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Rational versus unreasonable persuasion in doctor-patient communication: A normative account

机译：医患沟通中的理性与不合理的说服：一个规范的解释

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Objective: Persuasion plays a critical role in doctor-patient communication. The relevant literature tends to equate persuasion to manipulation as a suboptimal form of interaction. The objective of this paper is to distinguish among different types of persuasion processes and to highlight when their use can be beneficial or risky from the perspective of the patient's autonomy. Methods: This paper presents a conceptual analysis of persuasion based on the analytical and normative frameworks of argumentation theory. Results: Persuasion is a generic term that refers to at least four main forms of persuasion: rational persuasion, unintentional unreasonable persuasion, intentional (without deception) unreasonable persuasion and intentional (with deception) unreasonable persuasion (i.e., manipulation). Conclusion: Rational persuasion can be a process of value for the medical encounter. The other forms of persuasion can negatively impact patients' decision making. They are suboptimal for different reasons that are partly due to the quality of communication, and partly due to ethics of the medical conduct. Practice implications: This paper offers a basis for developing training opportunities that foster deeper understanding of different forms and uses of persuasion. Also, it can inspire the development of educational material for patients targeted to the enhancement of their critical health literacy.
机译：目的：说服在医患沟通中起着至关重要的作用。相关文献倾向于将说服等同于操纵作为互动的次优形式。本文的目的是区分不同类型的说服过程，并从患者的自主权角度突出使用它们的时机是有益的还是有风险的。方法：本文在论证理论的分析和规范框架的基础上，对说服进行了概念分析。结果：说服是一个通用术语，指的是至少四种主要的说服形式：理性说服，无意的不合理说服，有意的（无欺骗）不合理的说服和有意的（有欺骗）不合理的说服（即操纵）。结论：合理的说服力可能是医疗遭遇的价值过程。其他形式的说服会对患者的决策产生负面影响。由于各种原因，它们之所以不是最优的，部分原因是由于沟通的质量，部分是由于医疗行为的道德规范。实践意义：本文为开发培训机会提供了基础，以促进对说服的不同形式和用法的深入了解。而且，它可以激发针对患者的教育材料的开发，以提高他们的关键健康素养。

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