Generating the perception of choice: The remarkable malleability of option-listing

Merran Gurney Toerien, Markus Reuber, Rebecca Shaw, Roderick Duncan

Research output: Contribution to journalArticlepeer-review


The normative view that patients should be offered more choice both within and beyond the UK's National Health Service (NHS) has been increasingly endorsed. However, there is very little research on whether – and how – this is enacted in practice. Based on 223 recordings of neurology outpatient consultations and participants’ subsequent self-reports, this article shows that ‘option-listing’ is a key practice for generating the perception of choice. The evidence is two-fold: first, we show that neurologists and patients overwhelmingly reported that choice was offered in those consultations where option-listing was used; second, we demonstrate how option-listing can be seen, in the interaction itself, to create a moment of choice for the patient. Surprisingly, however, we found that even when the patient resisted making the choice or the neurologist adapted the practice of option-listing in ways that sought acceptance of the neurologist's own recommendation, participants still agreed that a choice had been offered. There was only one exception: despite the use of option-listing, the patient reported having no choice, whereas the neurologist reported having offered a choice. We explore this deviant case in order to shed light on the limits of option-listing as a mechanism for generating the perception of choice.

Original languageEnglish
Pages (from-to)1250-1267
Number of pages18
JournalSociology of Health and Illness
Issue number7
Early online date3 Aug 2018
Publication statusPublished - 9 Sep 2018

Bibliographical note

© 2018 Crown copyright. Sociology of Health & Illness © 2018 Foundation for the Sociology of Health & Illness.This article is published with the permission of the Controller of HMSO and the Queen’s Printer for Scotland. This is an author-produced version of the published paper. Uploaded in accordance with the publisher’s self-archiving policy. Further copying may not be permitted; contact the publisher for details


  • Conversation analysis
  • doctor-patient interaction
  • neurology
  • option-listing
  • patient choice

Cite this