Ärztliche Therapieentscheidungsempfeh-lungen in der Onkologie und die Rolle des Personalpronomens wir bei der Aushandlung ärztlicher agency

Abstract

This article focuses on the use of first person plural ‚wir‘ (we) in treatment recommendations. After outlining the research on practices of recommending and decision making in medical interaction as well as the relevance of these practices for therapeutic interventions, we show on the basis of 56 oncological consultations how doctors use ‚wir‘ (we) to encode collective agency (e.g. Enfield 2017) and thus index the recommendations as collectively decided upon by a medical team. Using the methods of Interactional Linguistics (e.g. Imo/Lanwer 2017), we then highlight two different strategies doctors use to account for these recommendations: (i) by explicitly naming the tumor board (and sometimes its members) as the decision-making body and thereby emphasizing the collective expertise of the different specialists who are part of the tumor board or (ii) by grounding the recommendation in the diagnosis itself and thus presenting the therapy as routine treatment to which there is no feasible alternative. Finally, we discuss whether our findings are in line with shared decision making (e.g. Koerfer/Albus 2015), which is often regarded to be the ideal in this context. The article aims to contribute to an empirically grounded description of decision-making processes in medical interaction and the role personal pronouns as markers of agency play in them.