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.
(2001) Clinical care and conversational contingencies: The role of patients’ self-diagnosis in medical encounters. Text 211: 83-111.
Glasser, Barney, and Anselm L. Strauss
(1965) Awareness of Dying. Chicago, IL: Aldine.
Good, Mary-Jo, Byron Good, Cynthia Schaffer, and Stuart Lind
(1990) American oncology and the discourse on hope. Culture, Medicine and Psychiatry 141: 59-79.
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.
Heritage, John, and T. Stivers
(1999) Online commentary in acute medical visits: A method of shaping patient expectations. Social Science and Medicine 491: 1501-1517.
Heritage, John, and Douglas Maynard
(2006) (eds) Communication in Medical Care: Interaction Between Primary Care Physicians and Patients. Cambridge: Cambridge University Press. BoP
Keskes, Istvan
(2010) Situation-bound utterances as pragmatic acts. Journal of Pragmatics. 42.1: 2889-2897.
Leppanen, V
(1998) Structures of District Nurse-Patient Interaction. Lund, Sweden: Department of Sociology, Lund University.
Levinson, Stephen
(1979) Activity types and language. Linguistics 171: 365-399. BoP
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.
Maynard, Douglas
(1991) Interaction and asymmetry in clinical discourse. American Journal of Sociology 971: 448-495.
Maynard, Douglas
(1996) On ‘realisation’ in everyday life: The forecasting of bad news as a social relation. American Sociological Review 16.1: 109-131.
Maynard, Douglas
(2003) Bad News, Good News: Conversational Order in Everyday Talk and Clinical Settings. Chicago: University of Chicago Press.
Maynard, Douglas
(2005) ‘Does it mean I’m gonna die?’: On meaning assessment in the delivery of diagnostic news. Social Science and Medicine.
Mey, Jacob
(2001) Pragmatics: An Introduction. Oxford: Blackwell Publishers.
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.
Odebunmi, Akin
(2005) Politeness and face management in hospital conversational interactions in South- Western Nigeria. Ibadan: Journal of English Studies 21: 1-22.
Odebunmi, Akin
(2006a) Meaning in English: An introduction. Ogbomoso: Critical Sphere.
(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.
Odebunmi, Akin
(2008) Pragmatic strategies of diagnostic news delivery in Nigerian hospitals. Linguistik Online 36.4: 21-37.
Odebunmi, Akin
(2010a) Tracking ideology in political news. California Linguistic Notes XXXV (2).
(2010c) Code selection at first meetings: A pragmatic analysis of doctor- client conversations in Nigeria. Unpublished manuscript.
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.
Odebunmi, Akin, and Peter Auer
(2011) Face, politeness and culture in doctor-client encounters in Nigeria. Unpublished manuscript.
Ong, LM, J.C. de Haes, A.M. Hoos, and F.B. Lammes
(1995) Doctor-patient communication: A review of the literature. Public Medicine 401: 903-918.
Perakyla, Anssi
(1998) Authority and accountability: The delivery of diagnosis in primary health care. Social Psychology Quarterly 61.4: 301-320.
Stivers, Tanya
(1998) Prediagnostic commentary in veteranarian-client interaction. Research on Language and Social Interaction 31.2: 241-277. BoP
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. [URL]. Accessed May 20, 2010.
Tseng, Ming-Yu
(2010) The pragmatic act of fishing for personal details: From choice to performance. Journal of Pragmatics 421: 1982-1996. BoP
Williams, John
(2009) Medical Ethics Manual. France: World Medical Association.
Cited by
Cited by 4 other publications
Ewuoso, Cornelius
2019. Paltering and an African moral theory: Contributing an African perspective to the ethical literature on paltering. South African Journal of Philosophy 38:1 ► pp. 55 ff.
2016. You didn’t give me to go and buy’: Negotiating accountability for poor health in post-recommendation medical consultations. Journal of Pragmatics 93 ► pp. 1 ff.
This list is based on CrossRef data as of 13 march 2024. Please note that it may not be complete. Sources presented here have been supplied by the respective publishers.
Any errors therein should be reported to them.