Strategic Maneuvering in Treatment Decision-Making Discussions: Two Cases in Point

Nanon Labrie*

*Corresponding author for this work

    Research output: Contribution to JournalArticleAcademicpeer-review


    Over the past decade, the ideal model of shared decision-making has been increasingly promoted as the preferred standard of doctor-patient communication in medical consultation. The model advocates a treatment decision-making process in which the doctor and his patient are considered coequal partners that carefully negotiate the treatment options available in order to ultimately reach a treatment decision that is mutually shared. Thereby, the model notably leaves room for-and stimulates-argumentative discussions to arise in the context of medical consultation. A paradigm example of a discussion that often emerges between doctors and their patients concerns antibiotics as a method of treatment for what is presumed to be a viral infection. Whereas the doctor will generally not encourage treatment with antibiotics, patients oftentimes prefer the medicine to other methods of treatment. In this paper, two cases of such antibiotic-related discussions in consultation are studied using insights gained in the extended pragma-dialectical theory to argumentation. It is examined how patient and physician maneuver strategically in order to maintain a balance between dialectical reasonableness and rhetorical effectiveness, as well as an equilibrium between patient participation and evidence-based medication, while arguing a case for and against antibiotics respectively.

    Original languageEnglish
    Pages (from-to)171-199
    Number of pages29
    Issue number2
    Publication statusPublished - 1 May 2012


    • Antibiotics
    • Doctor-patient consultation
    • Pragma-dialectics
    • Shared decision-making
    • Strategic maneuvering


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