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Learning more about the decision making context is important
| The first 150 words of the full text of this article appear below. |
Communication difficulties between doctors and
patients have been looked at by researchers from several disciplines
who have tried to explore why these occur. Mishler, for example, has
argued that doctors and patients talk to each other with different
voices.1 The voice of medicine is characterised by medical
terminology, objective descriptions of physical symptoms, and the
classification of these within a reductionist biomedical
model.1 The voice of patients, on the other hand, is
characterised by non-technical discourse about the subjective
experience of illness within the context of social relationships and
the patient's everyday world. Typically, doctors have more power than
patients to structure the nature of the interaction between them. As a
consequence, patients may feel that their voice is overridden,
silenced, or stripped of personal meaning and social context. To
improve communications between doctors and patients we need also to
understand the nature of the decision making that is taking
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