Cover not available

In:Discourses of Helping Professions:
Edited by Eva-Maria Graf, Marlene Sator and Thomas Spranz-Fogasy
[Pragmatics & Beyond New Series 252] 2014
► pp. 227–255

Get fulltext from our e-platform
JBE logo with link
PDF logo with download linkDownload Book PDF
authorization required

“Doctor vs. patient”

Performing medical decision making via communicative negotiations

Published online: 18 December 2014
DOI logo with link
https://doi.org/10.1075/pbns.252.10pet
The physician-patient-relationship and the process of decision making are widely dealt with in linguistics and medical ethics. However, there is little knowledge on how the physician-patient-relationship is initially established and which roles doctor and patient are adopting in it. To close this gap, this paper uses videotaped interactions between third year medical students and standardized simulated patients, covering information and treatment decisions following a diagnosis of high blood pressure as empirical bases. In addition to the conversation-analytical approach, the medical-ethic typology of relationship-construction is applied in the analysis. The analysis shows that a global relationship-model for a whole conversation does not work for the interactive process of decision making. In addition to furnishing insights about the communicative course of decision making, this paper aims to strengthen linguistic research on medical decision making and to aspire to a stronger cooperation between medical ethics and linguistics.
References (31)
References
Beauchamp, Tom L., and James F. Childress. 2009. Principles of Biomedical Ethics.Oxford, New York: Oxford University Press.Google Scholar logo with link to Google Scholar
Deppermann, Arnulf. 2008. Gespräche analysieren: Eine Einführung. Wiesbaden: Verlag für Sozialwissenschaften. Google Scholar logo with link to Google Scholar
Deutsche Hochdruckliga e.V. DHL® - Deutsche Hypertonie Gesellschaft. 2008. Leitlinien zur Behandlung der arteriellen Hypertonie. [URL] [last access: August 12, 2012].Google Scholar logo with link to Google Scholar
Domke, Christine. 2006. Besprechungen als organisationale Entscheidungskommunikation. Berlin, New York: de Gruyter. Google Scholar logo with link to Google Scholar
Elwyn, Glyn, Adrian Edwards, and Paul Kinnersley. 1999. “Shared-Decision-Making in Primary Care: The Neglected Second Half of the Consultation.” The British Journal of General Practice 49: 477–482.Google Scholar logo with link to Google Scholar
Emanuel, Ezekiel J., and Linda L. Emanuel. 1992. “Four Models of the Physician-Patient Relationship.” Journal of the American Medical Association 267: 2221–2226. Google Scholar logo with link to Google Scholar
Feuerstein, Günter, and Ellen Kuhlmann (eds). 1999. Neopaternalistische Medizin: Der Mythos der Selbstbestimmung im Arzt-Patient-Verhältnis. Bern: Hans Huber.Google Scholar logo with link to Google Scholar
Hartog, Jennifer. 1993. “Laienvorstellungen im genetischen Beratungsgespräch.” In Arzt-Patienten-Kommunikation: Analysen zu interdisziplinären Problemen des medizinischen Diskurses, ed. by Petra Löning, and Jochen Rehbein, 115–133. Berlin, New York: de Gruyter. Google Scholar logo with link to Google Scholar
Heritage, John, and Douglas W. Maynard (eds). 2006. Communication in Medical Care: Interaction Between Primary Care Physicians and Patients. Cambridge: University Press. Google Scholar logo with link to Google Scholar
Heritage, John, Marc N. Elliott, Tanya Stivers, Andrea Richardson, and Rita Mangione-Smith. 2010. “Reducing Inappropriate Antibiotics Prescribing: The Role of Online Commentary on Physical Examination Findings.” Patient Education and Counseling 81: 119–125. Google Scholar logo with link to Google Scholar
Kettner, Matthias, and Matthias Kraska. 2009. “Kompensation von Arzt-Patient-Asymmetrien im Rahmen einer Theorie kommunikativen Handelns.” In Klinische Ethik: Aktuelle Entwicklungen in Theorie und Praxis, ed. by Jochen Vollmann, Jan Schildmann, and Alfred Simon, 243–260. Frankfurt, New York: Campus Verlag.Google Scholar logo with link to Google Scholar
Klemperer, David. 2003. Wie Ärzte und Patienten Entscheidungen treffen: Konzepte der Arzt-Patient-Kommunikation. Berlin: Wissenschaftszentrum für Sozialforschung.Google Scholar logo with link to Google Scholar
Koerfer, Armin, Rainer Obliers, and Karl Köhle. 2005. “Der Entscheidungsdialog zwischen Arzt und Patient: Modelle der Beziehungsgestaltung in der Medizin. ” In Psychosomatische Gesprächsführung in der Frauenheilkunde, ed. by Mechthild Neises, Susanne Ditz, and Thomas Spranz-Fogasy, 137–157. Stuttgart: Wissenschaftliche Verlagsgesellschaft.Google Scholar logo with link to Google Scholar
Koerfer, Armin, Christian Albus, Rainer Obliers, and Karl Köhle. 2008. “Kommunikationsmuster in der medizinischen Entscheidungsfindung.” In Profession und Kommunikation, ed. by Susanne Niemeier, and Hajo Diekmannshenke, 121–156. Bern: Lang.Google Scholar logo with link to Google Scholar
Mancia, Giuseppe, et al. 2009. “Reappraisal of European Guidelines on Hypertension Management: A European Society of Hypertension Task Force Document.” Journal of Hypertension 27: 2121–2158. Google Scholar logo with link to Google Scholar
Nowak, Peter. 2010. Eine Systematik der Arzt-Patient-Interaktion: Systemtheoretische Grundlagen, qualitative Synthesemethodik und diskursanalytische Ergebnisse zum sprachlichen Handeln von Ärztinnen und Ärzten. Frankfurt am Main: Peter Lang Verlag.Google Scholar logo with link to Google Scholar
Parsons, Talcott. 1951. “Illness and the Role of the Physician: A Sociological Perspective.” American Journal of Orthopsychiatry 21 (3): 452–460. Google Scholar logo with link to Google Scholar
Pawelczyk, Joanna. 2011. Talk as Therapy: Psychotherapy in a Linguistic Perspective. Amsterdam: Walter de Gruyter. Google Scholar logo with link to Google Scholar
Peräkylä, Anssi. 1998. “Authority and Accountability: The Delivery of Diagnosis in Primary Health Care.” Social Psychology Quarterly 61 (4): 301–320. Google Scholar logo with link to Google Scholar
Peters, Tim. 2008. Macht im Kommunikationsgefälle: der Arzt und sein Patient. Berlin: Frank und Timme.Google Scholar logo with link to Google Scholar
Rockenbauch, Katrin, and Jan Schildmann. 2011. “Partizipative Entscheidungsfindung (PEF): Eine systematische Übersichtsarbeit zu Begriffsverwendung und Konzeptionen.” Das Gesundheitswesen 73: 399–408. Google Scholar logo with link to Google Scholar
Sator, Marlene. 2011. Schmerzdifferenzierung: Eine gesprächsanalytische Untersuchung ärztlicher Erstgespräche an der Kopfschmerzambulanz. Wien: Vienna University Press.Google Scholar logo with link to Google Scholar
Scheibler, Fülöp. 2004. Shared Decision-Making. Von der Compliance zur partnerschaftlichen Entscheidungsfindung. Bern: Hans Huber.Google Scholar logo with link to Google Scholar
Schildmann, Jan, and Tim Peters. “Risikokommunikation in der Arzt-Patient-Beziehung: Ein interdisziplinärer Beitrag zum professionellen Umgang mit Unsicherheiten und Wahrscheinlichkeiten in der Medizin”. Speech given at the conference “Risikokommunikation”, Mühlheim an der Ruhr, Germany, June 23, 2010.
Selting, Margret, et al. 2009. “Gesprächsanalytisches Transkriptionssystem 2 (GAT 2).” Gesprächsforschung – Online-Zeitschrift zur verbalen Interaktion 10: 353–402.Google Scholar logo with link to Google Scholar
Spranz-Fogasy, Thomas. 2010. “Verstehensdokumentation in der medizinischen Kommunikation: Fragen und Antworten im Arzt-Patient-Gespräch.” In Verstehen in professionellen Handlungsfeldern, ed. by Arnulf Deppermann, Ulrich Reitemeier, Reinhold Schmitt, and Thomas Spranz-Fogasy, 27–116. Tübingen: Narr.Google Scholar logo with link to Google Scholar
Stivers, Tanya, Rita Mangione-Smith, Marc Elliott, Laurie McDonald, and John Heritage. 2003. “Why Do Physicians Think Parents Expect Antibiotics? What Parents Report vs What Physicians Believe.” The Journal of Family Practice 52 (2): 140–148.Google Scholar logo with link to Google Scholar
Stivers, Tanya. 2006. “Treatment Decisions: Negotiations Between Doctors and Patients in Acute Care Encounters.” In Communication in Medical Care: Interaction Between Primary Care Physicians and Patients, ed. by John Heritage, and Douglas W. Maynard, 297–312. Cambridge: University Press.Google Scholar logo with link to Google Scholar
. 2011. Prescribing Under Pressure: Parent-Physician Conversations and Antibiotics. Oxford: Oxford University Press.Google Scholar logo with link to Google Scholar
Vollmann, Jochen. 2000. “Das Informed Consent-Konzept als Politikum in der Medizin. Patientenaufklärung und Einwilligung aus historischer und medizinethischer Perspektive.” In Angewandte Ethik als Politikum, ed. by Matthias Kettner, 253–279. Frankfurt am Main: Suhrkamp.Google Scholar logo with link to Google Scholar
Wallace, Peggy. 2007. Coaching Standardized Patients for Use in the Assessment of Clinical Competence. New York: Springer Publishing Company.Google Scholar logo with link to Google Scholar
Cited by (1)

Cited by one other publication

Natia Badridze, Maia Advadze, Nino Elisabedashvili, Irma Khachidze & Nana Nikolaishvili
2023. A STUDY OF COMMUNICATIVE STRATEGIES AND TACTICS IN MEDICAL COLLEGIAL DISCOURSE. World Science :4(82) DOI logo

This list is based on CrossRef data as of 28 november 2025. Please note that it may not be complete. Sources presented here have been supplied by the respective publishers. Any errors therein should be reported to them.

Mobile Menu Logo with link to supplementary files background Layer 1 prag Twitter_Logo_Blue