Segal Judy Z
University of British Columbia, Canada.
Health (London). 2007 Apr;11(2):227-44. doi: 10.1177/1363459307074695.
The resources of rhetorical theory, the classical theory of persuasion, can be marshaled to help physicians evaluate patient complaints for which there is no corresponding objective evidence and which rely, therefore, on the persuasiveness of patients to be taken seriously (contestable complaints). An appropriate focus for the evaluation of such complaints is argumentation itself: what, in the absence of objective evidence of disease, counts as a good argument for a patient to be eligible for medical attention? How do patients convince physicians that they are ill and in need of care - and, conversely, how do physicians convince patients, when the need arises, that they are well and not good candidates for medical intervention? Two rhetorical concepts are especially productive for the analysis of argumentation. One is kairos, the Sophistic notion of contingency, and the other is pisteis, the Aristotelian catalogue of persuasive appeals. A focus on types of arguments directs attention away from types of patients (difficult, suspect, malingering and so on), and provides a more neutral means of judging claims to illness.
修辞理论资源，即经典说服理论，可被用来帮助医生评估那些没有相应客观证据、因此要依靠患者的说服力才能得到认真对待的患者诉求（有争议的诉求）。对此类诉求进行评估的一个恰当关注点是论证本身：在没有疾病客观证据的情况下，什么可算作患者有资格获得医疗关注的有力论据？患者如何说服医生他们生病了且需要治疗——相反，当有必要时，医生又如何说服患者他们很健康，不是医疗干预的合适对象？有两个修辞概念对论证分析特别有成效。一个是时机，即智者派的偶然性概念，另一个是可信度，即亚里士多德的说服诉求类别。关注论证类型能将注意力从患者类型（难缠的患者、可疑的患者、装病的患者等等）上转移开，并提供一种更中立的方式来判断疾病诉求。
