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Orientations to Epistemics and Deontics in Treatment Discussions
Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Languages, Department of Linguistics and Philology. (språk och åldrande)
Victoria University of Wellington, New Zealand.
2015 (English)In: Journal of Pragmatics, ISSN 0378-2166, E-ISSN 1879-1387, Vol. 78, 39-53 p.Article in journal (Refereed) Published
Abstract [en]

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. 

Place, publisher, year, edition, pages
2015. Vol. 78, 39-53 p.
Keyword [en]
Conversation analysis, medical interaction, health communication, treatment proposals, epistemics, deontics
National Category
Humanities General Language Studies and Linguistics
Research subject
URN: urn:nbn:se:uu:diva-239307DOI: 10.1016/j.pragma.2015.01.005ISI: 000350529100004OAI: oai:DiVA.org:uu-239307DiVA: diva2:774126
Värdighet i social interaktion: En pilotstudie av möten mellan äldre människor och yrkesutövare inom vård och omsorg.Språk och åldrande
Forte, Swedish Research Council for Health, Working Life and Welfare, 2013-2169
Available from: 2014-12-22 Created: 2014-12-22 Last updated: 2016-03-09Bibliographically approved

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Lindström, Anna
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