Shared decision-making and argumentation: a pragma-dialectical perspective on medical consultations as discussion situations

Pilgram, R.

doi:doi:10.1075/jaic.25025.pil

Shared decision-making has become the ideal for medical decision-making. Given the pivotal role of argumentation within this process, shared decision-making has increasingly been examined through the lens of argumentation theory, particularly pragma-dialectics. This perspective paper outlines the pragma-dialectical contributions to the analysis of shared decision-making and explores the potential of this theory for addressing current and future challenges in medical decision-making. It aims to show that normative argumentation approaches, particularly the pragmadialectical approach, are crucial for understanding and possibly improving shared decision-making. First, the paper discusses the alignment between shared decision-making and the ideal of a critical discussion, barriers to shared decision-making as violations of discussion rules and higher-order conditions, and the application of the pragma-dialectical approach to complex decision-making scenarios involving patient...Show moreShared decision-making has become the ideal for medical decision-making. Given the pivotal role of argumentation within this process, shared decision-making has increasingly been examined through the lens of argumentation theory, particularly pragma-dialectics. This perspective paper outlines the pragma-dialectical contributions to the analysis of shared decision-making and explores the potential of this theory for addressing current and future challenges in medical decision-making. It aims to show that normative argumentation approaches, particularly the pragmadialectical approach, are crucial for understanding and possibly improving shared decision-making. First, the paper discusses the alignment between shared decision-making and the ideal of a critical discussion, barriers to shared decision-making as violations of discussion rules and higher-order conditions, and the application of the pragma-dialectical approach to complex decision-making scenarios involving patient companions. Second, it considers how the pragma-dialectical approach may be used to confront the emerging issues of medical misinformation and artificial intelligence in medical decision-making.
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Shared decision-making and argumentation: a pragma-dialectical perspective on medical consultations as discussion situations