Argumentation in medical communication: Why it matters for patient care

Argumentation matters in medical communication

Effective communication is a cornerstone of good medicine. It underpins everything from diagnosis and treatment planning to patient satisfaction and long-term health outcomes. While much emphasis is placed on empathy, active listening, and cultural sensitivity in clinical communication, one crucial yet often overlooked element is argumentation—the structured exchange of reasons, evidence, and viewpoints to support decision-making.

In the clinical setting, argumentation plays a significant role in key areas such as shared decision-making, informed consent, and the discussion of treatment options. Far from being confrontational or adversarial, argumentation in medicine is a collaborative, respectful process aimed at arriving at the best possible course of action for the patient.

Communication and patient outcomes: The big picture

Before diving into argumentation specifically, it's important to understand why communication matters so profoundly in healthcare.

Numerous studies have linked effective clinician-patient communication to:

• Improved treatment adherence
• Higher levels of patient satisfaction
• Better clinical outcomes
• Reduced medical errors
• Increased patient safety

Poor communication, on the other hand, is a leading contributor to malpractice claims and adverse events. When patients don’t fully understand their diagnosis, the reasons behind a treatment plan, or the risks of a procedure, the results can be devastating—not just medically, but emotionally and financially as well.

What is argumentation in medicine?

In everyday language, “argument” often suggests conflict. But in the context of communication theory and healthcare ethics, argumentation refers to the rational and respectful exchange of ideas and reasons.

In medicine, this might include:

• A clinician explaining why one treatment option is preferable over another
• A patient expressing doubts or preferences and providing reasons for them
• A discussion where risks, benefits, and values are evaluated openly

This structured form of communication enables both the clinician and patient to co-construct decisions, rather than one party unilaterally dictating them. It fosters transparency, trust, and collaboration—all of which are essential in today’s healthcare environment.

Argumentation in shared decision-making

One of the clearest applications of argumentation is in shared decision-making (SDM). SDM is a process where clinicians and patients work together to make choices that align with both clinical evidence and the patient’s values and preferences.

In this context, argumentation involves:

• Presenting evidence-based options
• Discussing pros and cons
• Clarifying patient values and goals
• Working through disagreements in a respectful, rational way

Consider a patient with atrial fibrillation who must choose between different anticoagulation therapies. The clinician can explain the benefits, risks, and logistics of each option. The patient may have lifestyle concerns (e.g., aversion to regular blood tests or dietary restrictions) that influence their preference. Through argumentation, both parties can weigh these factors logically and arrive at a shared decision that is medically sound and personally acceptable.

Informed consent: Beyond the signature

Another critical area where argumentation matters is informed consent. Too often, this process is reduced to a rushed conversation followed by a signature on a form. But informed consent is much more than a legal requirement—it is an ethical conversation.

Effective informed consent requires that:

• The patient understands the nature of the procedure or treatment
• Risks, benefits, and alternatives are clearly explained
• The patient has the opportunity to ask questions and express concerns
• The decision is made voluntarily and without coercion

Here, argumentation allows for a deeper understanding. A patient may question the necessity of a proposed surgery or express fear about side effects. A good clinician will respond not by shutting down the conversation, but by offering clear, evidence-based explanations—and by listening to and validating the patient’s concerns. This two-way reasoning process builds trust and promotes autonomy.

Argumentation in treatment advice and health behaviour change

Beyond major decisions, argumentation plays a role in everyday treatment conversations. For example, a patient with newly diagnosed type 2 diabetes might resist starting insulin therapy. Rather than merely insisting on it, the clinician can engage in argumentation: exploring the patient’s concerns, providing reasons for the recommendation, and offering counterarguments based on clinical experience or outcomes data.

This technique is also central to motivational interviewing, a counselling style used to encourage behaviour change. In this method, clinicians help patients weigh their ambivalence and build internal motivation by eliciting and reinforcing their own arguments for change—whether it's quitting smoking, reducing alcohol intake, or adopting a healthier diet.

Ethical and professional considerations

Importantly, argumentation in medicine must be ethical and respectful. It should never be used to manipulate or pressure a patient. Instead, it should aim to:

• Clarify misunderstandings
• Correct misinformation
• Support autonomy
• Promote patient-centred care

It also demands that clinicians are self-aware about their own biases, and willing to explain (and sometimes re-evaluate) their recommendations.

As Harvard’s Arthur Kleinman noted, clinicians must recognise that biomedicine itself is a cultural system, with its own assumptions and frameworks. Argumentation, when practiced thoughtfully, creates space for bridging different belief systems—whether cultural, religious, or personal.

In conclusion

Argumentation is not just for academics or courtroom debates—it is a vital, practical tool in medical communication. When used appropriately, it strengthens the therapeutic alliance, enhances decision-making, and ultimately improves care.

In an era where patient empowerment, evidence-based practice, and personalised medicine intersect, mastering the art of argumentation is not a luxury—it’s a necessity. Clinicians who can reason with, not just talk at, their patients are better equipped to guide, support, and heal.

So, the next time you’re faced with a complex medical decision—whether as a patient or a healthcare professional—remember: the best outcomes come not from avoiding the hard conversations, but from engaging in them with clarity, respect, and purpose.

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Author: Kara Gilbert, KMG Communications