'Unilateral' and 'bilateral' practitioner approaches in decision-making about treatment

Sarah Collins, Paul Drew, Ian Watt, Vikki Entwistle

Research output: Contribution to journalArticlepeer-review

113 Citations (Scopus)


Practitioners can present and discuss decisions about the management of health problems in a variety of ways during consultations. This paper examines in detail how doctors talk with patients in relation to decision-making about treatment. Conversation analyses of decision-making sequences in consultations about diabetes in primary care and about treatment of ear nose and throat (ENT) cancer in a specialist oncology setting, both in the UK, revealed a spectrum of practitioner approaches ranging from more 'bilateral' to more 'unilateral'. This paper identifies the key communicative and organisational features of these approaches and provides some preliminary observations about the implications of these for patient participation in decision-making.
Original languageEnglish
Pages (from-to)2611-2627
Number of pages17
JournalSocial Science & Medicine
Issue number12
Early online date11 Jul 2005
Publication statusPublished - Dec 2005


  • doctor-patient consultations
  • decision-making
  • conversation analysis
  • patient participation
  • United Kingdom


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