Article published In: Future Perspectives in Medical Argumentation
Edited by Sarah Bigi and Maria Grazia Rossi
[Journal of Argumentation in Context 14:3] 2025
► pp. 305–320
Shared decision-making and argumentation
A pragma-dialectical perspective on medical consultations as discussion situations
Available under the Creative Commons Attribution (CC BY) 4.0 license.
For any use beyond this license, please contact the publisher at rights@benjamins.nl.
Open Access publication of this article was funded through a Transformative Agreement with Leiden University.
Published online: 4 December 2025
https://doi.org/10.1075/jaic.25025.pil
https://doi.org/10.1075/jaic.25025.pil
Abstract
Shared decision-making has become the ideal for medical decision-making. Given the pivotal role of argumentation within this process, shared decision-making has increasingly been examined through the lens of argumentation theory, particularly pragma-dialectics. This perspective paper outlines the pragma-dialectical contributions to the analysis of shared decision-making and explores the potential of this theory for addressing current and future challenges in medical decision-making. It aims to show that normative argumentation approaches, particularly the pragma-dialectical approach, are crucial for understanding and possibly improving shared decision-making. First, the paper discusses the alignment between shared decision-making and the ideal of a critical discussion, barriers to shared decision-making as violations of discussion rules and higher-order conditions, and the application of the pragma-dialectical approach to complex decision-making scenarios involving patient companions. Second, it considers how the pragma-dialectical approach may be used to confront the emerging issues of medical misinformation and artificial intelligence in medical decision-making.
Article outline
- 1.Introduction
- 2.Applying pragma-dialectics to shared decision-making
- 2.1Shared decision-making’s compatibility with a critical discussion
- 2.2Obstacles to shared decision-making as rule violations
- 2.3A pragma-dialectical analysis of complex shared decision-making
- 3.Applying pragma-dialectics to other challenges for shared decision‑making
- 4.Conclusion and discussion
- Notes
Literature
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