In Yolŋu epistemology (theories of knowledge), truth is something negotiated in a context where the meanings of signs and significations are agreed upon.
In some contexts (like the secret/sacred) the negotation power of ordinary Yolŋu is suspended and those in control exercise a special constitutive power through language. Some Yolŋu, assuming the same to be the case for English speakers, suspect that there is a secret English which Balanda withold from Yolŋu (Christie and Perrett,1996).
Similarly, in the context of biomedical health systems, some Yolŋu identify a special and dangerous power in the language of medical practitioners.
For example, there is a belief expressed by some Yolŋu that verbalising a diagnosis can in some way bring the sickness into being. This is an extreme effect of power imbalance and an absence of shared understandings.
One Yolŋu woman explained that when health staff provide warnings - or even statistics - about potential health problems this could be construed as a 'threat', as prior knowledge of future illness can imply involvement in causing the illness through sorcery. Similar perspectives were evident in informal discussions with other Yolŋu during the Sharing the True Stories project.
A very experienced physician also noted that Aboriginal people are reluctant to talk about how they feel although they will talk about their sickness after it has passed, which may be related to this avoidance of 'naming' their illness:
..if you say to a whitefella 'how are you feeling?' you'll get every complaint under the sun, whereas not infrequently an Aboriginal person will not tell you a thing even when they are really sick - (but) if they have been sick and they are better most people can tell you that...
It is important to recognise the extent to which Yolŋu understandings about causality might influence their utilisation of medical services and their interactions with service providers. Increasing the level of shared understanding - for health staff and patients - about both the Yolŋu and Balanda perspectives is one way to minimise such sources of miscommunication within and beyond clinical encounters.