Author: Patricia Nneka Ogbuehi & Obiekea Ebele Stella
Date: 2026
This study examines how politeness strategies function in medical consultation discourse to co-construct patient autonomy and professional authority. While doctor–patient encounters inherently involve institutional hierarchy, the study demonstrates that authority and autonomy are not fixed roles but interactional achievements negotiated sequentially through language. Drawing on Brown and Levinson's (1987) Politeness Theory and relational-discursive perspectives, the study employs qualitative discourse analysis of a doctor–patient interaction to explore how authority and autonomy are negotiated sequentially through language. The findings reveal that consultations are organized turn by turn through the strategic use of positive politeness in the form of greetings, appreciation, empathy, negative politeness such as hedging, modalization, conditional phrasing, bald on-record clarity, and collaborative framing using inclusive pronouns such as “we”. The study shows that doctors maintained institutional authority through agenda-setting, diagnostic questioning, and recommendation framing, while mitigating directives to protect patients' face needs and encourage participation. Patients enacted autonomy through narrative elaboration, calibrated symptom descriptions, epistemic claims, and hedged commitments. The findings also reveal that directness in institutional contexts may function as cooperative efficiency rather than impoliteness. The study therefore concludes that authority and autonomy emerge not as oppositional constructs but as interactional achievements co-constructed through turn-by-turn negotiation shaped by institutional norms.
Keywords: Politeness Strategies, Autonomy, Professional Authority, Consultation Discourse, Doctor–patient Interaction, Brown And Levinson Theory.
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