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Article published In:
Argumentation and Patient Centered Care
Edited by Francisca Snoeck Henkemans, Roosmaryn Pilgram and Nanon Labrie
[Journal of Argumentation in Context 7:2] 2018
► pp. 161–176

A pragma-dialectical perspective on obstacles to shared decision-making

| University of Amsterdam | Leiden University
| University of Amsterdam

Shared medical decision-making has been analyzed as a particular kind of argumentative discussion. In the pragma-dialectical argumentation theory, different types of conditions and rules are formulated for the ideal of a reasonable argumentative discussion. In this paper, we shall first show how making use of the distinctions made in the pragma-dialectical theory between different types of conditions for reasonable discussion can help to give a more systematic account of the obstacles that need to be overcome for shared decision-making to be successful. Next, by referring to the rules for critical discussion, we shall provide a more detailed explanation than can be found in the literature on health communication of why certain types of conduct of the participants in the medical encounter can be analyzed as obstacles to the goal of shared decision-making.

Keywords: discussion rules, fallacies, higher order conditions, obstacles to shared decision-making, pragma-dialectical argumentation theory
Article outline
  • 1.Introduction
  • 2.An argumentative analysis of the conditions for shared decision-making
  • 3.Violations of discussion rules
    • 3.1Patients’ participation
    • 3.2Doctors’ argumentation
    • 3.3Authority argumentation
  • 4.Conclusion
  • Notes
  • References
Published online: 12 October 2018
DOI logo
https://doi.org/10.1075/jaic.18027.pil
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Cited by 2 other publications

Akkermans, Aranka, Sanne Prins, Amber S. Spijkers, Jean Wagemans, Nanon H. M. Labrie, Dick L. Willems, Marcus J. Schultz, Thomas G. V. Cherpanath, Job B. M. van Woensel, Marc van Heerde, Anton H. van Kaam, Moniek van de Loo, Anne Stiggelbout, Ellen M. A. Smets & Mirjam A. de Vos
2023. Argumentation in end-of-life conversations with families in Dutch intensive care units: a qualitative observational study. Intensive Care Medicine 49:4 ► pp. 421 ff. DOI logo
Labrie, Nanon
2019. “Doctor, I disagree”. Journal of Argumentation in Context 8:3 ► pp. 336 ff. DOI logo

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