汉语门诊环境下的医患不礼貌话语与权力

Impoliteness and Power of Doctors and Patients in Chinese Outpatient Context

门诊会话是医生与患者权力交锋的第一战场。以Culpeper的不礼貌策略为基础,结合French&Raven的权力基础理论,通过对门诊会话语料进行定量与定性分析,揭示了在门诊开始与结束、主诉与拓展以及诊断与治疗阶段医患双方采用不礼貌策略的差异,发现医生不礼貌策略使用频率及类型均胜于患者,同时患者迫于权势压力,回应策略非常有限。对语料背后的权力因素进行分析后发现,医生多依赖法定权力、专家权力、信息权力以成就医患权力博弈格局。随着门诊会话的发展,医患会话冲突呈现愈演愈烈的趋势,但多数冲突以患者对医生权力的妥协而告终。

Outpatient department is the first battlefield for doctors and patients. Based on Culpeper＇s impoliteness strategies and referring to French ＆ Raven＇s bases of power, this paper makes a qualitative and quantitative analysis of authentic medical dis- course, in order to unfold the discrepancies in the kinds and frequency of impoliteness strategies by doctors and patients in differ- ent phases of doctor - patient talk, namely the Opening and Closing phase, the Complaint and Elaboration phase and the Diagno- sis and Treatment phase. This paper then verifies the asymmetry of power between doctors and patients, which greatly restricts the latter＇s responses. After an anatomy of these cases from the perspective of power bases, this paper finds that doctors make more use of legitimate power, expert power and information power to shape the doctor - patient gaming pattern. Statistics show doctor - patient talk could be more and more intensified along its development, and often ended with patients＇ compromise.