Using keywords to analyze conflicts in doctor-patient consultations

This paper focuses on the function of conflict prevention performed by keywords and key-expressions within medical consultations. Doctor-patient interaction within medical consultations can be interpreted as a problem-solving discussion, as it is oriented to the solution of a certain health problem. As such, medical consultations are based on an argumentative discussion, in which, roughly speaking, both parties try to reason together in order to find a solution for the patient s health problem. In this sense, a non-mixed dispute (van Eemeren and Grootendorst 2004) often arises, in which doctor and patient discuss a standpoint, normally advanced by the doctor, about the patient s diagnosis or therapy. Problem-solving, however, is not the only possible interaction scheme (Rigotti and Rocci 2006) that can be involved in doctor-patient consultations. Indeed, other more confrontational interaction schemes are possible, which may also tend to real controversies; these cases are often triggered by the asymmetry of competences and knowledge which is typical of the relationship between doctors and patients. Such situations, of course, affect the quality of the consultation, because the issue at stake ceases to be the patient s health, and becomes the relationship between the patient and the doctor (in terms of trust, reliability, etc.). Ultimately, this may have negative effects on the patient s health and, thus, more in general, may contradict the raison d être of the health system. Thus during the medical consultation conflicts need to be avoided both by doctor and patient. The choice of keywords and key-expressions appears to be a crucial step within a strategy of conflict prevention . In fact, thanks to their close link to the relevant endoxa, their ability to trigger inferences, and their centrality within the argumentative structure of persuasive texts, keywords can be very important tools in the creation of emotive arguments and the prevention of conflict. Relying on examples from real-life consultations, this paper shows how keywords and key-expressions realize this function.