A Pragmatic Study Of Deontic Authority-based Resolution Of Caregiver Resistance In Treatment Discussions

This study aims to examine how doctors deploy deontic authority to resolve caregivers' deontic right-based resistance in treatment discussions from the perspective of pragmatics.Deontic authority/right,which refers to the right to determine future action,has hardly been applied in pragmatic studies of interaction in institutional contexts.This study adopts a discursive approach to analyze how doctors identify and resolve caregivers' resistance to treatment recommendations within the frame of deontic authority/right.Data for this study are 30 online medical consultations selected from a medical counseling website.Three research questions are addressed in this study.(1)What are the types of deontic right-based resistance proposed by caregivers?(2)How do doctors deploy deontic authority to resolve caregivers' deontic right-based resistance?(3)Why do doctors employ different forms of deontic authority to resolve caregivers' deontic right-based resistance?For the above questions,main findings are presented as follows:First,two types of deontic right-based caregiver resistance are identified,namely strong deontic right-based resistance and weak deontic right-based resistance.Strong deontic right-based resistance refers to the phenomenon that caregivers resist doctors' treatment recommendations by instigating an alternative treatment plan without providing the reason for doing so.Weak deontic right-based resistance is composed of two subtypes.Specifically,in a weak deontic right-based resistance,the caregiver resists either by instigating an alternative treatment plan but providing the reason for doing so or by simply presenting the potentially discrepant symptoms that may make the doctor's treatment recommendation irrelevant or problematic.Second,two kinds of deontic authority-based resolution of caregiver resistance are found,viz.strong deontic authority-based resolution and mitigated deonticauthority-based resolution.The former can be further divided into two subcategories,i.e.pronouncement and permission.The latter consists of four formulations,that is,mitigated pronouncement,mitigated permission,proposal and suggestion.Last but not least,based on the above findings,it is found that deontic territory is the key factor that affects doctors' ways of response.Since strong deontic right-based resistance stands for an overt intrusion into doctors' deontic territory in essence,doctors need to protect their authority via the use of strong deontic authority.On the contrary,weak deontic right-based resistance either intrudes into doctors' deontic territory in a mitigated way or does not intrude into doctors' deontic territory at all;thus,doctors do not need to use strong deontic authority to claim their authority.The contributions of this study are as follows.Firstly,this study enriches research on deontic authority/right in interaction from a pragmatic perspective and proves that deontic authority/right can be studied independently,despite its interrelatedness with epistemic authority.Secondly,since prior studies rarely pay attention to how doctors resolve resistance,this study contributes to this line of research and consequently it can shed light on how doctors identify and resolve caregivers' resistance in real life.