genre as struggle : Toward a cognitive-pragmatic account of an emerging genre

This study investigates the cognitive-pragmatic motivations for the emergence of a genre of health communication called Patient Decision Aid (PDA). It elucidates genre as struggle, i.e. how the emerging genre exemplifies various struggles on three strata: the difficulties facing patients, doctors, and health providers at practice level; the changes anticipated to take place at discourse level; and the tensions in the pragmatics-cognition-society nexus. Particularly illustrated here are five struggles that characterize changes or breakthroughs that PDAs are anticipated to make. It suggests that the five struggles roughly correspond to five principles for genre theory proposed by Berkenkotter and Huckin (1993), with some modification of the latter. It also illustrates that genre intervenes in the complexity between social issues and social cognition and that PDAs as a new genre involve restructuring, reshaping and redesigning the key discourse facets (e.g. prior discourse, participants, language, medium, the world, and purpose). Based on examples of Chinese-language PDAs officially released in Taiwan and on information from health professionals, policy makers, and PDA developers, this study contributes empirical evidence toward a better understanding of an emerging genre.