Strategically eliciting concessions from patients in treatment decision-making discussions

In this paper it is examined how doctors may strategically elicit concessions from their patients in order to create a favorable point of departure for the treatment decision-making discussion. Using the dialectical profile for establishing starting points in an argumentative discussion (van Eemeren, Houtlosser, and Snoeck Henkemans 2007) as an analytic tool, an overview is provided of the different — analytically relevant — dialectical moves that doctors may make at the opening stage of the discussion and the possible subsequent dialectical pathways. Based on examples taken from actual consultation practice, each of these pathways is illustrated. Moreover, some of the strategic maneuvers doctors may deploy to start the critical resolution process in the most favorable way are identified, linking these maneuvers to the aims that are inherently embedded in the broader institutional context in which the discussion takes place.