Maynard, D. W. (2004). On predicating a diagnosis as an attribute of a person. Discourse Studies, 6(1),53-76.

Douglas Maynard’s “On Predicating a Diagnosis as an Attribute of a Person” explores, through conversational analysis, interactions between healthcare workers and patients at the time of diagnosis. Specifically, Maynard explores how practitioners employ two discursive moves, “citing the evidence” and “asserting the condition” to attribute a diagnosis. The article also seeks to shed light on the reception of the diagnosis by the patient.

Maynard interrogates the conversations of diagnosis in two primary settings: 1) a children’s disabilities diagnostic clinic, and 2) a free HIV testing clinic. His explorations of diagnosis are built on a corpus of diagnosis pronouncements from these two facilities. In each of the cases used in the corpus, the diagnosis was eventually confirmed.

Through his analysis, Maynard suggests that diagnostic pronouncements that consist only of “bald assertions” tend to be received as presumptive and confrontational, and result in more patient disputes. The corpus data suggest that diagnostic pronouncements that begin with evidence citation (from tests and inventories) contribute to the patient’s perception of medical authority. Maynard argues that the evidence-based diagnostic pronouncement, with its impact on perceived medical authority, predisposes the patient to be more receptive to the attribution of the medical condition.