A rhetorical analysis of patient decision aids for genetic testing: Scientific knowledge, embodiment, and problematic integration in biomedicine

I consider how patient decision aids—technical communication documents created by biomedical practitioners—work to help people decide whether they should request genetic tests. I sample a genre of non-commercial patient decision aids that I term gateway documents developed by representatives of teaching hospitals, patient advocacy groups, professional biomedical organizations, and government entities to introduce genetic testing information, benefits, and disadvantages. I include two sample sets: genetic testing for cancer and prenatal diagnostic genetic testing. I develop a rhetorical framework that includes elements of deliberation, epideixis, scientific knowledge, and embodied knowledge. I incorporate into these elements the theory of problematic integration, which describes the interrelationships between probabilistic orientations—the scientific knowledge of biomedical practitioners—and evaluative orientations—the embodied knowledge of people seeking genetic testing. My rhetorical analysis of the sample sets describes the benefits and disadvantages constructed by the document authors’ use of embodied knowledge, scientific knowledge, or a combination of both. My application of problematic interaction theory reveals that the authors have constructed arguments using veiled paternalism and that the benefits and disadvantages are imbalanced. I offer a rubric using the criteria of my rhetorical framework that may assist patient decision aid authors in creating balanced argumentation that includes benefits and disadvantages using embodied knowledge and scientific knowledge. I conclude with advocacy for critical bioethical communication: the leadership of technical communication and rhetoric in the interdisciplinary study of decision-making for genetic testing.

Name thesis:degree_name

Doctor of Philosophy

Level thesis:degree_level

Doctoral

Discipline thesis:degree_discipline

Technical Communication and Rhetoric

Grantor

Texas Tech University

Year dc:date.issued

2014

Author dc:creator

• Kirkscey, Russell

Chair dc:contributor.committeechair

• Koerber, Amy

Committee members dc:contributor.committeemember

• Carter, Joyce L.
• Rickly, Rebecca

• Rhetorical analysis
• Patient decision aids
• Genetic testing
• Deliberation
• Epideixis
• Problematic integration
• Embodiment
• Scientific knowledge

Handle dc:identifier.uri

http://hdl.handle.net/2346/60615

OAI identifier oai:identifier

oai:ttu-ir.tdl.org:2346/60615