Chapter 7 158 “Dancing is the world’s favorite metaphor.” – Kristy Nilsson It takes two to tango Dance is used as a metaphor all over the world. As Herbert H. Clark, a psycholinguist known for his theory of “common ground” (individuals engaged in conversation must share knowledge in order to be understood and have a meaningful conversation (30,31)) wrote: “It takes two people working together to play a duet, shake hands, play chess, waltz, teach, or make love.”(32). Our main question in this thesis was “how can care decision conversations be improved?”. We will use the metaphor of a ballroom dance to cover all necessities for care decision conversations. This provides targets for improving care decision conversations, which we will further elaborate on in the future perspectives section. A ballroom dance is danced with two partners together, just as you need (at least) two people for a conversation. Both with their own individual style and rhythm. Both partners need to be willing to dance (be aware of the relevance of care decision conversations) and know the dancing steps (knowledge on what the conversation comprehends, goal of the care decision conversation): they need common ground. Then, someone has to ask the other one to dance, either verbally or nonverbally (one needs to take the initiative for the care decision conversation, either explicitly or implicitly). Timing is important in this initiative, when your partner is just holding a full glass, it might be better to wait a few minutes until it is empty. In dance, one of the partners is the leader and the other one is the follower. Although these are different roles, both are equal. One cannot dance without the other, they need each other and both play their part in performing the dance. In a care decision conversation, the physician and patient have different roles as well, but on order to come to a meaningful conversation, they have to be equal and both contribute to the conversation. Whilst the physician contributes medical knowledge, the patients contributes goals and values, as these are in their epistemic domain. And also in a conversation it is useful if someone takes the lead and structures the conversation, a task that most logically lies with the physician.
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