Arriving at the postmodern medical consultation

Abstract

The analysis of the medical consultation is characterised by mainly prescriptive attempts to recommend ‘best practice’. As the role of the individual in society has gained prominence, the power relationships in medical practice have had to change to reflect the increasing recognition of autonomy and self-determination. Medical discourse is at a junction, having to relinquish authoritarianism and grapple with the concept of sharing information and decisions in an area where complex and uncertain data exist, albeit often without full disclosure. The writing of Foucault and Lyotard and the concept of postmodernism fit well with the idea that the consultation between doctors and patients is increasingly becoming a contested space that occupies multiple voices, such as that of the media, the pharmaceutical industry, government-led guidelines and that of the profession. Creating the circumstances and the means for creating an effective dialogue in the postmodern consultation is the prime task for physicians.

Key Words:

• consultation
• postmodernism
• shared decision-making
• decision aids