Ethical challenges in argumentation and dialogue in a healthcare context.

As the average age of the population increases, so too do the number of people living with chronic illnesses. With limited resources available, the development of dialogue-based e-health systems that provide justified general health advice offers a cost-effective solution to the management of chronic conditions. It is however imperative that such systems are responsible in their approach. We present in this paper two main challenges for the deployment of e-health systems, that have a particular relevance to dialogue and argumentation: collecting and handling health data, and trust. For both challenges, we look at specific issues therein, outlining their importance in general, and describing their relevance to dialogue and argumentation. Finally, we go on to propose six recommendations for handling these issues, towards addressing the main challenges themselves, that act both as general advice for dialogue and argumentation research in the e-health domain, and as a foundation for future work on this topic

Integrating argumentation with social conversation between multiple virtual coaches

This paper presents progress and challenges in developing a platform for multi-character, argumentation based, interaction with a group of virtual coaches for healthcare advice and promotion of healthy behaviours. Several challenges arise in the development of such a platform, e. g., choosing the most effective way of utilising argumentation between the coaches with multiple perspectives, handling the presentation of these perspectives and finally, the personalisation and adaptation of the platform to the user types. In this paper, we present the three main challenges recognized, and show how we aim to address these.</p

Explaining the outcome of knowledge-based systems; a discussion-based approach

Many inferences made in everyday life are only valid in the absence of explicit counter information. This has led to the development of nonmonotonic logics. The kind of reasoning performed by these logics can be difficult to explain to the average end-user of a knowledge based system that implements them. Although the system can still give advice, it is hard for the user to assess the rationale be- hind this advice. In this paper we propose an argumentation approach that enables the advice to be assessed through an interactive dialogue with the system much like the discussion one might have with a col- league. The aim of thie dialogue is for the system to convince the user that the advice is well-founded

Arguing ‘for' the Patient: Informed Consent and Strategic Maneuvering in Doctor-Patient Interaction

As a way to advance integration between traditional readings of the medical encounter and argumentation theory, this article conceptualizes the doctor-patient interaction as a form of info-suasive dialogue. Firstly, the article explores the relevance of argumentation in the medical encounter in connection with the process of informed consent. Secondly, it discloses the risks inherent to a lack of reconciliation of the dialectical and rhetorical components in the delivery of the doctor's advice, as especially resulting from the less than ideal conditions of the internal states of the doctor and the patient, and the lack of symmetry in their statu

Analysing Policy Arguments

Abstract The complexity and distinctiveness of policy discourse bring a need for methods and advice in both specifying and assessing policy arguments. The paper reviews, links and systematizes work in three areas: (1) general advice from 'informal logic' on the exploration and analysis of sets of propositions that make up broad arguments; (2) commentaries on important elements and tactics in policy argumentation in particular, with special attention to aspects of 'framing'; and (3) proposed methods to specify and appraise whole positions in policy argument, including the 'logical framework approach' and Fischer's Logic of Policy Question

Pascal’s wager: tracking an intended reader in the structure of the argument

Pascal’s wager is the name of an argument in favor of belief in God presented by Blaise Pascal in §233 of Thoughts. Ian Hacking (1972) pointed out that Pascal’s text involves three different versions of the argument. This paper proceeds from this identification, but it concerns an examination of the rhetorical strategy realized by Pascal’s argumentation. The final form of Pascal’s argument is considered as a product that could be established only through a specific process of persuasion led with respect to an intended reader with a particular set of initial beliefs. The text uses insights from the pragma‐dialectical approach to argumentation, especially the concept of rhetorical effectiveness of particular choices from the topical potential. The argumentation structure of Pascal’s wager is considered to be a reflection of the anticipated course of dialogue with the reader critically testing the sustainability of Pascal’s standpoint “You should believe in God”. Based on the argumentation reconstruction of three versions of the argument, Pascal’s idea of opponent/audience is identified. A rhetorical analysis of the effects of his argumentative strategy is proposed. The analysis is based on two perspectives on Pascal’s argument: it examines the strategy implemented consistently by all arguments and the strategy of a formulation of different versions of the wager

Ad Stuprum: The Fallacy of Appeal to Sex

Arguments sometimes appeal to sex by invoking the sexuality of a model or a person or the promise of sexual gratification. When sexual gratification is not a relevant consideration, the appeal seems to be fallacious. We will address when this may be an appropriate line of reasoning -- there is such a thing as “sex appeal”--and when it may be biased to assume the relevance of sexuality. Advertising, which provides infinite examples of appeal to sex, may be questionable as a case of argumentation, as opposed to some other sort of negotiation or communication, especially perhaps in its reliance on visual imagery. Yet, more classic textual cases of appeal to sex can be found (e.g. Lysistrata), as well as what may be reasonable enough practical advice (e.g. in advice columns) about making oneself sexually attractive. Its appropriate role sometimes as a practical consideration suggests that appeal to sex is analogous to appeal to force, or ad baculum, which can be relevant in a negotiation dialogue, Douglas Walton argues. So, it deserves at least the same attention from argumentation scholars, and perhaps even more from critical thinking educators in cultures more saturated with sexuality than with threats

Building bridges between doctors and patients: the design and pilot evaluation of a training session in argumentation for chronic pain experts

Shared decision-making requires doctors to be competent in exchanging views with patients to identify the appropriate course of action. In this paper we focus on the potential of a course in argumentation as a promising way to empower doctors in presenting their viewpoints and addressing those of patients. Argumentation is the communication process in which the speaker, through the use of reasons, aims to convince the interlocutor of the acceptability of a viewpoint. The value of argumentation skills for doctors has been addressed in the literature. Yet, there is no research on what a course on argumentation might look like. In this paper, we present the content and format of a training session in argumentation for doctors and discuss some insights gained from a pilot study that examined doctors' perceived strengths and limitations vis-à-vis this training

Argumentation graphs with constraint-based reasoning for collaborative expertise

Collaborative processes are very important in telemedicine domain since they allow for making right decisions in complex situations with multidisciplinary staff. When modelling these collaborative processes, some inconsistencies can appear. In semantic modelling conceptual graphs), these inconsistencies are verified using constraints. In this work, collaborative processes are represented using an argumentation system modelled in a conceptual graph formalism where inconsistencies could be particular bad attack relation between arguments. To overcome these inconsistencies, two solutions are proposed. The first one is to weight the arguments evolving in the argumentation system on the basis of the competencies of the health professionals and the credibility of the sources justifying their advice (arguments), and the second one is to model some law concepts as constraints in order to check their compliance of the collaborative process

Evaluating Motivational Interviewing in the Physician Assistant Curriculum

Purpose Motivational interviewing (MI) is an evidence-based technique that enables clinicians to help patients modify health behaviors. Although MI is an essential tool for physician assistants (PAs), the extent to which it is addressed in PA curricula in the United States is unknown. This study is a comprehensive description of MI education in PA programs in the United States. Methods Data are from the 2014 Physician Assistant Education Association Annual Program Survey. Descriptive statistics were conducted on de-identified data from all 186 PA programs in the United States. Results Of the 186 PA programs surveyed, 72.58% (n = 135) reported at least one course providing MI training. Availability of courses providing training in skills essential to the MI process varied. Having a course with verbal communication training was most frequently endorsed, and having a course with training in developing discrepancy was least frequently endorsed. The most popular teaching modality was lecture (84.95%, n = 158), whereas only 41.40% (n = 77) and 58.60% (n = 109) reported role play with evaluation and standardized patient exercises with evaluation, respectively. Conclusions More than 70% of programs included at least one course in their curriculum that provided training in MI, suggesting that PA programs recognize the importance of MI. Instruction in change talk was not provided in nearly half of the programs. Role-play and standardized patient exercises with evaluation were underused methods despite their proven efficacy in MI education. As the first comprehensive benchmark of MI education for PAs, this study shows that although most programs address MI, opportunities exist to improve MI training in PA programs in the United States