Toerien2018

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Toerien2018
BibType ARTICLE
Key Toerien2018
Author(s) Merran Toerien
Title Deferring the Decision Point: Treatment Assertions in Neurology Outpatient Consultations
Editor(s)
Tag(s) EMCA, Medical, Neurology, Treatment recommendations
Publisher
Year 2018
Language English
City
Month
Journal Health Communication
Volume 33
Number 11
Pages 1355-1365
URL Link
DOI 10.1080/10410236.2017.1350912
ISBN
Organization
Institution
School
Type
Edition
Series
Howpublished
Book title
Chapter

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Abstract

Recommendations can be implied by asserting some generalisation about a treatment’s benefit without overtly directing the patient to take it. Focusing on a collection of assertions in UK neurology consultations, this paper shows that these are overwhelmingly receipted as “merely” doing informing and argues that this is made possible by their ambiguous design: their relatively depersonalised formats convey that the neurologist is simply telling the patient what’s available,but the link made between the treatment and the patient’s condition implies that it will be of benefit. Thus, assertions, while stopping short of telling the patient what to do, are hearable as recommendation relevant. This delicates balance leaves it up to the patient to respond either to the implied or on-record action (recommending vs. informing). When treated as “merely” doing informing, assertions defer the decision point until the neurologist has done something more. Three main interactional functions of this are identified as follows: (i) indicating the existence of a solution to a concern, without making a decision relevant next; (ii) orienting to the patient’s right to choose; and (iii) making “cautious” recommendations.

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