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- Volume 1, Issue, 2012
Journal of Argumentation in Context - Volume 1, Issue 1, 2012
Volume 1, Issue 1, 2012
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Argumentation and informed consent in the doctor–patient relationship
Author(s): Jerome Bickenbachpp.: 5–18 (14)More LessArgumentation theory has much to offer our understanding of the doctor-patient relationship as it plays out in the context of seeking and obtaining consent to treatment. In order to harness the power of argumentation theory in this regard, I argue, it is necessary to take into account insights from the legal and bioethical dimensions of informed consent, and in particular to account for features of the interaction that make it psychologically complex: that there is a fundamental asymmetry of authority, power and expertise between doctor and patient; that, given the potential for coercion, it is a challenge to preserve the interactive balance presumed by the requirement of informed consent; and finally that the necessary condition that patients be ‘competent to consent’ may undermine the requirement of respecting patient autonomy. I argue argumentation theory has the resources to deal with these challenges and expand our knowledge, and appreciation, of the informed consent interaction in health care.
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Institutional constraints on strategic maneuvering in shared medical decision-making
Author(s): A. Francisca Snoeck Henkemans and D. Mohammedpp.: 19–32 (14)More LessIn this paper it is first investigated to what extent the institutional goal and basic principles of shared decision making are compatible with the aim and rules for critical discussion. Next, some techniques that doctors may use to present their own treatment preferences strategically in a shared decision making process are discussed and evaluated both from the perspective of the ideal of shared decision making and from that of critical discussion.
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Reasonableness of a doctor’s argument by authority: A pragma-dialectical analysis of the specific soundness conditions
Author(s): Roosmaryn Pilgrampp.: 33–50 (18)More LessArgumentation can play an important role in medical consultation. A doctor could, for instance, argue in support of a treatment advice to overcome a patient’s hesitance about it. In this argumentation, the doctor might explicitly present him- or herself as an authority, thereby presenting an argument by authority. Depending on the specific conditions under which the doctor advances such an argument, the doctor’s argument by authority can constitute a sound or a fallacious contribution to the discussion. In this paper, I shall determine what the specific soundness conditions are that apply to a doctor’s argumentation by authority in medical consultation.
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Evaluating argumentative moves in medical consultations
Author(s): Sarah Bigipp.: 51–65 (15)More LessThe relevance of context has been acknowledged also recently as a fundamental element for the correct evaluation of argumentative moves within institutional fields of interaction. Indeed, not considering the larger culture-specific and social features of the context within which the interactions take place poses problems of interpretation of the data and comparability of results. Starting from these considerations, the paper aims at discussing a model for the description of the social context of interaction that may allow for a better interpretation and evaluation of argumentative moves within medical consultations. The efficacy of the model is shown by applying it to the description and analysis of examples of real-life consultations recorded in the Italian region of Lombardy. In the first section, the model for the description of the social context of interaction is presented and discussed. In the second section, examples of argumentative passages from a selection of consultations are presented and commented on by relying on the model. Some concluding remarks and further developments of the research are proposed in the final section
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Teaching argumentation theory to doctors: Why and what
Author(s): Sara Rubinelli and Claudia Zaninipp.: 66–80 (15)More LessThis paper supports the need for health professionals to be trained in argumentation theory, by illustrating the challenges that they face in interacting with patients and according to the different models of consultation that patients prefer. While there is no ideal model of consultation that can be promoted universally, the ability to construct arguments in support of health professionals’ points of view, as well as the ability to engage in critical discussion with patients, translate in essential skills for reaching patients’ agreement when communication develops through the interpretative model or the informed decision model or, eventually, shared decision-making.
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Direct-to-consumer advertisements for prescription drugs as an argumentative activity type
Author(s): Renske Wierda and Jacky Visserpp.: 81–96 (16)More LessWith direct-to-consumer advertisements (DTCA), pharmaceutical companies can market their prescription drugs directly to consumers. In order to properly study the argumentative aspect of these advertisements from a pragma-dialectical perspective, it is necessary to characterize DTCA as an ‘argumentative activity type’. This characterization shows that in DTCA, the advertiser combines two genres of communicative activity: promotion and consultation. The use of promotion stems from the advertiser’s commercial objective of selling products, while the use of consultation is a result of the legal obligation to present a fair balance between arguments for and against the use of a drug.
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The strategic function of variants of pragmatic argumentation in health brochures
Author(s): Lotte van Poppelpp.: 97–112 (16)More LessIn this paper, I examine the strategic function of four variants of pragmatic argumentation in the context of advisory health brochures. I argue that each variant functions as a strategic manoeuvre that deals with potential countermoves: with variant I and II writers can address anticipated doubt with respect to the standpoint and with variants III and IV they can strategically erase potential criticism of or possible alternatives to the proposed action.
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Argumentation and risk communication about genetic testing: Challenges for healthcare consumers and implications for computer systems
Author(s): Nancy L. Greenpp.: 113–129 (17)More LessAs genetic testing for the presence of potentially health-affecting mutations becomes available for more genetic conditions, many people will soon be faced with the decision of whether or not to have a genetic test. Making an informed decision requires an understanding and evaluation of the arguments for and against having the test. As a case in point, this paper considers argumentation involving the decision of whether to have a BRCA gene test, one of the first commercially available genetic tests. First, argumentation in a five-page patient brochure from a for-profit company that provides BRCA gene testing, is analyzed. Next, for comparison, argumentation on BRCA testing in materials for healthcare consumers written by a not-for-profit health plan and a government organization, is analyzed. In view of the challenges identified by considering these examples, this article discusses how argumentation-oriented computer systems may be able to help the healthcare consumer to make informed decisions about genetic testing.
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“It is about our body, our own body!”: On the difficulty of telling dutch women under 50 that mammography is not for them
Author(s): Peter J. Schulz and Bert Meuffelspp.: 130–142 (13)More LessThis article is concerned with the reasons why sometimes good arguments in health communication leaflets fail to convince the targeted audience. As an illustrative example it uses the age-dependent eligibility of women in the Netherlands to receive routine breast cancer screening examinations: according to Dutch regulations women under 50 are ineligible for them. The present qualitative study rests on and complements three experimental studies on the persuasiveness of mammography information leaflets; it uses interviews to elucidate reasons why the arguments in the health communication leaflets for the exclusion of women under 50 from routine mammographic screenings do not work.
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Arguing with oneself
Author(s): Marta Zampa and Daniel Perrin
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