Concealment in consultative encounters in Nigerian hospitals

Abstract

Although communication in medical practice is reputed for exactitude and objectivity, many doctors in several countries make equivocal, concealing utterances in certain situations when relating with clients. This phenomenon, despite its importance in doctor-client interaction, has received little attention from language scholars who have discussed concealment mainly as a strategy in news delivery. The present study examines concealment items in the interaction between doctors and clients in South-western Nigerian hospitals and their pragmatic implications for medical communication in Nigeria. Fifty (50) conversations between doctors and clients on several ailments were tape-recorded in the six states of South-western Nigeria. Structured and unstructured interviews were conducted with selected doctors and clients. The corpus was examined for the linguistic and pragmatic resources deployed by doctors in concealing information, and was analysed using Jacob Mey’s theory of pragmeme and insights from the literature on news delivery strategies. Concealment was found to take place between doctors and clients in a two-phase mode: Referential and pragmatic. Utterances which have descriptive forms at the referential level assume subjective and divergent shades in the context of concealment at the pragmatic level. Nine concealment strategies (jargonisation, veiling, forecasting, mitigation, stalling, normalisation, dysphemisation, euphemisation and doublespeak) were found to be employed to achieve four broad goals: Preventive, palliative, culture-compliant and confidential with respect to 25 diseases /medical procedures. Concealment in consultative encounters takes into account the socio-psychological security needs of clients and attends positively to clients’ cultural expectations.