Conversational Implicatures in Medical Discourse: An Analysis of Doctor-Patient Dialogues in Amman, Jordan
DOI:
https://doi.org/10.17507/tpls.1407.28Keywords:
conversational implicatures, medical discourse, doctor-patient dialogues, Grice’s maxim, cooperative principlesAbstract
Effective communication is crucial in medical practice, and adherence to Grice's conversational maxims (quantity, quality, relevance, and manner) can improve communication between doctors and patients. In medical practice, doctors must provide clear and concise information while being honest about medical conditions and treatment options. It is also essential for doctors to communicate using simple language to ensure that the patients understand. This study analyses conversational implicature considering medical discourse in Amman. Twenty-six observations (tape-recorded doctor-patient dialogues) were randomly selected from private and government clinics in Amman, Jordan. The data was sorted and analyzed using the qualitative method of a six-phase framework. This study identifies the cooperative principles, their functions, and conversational implicature in doctor-patient discourse. Our results indicate the significance of all four conversational maxims in medical discourse, with manner being the most prominent aspect, followed by quality, relevance, and quantity. The function of cooperative principles observed in presenting the concepts of expression, direction, assertion, and declaration enhances the quality of medical discourse and promotes clarification in conversation. We observed that non-cooperative conversational implicatures are more frequently used in the doctor-patient dialogue, flouting Grice’s maxims. This flaw could lead to ineffective communication and negative health outcomes. In medical discourse, 66.7% of instances violated the Grice maxim, indicating non-cooperative conversation, while 33.3% involved cooperative implicature. The effective observance of the conversational maxims can positively impact doctors' communication with patients and promote better understanding of medical condition and treatment options that may lead to improved health outcomes.
References
Akinwato, S. A., & Ogundele, T. (2021). Friends, Please do not choose to go to hell”: Linguistic Strategies and Discourse Functions of Appeals in Christian Religious Tracts. Journal of Humanities, 2(6), 197-204.
Anestis, E., Eccles, F. J., Fletcher, I., Triliva, S., & Simpson, J. (2022). Healthcare professionals’ involvement in breaking bad news to newly diagnosed patients with motor neurodegenerative conditions: a qualitative study. Disability and Rehabilitation, 44(25), 7877-7890. Retrieved in January 10, 2023, from https://doi.org/10.1080/09638288.2021.2002436
Bloor, M., & Bloor, T. (2013). The Practice of Critical Discourse Analysis: an Introduction. Taylor & Francis. Retrieved January 26, 2007, from https://doi.org/10.4324/9780203775660
Channell, A., Clutton, E., & Capaccio, G. (1994). Phase segregation and impact toughness in linear low density polyethylene. Polymer, 35(18), 3893-3898. https://doi.org/10.1016/0032-3861(94)90272-0
Clark, H. H., & Marshall, C. R. (1981). Definite knowledge and mutual knowledge. In Aravind K. Joshi, Bonnie L. Webber & Ivan A. Sag (eds.), Elements of Discourse Understanding. Cambridge, UK: Cambridge University Press. pp. 10–63.
Davis, W. A., & Davis, W. A. (2016). Implicature. Springer. The Stanford Encyclopedia of Philosophy (Fall 2019 Edition) Retrieved November 17, 2022, from https://doi.org/10.1007/978-94-017-7546-5_2
Fryer, D. L. (2022). Engagement in Medical Research Discourse: A Multisemiotic Approach to Dialogic Positioning. (1st ed.). Routledge. Retrieved September, 20, 2021, from https://doi.org/10.4324/9781003041146
Gazdar, G. (1979). A solution to the projection problem. In Presupposition (pp. 57-89). Leiden, The Netherlands: Brill. Retrieved November 17, 2022, from https://doi.org/10.1163/9789004368880_003
Gibbs Jr, R. W., & Moise, J. F. (1997). Pragmatics in understanding what is said. Cognition, 62(1), 51-74. Retrieved November 17, 2022, from https://doi.org/10.1016/S0010-0277(96)00724-X
Gordon, T., & Edwards, W. S. (1997). Making the patient your partner: Communication skills for doctors and other caregivers. ABC-CLIO. 1995. 213 p. Retrieved November 17, 2022, from http://hdl.handle.net/10822/879559
Grice. (1975a). Logic and Conversation (Vol. 3). Leiden, The Netherlands: Brill. Retrieved November 17, 2022, from https://doi.org/https://doi.org/10.1163/9789004368811_003
Grice. (1975b). Logic and conversation. In Speech acts (pp. 41-58). Leiden, The Netherlands: Brill. Retrieved November 17, 2022, from https://doi.org/10.1163/9789004368811_003
Haugh, M. (2015). Im/politeness implicatures. Berlin, München, Boston: De Gruyter Mouton; Retrieved November 17, 2022, from 2015. https://doi.org/10.1515/9783110240078
Huda, M. (2013a). Conversational Implicature Found in Dialogue of Euro Trip Movie. Jurnal Ilmiah Mahasiswa Fakultas Ilmu Budaya Universitas Brawijaya, 3(1). Retrieved November 17, 2022, from https://www.neliti.com/publications/202487/conversational-implicature-found-in-dialogue-of-euro-trip-movie
Huda, M. (2013b). Conversational implicature found in dialogue of Euro Trip Movie. Jurnal Ilmiah Mahasiswa Fakultas Ilmu Budaya Universitas Brawijaya, vol. 3, no. 1, 2013.
Jeffries, L., & McIntyre, D. (2010). Stylistics. Cambridge University Press. Retrieved September 1, 2010, from https://pure.hud.ac.uk/en/publications/stylistics
Kordić, S., Van Loenen, E., & Walker, A. (1991). Current imaging of cleaved silicon pn junctions with an ultrahigh vacuum scanning tunneling microscope. Applied physics letters, 59(24), 3154-3156. Retrieved November 17, 2022, from https://doi.org/10.1063/1.105769
Lazaraton, A. (2002). A qualitative approach to the validation of oral language tests (Vol. 14). Cambridge University Press. Retrieved in 2022, from https://assets.cambridge.org/97805210/02677/frontmatter/9780521002677_frontmatter.pdf
Levinson, S. C., Levinson, S. C., & Levinson, S. (1983). Pragmatics. Cambridge university press. Retrieved November 17, 2022, from urn:lcp:pragmatics00levi:lcpdf:c20e261b-e7a8-427f-bc2f-b13dd3abac48
Malik, S., Riaz, W., Jabeen, T., & Abbasi, A. S. (2022). Language as a hegemonic tool: critical discourse analysis of a cosmetic Sergeon’s medical discourse. PalArch's Journal of Archaeology of Egypt/Egyptology, 19(2), 22-32. Retrieved November 17, 2022, from https://www.researchgate.net/publication/364959274_language_as_a_hegemonic_tool_critical_discourse_analysis_of_a_cosmetic_sergeon's_medical_discourse_pjaee_19_2_2022_language_as_a_hegemonic_tool_critical_discourse_analysis_of_a_cosmetic_sergeon's_medi
Mandarani, V. (2020). Understanding the Meaning of Speaking by Conversational Implicature. Retrieved June 22, 2020, from http://eprints.umsida.ac.id/id/eprint/7524
Risdianto, F. (2011). A conversational implicature analysis in Oscar Wilde’s short story “happy prince”. Register Journal, 4(2), 196-213. Retrieved November 17, 2022, from https://doi.org/10.18326/rgt.v4i2.196-213
Riyanti, R. R., & Sofwan, A. (2016). Speech Act And Grice’ S Maxims Non Observancein Her World Magazine Advertisements. English Education Journal, 6(2), 25-32. Retrieved November 17, 2022, from https://journal.unnes.ac.id/sju/index.php/eej/article/view/13054
Schegloff, E. A. (1999). Discourse, pragmatics, conversation, analysis. Discourse studies, 1(4), 405-435. Retrieved November 17, 2022, from https://doi.org/10.1177/1461445699001004002
Statham, S. (2022). Critical Discourse Analysis: A Practical Introduction to Power in Language. (1st ed.). Routledge. Retrieved April 4, 2022, from https://doi.org/10.4324/9780429026133
Verschueren, J., & Östman, J.-O. (2011). Discursive Pragmatics: Handbook of Pragmatics Highlights. John Benjamin Publishing Company. Retrieved in 2011 from https://benjamins.com/catalog/hoph
Westcott, R., Ronan, K., Bambrick, H., & Taylor, M. (2020). Natural hazards and adaptive response choices in a changing climate: Promoting bushfire preparedness and risk reduction decision-making. Social Sciences & Humanities Open, 2, 1. Retrieved November 17, 2022, from https://doi.org/https://doi.org/10.1016/j.ssaho.2020.100065
Yule, G. (1996). The study of language. Cambridge university press. Retrieved November 17, 2022, from https://eric.ed.gov/?id=ED401725
Zalta, E. N., Nodelman, U., Allen, C., & Perry, J. (1995). Stanford encyclopedia of philosophy. In Metaphysics Research Lab, Center for the Study of Language and Information. Retrieved November 17, 2022, from https://ruccs.rutgers.edu/images/personal-zenon-pylyshyn/class-info/Consciousness_2014/StanfordEncyclopedia/consciousness-temporal_sc.pdf
Zhang, S., & Zhang, Y. (2015). Scalar implicature: a Saussurean system-based approach. Language Sciences, 51, 43-53. Retrieved November 17, 2022, from https://doi.org/10.1016/j.langsci.2015.05.003