Cats, dogs, and sweets in the clinical negotiation of reality: On politeness and coherence in pediatric discourse

Abstract

ABSTRACTDoctor–parent–child interaction is analyzed in terms of Brown and Levinson's (1978) theory on facework and politeness. The determinism of the Brown and Levinson (B & L) model is discussed in terms of the present data, which show how discourse is a matter of continuousnegotiationbetween participants. For instance, it is shown how the on record/off record distinction is best understood sequentially. When doctors seem to sense that respectful indirectness does not work, they tend to phrase their requests in an increasingly direct fashion. Hence, the full meaning of doctors' directives is revealed only via the outcome of social interaction, regulated by both parties (doctor and patient/spokesperson). This means that utterances must be analyzed sequentially (and not in a mechanistic, static fashion). Moreover, discourse cannot be understood in terms of any unidirectional social determinism. It is also shown here how doctors can talk to parents through children, as it were. Within a joking relationship format with the child, it is possible for a doctor to convey potentially offensive information to the child's parent. Doctors' moves can thus be seen as direct or indirect depending on type of addressee perspective (parent as participant or as side-participant). The pediatric multiparty setting thus highlights the impossibility of a more formalistic application of the B & L model. (Politeness, facework, negotiations, medical discourse, child discourse)