ISSA Proceedings 2010 – Shared Medical Decision-Making: Strategic Maneuvering By Doctors in The Presentation Of Their Treatment Preferences To Patients

• by: A. Francisca Snoeck Henkemans - University of Amsterdam

1. Shared decision making
Shared decision making is a treatment decision making model that has over the last ten years increased in popularity as an alternative to models in which either the physician decides what is best for the patient and encourages the patient to consent to this decision, or in which the patient takes a decision after having been given the needed medical information and thus gives “informed consent” (Charles, Gafni & Whelan 1997).
Charles et al. (1997) argue that in neither of these models one can speak of shared decision making. In the first model, the patient is left outside the decision making process, in the second, the role of the physician is limited to that of transferring information instead of a real participation in the discussion (p. 683). According to Charles et al. “unless both patient and physician share treatment preferences, a shared treatment decision-making process did not occur”. Légaré et al. (2008) provide the following definition of shared decision making:
a decision-making process jointly shared by patients and their health care provider […] It relies on the best evidence about risks and benefits associated with all available options (including doing nothing) and on the values and preferences of patients, without excluding those of health professionals (p. 1).

Frosch and Kaplan (1999) explain that shared decision making goes several steps further than informed consent:
Beyond presenting the patient with facts about a procedure, a shared decision making is a process by which doctor and patient consider available information about the medical problem in question, including treatment options and consequences, and then consider how these fit with the patient’s preferences for health states and outcomes. After considering the options, a treatment decision is made based on mutual agreement (p. 2). Read more

ISSA Proceedings 2010 – The Nature And Purpose Of Dialectic: Aristotle And Contemporary Argumentation Theory

• by: Marta Spranzi - University of Versailles St-Quentin-en-Yvelines CERSES – University of Paris Descartes

References to Aristotle’s notion of dialectic in contemporary argumentation theory, rhetoric of science and theory of controversies are conspicuous by there presence but also, sometimes, by their absence. Scholars working in argumentation theory often refer to Aristotle’s dialectic, and they do so in different ways; this is not surprising given the notoriously cryptic nature of Aristotle’s Topics, the work where Aristotle’s approach to dialectic is spelled out. Other scholars – most notably Nicholas Rescher and James Freeman – explore dialectical reasoning quite independently from any reference to Aristotle. In this paper, I would like to show that despite their emphasis on dialogue, contemporary argumentation theories – at least those explicitly referring to Aristotle – do not sufficiently distinguish the respective purposes of dialectic and rhetoric and fail to give an adequate epistemic account of dialectic. Quite surprisingly, as we shall see, the most Aristotelian approach to dialectic is James Freeman’s (2005), who does not explicitly refer to Aristotle.

Aristotelian dialectic has been alternatively described as a means of rational persuasion, as a tool for testing claims to knowledge or for raising doubts about uncertain statements, and finally as an instrument for attaining knowledge and even reaching the first principles of the sciences (Sim 1999). The relationship between dialectic and rhetoric is particularly controversial; the opening enigmatic sentence of Aristotle’s Rhetoric – “rhetoric is the counterpart (‘antistrophos’) of dialectic” – has been, and still is widely commented on. Its meaning is obviously open to a variety of interpretations, each of which sheds a different light on the similarities and differences between dialectic and rhetoric. This lack of consensus might appear as a setback if one intends to unearth the real meaning of Aristotle’s work; however, the wealth of insights provided by these different analyses can be viewed as an advantage, if one is interested in the potential for further developments. Read more

ISSA Proceedings 2010 – Conceptual Metaphors And Flexibility In Political Notions In Use In 19th Century Romanian Parliamentary Discourse

• by: Ariadna Ştefănescu - University of Bucharest

 1. Introduction
Each political event is inscribed in a natural chronology, but at the same time, through the way society experiences its appearance and existence, it constructs a mode of temporality of its own (Kosellek 2004, p. 95); the subjective temporal structures which render a political event and are partially responsible for the set of conceptual tropes by which it is indicated in the discourses of a particular historical age suggest the way in which that political event is conceptualized by society or by a more restricted group at a given moment. Also, the modelling of a political notion is done by the unitary association with a certain range of emotions, with a particular appraisal system, and a predominant type of engagement of the ‘voices’ that advocate it and are of the epoch tenors.
In this study, we shall dwell upon the agrarian reform effected in a particular 19th century period and we shall regard it as a historical event and as a concept; the agrarian reform was the stake of a large argumentative endeavour.

We have started from the pre-theoretical observation that, retrospectively in the second half of the 19th century, two major concepts, the agrarian reform and the Union of the Romanian Principalities, had a different emotional potential by comparison with our time and by comparison with the feudal and pre-modern period. We have also noticed that the discourse of that age was couched in sensualist terms and employed constructions such as the feeling of the law, the feeling with which something is uttered, the love for property, the wary feeling that enveloped this or that political decision, the metaphorical adjective on the wing used to express the concept of progress, all of which coinages were frequent and considered to be fashionable expressions. The frequent phrase have a keen sense for the law appears to us as symptomatic for the merger of emotions with concepts in Romanian parliamentary discourses in the 19th century, which occurred probably also under the influence of late Romanticism. Today this expression would not be used in political discourse at all, being felt as probably too „pathetic”. Read more

ISSA Proceedings 2010 – Adaptation To Adjudication Styles In Debates And Debate Education

• by: Masako Suzuki, Jiro Hasumi, YoshiroYano & Kazumi Sakai - Keio University, Keio University, Chuo University and Keio University

1. Introduction
Academic discussion over debate adjudication paradigms gained enthusiasm in 80s and early 90s. Main contributors were in the U.S. and the discussion was based on how collegiate debate tournaments were run and judged at NDT, CEDA and others sharing the same (or at least similar) format(s) with months of research and preparation for a topic and adjudicator pool (Prepared Debate Contests). Japanese debating community then was with similar debate formats and introduced the theories developed there. Now after almost two decades from then, the number and size of international tournaments have grown. Major international tournaments are with impromptu topics and had been with a separated adjudication pool till recent (Impromptu Debate Contests). Analysis on the adjudication paradigm of the later community is a necessary update not only for participating students who wish to learn debating in both paradigms but especially for researchers who hope to analyze how audience evaluate arguments. As Zarefsky wrote, if the starting point of analysis were the contest debate then the inquiry into paradigms would be trivialized (Zarefsky, 1982, p.141). Analysis on how the adjudication paradigm affects the decision by audience and its repercussion to the argumentation of speakers stays significant in shaping better rules for substantial debates happening everyday in the society.

This paper[i] first applies the theories and terms used in the discussion on debate paradigms in 1980s and 1990s to explain how adjudication is done at international tournaments nowadays. Then we elaborate the difference in adjudication between two distinctive debate communities. Lastly, we examine how students shift and adjust their speeches according to the new adjudication style to them and how the difference of adjudication style influences educational effect of debating programs. Read more

ISSA Proceedings 2010 – An Analysis Of TV Debate: Democratic Party Of Japan Leadership Between Hatoyama And Okada

• by: Takeshi Suzuki - Meiji University, Tokyo Takayuki Kato - Seiwa University, Chiba

On May 11, 2009, the party leader Ichiro Ozawa announced his decision to step down under a shadow of financial scandal which allegedly lowered the support rate for the Democratic Party of Japan (DPJ)[i]:
“I have decided to step down [from the post of DPJ president] to make our party unity stronger so as to secure victory in the upcoming House of Representatives election and to realize a regime change,” Ozawa said at the press conference. (Editorial; Public disapproval, 2009, p. 4)

With Ozawa’s resignation, the party executives set the leadership election for May 16. It was just five days from the announcement till the election so that they would avoid having a long interregnum. Indeed, they needed to prepare for the Lower House election scheduled in the upcoming summer. On May 12 to their supporters, and on 14 officially, with the damaged public confidence in the DPJ, the two candidates Yukio Hatoyama and Katsuya Okada ran for the party leadership election to win trust not only from its 221 lawmakers, or the voters of the party election, but also from the Japanese public, who would essentially be choosing a prime minister in the upcoming House of Representatives election. Read more

ISSA Proceedings 2010 – Argumentology About The Possibility Of Dialogue Between New Logic, Rhetoric, Dialectics

• by: Viktor Tchouechov - Academy of Public Administration, Minsk

1.What is Argumentology?
Firstly, the term “argumentology” was sporadically used in 80-ies by Dutch scholars E. Barth, E. Krabbe, and J.L. Martens as a synonymous of theory of argumentation (Barth & Martens 1981). But the term did not receive a strong support in theorists’ of argumentation circles. [i]

In 80-90-ies of XX century there were a lot of theories of argumentation, and formal dialectics (Barth & Krabbe 1982), the Amsterdam pragma-dialectic theory of argumentation, as well as the linguistic theory argumentation of J. Ascombre and O. Ducrot were the examples (Van Eemeren, Grootendorst & Kruiger 1987, Ascombre, Ducrot, 1983). Some of these theories had a proper philosophical component. A philosophical component of formal dialectics was connected with analytical philosophy, and pragma-dialectic theory of argumentation had orientation to K. Popper’s critical rationalism. However, even in 90-ies there were a lot of old and new theories of argumentation with unclear and unexpressed philosophical foundations. In that context a necessity in a relatively independent domain of philosophy of theory of argumentation research was emerged. For a philosophical domain of argumentation study I have proposed to use such term as “argumentology”. Read more