title: Linguistic analysis of face-to-face interviews with patients with an explicit request for euthanasia, their closest relatives, and their attending physicians: the use of modal verbs in Dutch.
abstract: BACKGROUND
  The literature, field research, and daily practice stress the need for adequate communication in palliative care. Although language is of the utmost importance in communication, linguistic analysis of end-of-life discussions is scarce.
  
  
  OBJECTIVE
  Our aim is 2-fold: We want to determine what the use of 4 significant Dutch modal verbs expressing volition, obligation, possibility, and permission reveals about the concept of unbearable suffering and about physicians' communicative style.
  
  
  METHODS
  We quantitatively (TextStat) and qualitatively (bottom-up approach) analyzed the use of the modal verbs in 15 interviews, with patients requesting euthanasia or physician-assisted suicide, their physicians, and their closest relatives.
  
  
  RESULTS
  An essential element of unbearable suffering is the patient's incapacity to perform certain tasks. Further, the physician's preference for particular modal verbs reveals whether his attitude toward patients is more or less patronizing and more or less appreciative.
  
  
  CONCLUSIONS
  Linguistic analysis can help medical professionals to better understand their communicative skills, styles, and approach to patients in end-of-life situations. We have shown how linguistic analysis can contribute to a better understanding of physician-patient interaction. Moreover, we have illustrated the usefulness of interdisciplinary research in the medical domain.
authors.affiliation: Subfaculty of Language and Communication, KU Leuven, Antwerp, Belgium.
authors.forename: Sylvain M
authors.initials: SM
authors.lastname: Dieltjens
authors.forename: Priscilla C
authors.initials: PC
authors.lastname: Heynderickx
authors.forename: Marianne K
authors.initials: MK
authors.lastname: Dees
authors.forename: Kris C
authors.initials: KC
authors.lastname: Vissers
mesh_terms: D001291:Attitude of Health Personnel; D016208:Databases, Factual / Q000706:statistics & numerical data; D005065:Euthanasia / Q000523:psychology*; D005190:Family / Q000523:psychology*; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008037:Linguistics; D008297:Male; D008960:Models, Psychological; D009426:Netherlands; D010817:Physician-Patient Relations; D011795:Surveys and Questionnaires; D014705:Verbal Behavior
keywords: applied linguistics; discourse analysis; end-of-life; euthanasia; modal verbs; palliative care; physician-patient relationship; unbearable suffering