From diagnosis to doubt: epistemic authority, patient questions, and the pragmatics of medical explanation in Indonesia
DOI:
https://doi.org/10.67490/ijml.v1i3.1047Keywords:
Diagnostic communication, epistemic authority, medical explanation, patient questions, pragmaticsAbstract
Background: Diagnostic explanation in Indonesian healthcare discourse is shaped by asymmetrical expertise, patient uncertainty, institutional authority, and increasing reliance on public digital health information. Objective: This study examines how epistemic authority is constructed, questioned, and recalibrated through patient questions and medical explanations in Indonesian diagnostic discourse. Method: Using a qualitative corpus-assisted pragmatic design, this study analyzed 35 public Indonesian explanation sequences drawn from patient Q&A texts, verified health education materials, and contextual documents on patient rights, second opinion, medical records, and diagnostic accountability. Results: Diagnostic authority was most visibly organized through expert interpretation, procedural validation, institutional diagnostic pathways, test-mediated evidence, professional redirection, and rights-based accountability. Patient questions functioned not merely as requests for information but as pragmatic acts of clarification, confirmation, risk inquiry, procedural checking, second-opinion comparison, and reassurance seeking. Medical explanations managed uncertainty through terminological simplification, evidential grounding, referral, risk calibration, uncertainty acknowledgement, and legally or institutionally framed accountability. Implication: This study shows that diagnostic trust depends on whether clinical authority remains intelligible, answerable, and reviewable when patients voice doubt. Novelty: This study contributes a pragmatic model for analyzing diagnostic doubt as a structured form of epistemic participation rather than a failure of patient compliance.
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