Volume 5, Issue 1

Although linguists have been exploring the nuances of politeness for decades, beginning with the pioneering works of Lakoff (1973), Brown and Levinson (1987) and Leech (1983), there has been little research focusing on impoliteness in medical interaction. Communication between various types of medical caregivers, too, is an under-researched area; most research on medical interaction involves doctor-patient discourse. Using an ethnographic discourse analytic approach, this study begins to address this gap by examining interactions during an interdisciplinary discharge rounds meeting at a major urban teaching hospital. In a teaching hospital, there is potential conflict between physicians-in-training and other members of caregiving teams; while physicians occupy a higher position on the administrative and social hierarchy of the hospital, other caregivers (e. g., registered nurses – who have sometimes had over 20 years of medical experience and spend much more time with patients than medical doctors) must determine how to be polite/politic in voicing their opinions and suggestions regarding patient care. I explore politeness strategies used by various members of caregiving teams (e. g., registered nurses, social workers) to negotiate patient care decisions within the hospital hierarchy. Results indicate that mitigating strategies are an integral part of the communicative process within the institutional hierarchy of a teaching hospital.

Previous research in the field of politeness studies indicates that different discourse genres are characterized by different degrees of adherence to politeness rules (Lakoff 1989). In the genetic counselling setting, we propose that verbal behaviour should be analyzed within a broader framework of politic verbal behaviour (Watts 1989, 2003). We examine an L2 English context in Hong Kong to illustrate how the sociocultural context shapes the notion of politic behaviour. By sociocultural context, we are referring to the combination of language used, in this case English as a second language, the background of the interactants, and the institutional setting in which the interactions take place. In genetic counselling, politic behaviour is influenced by two well-established concepts: informed choice and nondirective counselling. Informed choice concerns the decision that a pregnant woman makes regarding genetic screening and testing. Nondirectiveness reflects the autonomous nature of the choice and the fact that the health care provider should act as a facilitator of the woman's choice, avoiding any imposition. Given these institutional goals, we discuss how health care providers negotiate politic behaviour to facilitate the decision-making process and illustrate that considerations of language and participant background take precedence over nondirectiveness in this L2 context.

This paper looks at communication between staff and residents in a Japanese elderly care facility. It discusses the role of politeness in this special type of health care setting from a cross-cultural perspective. Starting with a review of previous literature on the topic, some basic characteristics of communication between staff and residents in nursing homes are outlined. The overall conditions that apply in the caring context with regard to linguistic politeness are described on the basis of Brown and Levinson's framework. The main part of the paper presents speech data from a Japanese nursing home, analyzed in direct comparison with data from other cultural contexts. In so doing, an attempt is made to outline some common communicative features in institutional elderly care. The summarizing discussion focuses on the question of whether the special conditions of institutional elderly care may indeed generate very similar types of communication across different cultural settings.

Politeness is of particular importance in health care contexts, where a number of international agreements and consensus statements formulated by policy makers demand that accord should be maintained, agreement should be solicited, and an attitude of respect be sustained especially when burdensome or intimate matters are being discussed. This paper explores the patterns of politeness in a corpus of material from a UK study of telephone encounters between NHS Direct health advisers and callers presenting with a need for advice over medication. In the opening sequences of interaction the questions that advisers asked the callers often included multiple politeness markers, for example through terms such as “may” and “just”, as in “may I just ask you?”. Politeness markers were often multiply layered, falling into three part structures which occurred when mundane information such as callers' names and telephone numbers were being elicited. Where more intimate matters were at stake, advisers minimized imposition and, arguably, undertook rapport building by means of preambles to the question such that the impending intrusion is accounted for, explained or mitigated. A potentially problematic question could also be followed up by further relational work and humour. There are important implications here for understanding politeness itself, especially where it is displayed by an institutionally more powerful or symbolically credentialed interactant towards one who is less advantaged.

This paper examines politeness strategies in relation to advice-giving in an online self-management programme for people with arthritis. Participants are asked to make weekly action plans, setting goals in relation to relevant topics such as diet and exercise, and a major online activity for participants is to give feedback to each other on these action plans. Thus participants online carry out face-threatening acts such as giving advice and criticizing elements of others' action plans. Participants use a variety of strategies to mitigate their feedback, including indirect suggestions framed as declaratives or rhetorical questions, and widespread use of positive politeness strategies. Participants make frequent use of short personal narratives in their feedback, demonstrating shared problems, concerns, and experiences, thus embodying positive politeness. This narrative feedback typically describes how the writer of the message has addressed the same problem as the recipient, and these narratives therefore also embody indirect advice. Moreover, by showing how the writer has addressed the problem, these narratives also serve to construct the writer as a self-managing expert patient.