Any steps stretching professional boundaries, in particular in professions with humble intentions, should be navigated very cautiously. In a hospital setting, staff members may swear at each other. In general, though, in settings of patient care such as hospital and outpatient care offensive language from either a patient or a staff member is not endorsed. Although, in a few aspects of patient care, obscenities may come handy.
Profanities are spontaneous. They often occur in an uninhibited fashion in those with conditions such as stroke, dementia, Tourette's syndrome and a few other neurological disorders and many psychiatric disorders. The patient may only be able to use excessive or exclusively expletive language. In particular, prior to official diagnosis of a specific contributing condition, some care providers may withdraw themselves from this kind patient, labeling patient as rude and someone with which to limit contact. As a result, symptoms of a medical condition in the form of profanities can frequently go undetected due to its classification as an unacceptable social norm rather than as a possible presenting symptom.
It is always a good idea to explore different aspects of pathology when making a diagnosis. In the case of constant patient care rejections in the form of swearing or other inappropriate social norm, neurological and psychiatric disorders are always a good place to start. Instead of rejecting a patient socially and contributing to the degradation of their condition, a smart alternative is to investigate alternate ways of addressing the situation.
In addition to the aforementioned group, a sizable patient population will use intentional profanities towards healthcare staff. Without the organic cause of a neurological and psychiatric disorder, these profanities are often a spontaneous reaction to pain or malicious experience. It is important to note that this behavior is inconsistent and it improves as experience gets better or pain subsides. With continued care and respect towards this sub-group of patients, it is possible for the behavior to improve dramatically. Patients may even leave with a positive experience and that can eventually lead to improved overall job satisfaction in hospital or healthcare settings.
A patient can curse but swearing from physician towards the patient is considered socially unacceptable. In extreme cases (still under investigation by researchers) profanity from a health care provider towards a patient who uses excessive foul language can bring a sense of similarity/equality, and trustworthiness. This is achieved by talking to a patient using their vocabulary style rather than well thought out and academic language. Thus bringing a sense of familiarity and trustworthiness and alleviating some frustrations. As a result, treatment compliance may improve and eventually lead to a better outcome. It is always worthwhile to attempt an alternate method if it brings good to patient and families.
When it comes to health care, a patient resides over almost all decision making with a few exceptions. A physician has a duty to press a patient to ensure medication compliance and counsel on leading a healthy lifestyle within accepted boundaries. To fulfill these duties, could it be acceptable to swear in the presence of or towards a patient in certain situations? This needs to be carefully be evaluated on a case by case basis. So is all swearing in medicine dictated by the doctor-patient relationship? on the intensity of the situation? on the strength of emotions?