Toerien, M., Shaw, R. and Reuber, M. (2013) Initiating decision-making in neurology consultations 'recommending' versus 'option-listing' and the implications for medical authority. Sociology of Health and Illness, 35(6), pp. 873-890. (doi: 10.1111/1467-9566.12000)
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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.
Item Type: | Articles |
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Status: | Published |
Refereed: | Yes |
Glasgow Author(s) Enlighten ID: | Shaw, Dr Rebecca |
Authors: | Toerien, M., Shaw, R., and Reuber, M. |
College/School: | College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Health Economics and Health Technology Assessment |
Journal Name: | Sociology of Health and Illness |
Publisher: | Blackwell |
ISSN: | 0141-9889 |
ISSN (Online): | 1467-9566 |
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