PurposeIn intensive care units (ICUs), decisions about the continuation or discontinuation of life-sustaining treatment (LST) are made on a daily basis. Professional guidelines recommend an open... Show morePurposeIn intensive care units (ICUs), decisions about the continuation or discontinuation of life-sustaining treatment (LST) are made on a daily basis. Professional guidelines recommend an open exchange of standpoints and underlying arguments between doctors and families to arrive at the most appropriate decision. Yet, it is still largely unknown how doctors and families argue in real-life conversations. This study aimed to (1) identify which arguments doctors and families use in support of standpoints to continue or discontinue LST, (2) investigate how doctors and families structure their arguments, and (3) explore how their argumentative practices unfold during conversations.MethodA qualitative inductive thematic analysis of 101 audio-recorded conversations between doctors and families.ResultsSeventy-one doctors and the families of 36 patients from the neonatal, pediatric, and adult ICU (respectively, N-ICU, P-ICU, and A-ICU) of a large university-based hospital participated. In almost all conversations, doctors were the first to argue and families followed, thereby either countering the doctor's line of argumentation or substantiating it. Arguments put forward by doctors and families fell under one of ten main types. The types of arguments presented by families largely overlapped with those presented by doctors. A real exchange of arguments occurred in a minority of conversations and was generally quite brief in the sense that not all possible arguments were presented and then discussed together.ConclusionThis study offers a detailed insight in the argumentation practices of doctors and families, which can help doctors to have a sharper eye for the arguments put forward by doctors and families and to offer room for true deliberation. Show less
Labrie, N.; Kunneman, M.; Veenendaal, N. van; Kempen, A. van; Vliet, L. van 2023
Objective: To develop valid and realistic manipulations for video-vignette research using expert opinion rounds, in preparation of an experimental study on clinicians' (un)reasonable argumentative... Show moreObjective: To develop valid and realistic manipulations for video-vignette research using expert opinion rounds, in preparation of an experimental study on clinicians' (un)reasonable argumentative support for treatment de-cisions in neonatal care. Methods: In three rounds, N = 37 participants (parents/clinicians/researchers) provided feedback on four video -vignette scripts and completed listing, ranking, and rating exercises to determine which (un)reasonable argu-ments clinicians may provide to support treatment decisions. Results: Round 1: participants deemed the scripts realistic. They judged that, on average, clinicians should provide two arguments for a treatment decision. They listed 13-20 reasonable arguments, depending on the script. Round 2: participants ranked the two most salient, reasonable arguments per script. Round 3: participants rated the most plausible, unreasonable arguments from a predefined list. These results guided the design of 12 experimental conditions. Conclusion: Expert opinion rounds are an effective method to develop video-vignettes that are theoretically sound and ecologically realistic and offer a powerful means to include stakeholders in experimental research design. Our study yielded some preliminary insights into what are considered prevalent (un)reasonable arguments for clinicians' treatment plans. Practice implications: We provide hands-on guidelines on involving stakeholders in the design of video-vignette experiments and the development of video-based health communication interventions - both for research and practice. Show less
This contribution is a plea to pay more systematicattention to the infrequently studied, fine-grained grammatical phenomenon ofcomplementation in the analysis of political discourse. The way the... Show moreThis contribution is a plea to pay more systematicattention to the infrequently studied, fine-grained grammatical phenomenon ofcomplementation in the analysis of political discourse. The way the Dutchradical populist Geert Wilders uses complementation serves as a case study tothat end. In the first half of the contribution, an in-depth description of thephenomenon of complementation is given; it is argued that the use ofcomplementation affects the degree of certainty by which a speaker presents hisideas. The second half of the contribution reports on a diachronic analysis ofGeert Wilders’ use of complementation in 47 parliamentary speeches held between2004 and 2009. It is argued that Wilders’ use of complementation significantlydecreases between 2004 and 2009. The decrease is not a gradual transition: abreak occurs between 2006 and 2007. This is an indication that Wilders offersless room for discussion from this period onwards. Strikingly, Wilders’ changeduse of complementation coincides with the moment that political scientistsindicate as the moment that Wilders’ political views radicalized. The casestudy not only shows that studying complementation can add to the inventory oflinguistic phenomena relevant to the analysis of political discourse; it alsostresses the significance of combining quantitative and qualitative methods ofanalysis for the quantification of stylistic phenomena. Show less
The aim of this study is to specify the strategic function of stance adverbs when qualifying a standpoint in an argumentative discussion. Stance adverbs are words like __clearly__, __obviously__, _... Show moreThe aim of this study is to specify the strategic function of stance adverbs when qualifying a standpoint in an argumentative discussion. Stance adverbs are words like __clearly__, __obviously__, __perhaps__, __technically__, __frankly__, and __fortunately__. They have been extensively studied in the fields of semantics and syntax as well as pragmatics and discourse analysis. However, they have not specifically been studied with an interest in their effect on the progress of an argumentative discussion when they are used to qualify the standpoint. In this study a specific argumentative perspective is adopted, according to which the strategic function of stance adverbs is described with respect to the burden of proof that an arguer incurs when advancing a standpoint. In this view, an arguer chooses a particular way to qualify the standpoint in an attempt to successfully meet his obligation to defend the standpoint at the end of the argumentative discussion. The proposed theoretical account provides a basis for assessing whether the use of a stance adverb to qualify a standpoint observes the standards that should be followed for a reasonable resolution of a difference of opinion. Show less
