Communicative Rationality and Clinical Decision-Making: A Habermasian Perspective on the Doctor-Patient Relationship.

Clinical encounters are where biomedical knowledge, institutional norms, and patients' lived experiences meet. Yet, modern healthcare structures these encounters through documentation, performance measures, and digital tools. These systems prioritise efficiency and measurable outcomes, often creating barriers to authentic dialogue between clinicians and patients. This tension raises philosophical questions about what conditions are necessary for meaningful clinical interactions. This article analyses the doctor-patient relationship using Jürgen Habermas' theory of communicative action. It argues that the key dynamic in clinical consultation is the negotiation of validity claims: truth (biomedical facts), normative rightness (institutional obligations), and sincerity (subjective experience). On this basis, the article proposes a conceptual model that characterises consultation as the interaction among three domains - biomedical facts, institutional norms, and patients' lived experience - summarised as 'Facts, Norms, and Lives.' The analysis studies how modern healthcare pressures shift clinical communication from dialogue aimed at mutual understanding to interaction driven by instrumental goals. The article argues that communicative methods - such as narrative competence and collaborative decision-making - not only restore deliberative legitimacy in clinical encounters, but additionally reinforce the normative foundations of medical practice by conceptualising the consultation as a communicative structure.