IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v62y2006i8p1902-1916.html
   My bibliography  Save this article

"Does it mean I'm gonna die?": On meaning assessment in the delivery of diagnostic news

Author

Listed:
  • Maynard, Douglas W.

Abstract

This paper investigates how, in the delivery of diagnostic news, participants to the delivery may engage in meaning assessment or interpreting the news. It draws on data from 24 conversations in developmental disabilities clinics, internal medicine clinics and HIV counselling and testing clinics in the USA. The analysis shows that participants initiate meaning assessment sequences whereby one participant proposes what the news means and the other aligns or disaligns with the proposal. When meaning assessment occurs, the preferred way for this to happen is that the clinician initiates and proposes an interpretation. Following the interpretive proposal, a patient or family member aligns or disaligns with the interpretation, with alignment being sought over disalignment. Further practices of meaning assessment are "affirming the positive" and "disconfirming the negative," which work to provide relatively benign interpretations of news. Analysis of a collection of meaning assessment sequences in clinical settings is brought to bear on a single case in which an internist tells a patient that he has stomach cancer. After delivering the diagnosis, this doctor neither affirms the positive nor disconfirms the negative, and the patient ends up asking, "Does it mean I'm gonna die?" At this point, the interview gets disrupted as the patient withdraws. Asking what the news means is a structurally dispreferred way of handling problems of meaning, and as such this patient's exhibition of difficulty is an outcome of orderly social practices. A clinician's withholding of auspicious meaning assessment may undermine the relationship with patients and/or family members and disrupt the encounter.

Suggested Citation

  • Maynard, Douglas W., 2006. ""Does it mean I'm gonna die?": On meaning assessment in the delivery of diagnostic news," Social Science & Medicine, Elsevier, vol. 62(8), pages 1902-1916, April.
  • Handle: RePEc:eee:socmed:v:62:y:2006:i:8:p:1902-1916
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277-9536(05)00504-6
    Download Restriction: Full text for ScienceDirect subscribers only

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Heritage, John & Stivers, Tanya, 1999. "Online commentary in acute medical visits: a method of shaping patient expectations," Social Science & Medicine, Elsevier, pages 1501-1517.
    Full references (including those not matched with items on IDEAS)

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:62:y:2006:i:8:p:1902-1916. See general information about how to correct material in RePEc.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Dana Niculescu). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service hosted by the Research Division of the Federal Reserve Bank of St. Louis . RePEc uses bibliographic data supplied by the respective publishers.