Volume 7, Issue 2
  • ISSN 2211-4742
  • E-ISSN: 2211-4750
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In this paper, argumentation practices will be discussed in view of their potential for favoring effective information sharing and the creation of ‘emergent common ground’, i.e. the common ground that is sought, created and co-constructed in the process of communication. Argumentation is usually tightly knit with information sharing: if the parties have not previously shared a sufficient amount of relevant knowledge, it is difficult for them to produce effective argumentation. Based on these premises, in this paper the argumentation stages of medical encounters will be viewed as opportunities to reveal and integrate insufficient common ground between clinicians and patients. By relying on the analysis of a corpus of real life encounters in a chronic care setting, the interaction between information sharing and argumentation will be shown, along with problematic cases of misunderstandings or ineffective argumentation due to lack of common ground. Implications for the clinical practice will be discussed.


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  1. Allan, K.
    2013 “What Is Common Ground?” In A. Capone , F. L. Piparo , and M. Carapezza (Eds.), Perspectives on Linguistic Pragmatics (pp.285–310). Cham: Springer. 10.1007/978‑3‑319‑01014‑4_11
    https://doi.org/10.1007/978-3-319-01014-4_11 [Google Scholar]
  2. Asterhan, C. S. C. , and B. B. Schwartz
    2009 “Argumentation and Explanation in Conceptual Change: Indications from Protocol Analyses of Peer-to-Peer Dialog.” Cognitive Science33 (3):374–400. 10.1111/j.1551‑6709.2009.01017.x
    https://doi.org/10.1111/j.1551-6709.2009.01017.x [Google Scholar]
  3. Bigi, S.
    2014 “Key Components of Effective Collaborative Goal Setting in the Chronic Care Encounter.” Communication and Medicine11 (2):103–115. 10.1558/cam.v11i2.21600
    https://doi.org/10.1558/cam.v11i2.21600 [Google Scholar]
  4. 2015 “Can Argumentation Skills Become a Therapeutic Resource? Results from an Observational Study in Diabetes Care.” In F. H. van Eemeren and B. Garssen (Eds.). Scrutinizing Argumentation in Practice (pp.281–294). Amsterdam: John Benjamins. 10.1075/aic.9.16big
    https://doi.org/10.1075/aic.9.16big [Google Scholar]
  5. 2016aCommunicating (with) Care. Amsterdam: IOS Press.
    [Google Scholar]
  6. 2016b “Communication Skills for Patient Engagement: Argumentation Competencies as Means to Prevent or Limit Reactance Arousal, with an Example from the Italian Healthcare System.” Frontiers in Psychology, 7:1472. 10.3389/fpsyg.2016.01472
    https://doi.org/10.3389/fpsyg.2016.01472 [Google Scholar]
  7. Bigi, S. , and G. Lamiani
    2016 “The Power of Words: Deliberation Dialogue as a Model to Favor Patient Engagement in Chronic Care.” In G. Graffigna (Ed.), Promoting Patient Engagement and Participation for Effective Healthcare Reform (pp.66–92). Hershey, Pennsylvania: IGI Global.
    [Google Scholar]
  8. Brown, J. B. , Stewart, M. , McCracken, E. , McWhinney, I. R. , and J. Levenstein
    1986 “The Patient-Centred Clinical Method. 2. Definition and Application.” Family Practice3 (2):75–79. 10.1093/fampra/3.2.75
    https://doi.org/10.1093/fampra/3.2.75 [Google Scholar]
  9. Epstein, R. M. , and R. L. J. Street
    2011 “The Values and Value of Patient-Centered Care.” Annals of Family Medicine9 (2):100–103. 10.1370/afm.1239
    https://doi.org/10.1370/afm.1239 [Google Scholar]
  10. Heritage, J.
    2010 “Questioning in Medicine.” In A. F. Freed and S. Ehrlich (Eds.), “Why do you ask?”. The Function of Questions in Institutional Discourse (pp.42–68). New York: Oxford University Press.
    [Google Scholar]
  11. Ishikawa, H. , Hashimoto, H. , and T. Kiuchi
    2013 “The Evolving Concept of “Patient-​Centeredness” In Patient-Physician Communication Research.” Social Science and Medicine (1982)96:147–153. 10.1016/j.socscimed.2013.07.026
    https://doi.org/10.1016/j.socscimed.2013.07.026 [Google Scholar]
  12. Kecskes, I.
    2008 “Dueling Contexts: A Dynamic Model of Meaning.” Journal of Pragmatics40 (3):385–406. 10.1016/j.pragma.2007.12.004
    https://doi.org/10.1016/j.pragma.2007.12.004 [Google Scholar]
  13. 2010 “The Paradox of Communication: A Socio-Cognitive Approach.” Pragmatics and Society1 (1):50–73. 10.1075/ps.1.1.04kec
    https://doi.org/10.1075/ps.1.1.04kec [Google Scholar]
  14. 2014Intercultural Pragmatics. New York: Oxford University Press.
    [Google Scholar]
  15. Kecskes, I. , and F. Zhang
    2009 “Activating, Seeking, and Creating Common Ground: A Socio-Cognitive Approach.” Pragmatics and Cognition17 (2):331–355. 10.1075/pc.17.2.06kec
    https://doi.org/10.1075/pc.17.2.06kec [Google Scholar]
  16. 2013 “On the Dynamic Relations Between Common Ground and Presupposition.” In A. Capone , F. L. Piparo , and M. Carapezza (Eds.), Perspectives on Linguistic Pragmatics (pp.375–396). Cham: Springer. 10.1007/978‑3‑319‑01014‑4_15
    https://doi.org/10.1007/978-3-319-01014-4_15 [Google Scholar]
  17. Kurtz, S. , Silverman, J. , Benson, J. , and J. Draper
    2003 “Marrying content and process in clinical method teaching: enhancing the Calgary-Cambridge guides.” Academic Medicine: Journal of the Association of American Medical Colleges78 (8):802–809. 10.1097/00001888‑200308000‑00011
    https://doi.org/10.1097/00001888-200308000-00011 [Google Scholar]
  18. Labrie, N.
    2012 “Strategic Maneuvering in Treatment Decision-Making Discussions: Two Cases in Point.” Argumentation26 (2):171–199. 10.1007/s10503‑011‑9228‑5
    https://doi.org/10.1007/s10503-011-9228-5 [Google Scholar]
  19. 2013 “Strategically Eliciting Concessions from Patients in Treatment Decision-Making Discussions.” Journal of Argumentation in Context2 (3):322–341. 10.1075/jaic.2.3.03lab
    https://doi.org/10.1075/jaic.2.3.03lab [Google Scholar]
  20. 2015 “The Promise and Prospects of Argumentation for Public Health Communication.” Journal of public health research4 (1):547–549. 10.4081/jphr.2015.547
    https://doi.org/10.4081/jphr.2015.547 [Google Scholar]
  21. Labrie, N. , and P. Schulz
    2014 “The Effects of General Practitioners’ Use of Argumentation to Support Their Treatment Advice: Results of an Experimental Study Using Video-​Vignettes.” Health communication30 (10):951–961. 10.1080/10410236.2014.909276
    https://doi.org/10.1080/10410236.2014.909276 [Google Scholar]
  22. 2015 “Exploring the Relationships Between Participatory Decision-Making, Visit Duration, and General Practitioners’ Provision of Argumentation to Support their Medical Advice: Results from a Content Analysis.” Patient education and counseling98 (5):572–577. 10.1016/j.pec.2015.01.017
    https://doi.org/10.1016/j.pec.2015.01.017 [Google Scholar]
  23. Labrie, N. , Schulz, P. , and S. Zurbriggen
    2015 “The Effects of Reasoned Shared Decision-Making on Consultation Outcomes: Results of a Randomized-Controlled Experiment Among a Student Population.” Studies in Communication Sciences15 (2):182–189. 10.1016/j.scoms.2015.09.002
    https://doi.org/10.1016/j.scoms.2015.09.002 [Google Scholar]
  24. Lamiani, G. , Bigi, S. , Mancuso, M. E. , Coppola, A. , and E. Vegni
    2017 “Applying a Deliberation Model to the Analysis of Consultations in Haemophilia: Implications for Doctor-Patient Communication.” Patient Education and Counseling100 (4):690–695. 10.1016/j.pec.2016.11.021
    https://doi.org/10.1016/j.pec.2016.11.021 [Google Scholar]
  25. Lamiani, G. , Strada, I. , Mancuso, M. E. , Coppola, A. , Vegni, E. , and E. A. Moja
    ; the Pro-Adherence Study Group 2015 “Factors Influencing Illness Representations and Perceived Adherence in Haemophilic Patients: A Pilot Study.” Haemophilia21 (5):598–604. 10.1111/hae.12654
    https://doi.org/10.1111/hae.12654 [Google Scholar]
  26. Levenstein, J. , McCracken, E. , McWhinney, I. R. , Stewart, M. , and J. B. Brown
    1986 “The Patient-Centred Clinical Method. 1. A Model for the Doctor-Patient Interaction in Family Medicine.” Family Practice3 (1):24–30. 10.1093/fampra/3.1.24
    https://doi.org/10.1093/fampra/3.1.24 [Google Scholar]
  27. Levinson, S. C.
    1992 “Activity Types and Language.” In P. Drew and J. Heritage (Eds.), Talk at Work: Interaction in Institutional Settings (pp.66–100). Cambridge: Cambridge University Press.
    [Google Scholar]
  28. Macagno, F.
    forthcoming. “Practical Reasoning and the Act of Naming Reality.” Revue internationale de philosophie.
    [Google Scholar]
  29. Mead, N. , and P. Bower
    2000 “Patient-Centredness: a Conceptual Framework and Review of the Empirical Literature.” Social Science and Medicine (1982)51 (7):1087–1110. 10.1016/S0277‑9536(00)00098‑8
    https://doi.org/10.1016/S0277-9536(00)00098-8 [Google Scholar]
  30. Moja, E. , and E. Vegni
    1998 “La Medicina Centrata sul Paziente.” Annali di Medicina Interna13:56–64.
    [Google Scholar]
  31. Pan, D. , Chen, Y. , and S. Ju
    2018 “Argumentative Patterns in Chinese Medical Consultations.” Argumentation, 37–53. 10.1007/s10503‑017‑9428‑8
    https://doi.org/10.1007/s10503-017-9428-8 [Google Scholar]
  32. Pilgram, R.
    2009 “Argumentation in Doctor-Patient Interaction: Medical Consultation as a Pragma-Dialectical Communicative Activity Type.” Studies in Communication Sciences9 (2):153–169.
    [Google Scholar]
  33. Rossi, M. G. , Leone, D. , and S. Bigi
    2017 “The Ethical Convenience of Non-Neutrality in Medical Encounters: Argumentative Instruments for Healthcare Providers.” Teoria37 (2):139–157.
    [Google Scholar]
  34. Rubinelli, S.
    2013 “Rational versus Unreasonable Persuasion in Doctor–Patient Communication: A Normative Account.” Patient Education and Counseling92 (3):296–301. 10.1016/j.pec.2013.06.005
    https://doi.org/10.1016/j.pec.2013.06.005 [Google Scholar]
  35. Salmon, P.
    2015 “Argumentation and Persuasion in Patient-Centred Communication.” Patient Education and Counseling98:543–544. 10.1016/j.pec.2015.03.010
    https://doi.org/10.1016/j.pec.2015.03.010 [Google Scholar]
  36. Silverman, J. , Kurtz, S. , and J. Draper
    1998Skills for Communicating with Patients. Oxon: Radcliff Medical Press.
    [Google Scholar]
  37. Snoeck Henkemans, A. F.
    2016 “Argumentative Patterns in Over-the-Counter Medicine Advertisements.” Argumentation30:81–95. 10.1007/s10503‑015‑9373‑3
    https://doi.org/10.1007/s10503-015-9373-3 [Google Scholar]
  38. Stewart, M. , and D. Roter
    1989Communicating with Medical Patients. London: Sage Publications.
    [Google Scholar]
  39. Stewart, M. , Brown, J. B. , Levenstein, J. , McCracken, E. , and I. R. McWhinney
    1986 “The Patient-Centred Clinical Method. 3. Changes in Residents’ Performance over Two Months of Training.” Family Practice3 (3):164–167. 10.1093/fampra/3.3.164
    https://doi.org/10.1093/fampra/3.3.164 [Google Scholar]
  40. Stewart, M. , Brown, J. B. , Weston, W. W. , McWhinney, I. R. , McWilliam, C. L. , and T. L. Freeman
    (Eds) 1995Patient Centered Medicine; Transforming the Clinical Method. London: Sage Publications.
    [Google Scholar]
  41. van Eemeren, F. H. , and P. Houtlosser
    2005 “Theoretical Construction and Argumentative Reality: An Analytic Model of Critical Discussion and Conventionalised Types of Argumentative Activity.” OSSA Conference Archive, Paper 9.
    [Google Scholar]
  42. van Poppel, L.
    2014 “The Strategic Function of Variants of Pragmatic Argumentation in Health Brochures.” In S. Rubinelli and A. F. Snoeck Henkemans (Eds.), Argumentation and health (pp.97–112). (Benjamins current topics; No. 64). Amsterdam: John Benjamins Publishing Company.
    [Google Scholar]
  43. Veldhuijzen, W.
    2011 Challenging the Patient Centred Paradigm: Designing Feasible Guidelines for Doctor-Patient Communication. Doctoral dissertation, Maastricht University.
  44. Wierda, R. , and J. Visser
    2012 “Direct-to-Consumer Advertisements for prescription drugs as an argumentative activity type.” Journal of Argumentation in Context1 (1):81–96. 10.1075/jaic.1.1.07wie
    https://doi.org/10.1075/jaic.1.1.07wie [Google Scholar]
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