A decision we have to make together: A qualitative analysis of inclusiveness and exclusiveness of personal pronouns as a strategic maneuver in medical bad news conversations

Effective communication between physicians and patients in bad news conversation is essential, especially when it concerns decisions about treatment and quality of life issues. In this thesis, the central theme is how the semantics and pragmatics of personal pronouns, in particular ‘I’, ‘you’ and ‘we’, contribute to the inclusiveness of exclusiveness of the patient in the treatment discussion and, therefore, influence the discussion of the oncological treatment process. By means of evaluating the pronouns used by the physicians in eleven bad news conversations, the strategic function of this word class is revealed. These pronouns could, specifically, be interpreted as ‘actual pronouns’, as ‘generic pronouns’ (‘enlarged inclusiveness’, ‘rhetorical’ and ‘specific’) or as ‘other’ (dysfluencies, fillers and ‘no code’). The concept of strategic maneuvering that is used here, serves to evaluate the argumentative moves the physician makes to effectively and dialectically present the ‘best’...Show moreEffective communication between physicians and patients in bad news conversation is essential, especially when it concerns decisions about treatment and quality of life issues. In this thesis, the central theme is how the semantics and pragmatics of personal pronouns, in particular ‘I’, ‘you’ and ‘we’, contribute to the inclusiveness of exclusiveness of the patient in the treatment discussion and, therefore, influence the discussion of the oncological treatment process. By means of evaluating the pronouns used by the physicians in eleven bad news conversations, the strategic function of this word class is revealed. These pronouns could, specifically, be interpreted as ‘actual pronouns’, as ‘generic pronouns’ (‘enlarged inclusiveness’, ‘rhetorical’ and ‘specific’) or as ‘other’ (dysfluencies, fillers and ‘no code’). The concept of strategic maneuvering that is used here, serves to evaluate the argumentative moves the physician makes to effectively and dialectically present the ‘best’ treatment option, determined by the activity type of medical consultations. In this thesis, the focus lies on examining the ‘rhetorical we’ and ‘specific we’, and the pronouns ‘you’ and ‘I’ in the analysis. The findings suggest that physicians use implicit propositions to seemingly follow the principles of shared decision making, but in fact oftentimes do not.Show less

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A decision we have to make together: A qualitative analysis of inclusiveness and exclusiveness of personal pronouns as a strategic maneuver in medical bad news conversations