ALAWDeontics and treatments.docx (90.71 kB)

Orientations to epistemics and deontics in treatment discussions

Download (90.71 kB)
journal contribution
posted on 31.03.2021, 02:37 by A Lindström, Ann Weatherall
© 2015 Elsevier B.V. An ideological shift to patient-centered health care raises questions about how, in the face of medical authority, patients can assert agency in interactions with doctors. This study uses conversation analysis to explore how epistemic and deontic orientations are raised and made relevant in different types of responses to treatment proposals across two health care settings - New Zealand general practice consultations and Swedish hospital-based physician encounters. By examining responses ranging from acceptance to strong resistance, we show patient practices for deferring to and resisting medical authority, which includes claiming independent access to expert knowledge and raising everyday, experientially based concerns. Doctors rightfully privilege their own epistemic expertise in treatment decisions but they also take patient experiences into consideration. In cases of strong resistance we found doctors raising patients' ultimate right to refuse treatment recommendation. Our analysis further nuances current knowledge by documenting the ways epistemic and deontic domains are observably relevant forces shaping the sequential unfolding of treatment proposals.

History

Preferred citation

Lindström, A. & Weatherall, A. (2015). Orientations to epistemics and deontics in treatment discussions. Journal of Pragmatics, 78, 39-53. https://doi.org/10.1016/j.pragma.2015.01.005

Journal title

Journal of Pragmatics

Volume

78

Publication date

01/03/2015

Pagination

39-53

Publisher

Elsevier BV

Publication status

Published

ISSN

0378-2166

eISSN

1879-1387

Language

en

Exports