'Shared decision-making? A linguistic perspective', by Dariusz Galasiński (Wolverhampton)
Shared decision-making (SDM) is more and more commonly assumed to be the preferred method of communicating with the patient. However, while there is significant research on its ‘nature’ and its limitations, a micro-discourse analytic perspective is adopted rarely. In this paper I go beyond the dominant discussions on SDM and explore the discourses underpinning shared decision-making, both as a concept and a process in the local context of interaction.
I focus on three kinds of texts which constitute SDM in different contexts – definitions, decision aids, and doctor-patient interactions in which decisions are negotiated. I argue that the discursive constructions of shared decision-making are at some odds with its explicit goals. I want to show that, despite SDM claims, its discourses construct paternalistic relations of power between the medic and the person in her/his care.
I conclude with an argument for a much closer collaboration between medicine and the social sciences offering a deeper reflection on how SDM is constructed in discourses about it as well as how it is performed in medical practices.
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