Discourse of Drug Information for Experts and Patients
47(43) Rare side effects: [...] flu-like illness
(44) Telmisartan Teva Pharma is not recommended in early pregnancy,
and must not be taken when more than 3 months pregnant
(45) Do not take Telmisartan Teva Pharma if you have severe liver
problemsInterestingly, in SmPCs these types of construals occur relatively
rarely if ever. One plausible explanation is the fact that PILs make
frequent use of comparisons in order to prevent potential incorrect drug
use or to describe complications as clear as possible. The corresponding
passages in SmPCs are either missing (because the information is
irrelevant for experts; see example (42)) or they are differently realized as
exemplified by example (46):
(46) Angiotensin II receptor antagonists should not be initiated during
pregnancy.In the above example, the negation not establishes another type of
contrast than in example (44), in which the drug Telmisartan Teva Pharma
is the (syntactic and semantic) Figure that is set off against the Ground
(containing the negations is not recommended and must not be taken); the
warning is addressed to the (female) medical patient representing the
implicit volitional Agent who is supposed to take the drug except in the
mentioned circumstances. If we compare the surface structures of example
(44) with the corresponding SmPC passage (example 46) we see that in
both cases a passive construction with a similar Figure-Ground distinction
is used: in example (46) the syntactic Figure is the substance Angiotensin
II receptor antagonists, which is profiled against the Ground should not be
initiated during pregnancy; however, the different verb choice associated
with the negation (must not be taken in example (44) vs. should not be
initiated example (46)) evokes a completely different conceptualization of
the contrasted actions taking vs. not taking the drug: in either case it is the
(female) medical patient who effectively will take or will not take the
drug, thus representing the (implicit) volitional agent. However, in
example (46) the negation (should not be initiated) in the first place
presupposes an implicit medical doctor who fulfills the role of (implicit)
volitional agent who is instructed to act in the manner as described (i.e. not
initiating the intake of the substance Angiotensin II receptor antagonists in
the case of pregnancy, which implicitly is contrasted with the action
initiating the intake in other conditions). This means that in the expert
conceptualization the (female) medical patient first of all fulfils the role of
undergoer/receiver (of the medical doctor's instruction), whereas her role