Laughter as Medical Providers' Resource: Negotiating Informed Choice in Prenatal Genetic Counseling

Abstract

This article aims to challenge the perception that in medical encounters laughter is an interactional resource primarily employed by patients. Drawing on 34 video-recorded prenatal genetic counseling (PGC) sessions collected in a Hong Kong hospital, and combining quantitative and qualitative methods, we illustrate that laughter is in fact frequently employed by the medical providers in our data. The particular focus of the article is on the ways in which laughter initiated by the medical providers assists interlocutors in negotiating informed choice, a crucial aspect of PGC sessions. Findings indicate that laughter initiated by the medical providers performs at least two PGC-specific functions: It assists the medical providers in “laughing off” and overcoming patients' resistance, and it helps them in dealing with patients' direct questions. Laughter is thus an important resource for the medical providers in pursuing the institutional goals of the interaction, namely negotiating informed choice with their patients.

Acknowledgments

The research reported here was fully supported by a grant from the Hong Kong Research Grants Council of the Hong Kong Special Administrative Region, China (project no. HKU 754609 H). We are very grateful to the anonymous reviewers and to Dr. Angela Chan and Dr. Zhang Wei for their valuable comments on earlier drafts of this article. All remaining infelicities are of course our own. We would like to thank the people who have participated in our research. A special thanks goes to the medical research team for their continuous support of our interactional study of PGC, in particular to Ms. Vivian Chan, Dr. H. Y. M. Tang, Dr. K. Y. Leung, and Dr. C. P. Lee.

Notes

¹While pregnant women are often referred to in the literature as “women” or “clients,” we use the term patient in line with the practices at the hospital where the data were collected. Similarly, we use the term Down Syndrome as opposed to “Down's Syndrome” in line with the practices at that hospital.

²In all data extracts the names of the participants and other identifiers have been removed.

³ Glenn (2003, p. 49) notes that he uses the term laughable “retroactively” to describe any referent that draws or has the potential to draw laughter.