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Papers by Jan Svennevig
Ingrid van Alphen & Isabelle Buchstaller (eds.): Quotatives: Cross-linguistic and cross-disciplinary perspectives. , 2012
Journal of Pragmatics, 2015
Social science & medicine (1982), Jan 26, 2015
Eliciting patients' values and treatment preferences is an essential element in models of sha... more Eliciting patients' values and treatment preferences is an essential element in models of shared decision making, yet few studies have investigated the interactional realizations of how physicians do this in authentic encounters. Drawing on video-recorded encounters from Norwegian secondary care, the present study uses the fine-grained empirical methodology of conversation analysis (CA) to identify one conversational practice physicians use, namely, formulations of patients' stance, in which physicians summarize or paraphrase their understanding of the patient's stance towards treatment. The purpose of this study is twofold: (1) to explore what objectives formulations of patients' stance achieve while negotiating treatment and (2) to discuss these objectives in relation to core requirements in shared decision making. Our analysis demonstrates that formulating the patient's stance is a practice physicians use in order to elicit, check, and establish patients' ...
Journal of Pragmatics, 2014
ABSTRACT Shared decision making has become an ideal in contemporary clinical practice, and guidel... more ABSTRACT Shared decision making has become an ideal in contemporary clinical practice, and guidelines recommend exploring patients’ preferences and providing them with options so they can make informed decisions. This paper examines how the ideal of sharedness is maintained and negotiated through epistemic and deontic resources in secondary care consultations where patients are given a choice between invasive and non-invasive treatment options. The analysis suggests that the physician's presentation of treatment options is often tilted in favor of one proposal over the other, yet giving the patient the right to make the final decision. The patients on the other hand regularly resist this responsibility by claiming lack of epistemic authority (e.g. I know nothing about it) or by making the decision contingent on the physician taking a stronger deontic stance (e.g. if you think so). This may be characterized as an inverted use of deontic authority from both parties: Physicians give patients deontic rights in their pursuit of independent commitment to their preferred option, while patients orient to physicians’ epistemic and deontic rights as a way to resist committing to the physicians’ propositions. These conflicting orientations to epistemic and deontic authority counteract the ideal of shared decision making.
Journal of Pragmatics, 2015
Gisle Andersen and Karin Aijmer (eds.): Pragmatics of Society (Handbooks of Pragmatics 5) , 2011
Pragmatics & Beyond New Series, 2000
Journal of Pragmatics, 2015
Discourse Studies 14, 3–10, 2012
Management Communication Quarterly, 2008
... Furthermore, it reflects that the sender has a high entitlement to per-form the action and a ... more ... Furthermore, it reflects that the sender has a high entitlement to per-form the action and a lowcontingency of the ... of the missing responses in the first lines and the ensuing complaint in Line 7. The fact that the formulation is repeated twice makes the directive force even more ...
Languages in Contrast, 2005
Language in Society, 2010
Journal of Pragmatics, 2012
Journal of Pragmatics, 2008
Ingrid van Alphen & Isabelle Buchstaller (eds.): Quotatives: Cross-linguistic and cross-disciplinary perspectives. , 2012
Journal of Pragmatics, 2015
Social science & medicine (1982), Jan 26, 2015
Eliciting patients' values and treatment preferences is an essential element in models of sha... more Eliciting patients' values and treatment preferences is an essential element in models of shared decision making, yet few studies have investigated the interactional realizations of how physicians do this in authentic encounters. Drawing on video-recorded encounters from Norwegian secondary care, the present study uses the fine-grained empirical methodology of conversation analysis (CA) to identify one conversational practice physicians use, namely, formulations of patients' stance, in which physicians summarize or paraphrase their understanding of the patient's stance towards treatment. The purpose of this study is twofold: (1) to explore what objectives formulations of patients' stance achieve while negotiating treatment and (2) to discuss these objectives in relation to core requirements in shared decision making. Our analysis demonstrates that formulating the patient's stance is a practice physicians use in order to elicit, check, and establish patients' ...
Journal of Pragmatics, 2014
ABSTRACT Shared decision making has become an ideal in contemporary clinical practice, and guidel... more ABSTRACT Shared decision making has become an ideal in contemporary clinical practice, and guidelines recommend exploring patients’ preferences and providing them with options so they can make informed decisions. This paper examines how the ideal of sharedness is maintained and negotiated through epistemic and deontic resources in secondary care consultations where patients are given a choice between invasive and non-invasive treatment options. The analysis suggests that the physician's presentation of treatment options is often tilted in favor of one proposal over the other, yet giving the patient the right to make the final decision. The patients on the other hand regularly resist this responsibility by claiming lack of epistemic authority (e.g. I know nothing about it) or by making the decision contingent on the physician taking a stronger deontic stance (e.g. if you think so). This may be characterized as an inverted use of deontic authority from both parties: Physicians give patients deontic rights in their pursuit of independent commitment to their preferred option, while patients orient to physicians’ epistemic and deontic rights as a way to resist committing to the physicians’ propositions. These conflicting orientations to epistemic and deontic authority counteract the ideal of shared decision making.
Journal of Pragmatics, 2015
Gisle Andersen and Karin Aijmer (eds.): Pragmatics of Society (Handbooks of Pragmatics 5) , 2011
Pragmatics & Beyond New Series, 2000
Journal of Pragmatics, 2015
Discourse Studies 14, 3–10, 2012
Management Communication Quarterly, 2008
... Furthermore, it reflects that the sender has a high entitlement to per-form the action and a ... more ... Furthermore, it reflects that the sender has a high entitlement to per-form the action and a lowcontingency of the ... of the missing responses in the first lines and the ensuing complaint in Line 7. The fact that the formulation is repeated twice makes the directive force even more ...
Languages in Contrast, 2005
Language in Society, 2010
Journal of Pragmatics, 2012
Journal of Pragmatics, 2008