1887
  1. Home
  2. e-Journals
  3. Pragmatics
  4. Volume 21, Issue 4
  5. Article
Volume 21, Issue 4
  • ISSN 1018-2101
  • E-ISSN: 2406-4238
PDF

Abstract

Although communication in medical practice is reputed for exactitude and objectivity, many doctors in several countries make equivocal, concealing utterances in certain situations when relating with clients. This phenomenon, despite its importance in doctor-client interaction, has received little attention from language scholars who have discussed concealment mainly as a strategy in news delivery. The present study examines concealment items in the interaction between doctors and clients in South-western Nigerian hospitals and their pragmatic implications for medical communication in Nigeria. Fifty (50) conversations between doctors and clients on several ailments were tape-recorded in the six states of South-western Nigeria. Structured and unstructured interviews were conducted with selected doctors and clients. The corpus was examined for the linguistic and pragmatic resources deployed by doctors in concealing information, and was analysed using Jacob Mey’s theory of pragmeme and insights from the literature on news delivery strategies. Concealment was found to take place between doctors and clients in a two-phase mode: Referential and pragmatic. Utterances which have descriptive forms at the referential level assume subjective and divergent shades in the context of concealment at the pragmatic level. Nine concealment strategies (jargonisation, veiling, forecasting, mitigation, stalling, normalisation, dysphemisation, euphemisation and doublespeak) were found to be employed to achieve four broad goals: Preventive, palliative, culture-compliant and confidential with respect to 25 diseases /medical procedures. Concealment in consultative encounters takes into account the socio-psychological security needs of clients and attends positively to clients’ cultural expectations.

© 2011 International Pragmatics Association
Loading

Article metrics loading...

/content/journals/10.1075/prag.21.4.06ode
2011-01-01
2025-04-27

  • From This Site

    /content/journals/10.1075/prag.21.4.06ode
    dcterms_title,dcterms_subject,pub_keyword
    -contentType:Journal -contentType:Contributor -contentType:Concept -contentType:Institution
    10
    5
Loading full text...

Full text loading...

References

  1. Buckman, Robert
    (2001) Communication skills in palliative care: A practical guide. Neurologic Clinics. 19 (4). www.ncbi.nlm.nih.gov/pubmed11854110. AccessedMay 20, 2010. doi: 10.1016/S0733‑8619(05)70057‑8
     https://doi.org/10.1016/S0733-8619(05)70057-8 [Google Scholar]
  2. Capone, Alesandro
    (2005) Pragmemes: A study with reference to English and Italian. Journal of Pragmatics. 37: 1355-1371. doi: 10.1016/j.pragma.2005.01.013
     https://doi.org/10.1016/j.pragma.2005.01.013 [Google Scholar]
  3. Chimombo, M. , and R. Roseberry
    (1998) The Power of Discourse: An Introduction to Discourse Analy- sis. New Jersey: Lawrence Erlbaum Associates, Inc.
     [Google Scholar]
  4. Fairclough, Norman
    (1989) Language and Power. London: Longman.
     [Google Scholar]
  5. Frankel, R.M
    (2001) Clinical care and conversational contingencies: The role of patients’ self-diagnosis in medical encounters. Text21: 83-111.
     [Google Scholar]
  6. Glasser, Barney , and Anselm L. Strauss
    (1965) Awareness of Dying. Chicago, IL: Aldine.
     [Google Scholar]
  7. Good, Mary-Jo , Byron Good , Cynthia Schaffer , and Stuart Lind
    (1990) American oncology and the discourse on hope. Culture, Medicine and Psychiatry14: 59-79. doi: 10.1007/BF00046704
     https://doi.org/10.1007/BF00046704 [Google Scholar]
  8. Heath, Collins
    (1992) Diagnosis and assessment in the medical consultation. In P. Drew and J. Heritage (eds.), Talk at Work: Interaction in Institutional Settings. Cambridge: Cambridge University Press, pp.235-267.
     [Google Scholar]
  9. Heritage, John , and T. Stivers
    (1999) Online commentary in acute medical visits: A method of shaping patient expectations. Social Science and Medicine 49: 1501-1517. doi: 10.1016/S0277‑9536(99)00219‑1
     https://doi.org/10.1016/S0277-9536(99)00219-1 [Google Scholar]
  10. Heritage, John , and Douglas Maynard
    (2006) (eds)Communication in Medical Care: Interaction Between Primary Care Physicians and Patients. Cambridge: Cambridge University Press. doi: 10.1017/CBO9780511607172
     https://doi.org/10.1017/CBO9780511607172 [Google Scholar]
  11. Keskes, Istvan
    (2010) Situation-bound utterances as pragmatic acts. Journal of Pragmatics. 42.1: 2889-2897. doi: 10.1016/j.pragma.2010.06.008
     https://doi.org/10.1016/j.pragma.2010.06.008 [Google Scholar]
  12. Leppanen, V
    (1998) Structures of District Nurse-Patient Interaction. Lund, Sweden: Department of Sociology, Lund University.
     [Google Scholar]
  13. Levinson, Stephen
    (1979) Activity types and language. Linguistics17: 365-399. doi: 10.1515/ling.1979.17.5‑6.365
     https://doi.org/10.1515/ling.1979.17.5-6.365 [Google Scholar]
  14. Maynard, Douglas
    (1989) Notes on the delivery and reception of diagnostic news regarding mental disabilities. In D.T. Helm , W.T. Anderson , A.J. Meehan and A.W. Rawls (eds.), The Interactional Order: New Directions in the Study of Social Order. New York: Irvington, pp. 54-67.
     [Google Scholar]
  15. (1991) Interaction and asymmetry in clinical discourse. American Journal of Sociology97: 448-495. doi: 10.1086/229785
     https://doi.org/10.1086/229785 [Google Scholar]
  16. (1996) On ‘realisation’ in everyday life: The forecasting of bad news as a social relation. American Sociological Review16.1: 109-131. doi: 10.2307/2096409
     https://doi.org/10.2307/2096409 [Google Scholar]
  17. (2003) Bad News, Good News: Conversational Order in Everyday Talk and Clinical Settings. Chicago: University of Chicago Press.
     [Google Scholar]
  18. (2005) ‘Does it mean I’m gonna die?’: On meaning assessment in the delivery of diagnostic news. Social Science and Medicine.
     [Google Scholar]
  19. Mey, Jacob
    (2001) Pragmatics: An Introduction. Oxford: Blackwell Publishers.
     [Google Scholar]
  20. Odebunmi, Akin
    (2003) Pragmatic features of English usage in hospital interactions amongst medical practitioners and patients in South-western Nigeria. Unpublished Ph.D. thesis. Obafemi Awolowo University, Ile-Ife.
  21. (2005) Politeness and face management in hospital conversational interactions in South- Western Nigeria. Ibadan: Journal of English Studies2: 1-22.
     [Google Scholar]
  22. (2006a) Meaning in English: An introduction. Ogbomoso: Critical Sphere.
     [Google Scholar]
  23. (2006b) Locutions in medical discourse in South-Western Nigeria. Pragmatics 16.1: 25-41.
     [Google Scholar]
  24. (2007) Acts doctors and patients perform in medical encounters in Nigeria. In Moji Olateju , Rotimi Taiwo and Adeleke Fakoya (eds.), Towards Understanding Discourse Strategies. Ago- Iwoye: Olabisi Onabanjo University Press, pp.1-17.
     [Google Scholar]
  25. (2008) Pragmatic strategies of diagnostic news delivery in Nigerian hospitals. Linguistik Online36.4: 21-37.
     [Google Scholar]
  26. (2010a) Tracking ideology in political news. California Linguistic Notes XXXV (2).
     [Google Scholar]
  27. (2010b) Ideology and body part metaphor in Nigerian English. Review of Cognitive Linguistics8.2: 272-299. doi: 10.1075/rcl.8.2.02ode
     https://doi.org/10.1075/rcl.8.2.02ode [Google Scholar]
  28. (2010c) Code selection at first meetings: A pragmatic analysis of doctor- client conversations in Nigeria. Unpublished manuscript.
  29. Odebunmi, Akin , and M.A. Alo
    (2010) Beliefs in GSM text-messaging among academics in two Nigerian universities. In Rotimi Taiwo (ed.), Handbook of Research on Discourse Behaviour and Digital Communication: Language Structures and So-cial Interaction. New York: IGI Global, pp. 468-478. doi: 10.4018/978‑1‑61520‑773‑2.ch029
     https://doi.org/10.4018/978-1-61520-773-2.ch029 [Google Scholar]
  30. Odebunmi, Akin , and Peter Auer
    (2011) Face, politeness and culture in doctor-client encounters in Nigeria. Unpublished manuscript.
  31. Ong, LM , J.C. de Haes , A.M. Hoos , and F.B. Lammes
    (1995) Doctor-patient communication: A review of the literature. Public Medicine 40: 903-918.
     [Google Scholar]
  32. Perakyla, Anssi
    (1998) Authority and accountability: The delivery of diagnosis in primary health care. Social Psychology Quarterly61.4: 301-320. doi: 10.2307/2787032
     https://doi.org/10.2307/2787032 [Google Scholar]
  33. Stivers, Tanya
    (1998) Prediagnostic commentary in veteranarian-client interaction. Research on Language and Social Interaction31.2: 241-277. doi: 10.1207/s15327973rlsi3102_4
     https://doi.org/10.1207/s15327973rlsi3102_4 [Google Scholar]
  34. The, Anne-Mei , Tony Hak , Gerard Koeter , and Gerrit van de Wal
    (2000) Collusion in doctor-patient communication about imminent death: An ethnographic study. Pubmed Journal. www.ncbi.nlm.nih.gov/pmc/articles/PMC. AccessedMay 20, 2010.
     [Google Scholar]
  35. Tseng, Ming-Yu
    (2010) The pragmatic act of fishing for personal details: From choice to performance. Journal of Pragmatics42: 1982-1996. doi: 10.1016/j.pragma.2009.12.004
     https://doi.org/10.1016/j.pragma.2009.12.004 [Google Scholar]
  36. Williams, John
    (2009) Medical Ethics Manual. France: World Medical Association.
     [Google Scholar]
/content/journals/10.1075/prag.21.4.06ode
Loading
  • Article Type: Research Article
Keyword(s): Concealment; Doctor-client interaction; Pragmeme; Socio-psychological security; Strategies

Most Cited

This is a required field
Please enter a valid email address
Approval was successful
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error