Talking About Advance Directives
A Discourse Analysis of Clinical Encounters in Hong Kong
Bibliographic Data
| ID | 23308751 |
|---|---|
| Authors | David Edmonds (0000-0002-8277-9980, University of Hong Kong), Olga Zayts (0000-0003-2946-0994, University of Hong Kong), Olga Zayts-Spence (University of Hong Kong), Irene Nga Yu Au (University of Hong Kong), Jacqueline K Yuen (0000-0002-9682-4367, University of Hong Kong), Jacqueline Kwan Yuk Yuen (School of Clinical Medicine) |
| Year | 2026 |
| Pages | 302228261463618-302228261463618 |
| Publication date | 2026-07-21 |
| Peer Reviewed | Yes |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | OMEGA - Journal of Death and Dying (JOURNAL) |
| Journal identifiers | ISSN: 0030-2228 • E-ISSN: 1541-3764 |
| Publisher | SAGE Publications (PUBLISHER • US) |
| DOI | 10.1177/00302228261463618 |
| PMID | 42479462 |
| OpenAlex | W7169852969 |
| Language | EN |
| References cited | 45 |
Advance directives are written statements outlining patients’ preferences regarding life-sustaining treatments at the end of their lives. These statements are brought about through discussions between patients, family, and clinicians. We take an interactional perspective on advance directives and focus on how they are talked about during clinical encounters in Hong Kong. The findings are based on a discourse analysis of 27 consultations. Clinicians talked about advance directives in three ways. First, clinicians talked about life-sustaining treatment when introducing advance directives as a topic. Second, clinicians emphasized principles of advance directives. Third, clinicians described what other patients had done with their advance directives. Our findings reveal that clinicians are oriented towards a potentially preferred outcome in these consultations: guiding patients towards signing advance directives. We discuss the findings with reference to a trend towards an interactional preference, and with regards to culture and clinical practice.
Conversation analysis · Critical discourse analysis · Discourse analysis · Focus (optics) · Focus group · Perspective (graphical) · Ethics and Legal Issues in Pediatric Healthcare · Grief, Bereavement, and Mental Health · Palliative Care and End-of-Life Issues
An Interactional Structure of Medical Activities During Acute Visits and Its Implications for Patients' Participation
Definition and recommendations for advance care planning
Communication in Palliative Care and About End of Life
Providing Opportunities for Patients to Say More about Their Pain without Overtly Asking
Introducing “A Question That Might, Perhaps, Scare you”
‘It's not magic’
Prevalence, Perception, and Predictors of Advance Directives among Hong Kong Chinese
Is Death Taboo for Older Chinese Immigrants
Deontic Authority in Interaction
Epistemics in Action
Death and Dying in Four Asian American Cultures
They are not taking it seriously”
Authority and Accountability
The Timing and Construction of Preference
Orientations to epistemics and deontics in treatment discussions
Norm talk and human cooperation
| Citation velocity | historical |
|---|---|
| Highly cited | No |