Attending to child agency in paediatric palliative care consultations: Adults' use of tag questions directed to the child.

Children's agency in their own lives is increasingly recognised as important, including within paediatric health care. The issue of acknowledging child agency is complex in the context of paediatric palliative care, where children have serious and complex conditions that often impact their ability to verbally communicate with others. This study explores how clinicians and parents/guardians direct talk towards a child patient when they are present in a consultation. Conversation analysis methods were used to examine 74 video-recorded paediatric palliative care consultations. Detailed turn-by-turn examination of the recorded consultations identified the recurrent use of a practice described by linguists as a 'tag question', which follows some statement (e.g. 'he loves that, don't ya'). Both clinicians and parents/guardians often directed these tag questions towards the child patient. Analysis demonstrated how these tag questions: (1) validated the child's epistemic authority over what was being said and (2) made a child's response a possible, but not necessary, next action. The findings are discussed in relation to the sociology of child agency and how this agency is acknowledged and displayed within and through social interaction. This research provides direct evidence of children's competence as informants about their own symptoms.

Discussing death: Making end of life implicit or explicit in paediatric palliative care consultations.

OBJECTIVE: To consider whether and how family members and clinicians discuss end of life during paediatric palliative care consultations. METHODS: Nine naturally occurring paediatric palliative care consultations were video recorded and analysed using conversation analytic methods. ANALYSIS: Focusing on three consultations in which end of life was treated as a certain outcome, analysis explored ways in which end of life was made either implicit or explicit within these consultations. Our analysis suggests that end of life was made explicit when: 1) ancillary to the current focus of discussion, 2) in relation to someone else's child, or 3) specifically relevant to the local context of the discussion. More commonly, in all other instances in the data, end of life was made implicit during discussions relating to this matter. CONCLUSION: This preliminary research indicates that the local context of a conversation can influence how end of life is mentioned and discussed. PRACTICE IMPLICATIONS: Clinicians often are encouraged to promote honest and 'open' discussions about end of life. Our findings show that it is not necessary to explicitly mention end of life in order to discuss it.

Cues to deception in context: response latency/gaps in denials and blame shifting.

Over 40 years of work on lying in psychology and communication has investigated numerous 'cues to deception'- the subtle signals people show when they are lying. One of these cues to deception is 'response latency' or the gap that occurs between questions and the lying response. The current investigation uses the methodology of conversation analysis to re-consider the question of response latency in the context of lying. Drawing on data from two naturalistic sources, the television shows COPS and the Jeremy Kyle Show, this investigation analyses response latencies in order to show the regular organization of gaps between turns in both lies and non-lies. The current investigation demonstrates that in blame shifting turns which are lies, any gaps between turns result from a display of upcoming 'trouble', rather than being related to lying per se. The investigation highlights the need to analyse lies in the contexts in which they are told, taking prior and subsequent talk into account.