Managing topics of birth and death in doctor–patient communication

Abstract

The birth and death of family members, as two contrastive human experiences, have different effects with regard to people's needs for social support and freedom from imposition. While topics of birth and death inevitably arise in medical consultations where doctors collect information about patients’ family history, little has been explored regarding how birth/death information is presented in spontaneous discourse. By examining 49 Taiwanese medical encounters between doctors and their elderly patients, this research observed the following. While the topic of birth and the birth information about the patient's family member is explicitly introduced or elicited via doctor's questions formulated with the birth core lexicon in Southern Min “senn/give birth to” (e.g., “how many children did you give birth to?”), discourse on death is not. Rather than being explicitly asked for, most information about patients’ deceased family members gets presented as responses to doctor's questions formulated with “a syntactical subject only” (e.g., “…and your husband?”) or conveying a positive assumption of a family member still being alive (e.g., “how old are your parents?”). These findings lead to my main argument that the face-threatening effects associated with death are balanced by posing an ambiguous question which opens a wide possibility for patients to volunteer death-related information which they perceive as relevant to the ongoing discourse, or by assuming the survival status of a family member and leaving the situation open for patients to confirm or correct this.