Authority under Siege: Transforming Resistance into Acceptance through Persuasion

• In Event: 1518 - Current Research in Ethnomethodology and Conversation Analysis

Abstract

Professional medical authority rests partly on patients’ voluntary compliance with physicians’ directives. Patients’ resistance to treatment recommendations and physicians’ ability to convert resistance into acceptance indexes the strength of contemporary professional authority. Using conversation analytic methods to analyze 149 video-recordings of patient-clinician encounters involving pediatric epilepsy patients, we identify three distinct grounds for resistance: preference-, fear-, and evidence-based resistance. Clinicians meet these grounds with three corresponding persuasion strategies ranging from pressuring, to coaxing, to accommodating. We show that clinicians discriminate between resistance that contests their ability to medically direct the treatment course versus challenges to the epistemic basis of the directive. Even when physicians increasingly rely on persuasion to achieve patient buy-in, they preserve professional authority. The interactional persuasion mechanisms extend to other institutional settings where resisters challenge authorities.
 

Authors

• Tanya Stivers, University of California-Los Angeles

• Stefan Timmermans, UCLA