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In:Dialogues of the Clinic: Encounters across medicine and beyond
Edited by Mariaelena Bartesaghi and Shelby Forbes
[Dialogue Studies 36] 2026
► pp. 118–149

Chapter 5
Intersubjectivity and dialogue in oncology visits

Resources for the opening up of dialogic moments between doctors and patients

 | Sapienza Università di Roma
 | Sapienza Università di Roma
 | Sapienza Università di Roma
 | University of California, Berkeley
This content is being prepared for publication; it may be subject to changes.
Abstract
This chapter examines the intersubjective foundations of dialogue in medical encounters. Rather than treating dialogue and intersubjectivity as synonymous, we argue that intersubjectivity constitutes the condition of possibility for dialogue by enabling participants to negotiate and sustain a shared understanding of the visit’s objectives as interaction unfolds. Drawing on Martin Buber’s philosophy of dialogue and Erving Goffman’s interactional sociology, we analyze how participants establish mutual recognition in turn-by-turn interaction. Our dataset consists of 60 video-recorded first-time oncology visits from two Italian hospitals. Across analyses conducted over the last seven years, we identify three practices central to negotiating intersubjectivity: (i) metapragmatic formulations, (ii) textual oralizing (reading/writing aloud), and (iii) the use of textual artifacts such as test results and prescriptions. These practices mediate transitions, repair misalignments, and create opportunities for recognizing participants’ perspectives. Dialogue thus emerges as a contingent and interactionally accomplished outcome.
Article outline
  • 1.Introduction
  • 2.Medical encounters and dialogue
  • 3.Dialogue and intersubjectivity
  • 4.The study: Data and method
  • 5.Managing time, roles, and interactional dynamics
    in medical encounters
  • 6.Tensions and negotiations in the pursuit of intersubjectivity
  • 7.Strategies towards sustaining intersubjectivity
    • 7.1Metapragmatic formulations
    • 7.2Textual oralizing
    • 7.3Using textual artifacts as scaffolds
  • 8.Discussion
  • 9.Conclusion
  • Notes
  • References
References (72)
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