Difference between revisions of "Toerien2013"

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|Journal=Sociology of Health & Illness
 
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Revision as of 09:46, 1 December 2019

Toerien2013
BibType ARTICLE
Key Toerien2013
Author(s) Merran Toerien, Rebecca Shaw, Markus Reuber
Title Initiating decision-making in neurology consultations: ‘recommending’ versus ‘option-listing’ and the implications for medical authority
Editor(s)
Tag(s) EMCA, Medical EMCA, Medical interaction, Institutional talk, Option-listing, Medical recommendations, Authority, Choice
Publisher
Year 2013
Language
City
Month
Journal Sociology of Health & Illness
Volume 35
Number 6
Pages 873–890
URL Link
DOI 10.1111/1467-9566.12000
ISBN
Organization
Institution
School
Type
Edition
Series
Howpublished
Book title
Chapter

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Abstract

This article compares two practices for initiating treatment decision-making, evident in audio-recorded consultations between a neurologist and 13 patients in two hospital clinics in the UK. We call these ‘recommending’ and ‘option-listing’. The former entails making a proposal to do something; the latter entails the construction of a list of options. Using conversation analysis (CA), we illustrate each, showing that the distinction between these two practices matters to participants. Our analysis centres on two distinctions between the practices: epistemic differences and differences in the slots each creates for the patient’s response. Considering the implications of our findings for understanding medical authority, we argue that option-listing – relative to recommending – is a practice whereby clinicians work to relinquish a little of their authority. This article contributes, then, to a growing body of CA work that offers a more nuanced, tempered account of medical authority than is typically portrayed in the sociological literature. We argue that future CA studies should map out the range of ways – in addition to recommending – in which treatment decision-making is initiated by clinicians. This will allow for further evidence-based contributions to debates on the related concepts of patient participation, choice, shared decision-making and medical authority.

Notes