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El consentimiento del paciente en el tratamiento de los datos de salud. Excepciones legales

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L IDIA B UISÁN I E SPELETA *

1. El consentimiento del paciente en el tratamiento de los datos de salud. Excepciones legales

The definite description the Side Show in 1), the factive verb realize in 2) and the change of state verb stop in 3) are the linguistic expressions that trigger the presuppositions, and for that reason they are called presupposition triggers.

Green (1989: 71-74) presents a taxonomy of the phenomena that have so far been labelled as presuppositions, and she finds there are three main kinds:

• Existence presuppositions: This is the most representative case.

It concerns the existence of definite descriptions. For example, the sentence I met Susan’s daughter at the market yesterday, presupposes that Susan has a daughter and that there is a market in the area I was at yesterday. Susan’s daughter and the market are the presupposition triggers.

• Factive presuppositions: There are several sorts of factive presuppositions. For example, the subject complements of mean, be obvious or prove, as well as the object complements of epistemic factives such as know or realize are considered to be presupposed true. So are the complements of emotive factive verbs such as be glad, amaze or be surprised. Thus, for instance, in the sentence: She knows that Peter is in town, the factive

8 See 3.2.

presupposition is that Peter is in town. Another example can be found in the counterfactive verb pretend, whose use presupposes that the complement is not true (e.g. Peter pretended that he was rich → Peter was not rich).

• Connotations: The restrictions of use of some lexical items have been claimed to be or reflect presuppositions about the situation in which they are used. A typical example of a connotation is found in the verb assassinate, which carries the implicit presupposition that the killing was intended -it would make no sense to say: *He accidentally assassinated his wife.

If we examine examples 1, 2 and 3 above, we shall see that they present, respectively, instances of an existence presupposition, a factive presupposition, and a connotation.

The phenomenon of presupposition is very complex indeed, and is still only partially understood. In this book, we are not going to analyze it in depth. Some authors (Stalnaker 1974, Karttunen & Peters, 1975, 1979, Horn 2004) put it on a par with the phenomenon of conventional implicature9 (Grice, 1975). For our purposes, suffice it to say that it constitutes an important ground for the study of some aspects of the interaction between semantics and pragmatics, and that the study of the use or presuppositions may be of great help when doing discourse analysis. Some more examples are considered in the following section.

3.6.1. Examples and analysis Examine some of the presuppositions in the following text:

Joanne, 47, had worked her way through college (1) as a bank teller, and by age 34 was a manager at the Bankers Trust Company in Manhattan (2). After her first (3) child was born, she continued (4) to commute three hours a day from her (5) Rahway, New Jersey, home. But when she was told (6) she had to travel repeatedly to Asia, she negotiated a severance package. […] Her career counselor (7) inspired Joanne to think about how her skills could translate outside the banking industry –and Joanne started (8) to imagine becoming an outplacement expert herself. When she was no longer (9) a client, the outplacement firm, Lee Hecht Harrison, hired her as a part-time consultant.

From: “Recipe for Resilience”, The Oprah Magazine, October 2002

9 See 3.2.

Perspectives on Discourse Analysis: Theory and Practice 69

The expressions in bold type are all presupposition triggers, and the triggered presuppositions are the following:

(1) Joanne once went to college (connotation).

(2) There exists a Bankers Trust Company in Manhattan (existence presupposition).

(3) Joanne has more than one child (connotation).

(4) Joanne had been commuting before (connotation).

(5) (It is a fact that) Joanne has a house in Rahway New Jersey, and that house exists, (mixture of factive and existence presupposition).

(6) Someone told Joanne she had to travel repeatedly to Asia (factive presupposition).

(7) (It is a fact that) Joanne had a career counsellor and this counsellor existed (mixture of factive and existence presupposition).

(8) Joanne hadn’t imagined becoming an outplacement expert before (connotation).

(9) Joanne was once a client of the outplacement firm (connotation).

1. Pragmatics is an indispensable source for discourse analysis. Many authors have defined pragmatics in different ways, but in most definitions it can be seen that elements such as context, meaning beyond literal meaning, speech acts, deixis, understatement, implicature, etc. are considered important components of this discipline.

2. Gricean Pragmatics is seen as one of the main contributions to the field of Pragmatics, for H. P. Grice’s (1975) ideas about speaker meaning and the cooperative principle have been and still are extremely influential. A central concept in Gricean Pragmatics is the notion of conversational implicature. Conversational implicatures are a kind of inference that can be derived from an utterance, and they are related to what Grice called the Cooperative Principle and its Maxims.

3. Speech acts, or illocutionary acts (i.e. the making of a statement, offer, promise, etc. in uttering a sentence, by virtue of the conventional force associated with it) are central to pragmatic theory and discourse analysis.

4. Searle (1969) systematized Austin’s work and developed a typology of speech acts. According to this author there are five basic kinds of speech acts: i) Representatives, ii) Directives, iii) Commissives, iv) Expressives and v) Declaratives. Searle (1975) also developed a theory of indirect speech acts.

5. Many terms or expressions used in discourse have a referring function.

Some types of reference depend on mutual knowledge; thus, the process by which referring expressions refer to an entity is not strictly semantic or truth-conditional; it is also pragmatic.

6. The relationship between language and context is clearly observed through the phenomenon of deixis. Linguistic items such as demonstratives, pronouns, tense, place and time adverbs such as now and here, some verbs like bring and take, as well as other grammatical features which are tied directly to the context of utterance, are prototypically deictic. Traditionally, deixis has been divided into three main categories: a) person, b) place and 3) time. But two more types are considered: Discourse and social deixis.

There are also three main kinds of deictic usage: gestural, symbolic and non-deictic.

7. Presuppositions are a kind of linguistic inference which is based more closely on the actual linguistic structure of sentences than on implicatures.

Presuppositions seem to be tied to particular words or aspects of surface structure in general, and these particular words or expressions constitute the presupposition triggers.

Perspectives on Discourse Analysis: Theory and Practice 71

Choose the answer that best suits the information given in Chapter 3.

1) Semantics and Pragmatics…

a) study the same phenomena.

b) are both concerned with meaning.

c) both focus on the users of a language.

2) Pragmatics deals with…

a) the truth-conditional meaning of utterances.

b) literal meaning.

c) all kinds of meaning different from the truth-conditional meaning.

3) One of the central concepts in Gricean Pragmatics is…

a) word meaning.

b) politeness.

c) speaker meaning.

4) Non-natural meaning (meaning –nn) has to do with…

a) the speaker’s communicative intention and the hearer’s interpretation of it.

b) literal meaning.

c) synonyms.

5) Implicatures are a kind of…

a) metaphor.

b) inference.

c) predicate.

6) Implicatures…

a) are triggered when a speaker flouts one or more of the maxims of the Cooperative Principle.

b) cannot be conventionalized.

c) are always conversational.

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