. Yet there is one way that patients are more knowledgeable. That is, patients experience first hand the symptom they are presenting with.

  15. I enjoyed Dr.Lee lecture on Medical Autonomy And Reactance. Durning his lecture he made think a lot about healthism . How our social and economic and healthcare, a person environment and education all play in people health. Poor person will have bad food choice as a person who more economic stable will have better choices in food. He also made me think how people present their communication towards other informing vs. commanding so people respect more treat you better by the way you word your ways of speaking and choice of words which makes sense.

    1. Once I interviewed a smoking cessation specialist, who said some women smoke because they want to have a smaller baby. A smaller baby means its easier to commute, or get up and down stairs, or do all the physical things on the job! :^(

  16. Doctor Lee’s lecture on health communications and its many determinants of health was very interesting and insightful. He informed us how medical errors were the third top killer of the U.S. in 2013 which is very alarming. It’s alarming since the other two top killers were health diseases (heart disease and cancer) which are way more difficult to control. In fact, knowing that 9/10 lack skills to manage health and prevent diseases raises the concern of needing more education on health communication and the dangers of medical errors. Suggestions I would propose are to require training courses in health communications and/or make it a required course when pursuing a medical major. I also learned about different policies/practices that society follows such as healthism and paternalism. I agree that paternalism is not a nanny state, but is a helping friend as Dr. Lee mentioned the FDA which is a credible source to many others as until a product is FDA approved, consumers avoid those medicines/products.

    1. Hi Kaityn, thanks for you comments. As I said in the lecture, not everybody agrees that “third leading cause of death” is accurate. Even still, medical errors are seen as modifiable, because they can be prevented through better communication. Speaking of “modifiable” heart disease and cancer have a HUGE behavioral component. For example, untreated hypertension is a modifiable risk factor for heart disease and stroke, as is smoking, as is untreated diabetes. Smoking, being overweight, eating too much deli meat, and not eating fruits and veggies is a risk factor for cancer that is, at least to some degree, within people’s control.

  17. Mr. Lee chooses the topic of psychological reactance and explains it thoroughly. He said health communication are being used to provide health and well-being of the human population, which can be divided into two Health campaign and patient providers. The topic is very interesting that he talks about especially when he said he works with CDC as health communication director.

  18. Psychological resistance is very important when it to and we need to in order to maintain and grow and grow health wise. You have to resist the McDonald’s in all the fast food and all the processed food and our most of our communities periour communities. Psychological resistance It’s really hard because you have a lot of pressure which is kind of like pia pressure you have to deal with social media you have to deal with Propaganda which is not easy. The distractions is hard to resist perseverances everything.. It also starts with your upbringing your environment In your education. Psychological resistance resistance is not easy but if you exercise it it can become easy overtime.

  19. In the lecture, Dr. Lee discussed the topic of Health Communication and how it is used to advance health and well-being of people and population. There ae two form of health communication to reach out to individuals which are health campaigns and patient provider. He further discussed that medical error is the leading cause of death and miscommunication with provider. It was sad to see that 40% of premature death is cause by ones doing.

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