In situations where experience shows that a particular intervention will not benefit a patient, common sense seems to suggest that the intervention should not be used. Yet it is precisely in these situations that a peculiar ethic begins to operate, an ethic that Eddy calls “the criterion of potential benefit.” According to this ethic, “a treatment is appropriate if it might have some benefit.” Thus, the various maxims learned in medical school instruct physicians that “‘an error of commission is to (...) be preferred to an error of omission,’ or ‘when in doubt, cut it out’ or ‘if but one patient is helped, then the treatment is worthwhile.’”. (shrink)

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. (shrink)

In recent years, the model of shared decision-making has become increasingly promoted as the preferred standard in doctor-patient communication. As the model considers doctor and patient as coe-qual partners that negotiate their preferred treatment options in order to reach a shared decision, shared de-cision-making notably leaves room for the usage of argumentation in the context of medical consultation. A paradigm example of argumentative conflict in consultation is the discussion that emerges between doctors and their patients concerning antibiotics as a method (...) of treatment for what is presumed to be a viral infec-tion. In this paper, a case of such argumentative conflict is studied, using the extended pragma-dialectical theory to argumentation. It is examined how a patient and her physician manoeuvre strategically in order to maintain a balance between dialectical reasonableness and rhetorical effectiveness, as well as an equilibri-um between patient participation and evidence-based medication, while arguing their case for and against antibiotics respectively. (shrink)