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

Abstract

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.

Keywords: Argumentation; Argumentation theory; Doctor–patient communication; Fallacies; Manipulation; Persuasion.