Mediated transparency: truth, truthfulness, and rightness in digital healthcare discourse

摘要

This thesis addresses the challenges of producing digitally mediated healthcare information, a high-stakes arena which is conceptualised as a complex discourse and its diverse producers as interlocutors within this discourse. The study is located theoretically in the tradition of universal or formal pragmatics, the foundation of Habermas’s theory of communicative action. Building on this theoretical core a conceptual framework is developed that integrates insight from several other traditions, including communication studies. The notion of communicative transparency is aligned with the idealised goal of a rich informational context supporting a range of perspectives in movement towards a balanced and consensual understanding by lay and expert actors of healthcare in our world. The central research question is: Can digital mediation increase the transparency of healthcare communication?udThe empirical focus rests on two organisations involved in the creation of digital information products. Key mediators of meaning in digital healthcare information are identified as the diverse types of expertise of its producers, the materiality of digital artefacts, and the communicative mechanisms, processes and practices that often lead to departures from the normative idealised standard of transparency. The methodology is a comparative case analysis based on field research employing principally interviews to build a rich corpus, analysed using a recursive in-depth thematic coding procedure to reveal the ways in which digitally mediated healthcare meanings are shaped and shared.udThe study demonstrates how communicative transparency emerges from shared frames of reference and common models of communication. It is concluded that digital mediation can indeed increase the transparency of healthcare information by supporting the deepening of Habermasian rational discourse, providing that validity claims to truth, truthfulness, and rightness can be raised and resolved at all stages in the discourse among all interlocutors, whatever their role and status.