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Invoking death: How oncologists discuss a deadly outcome

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  • Tate, Alexandra

Abstract

Existing sociological research documents patient and physician reticence to discuss death in the context of a patient's end of life. This study offers a new approach to analyzing how death gets discussed in medical interaction. Using a corpus of 90 video-recorded oncology visits and conversation analytic (CA) methods, this analysis reveals that when existing parameters are expanded to look at mentions of death outside of the end-of-life context, physicians do discuss death with their patients. Specifically, the most frequent way physicians invoke death is in a persuasive context during treatment recommendation discussions. When patients demonstrate active or passive resistance to a recommendation, physicians invoke the possibility of the patient's death to push back against this resistance and lobby for treatment. Occasionally, physicians invoke death in instances where resistance is anticipated but never actualized. Similarly, death invocations function for treatment advocacy. Ultimately, this study concludes that physicians in these data invoke death to leverage their professional authority for particular treatment outcomes.

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  • Tate, Alexandra, 2020. "Invoking death: How oncologists discuss a deadly outcome," Social Science & Medicine, Elsevier, vol. 246(C).
    • Handle: RePEc:eee:socmed:v:246:y:2020:i:c:s0277953619306677
    DOI: 10.1016/j.socscimed.2019.112672
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    References listed on IDEAS

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    Cited by:

    1. Hauge, Amalie M., 2020. "One last round of chemo? Insights from conversations between oncologists and lung cancer patients about prognosis and treatment decisions," Social Science & Medicine, Elsevier, vol. 266(C).
    2. Tate, Alexandra, 2022. "Death and the treatment imperative: Decision-making in late-stage cancer," Social Science & Medicine, Elsevier, vol. 306(C).
    3. Shachar, Leeor, 2022. "“You become a slightly better doctor”: Doctors adopting integrated medical expertise through interactions with E-patients," Social Science & Medicine, Elsevier, vol. 305(C).
    4. Toerien, Merran, 2021. "When do patients exercise their right to refuse treatment? A conversation analytic study of decision-making trajectories in UK neurology outpatient consultations," Social Science & Medicine, Elsevier, vol. 290(C).
    5. Fatigante, Marilena & Heritage, John & Alby, Francesca & Zucchermaglio, Cristina, 2020. "Presenting treatment options in breast cancer consultations: Advice and consent in Italian medical care," Social Science & Medicine, Elsevier, vol. 266(C).

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