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Article published In:
Towards Culture(s) of Dialogue: Communicating Unity and Diversity through Language and Discourse
Edited by Urszula Okulska, Grzegorz Kowalski and Urszula Topczewska
[Language and Dialogue 12:2] 2022
► pp. 284–305

Shifting addressivity

In/Exclusionary practices in triadic medical interaction with unaccompanied foreign minors

| University of Bologna
| University of Bologna
| University of Bologna

In dealing with recent migration-related phenomena, inclusion has become an increasingly common normative ethical imperative in socio-political discourse. Considering inclusion as a situated interactive accomplishment, this article reports findings from a study on medical visits, each one involving a physician, an unaccompanied foreign minor (UFM) and a professional educator. Adopting a Conversation Analysis-informed approach to a corpus of video-recorded visits, we analyze (a) the physician’s shifts in addressivity, which either foster or hinder UFM’s inclusion during the history-taking phase, and b) when and how these shifts occur. We contend that, by shifting addressivity, the physician navigates the locally incompatible goals of gaining reliable information on UFM patients and fostering their active participation. We contend that the micro-practice of shifting addressivity is consistent with the management of cultural-linguistic diversity proposed by the intercultural dialogue perspective.

Keywords: triadic medical interaction, interactive inclusion, unaccompanied foreign minors, addressivity, intercultural dialogue
Article outline
  • 1.Introduction
  • 2.Unaccompanied Foreign Minors in an inclusion-oriented society
  • 3.Epistemic asymmetries and agency distribution in medical encounters
    • 3.1Triadic medical visits with UFMs: The multiple asymmetries at stake
    • 3.2The history-taking phase in triadic medical visits with UFMs
  • 4.Data and analytical procedures
  • 5.Addressing the patient vs the professional educator: The physician’s in/exclusionary practices
    • 5.1Inclusionary shift: From the professional educator to the patient
    • 5.2Exclusionary shift: From the patient to the professional educator
    • 5.3Ex/Inclusionary shifts: From the patient to the professional educator and back
  • 6.Discussion
  • 7.Concluding remarks: Finding a balance between inclusion and (unavoidable) exclusion
  • Notes
  • References
Published online: 8 August 2022
DOI logo
https://doi.org/10.1075/ld.00126.car
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Cited by

Cited by 2 other publications

Caronia, Letizia, Vittoria Colla & Federica Ranzani
2022. Practices of Inclusion in Primary Care Visits of Unaccompanied Foreign Minors: Allocating Agency as an Interprofessionally Distributed Intercultural Competence. In Interculturality in Institutions [Culture in Policy Making: The Symbolic Universes of Social Action, ], ► pp. 209 ff. DOI logo
Caronia, Letizia, Federica Ranzani & Vittoria Colla
2023. Chapter 6. Pursuing understanding or engaging the patient?. In A Pragmatic Agenda for Healthcare [Pragmatics & Beyond New Series, 338], ► pp. 144 ff. DOI logo

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