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Silence as a manner within the doctor's epistemic posture during the diagnostic process: A case study in a French hospital

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  • Glauzy, Antoine

Abstract

The notion of silence often emerges between the lines in studies on diagnosis and the disclosure of bad news to patients. However, silence rarely takes center stage in such studies, risking an underestimation of its significance. This study, conducted through observations and semi-structured interviews in a hospital specializing in liver and pancreatic diseases, centers its analysis on the role of silence. It explores how institutional norms and constraints shape doctors' use of silence during consultations and diagnostic processes. The findings reveal that silence, understood as withholding information or concealing the name of a disease, serves distinct functions: in the pre-diagnostic phase, it helps prepare patients for the possibility of illness while respecting institutional expectations; at the moment of diagnosis, it reinforces doctors' adherence to a scientific framework. This research argues that silence is a central attitude of the doctor's epistemic posture, mediating the complex interplay between institutional demands and patient care.

Suggested Citation

  • Glauzy, Antoine, 2025. "Silence as a manner within the doctor's epistemic posture during the diagnostic process: A case study in a French hospital," Social Science & Medicine, Elsevier, vol. 378(C).
  • Handle: RePEc:eee:socmed:v:378:y:2025:i:c:s0277953625004836
    DOI: 10.1016/j.socscimed.2025.118153
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    References listed on IDEAS

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    1. Barry, Christine A. & Stevenson, Fiona A. & Britten, Nicky & Barber, Nick & Bradley, Colin P., 2001. "Giving voice to the lifeworld. More humane, more effective medical care? A qualitative study of doctor-patient communication in general practice," Social Science & Medicine, Elsevier, vol. 53(4), pages 487-505, August.
    2. King, Michael & Speck, Peter & Thomas, Angela, 1994. "Spiritual and religious beliefs in acute illness--Is this a feasible area for study?," Social Science & Medicine, Elsevier, vol. 38(4), pages 631-636, February.
    3. Jutel, Annemarie, 2016. "Truth and lies: Disclosure and the power of diagnosis," Social Science & Medicine, Elsevier, vol. 165(C), pages 92-98.
    4. Duran, Eduardo, 2021. "Diagnostic slippage: Medical uncertainty and engaged patienthood in the case of atypical disorders," Social Science & Medicine, Elsevier, vol. 280(C).
    5. Derbez, Benjamin, 2018. "Is there a “right time” for bad news? Kairos in familial communication on hereditary breast and ovarian cancer risk," Social Science & Medicine, Elsevier, vol. 202(C), pages 13-19.
    6. Haw, Jennie & Cunningham, Shannon & O'Doherty, Kieran C., 2018. "Epistemic tensions between people living with asthma and healthcare professionals in clinical encounters," Social Science & Medicine, Elsevier, vol. 208(C), pages 34-40.
    7. Locock, Louise & Nettleton, Sarah & Kirkpatrick, Susan & Ryan, Sara & Ziebland, Sue, 2016. "‘I knew before I was told’: Breaches, cues and clues in the diagnostic assemblage," Social Science & Medicine, Elsevier, vol. 154(C), pages 85-92.
    8. Jutel, Annemarie & Nettleton, Sarah, 2011. "Towards a sociology of diagnosis: Reflections and opportunities," Social Science & Medicine, Elsevier, vol. 73(6), pages 793-800, September.
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