Are we framing ‘the conversation’ well enough?

Calling these conversations ‘difficult’ will not encourage anyone, doctors included, to have the conversation.

As end-of-life conversations are thrust into the spotlight by a global pandemic, medics and the voluntary sector are trying to rise to the challenge of leading a national conversation. But how effective are we at this and is some of our default language undermining our efforts before we’ve even begun?

For example, Baroness Finlay, the palliative care expert, said recently:

“You must let people know now so that things can be put in place for you.

Those conversations are difficult for everybody. They’re never easy. We all live thinking it won’t happen to us. But you have to think it might.”

Baroness Finlay

She’s right, she’s arguing her point well and being honest. But is this a message that works? Is this call to action framed in a way that actually means more people will have the conversation? Sadly, I think not.

But first, I should explain more about what I’ve learnt about framing.

Why framing matters

“A talent for speaking differently, rather than for arguing well, is the chief instrument of cultural change.”

Richard Rorty

Human beings make sense of their world by forming stories in their head. We use the stories to think, joining the dots to form a bigger picture which drives our behaviour.

To be an effective communicator, you need to understand this. I’ve heard it put simplest by the Frameworks Institute. During a recent presentation at a Charity Comms event their director of impact, Nicky Hawkins, said this:

“An expert or campaigner can say one thing and people who don’t know the issue can hear something else entirely…Framing for change is less about changing minds and more about activating different thinking”

Nicky also said, never remind people of what you want them to forget. Which brings me back to the original quote about ‘difficult conversations’.

We can frame this better

There are a few words used in this quote that I think undermine the intention:

Those conversations are difficult for everybody. They’re never easy.

Even if this is always true, framing these conversations as ‘difficult’ will not encourage anyone, doctors included, to have the conversation. We might as well be saying to people, ‘please climb this mountain’.

This isn’t a one off slip of the tongue either, it is the default language of people working in end of life and I hear it regularly from all sorts of people. By the time I got round to finishing this blog, I’d heard it again! There are even many training programmes about these issues for doctors and they are almost always called (you’ve guessed it) Difficult Conversations!

I don’t have all the answers and there’s probably a lot to unpick here, but I think it’s a good start if we all begin to say these are ‘important conversations’ (and never say difficult). Because these issues are too important to make them a mountain to climb. Perhaps then more people will have the conversation and our culture will start to change.

I think the the message we all need to convey is something like this:

These conversations are important and necessary for you and your family.

So sit down for a cuppa to have the conversation and, if you need help, just ask. Because there’s free help waiting on the end of a phone. Then when you’re finished, there’s free help to write it down, keep it safe and share it.

That doesn’t sound difficult to me.

We’re interested to hear what you think, let us know via Twitter.