Discourse strategies by physicians in China : a case study of bad news delivery

Abstract

There is an intense doctor-patient relationship in China. Extensive studies have shown that poor communication between physicians and patients is one key factor leading to such extreme situation, and among all kinds of communications, bad news delivery is a special variety of medical communication; however, it has only been widely discussed in Western medical contexts. The aim of this thesis is to investigate how bad news is communicated between Chinese physicians and patients in Chinese medical contexts. This study assumes the fact that there will be some cultural implications on the delivery in interaction. 9 extracts of bad news delivery in medical setting were selected from the most popular Chinese medical-theme TV drama series, Intention, as the data of this thesis. Conversation Analysis (CA) is adopted as the analytical framework to analyze these data. Detailed analysis shows that Chinese physicians typically follow the News Delivery Sequence (NDS) process, which includes the announcement, response, elaboration and assessment turns. In these turns, some discourse strategies adopted by the Chinese physicians are similar to Western physicians, while some are more commonly used in Chinese medical contexts. The similarities and differences in strategies used by physicians in two different contexts can be explained by cultural differences and other factors. Besides, the Chinese cultural contexts imply that going to the hospital is not easy for every people in China. These findings may raise the awareness of the physicians so they should try to take the economic conditions of the patient into account. Moreover, both physicians and patients in China should bear their responsibilities of creating better medical communication, providing more understanding for each other.