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'Unilateral' and 'bilateral' practitioner approaches in decision-making about treatment

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  • Collins, Sarah
  • Drew, Paul
  • Watt, Ian
  • Entwistle, Vikki

Abstract

Practitioners can present and discuss decisions about the management of health problems in a variety of ways during consultations. This paper examines in detail how doctors talk with patients in relation to decision-making about treatment. Conversation analyses of decision-making sequences in consultations about diabetes in primary care and about treatment of ear nose and throat (ENT) cancer in a specialist oncology setting, both in the UK, revealed a spectrum of practitioner approaches ranging from more 'bilateral' to more 'unilateral'. This paper identifies the key communicative and organisational features of these approaches and provides some preliminary observations about the implications of these for patient participation in decision-making.

Suggested Citation

  • Collins, Sarah & Drew, Paul & Watt, Ian & Entwistle, Vikki, 2005. "'Unilateral' and 'bilateral' practitioner approaches in decision-making about treatment," Social Science & Medicine, Elsevier, vol. 61(12), pages 2611-2627, December.
    • Handle: RePEc:eee:socmed:v:61:y:2005:i:12:p:2611-2627
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    References listed on IDEAS

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    1. Roter, Debra & Frankel, Richard, 1992. "Quantitative and qualitative approaches to the evaluation of the medical dialogue," Social Science & Medicine, Elsevier, vol. 34(10), pages 1097-1103, May.
    2. Stivers, Tanya, 2002. "Participating in decisions about treatment: overt parent pressure for antibiotic medication in pediatric encounters," Social Science & Medicine, Elsevier, vol. 54(7), pages 1111-1130, April.
    3. Gwyn, Richard & Elwyn, Glyn, 1999. "When is a shared decision not (quite) a shared decision? Negotiating preferences in a general practice encounter," Social Science & Medicine, Elsevier, vol. 49(4), pages 437-447, August.
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    Cited by:

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    2. Angell, Beth & Bolden, Galina B., 2015. "Justifying medication decisions in mental health care: Psychiatrists' accounts for treatment recommendations," Social Science & Medicine, Elsevier, vol. 138(C), pages 44-56.

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