A pragma-dialectical perspective on obstacles to shared decision making

Shared medical decision-making has been analyzed as a particular kind of argumentative discussion. In the pragma-dialectical argumentation theory, different types of conditions and rules are formulated for the ideal of a reasonable argumentative discussion. In this paper, we shall first show how making use of the distinctions made in the pragma-dialectical theory between different types of conditions for reasonable discussion can help to give a more systematic account of the obstacles that need to be overcome for shared decision-making to be successful. Next, by referring to the rules for critical discussion, we shall provide a more detailed explanation than can be found in the literature on health communication of why certain types of conduct of the participants in the medical encounter can be analyzed as obstacles to the goal of shared decision-making.FGW – Publications not associated with a particular research are