Analysis Of Symmetry And Asymmetry In Physician-patient Conversation

Talk, as the main ingredient in the medical care, has been studied from different aspects. These studies have shown that physicians dominate and control the doctor-patient conversation. Thus, asymmetry is one of the hallmarks of medical conversation. This thesis seeks to contribute to discourse analysis research on how power asymmetries are located in conversations between doctors and patients. It concerns itself with the linguistic means by which asymmetry and symmetry are created in the medical encounter. On the one hand, analysis of asymmetry and symmetry in the encounter helps us understand the medical communication better. On the other hand, discourse analysis of medical encounter can help us realize how power is claimed and ratified. The thesis considers how the use of technical terms, formal or informal address terms, directives, interruption, topic change and address pronouns can all produce asymmetry or work towards creating symmetry within the medical encounter. In addition, the author will show how two overall constraints, politeness and the dominant medical view of illness affect the use (and abuse) of particular discourse moves, such as direct questioning and topic control. Contextual factors are also taken into account. Ways are summarized in which doctors can redress asymmetry and patients can promote symmetry in order to effectively shift the typically asymmetrical relationship. Similarities and differences observed in the two Chinese samples and the three English samples are also talked about.