A Study Of Power Asymmetry In Chinese Doctor-Patient Clinic Interaction From The Perspective Of Speech Act Theory

Based on the spot investigation, this thesis, from the perspective of speech act theory, analyzes and studies the characteristics of speech acts and the two parties'intentions in the D-P talks by adopting the quantitative and the qualitative analysis.This paper mainly follows the framework of Austin's and Searle's speech act theories. Besides that, it also refers to Leech's and D. Wunderlich's classification models of speech acts to analyze and to expound on the above discussed aspects.The corpus adopted in this research is collected, in January and February,2011, from six departments of the clinic in Xuchang People's Hospital in Henan Province. The methodology of this paper follows the following procedure:first,15 doctor-patient dialogues are chosen randomly from the 40 transcribed conversations which are recorded in consulting rooms, and a quantitative analysis is made; second, based upon the selected data, pragmatic functions of five speech acts are examined in the D-P talks, which are rogatives, reactives, representatives, directives and expressives, and the doctor-initiated and patient-initiated speech acts in the six stages of the D-P talks are also analyzed; third, the doctor's and the patient's intentions are discussed through analyzing their uses of speech acts, thereby disclosing the power asymmetry existing in the Chinese D-P outpatient interviews.Based upon the data analysis and cases discussion, the study has concentrated on the following aspects:(1) The doctor is usually inclined to employ rogatives, representatives, and directives while the patient prefers to adopt reactives, representatives and expressives.(2) In the opening phase of the Chinese clinic interviews, the two parties'intentions coincide with each other, and thereby show their complete and natural conformity to the power asymmetry.(3) In the history-taking and the examination phases, doctors mainly initiate rogatives and directives to collect helpful information for the next stage while patients apply reactives, expressives, and representatives to provide the required information, and cannot wait to state the redundant information as well. Therefore, in these two phases, their major intentions are consistent while the minor intentions are inconsistent. However, the two parties mainly attempt to comply with their asymmetry in the power relation.(4) In the diagnosis and the treatment-plan phases, the doctor mostly adopts representatives to explain and state the disease and also hopes to end the conversations as quickly as possible, while the patient mainly initiates rogatives to expect the doctor to make concrete and easy-to-understand explanations about their diagnoses. Therefore, the doctor's minor intention is inconsistent with the patient's fundamental intention to seek medical advice and medicine. The patient does not yield to his or her inferior position any more, and applies direct devices to enquire after the doctor for the information he or she needs.(5) In the closing phase, doctors mainly initiates directives and representatives to state the medical follow-up expecting patients to comply with their treatment plans, and thereby realize their fundamental intention'heal the wounded and rescue the dying'. As to the patients, they mostly apply expressives to express their attitudes towards doctors'advice, and to give their thanks. Therefore, in this phase, there is a reverse between their power relations.Finally, this paper makes a conclusion and an integration of the major findings, and also points out the innovations, limitations and further explorations, as well as some practical advice for the D-P communicative competence.