“[She] said: ‘take the test’ and I took the test”. Relational work as a framework to approach directiveness in prenatal screening of Chinese clients in Hong Kong

Abstract

AbstractIn this paper we apply the framework of relational work, or the work individuals invest in maintaining their relationships (Locher and Watts 2005), to the analysis of prenatal screening (PS) for Down Syndrome of Chinese clients in Hong Kong. PS has traditionally followed a nondirective principle that calls for an unbiased presentation of information and women’s autonomous decision- making regarding testing. However, in Chinese contexts, healthcare providers appear extremely directive; and women, in turn, explicitly express their expectations of being led in decision-making (Zayts et al. 2013). These observations lend support to previous politeness studies of Chinese institutional contexts wherein hierarchical communication has been described as “listening-centered, asymmetrical and differential” (Gao and Ting-Toomey 1998: 48). More recent politeness studies, however, warn against such stereotyping at a cultural level (Eelen 2001; Mills 2003, 2004; Watts 2003). In this paper, rather than using culture as an a priori explanatory variable to account for the directive stance of the healthcare providers, we argue that using the framework of relational work enables researchers to focus on how meaning is created and negotiated at the micro-level of an interaction, and to move away from “grand generalizations” about culture specific behaviors and expectations.