The Reasonableness of Argumentation from Expert Opinion in Medical Discussions: Institutional Safeguards for the Quality of Shared Decision Making

The ideal of shared decision making starts from the assumption that physicians and patients are able to take a joint decision as to what is the best treatment. However, since medical consultations are to be viewed as discussions between an expert and a layman, in practice it will often be the case that the patient has to rely on the physician’s expertise. In this article we examine the extent to which the Dutch laws, guidelines and professional conventions within the medical domain positively influence the quality of the process of shared decision making, even in cases where the physician makes use of an argument from expert opinion. To this end, we will chart some of the most important institutional safeguards for the quality of medical decisions and analyze how these safeguards relate to the critical questions associated with the argument scheme of argumentation from expert opinion

The Initial Phase of the Argumentative Discussions Between Parents and Children

This chapter examines the initial phase of parent\u2013child argumentative discussions during mealtime. The conceptual tool adopted for the analysis is based on the pragma-dialectical ideal model of a critical discussion (van Eemeren & Grootendorst\u201a 2004). The types of issues leading parents and children to engage in argumentative discussions during mealtime as well as the contribution that parents and children provide to the inception of argumentation are described and discussed. The analysis of the initial phase of parent\u2013child argumentative discussions also considers the role played by the specificity of the parent\u2013child relationship and the distinctive features of the activity of family mealtime for the beginning of an argumentative discussion. Exemplary argumentative sequences that bring to light the results obtained through the qualitative analysis of a larger corpus of argumentative discussions between parents and children are presented and discussed

The communicative functions of metaphors between explanation and persuasion

In the literature, the pragmatic dimension of metaphors has been clearly acknowledged. Metaphors are regarded as having different possible uses, and in particular, they are commonly viewed as instruments for pursuing persuasion. However, an analysis of the specific conversational purposes that they can be aimed at achieving in a dialogue and their adequacy thereto is still missing. In this paper, we will address this issue focusing on the distinction between the explanatory and persuasive goal. The difference between explanation and persuasion is often blurred and controversial from a theoretical point of view. Building on the analysis of explanation in different theories and fields of study, we show how it can be conceived as characterized by a cognitive and a pragmatic dimension, where the transference of understanding is used pragmatically for different dialogical goals. This theoretical proposal will be applied to examples drawn from the medical context, to show how a pragmatic approach to explanation can account for the complexity of the cases that can be found in actual dialogical contexts

The stereotypicality of symptomatic and pragmatic argumentation in consultations about palliative systemic treatment for advanced cancer

A recent line of argumentation research has focused on the examination of prototypical argumentative patterns – patterns that can be theoretically expected in view of the type of standpoint defended, the institutional aim, and the conventions and constraints of the context (Van Eemeren 2016: 13–15). This paper aims to add a new dimension to both this line of research and research on health communication by determining whether the prototypical types of argumentation in consultations about palliative systemic treatment for advanced cancer are stereotypical as well, that is, whether they are dominant in a quantitative sense (van Eemeren 2016: 16). For this purpose, a valid and reliable measurement instrument is developed and used in a content analysis of the transcripts of 49 consultations. On the basis of the results of this analysis, it can be concluded that the use of symptomatic and pragmatic argumentation is stereotypical in this type of consultations

The argumentative role of visual metaphor and visual antithesis in ‘fly-on-the-wall’ documentary

In this paper, we explore the argumentative role of visual metaphor and visual antithesis in the so-called 'fly-on-the-wall' documentary. In this subtype of documentary, which emphatically renounces voice-over narration, the filmmakers guide their viewers into reaching certain conclusions by making choices regarding the editing as well as the cinematography. We analyse a number of scenes from two films by one major representative of the Direct Cinema or 'fly-on-the-wall' documentary, Frederick Wiseman