Abstract
In the decision-making process for emergency medicine, family members participate on behalf of patients and must make important decisions in a timely manner. During the process, doctors and family members rely on conversations to make treatment decisions. This study used conversation analysis to evaluate the initial encounters between doctors and family members in emergency medicine. By clarifying how the participants used interactional resources to establish their positioning toward the medical consensus, this study attempted to contribute to the discussion regarding appropriate use of informed consent in practice.
As a result, this study found three major interactional resources that participants employed during the decision-making process: (1) the initial explanations by doctors are often designed as stories, allowing family members to gradually recognize the possibility of a patient's death; (2) doctors use sensational terms (look and feel etc.) when they explain patient's conditions to family members; such practices can transform an uncertain situation into a definite diagnosis; and (3) doctors make paradoxical suggestions repeatedly before reaching a final decision. When the final discussion is being made, the doctor's suggestions are designed to be very sensitive to family members' responses. These interactional resources are used to demonstrate consideration toward family members, thereby justifying the doctor's medical authority.
