756031261 03 01 01 JB John Benjamins Publishing Company 01 JB code DS 36 Eb 15 9789027243294 06 10.1075/ds.36 DG 002 02 01 DS 02 1875-1792 Dialogue Studies 36 01 ds.36 01 https://benjamins.com 02 https://benjamins.com/catalog/ds.36 1 B01 Mariaelena Bartesaghi Bartesaghi, Mariaelena Mariaelena Bartesaghi University of South Florida 2 B01 Shelby Forbes Forbes, Shelby Shelby Forbes University of North Carolina, Chapel Hill 01 eng 275 ix 260 + index LAN009030 v.2006 CFG 2 24 JB Subject Scheme COMM.GEN Communication Studies 24 JB Subject Scheme LIN.DIAL Dialogue studies 24 JB Subject Scheme LIN.DISC Discourse studies 24 JB Subject Scheme LIN.PRAG Pragmatics 06 01 <i>Dialogues of the Clinic: Encounters across medicine and beyond </i>is a unique anthology that centers dialogue as practice and challenge of medical encounters, taking up Mishler's famous provocation of a dichotomy between the voice of the lifeworld and the voice of medicine, or an awareness of the asymmetries of knowledge and authority in clinical encounters. <br />First, the authors in this book aim to define dialogue beyond interaction and to conduct a close analysis of empirical data from clinical consultations as diverse as visits in oncology, pediatrics, psychotherapy, medical student training, and speech language therapy. In doing so, they argue for the many possibilities and missed opportunities for clinicians in diverse cultural settings to engage dialogically, while constantly managing the multiple contingencies of personal, organizational, and institutional voices, texts, and artifacts. Dialogue and discourse scholars, clinical practitioners, and academics from the humanities and social sciences will appreciate this collection on how to approach dialogue conceptually and empirically, in clinical practice. 04 09 01 https://benjamins.com/covers/475/ds.36.png 04 03 01 https://benjamins.com/covers/475_jpg/9789027237743.jpg 04 03 01 https://benjamins.com/covers/475_tif/9789027237743.tif 06 09 01 https://benjamins.com/covers/1200_front/ds.36.hb.png 07 09 01 https://benjamins.com/covers/125/ds.36.png 25 09 01 https://benjamins.com/covers/1200_back/ds.36.hb.png 27 09 01 https://benjamins.com/covers/3d_web/ds.36.hb.png 10 01 JB code ds.36.prelim i iv 4 Prelim pages -1 10 01 JB code ds.36.toc vii 1 Table of contents 0 10 01 JB code ds.36.dedication v vi 2 Dedication 1 10 01 JB code ds.36.ack ix 1 Acknowledgments 2 10 01 JB code ds.36.intro 1 17 17 Chapter 3 1 A01 Shelby Forbes Forbes, Shelby Shelby Forbes University of North Carolina — Chapel Hill 2 A01 Mariaelena Bartesaghi Bartesaghi, Mariaelena Mariaelena Bartesaghi University of South Florida 20 agency 20 clinical interaction 20 dialogue 20 epistemics 20 morality 01 This introduction to our anthology finds us dazzled and unsteady inside a labyrinth of flowers, searching for dialogue as something other than mere communication or interaction. We examine how dialogue has come to function as a moral and epistemic ideal in medicine — one that promises understanding, care, and participation, even as it risks becoming prescriptive and rendered routine. As discourse and dialogue scholars who study clinical exchanges, we find, together with the authors in these pages, that approaching dialogue means engaging in empirical analysis as much as reflection about our pedagogical practice and lived experience. The voices and dialogues of the clinic are opportunities that emerge in spite of, and maybe because of, constraint — a dance between action and reaction in which meaning, ethics, and understanding are choreographed in the context of embodied vulnerability. 10 01 JB code ds.36.p01 Section header 4 10 01 JB code ds.36.01alb 20 45 26 Chapter 5 1 A01 Federico Maria Albertini Albertini, Federico Maria Federico Maria Albertini Tavistock and Portman NHS Foundation Trust, Systemic Psychotherapy Department | University of Bergamo, Human and Social Sciences Department 2 A01 Miriana Amoroso Amoroso, Miriana Miriana Amoroso Milan Center for Family Therapy 3 A01 Pietro Barbetta Barbetta, Pietro Pietro Barbetta University of Bergamo, Human and Social Sciences Department | International School of Systemic Therapy (ISST) 20 correspondence 20 disposition 20 embodied action 20 multimodal conversation analysis 01 As clinical psychologists familiar with the philosophical provocations of new materialism(s), we take dialogue as a multimodal process in which clinicians participate with their whole bodies and as an occurrence that includes both human and non-human actors. Using Multimodal Conversation Analysis (MCA), we examine five extracts from a first clinical session with Giovanna (GA), a young adolescent diagnosed with severe anorexia nervosa. We adopt Ingold’s (2020) concept of correspondence, which describes a knowledge-making process that emerges through direct engagement with both material and non-material entities. Unlike the notion of betweenness, where separated entities are joined, in-betweenness suggests that these entities are produced through their linking with one another. We expand the concept of dialogue (as correspondence) through three key perspectives: (1) dialogue as extending beyond verbal/oral communication, (2) materiality as an integral component of the dialogical process, and (3) dialogue as going beyond the boundaries of the “actual conversing couple.” 10 01 JB code ds.36.02dor 46 66 21 Chapter 6 1 A01 Gonen Dori-Hacohen Dori-Hacohen, Gonen Gonen Dori-Hacohen Tavistock and Portman NHS Foundation Trust, Systemic Psychotherapy Department 2 A01 Bracha Nir Nir, Bracha Bracha Nir University of Haifa 20 agency 20 communication disorders 20 dialogue 20 discourse analysis 20 phenomenology 20 power and asymmetry 20 speech-language therapy 01 This chapter explores the potential for dialogue within the context of speech-language therapy (SLT), a specialized field focusing on communicative impairments. Drawing on phenomenological theories of dialogue, the analysis examines interactions between a Hebrew- speaking SLT clinician and her child-client. Using discourse analysis, the study highlights the tension between the mechanical aspects of speech correction and the holistic, creative nature of dialogue. It argues that the clinician’s emphasis on correct pronunciation undermines opportunities for genuine dialogic engagement. Instead of fostering open, autonomous, and reciprocal communication, the sessions often prioritize adherence to linguistic norms, which may silence the child’s creative input and reduce their agency. This chapter invites us to rethink the nature of dialogue within the speech-language therapeutic setting, where the act of communication is both the medium and the goal of the encounter. 10 01 JB code ds.36.03bar 67 93 27 Chapter 7 1 A01 Claudio Baraldi Baraldi, Claudio Claudio Baraldi University of Modena and Reggio Emilia 20 agency 20 children 20 coordination 20 dialogue 20 interpreters 20 pediatric services 01 The aim of this chapter is to analyze the conditions and obstacles of dialogic communication in pediatric services involving migrant children, with and without interpreting services. Dialogic communication is conceptualized as based on participants’ equal opportunities to exercise agency. First, the chapter focuses on the general meaning of dialogue and the application and limits of dialogic communication to monolingual interaction between children, parents and pediatricians, and interpreter-mediated interaction. Second, the chapter presents field research on pediatric consultations without and with interpreting services, analyzing several excerpts from these consultations to show if and how dialogic communication is coordinated by clinicians alone and by interpreters working with clinicians, and with which effects for children’s agency. The excerpts show effective dialogue with children and, in a few cases, what I consider to be its failure. Finally, I compare the two research settings in terms of dialogue and support of children’s agency. 10 01 JB code ds.36.p02 95 1 Section header 8 10 01 JB code ds.36.04def 96 117 22 Chapter 9 1 A01 Staci Defibaugh Defibaugh, Staci Staci Defibaugh Old Dominion University 20 asymmetry 20 dialogue 20 discourse analysis 20 epilepsy 01 In this chapter, I analyze a medical visit between a physician assistant in neurology and a patient with uncontrolled seizures. Focusing on a series of exchanges throughout the visit, I note how the patient shares her concerns and fears about her seizures as well as how the physician assistant responds to these concerns and returns to them, sometimes even reformulating them as her own desires, as they work toward a solution. Through these interactional moments, I argue that engagement in dialogue cannot be fully understood or accomplished in individual sequences of talk; instead, it is the circulation and recurrence of particular topics, themes, and the shared concern and goal orientation that ultimately facilitate a productive medical encounter. 10 01 JB code ds.36.05fat 118 149 32 Chapter 10 1 A01 Marilena Fatigante Fatigante, Marilena Marilena Fatigante Sapienza Università di Roma 2 A01 Cristina Zucchermaglio Zucchermaglio, Cristina Cristina Zucchermaglio Sapienza Università di Roma 3 A01 Francesca Alby Alby, Francesca Francesca Alby Sapienza Università di Roma 4 A01 Laura Sterponi Sterponi, Laura Laura Sterponi University of California, Berkeley 20 conversation analysis 20 doctor-patient interaction 20 intersubjectivity 20 metapragmatic formulation 20 oncological setting 20 oralizing 20 texts 01 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. 10 01 JB code ds.36.06wes 150 174 25 Chapter 11 1 A01 Temple West West, Temple Temple West Eastern Virginia Medical School, Norfolk 20 communication skills 20 dialogue 20 empathy 20 medical education 20 patient’s’ narratives 01 Patients seek opportunities to share their stories with physicians as part of a meaningful clinical relationship. Although communication skills such as expressing empathy and eliciting patient narratives are central to medical education, the dialogic potential of clinical encounters often remains unrealized. Drawing on Raimo Puustinen’s claim that dialogue is fundamental to medical examination and treatment, this chapter argues that amplifying dialogue in medical education can strengthen both clinical information gathering and patient rapport. After briefly tracing historical models of the patient-provider relationship, the chapter examines the concepts of empathy and narrative and their relationship to dialogue. It then considers how communication skills are currently taught in medical training. Using transcribed encounters between medical students and standardized patients in clinical exam settings, the chapter demonstrates how open-ended questions at the beginning of interviews can transform routine exchanges into dialogic encounters that foster genuine empathy while also facilitating more effective and efficient clinical communication. 10 01 JB code ds.36.07eli 175 203 29 Chapter 12 1 A01 Elisa Rossi Rossi, Elisa Elisa Rossi University of Modena and Reggio Emilia 20 agency 20 dialogic facilitation 20 doctor-patient interaction 20 medical dialogue 20 narratives 20 patient-centered approach 01 Enhanced by “medical dialogue” and increasingly promoted within healthcare systems, patient-centred approaches consider patients as individuals with personal needs, fears, stories, questions, and suggestions for their care. In this chapter, I define dialogue as a particular form of communication usually enhanced by specific actions and expectations, which can facilitate patients’ active participation and agency in interactions with practitioners. Presenting data from 106 consultations video-recorded in five oncological units in hospitals in Northern Italy, this chapter focuses on doctors’ dialogic facilitation of patients’ initiatives, presented in narrative format, within first-time visits. In my analysis of transcribed excerpts of the consultation, I show the communicative actions by which physicians dialogically facilitate and co-construct patient narratives, and detail the effects this has on interaction, particularly in relation to the discovery of the symptoms, the impact the illness has on the patient’s identity and emotional well-being and the potential implications for their care. 10 01 JB code ds.36.08wic 204 230 27 Chapter 13 1 A01 Chad Wickman Wickman, Chad Chad Wickman Auburn University 20 clinical reporting 20 dialogism 20 medical case report 20 narrative medicine 20 patient voice 01 This chapter explores patient voice as a rhetorical and epistemological feature of clinical reporting. Drawing on published case reports that include a “patient’s perspective,” the author specifically examines how practitioners and patients use language to define their individual subjectivity, position themselves in relation to other voices in the text, and characterize each other relative to shared interactions and decision-making processes. I suggest that the medical case report provides unique insight into dialogic aspects of clinical documentation, and as a site of inquiry, shows how patient voice encounters and interacts with the discourse of biomedicine. The chapter concludes by discussing implications for research, practice, and work that seeks to amplify patient voice in healthcare settings. 10 01 JB code ds.36.p03 231 1 Section header 14 10 01 JB code ds.36.09car 232 258 27 Chapter 15 1 A01 Letizia Caronia Caronia, Letizia Letizia Caronia University of Bologna 20 agency 20 authority 20 dialogue 20 patient-centeredness 01 In the second half of the twentieth century, patient-centered care (PCC) gained ground as a dialogic practice within a new architecture of care and became the gold standard of healthcare worldwide. Adopting the analytical lenses of epistemic (in)justice and intersubjectivity, I reconstruct the history of this concept and argue that PCC and its corollaries (e.g., “patient empowerment and agency,” “shared decision making,” and “clinical empathy”) constitute a morally loaded doctrine whose raison d’être is ethical rather than clinical. Building on recent studies, I also illuminate the overlooked risks of uncritically adopting PCC: neglecting the non-agentic dimensions of “being a patient,” disregarding the dependence of effective caregiving on the caregiver’s epistemic and deontic authority, reinforcing abandonment through the rhetoric of empowerment, dismantling asymmetry-based models of care in favor of egalitarian consumer-provider relations, and tacitly aligning PCC with contemporary neoliberalism. 10 01 JB code ds.36.app1 259 260 2 Appendix 16 02 JBENJAMINS John Benjamins Publishing Company 01 John Benjamins Publishing Company Amsterdam/Philadelphia NL 02 December 2026 20261215 2026 John Benjamins B.V. 02 WORLD 13 15 9789027237743 01 JB 3 John Benjamins e-Platform 03 jbe-platform.com 09 WORLD 10 20261215 01 00 140.00 EUR R 01 00 118.00 GBP Z 01 gen 00 182.00 USD S 9031260 03 01 01 JB John Benjamins Publishing Company 01 JB code DS 36 Hb 15 9789027237743 BB 01 DS 02 1875-1792 Dialogue Studies 36 01 ds.36 01 https://benjamins.com 02 https://benjamins.com/catalog/ds.36 1 B01 Mariaelena Bartesaghi Bartesaghi, Mariaelena Mariaelena Bartesaghi University of South Florida 2 B01 Shelby Forbes Forbes, Shelby Shelby Forbes University of North Carolina, Chapel Hill 01 eng 275 ix 260 + index LAN009030 v.2006 CFG 2 24 JB Subject Scheme COMM.GEN Communication Studies 24 JB Subject Scheme LIN.DIAL Dialogue studies 24 JB Subject Scheme LIN.DISC Discourse studies 24 JB Subject Scheme LIN.PRAG Pragmatics 06 01 <i>Dialogues of the Clinic: Encounters across medicine and beyond </i>is a unique anthology that centers dialogue as practice and challenge of medical encounters, taking up Mishler's famous provocation of a dichotomy between the voice of the lifeworld and the voice of medicine, or an awareness of the asymmetries of knowledge and authority in clinical encounters. <br />First, the authors in this book aim to define dialogue beyond interaction and to conduct a close analysis of empirical data from clinical consultations as diverse as visits in oncology, pediatrics, psychotherapy, medical student training, and speech language therapy. In doing so, they argue for the many possibilities and missed opportunities for clinicians in diverse cultural settings to engage dialogically, while constantly managing the multiple contingencies of personal, organizational, and institutional voices, texts, and artifacts. Dialogue and discourse scholars, clinical practitioners, and academics from the humanities and social sciences will appreciate this collection on how to approach dialogue conceptually and empirically, in clinical practice. 04 09 01 https://benjamins.com/covers/475/ds.36.png 04 03 01 https://benjamins.com/covers/475_jpg/9789027237743.jpg 04 03 01 https://benjamins.com/covers/475_tif/9789027237743.tif 06 09 01 https://benjamins.com/covers/1200_front/ds.36.hb.png 07 09 01 https://benjamins.com/covers/125/ds.36.png 25 09 01 https://benjamins.com/covers/1200_back/ds.36.hb.png 27 09 01 https://benjamins.com/covers/3d_web/ds.36.hb.png 10 01 JB code ds.36.prelim i iv 4 Prelim pages -1 10 01 JB code ds.36.toc vii 1 Table of contents 0 10 01 JB code ds.36.dedication v vi 2 Dedication 1 10 01 JB code ds.36.ack ix 1 Acknowledgments 2 10 01 JB code ds.36.intro 1 17 17 Chapter 3 1 A01 Shelby Forbes Forbes, Shelby Shelby Forbes University of North Carolina — Chapel Hill 2 A01 Mariaelena Bartesaghi Bartesaghi, Mariaelena Mariaelena Bartesaghi University of South Florida 20 agency 20 clinical interaction 20 dialogue 20 epistemics 20 morality 01 This introduction to our anthology finds us dazzled and unsteady inside a labyrinth of flowers, searching for dialogue as something other than mere communication or interaction. We examine how dialogue has come to function as a moral and epistemic ideal in medicine — one that promises understanding, care, and participation, even as it risks becoming prescriptive and rendered routine. As discourse and dialogue scholars who study clinical exchanges, we find, together with the authors in these pages, that approaching dialogue means engaging in empirical analysis as much as reflection about our pedagogical practice and lived experience. The voices and dialogues of the clinic are opportunities that emerge in spite of, and maybe because of, constraint — a dance between action and reaction in which meaning, ethics, and understanding are choreographed in the context of embodied vulnerability. 10 01 JB code ds.36.p01 Section header 4 10 01 JB code ds.36.01alb 20 45 26 Chapter 5 1 A01 Federico Maria Albertini Albertini, Federico Maria Federico Maria Albertini Tavistock and Portman NHS Foundation Trust, Systemic Psychotherapy Department | University of Bergamo, Human and Social Sciences Department 2 A01 Miriana Amoroso Amoroso, Miriana Miriana Amoroso Milan Center for Family Therapy 3 A01 Pietro Barbetta Barbetta, Pietro Pietro Barbetta University of Bergamo, Human and Social Sciences Department | International School of Systemic Therapy (ISST) 20 correspondence 20 disposition 20 embodied action 20 multimodal conversation analysis 01 As clinical psychologists familiar with the philosophical provocations of new materialism(s), we take dialogue as a multimodal process in which clinicians participate with their whole bodies and as an occurrence that includes both human and non-human actors. Using Multimodal Conversation Analysis (MCA), we examine five extracts from a first clinical session with Giovanna (GA), a young adolescent diagnosed with severe anorexia nervosa. We adopt Ingold’s (2020) concept of correspondence, which describes a knowledge-making process that emerges through direct engagement with both material and non-material entities. Unlike the notion of betweenness, where separated entities are joined, in-betweenness suggests that these entities are produced through their linking with one another. We expand the concept of dialogue (as correspondence) through three key perspectives: (1) dialogue as extending beyond verbal/oral communication, (2) materiality as an integral component of the dialogical process, and (3) dialogue as going beyond the boundaries of the “actual conversing couple.” 10 01 JB code ds.36.02dor 46 66 21 Chapter 6 1 A01 Gonen Dori-Hacohen Dori-Hacohen, Gonen Gonen Dori-Hacohen Tavistock and Portman NHS Foundation Trust, Systemic Psychotherapy Department 2 A01 Bracha Nir Nir, Bracha Bracha Nir University of Haifa 20 agency 20 communication disorders 20 dialogue 20 discourse analysis 20 phenomenology 20 power and asymmetry 20 speech-language therapy 01 This chapter explores the potential for dialogue within the context of speech-language therapy (SLT), a specialized field focusing on communicative impairments. Drawing on phenomenological theories of dialogue, the analysis examines interactions between a Hebrew- speaking SLT clinician and her child-client. Using discourse analysis, the study highlights the tension between the mechanical aspects of speech correction and the holistic, creative nature of dialogue. It argues that the clinician’s emphasis on correct pronunciation undermines opportunities for genuine dialogic engagement. Instead of fostering open, autonomous, and reciprocal communication, the sessions often prioritize adherence to linguistic norms, which may silence the child’s creative input and reduce their agency. This chapter invites us to rethink the nature of dialogue within the speech-language therapeutic setting, where the act of communication is both the medium and the goal of the encounter. 10 01 JB code ds.36.03bar 67 93 27 Chapter 7 1 A01 Claudio Baraldi Baraldi, Claudio Claudio Baraldi University of Modena and Reggio Emilia 20 agency 20 children 20 coordination 20 dialogue 20 interpreters 20 pediatric services 01 The aim of this chapter is to analyze the conditions and obstacles of dialogic communication in pediatric services involving migrant children, with and without interpreting services. Dialogic communication is conceptualized as based on participants’ equal opportunities to exercise agency. First, the chapter focuses on the general meaning of dialogue and the application and limits of dialogic communication to monolingual interaction between children, parents and pediatricians, and interpreter-mediated interaction. Second, the chapter presents field research on pediatric consultations without and with interpreting services, analyzing several excerpts from these consultations to show if and how dialogic communication is coordinated by clinicians alone and by interpreters working with clinicians, and with which effects for children’s agency. The excerpts show effective dialogue with children and, in a few cases, what I consider to be its failure. Finally, I compare the two research settings in terms of dialogue and support of children’s agency. 10 01 JB code ds.36.p02 95 1 Section header 8 10 01 JB code ds.36.04def 96 117 22 Chapter 9 1 A01 Staci Defibaugh Defibaugh, Staci Staci Defibaugh Old Dominion University 20 asymmetry 20 dialogue 20 discourse analysis 20 epilepsy 01 In this chapter, I analyze a medical visit between a physician assistant in neurology and a patient with uncontrolled seizures. Focusing on a series of exchanges throughout the visit, I note how the patient shares her concerns and fears about her seizures as well as how the physician assistant responds to these concerns and returns to them, sometimes even reformulating them as her own desires, as they work toward a solution. Through these interactional moments, I argue that engagement in dialogue cannot be fully understood or accomplished in individual sequences of talk; instead, it is the circulation and recurrence of particular topics, themes, and the shared concern and goal orientation that ultimately facilitate a productive medical encounter. 10 01 JB code ds.36.05fat 118 149 32 Chapter 10 1 A01 Marilena Fatigante Fatigante, Marilena Marilena Fatigante Sapienza Università di Roma 2 A01 Cristina Zucchermaglio Zucchermaglio, Cristina Cristina Zucchermaglio Sapienza Università di Roma 3 A01 Francesca Alby Alby, Francesca Francesca Alby Sapienza Università di Roma 4 A01 Laura Sterponi Sterponi, Laura Laura Sterponi University of California, Berkeley 20 conversation analysis 20 doctor-patient interaction 20 intersubjectivity 20 metapragmatic formulation 20 oncological setting 20 oralizing 20 texts 01 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. 10 01 JB code ds.36.06wes 150 174 25 Chapter 11 1 A01 Temple West West, Temple Temple West Eastern Virginia Medical School, Norfolk 20 communication skills 20 dialogue 20 empathy 20 medical education 20 patient’s’ narratives 01 Patients seek opportunities to share their stories with physicians as part of a meaningful clinical relationship. Although communication skills such as expressing empathy and eliciting patient narratives are central to medical education, the dialogic potential of clinical encounters often remains unrealized. Drawing on Raimo Puustinen’s claim that dialogue is fundamental to medical examination and treatment, this chapter argues that amplifying dialogue in medical education can strengthen both clinical information gathering and patient rapport. After briefly tracing historical models of the patient-provider relationship, the chapter examines the concepts of empathy and narrative and their relationship to dialogue. It then considers how communication skills are currently taught in medical training. Using transcribed encounters between medical students and standardized patients in clinical exam settings, the chapter demonstrates how open-ended questions at the beginning of interviews can transform routine exchanges into dialogic encounters that foster genuine empathy while also facilitating more effective and efficient clinical communication. 10 01 JB code ds.36.07eli 175 203 29 Chapter 12 1 A01 Elisa Rossi Rossi, Elisa Elisa Rossi University of Modena and Reggio Emilia 20 agency 20 dialogic facilitation 20 doctor-patient interaction 20 medical dialogue 20 narratives 20 patient-centered approach 01 Enhanced by “medical dialogue” and increasingly promoted within healthcare systems, patient-centred approaches consider patients as individuals with personal needs, fears, stories, questions, and suggestions for their care. In this chapter, I define dialogue as a particular form of communication usually enhanced by specific actions and expectations, which can facilitate patients’ active participation and agency in interactions with practitioners. Presenting data from 106 consultations video-recorded in five oncological units in hospitals in Northern Italy, this chapter focuses on doctors’ dialogic facilitation of patients’ initiatives, presented in narrative format, within first-time visits. In my analysis of transcribed excerpts of the consultation, I show the communicative actions by which physicians dialogically facilitate and co-construct patient narratives, and detail the effects this has on interaction, particularly in relation to the discovery of the symptoms, the impact the illness has on the patient’s identity and emotional well-being and the potential implications for their care. 10 01 JB code ds.36.08wic 204 230 27 Chapter 13 1 A01 Chad Wickman Wickman, Chad Chad Wickman Auburn University 20 clinical reporting 20 dialogism 20 medical case report 20 narrative medicine 20 patient voice 01 This chapter explores patient voice as a rhetorical and epistemological feature of clinical reporting. Drawing on published case reports that include a “patient’s perspective,” the author specifically examines how practitioners and patients use language to define their individual subjectivity, position themselves in relation to other voices in the text, and characterize each other relative to shared interactions and decision-making processes. I suggest that the medical case report provides unique insight into dialogic aspects of clinical documentation, and as a site of inquiry, shows how patient voice encounters and interacts with the discourse of biomedicine. The chapter concludes by discussing implications for research, practice, and work that seeks to amplify patient voice in healthcare settings. 10 01 JB code ds.36.p03 231 1 Section header 14 10 01 JB code ds.36.09car 232 258 27 Chapter 15 1 A01 Letizia Caronia Caronia, Letizia Letizia Caronia University of Bologna 20 agency 20 authority 20 dialogue 20 patient-centeredness 01 In the second half of the twentieth century, patient-centered care (PCC) gained ground as a dialogic practice within a new architecture of care and became the gold standard of healthcare worldwide. Adopting the analytical lenses of epistemic (in)justice and intersubjectivity, I reconstruct the history of this concept and argue that PCC and its corollaries (e.g., “patient empowerment and agency,” “shared decision making,” and “clinical empathy”) constitute a morally loaded doctrine whose raison d’être is ethical rather than clinical. Building on recent studies, I also illuminate the overlooked risks of uncritically adopting PCC: neglecting the non-agentic dimensions of “being a patient,” disregarding the dependence of effective caregiving on the caregiver’s epistemic and deontic authority, reinforcing abandonment through the rhetoric of empowerment, dismantling asymmetry-based models of care in favor of egalitarian consumer-provider relations, and tacitly aligning PCC with contemporary neoliberalism. 10 01 JB code ds.36.app1 259 260 2 Appendix 16 02 JBENJAMINS John Benjamins Publishing Company 01 John Benjamins Publishing Company Amsterdam/Philadelphia NL 02 December 2026 20261215 2026 John Benjamins B.V. 02 WORLD 01 JB 1 John Benjamins Publishing Company +31 20 6304747 +31 20 6739773 bookorder@benjamins.nl 01 https://benjamins.com 01 WORLD US CA MX 10 20261215 01 02 JB 1 00 140.00 EUR R 02 02 JB 1 00 148.40 EUR R 01 JB 10 John Benjamins Publishing Company +31 20 6304747 bookorder@benjamins.nl 01 GB 10 20261215 02 02 JB 1 00 118.00 GBP Z 01 JB 2 Casemate Academic 610-853-9131 610-853-9143 Girard.Kratz@casematepublishers.com 01 https://benjamins.com 02 US CA MX 10 20261215 01 gen 02 JB 1 00 182.00 USD