In our anecdotal experience, radiological discourse–particularly the written form–is filled with the passive voice. “There is a nodule in the lateral segment of the right lower lobe that is thought to be…” “A total of 35 cases were included in the series.” “The data were analyzed using…” “The catheter was then exchanged over the wire.” Particularly, in the domains of research publications and the reporting of radiologic procedures, the passive voice appears to dominate.
Yet authorities on writing repeatedly warn against the use of the passive voice, saying that it almost always degrades the quality of writing and speaking. Says William Strunk, the author of one of the 20th century’s writers’ bibles, The Elements of Style , “The active voice is usually more direct and vigorous than the passive.” . The Columbia Guide to Standard American English states, “If you want your words to seem impersonal, indirect, and noncommittal, passive is the choice.” . One of the 20th century’s greatest writers, George Orwell, writes “Never use the passive voice when you can use the active.” .
So why, then, is the passive voice so prevalent in the writing of radiologists? In what follows, we briefly outline the meaning of the passive voice, review the history of its use in scientific and medical writing, and examine the arguments for and against it. We believe that many of the radiologists who opt for the passive voice do so out of sheer habit, and not as the result of any conscious deliberation on the matter, and we argue that the quality of writing in radiology–and by extension, the quality of thinking in the field–could be improved by shifting the balance toward greater reliance on active voice.
In a sentence written in the active voice, the subject is the actor. In a passive voice sentence, the subject is acted on. For example, “I explained the procedure and its benefits, risks, and alternatives to the patient and obtained informed consent” is in active voice, whereas “the procedure, its benefits, risks, and alternatives were explained to the patient” is in the passive voice. As in the latter case, it is quite common in radiology writing to omit the subject altogether, leaving it uncertain who performed a particular action.
One simple clue that a writer is using the passive voice is the presence of a variation of the verb “to be” in the verb phrase. Examples include am, is, are, were, been, and so forth. Of course, this is not true in every case, but it is suggestive. Another clue is the presence of prepositional phrases using words such as “by,” as in “action x was performed by agent y.”
Many good writers and English instructors warn against the use of the passive voice because it tends to make sentences seem awkward, flat, and unengaging. In scientific discourse up to the end of the 19th century, writers actually tended to prefer the active voice . At that time, the concept of scientific rationality grew increasingly influential, and so the passive voice, which was seen as more objective, began to replace the active . Instead of saying that the experimenter or physician did something or thought something was a good idea, the writer could simply say that something was done, or that a particular course of action “was indicated.” This makes it sound as though had anyone else done it or examined the situation carefully, the result would have been the same.
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References
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2. Wilson K.: The Columbia guide to standard American English.1993.Columbia University PressNew York City, NY
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