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Part of
A Pragmatic Agenda for Healthcare: Fostering inclusion and active participation through shared understanding
Edited by Sarah Bigi and Maria Grazia Rossi
[Pragmatics & Beyond New Series 338] 2023
► pp. 172–199

Chapter 7
Negotiation and joint construction of meaning (or why health providers need philosophy of communication)

| University of Cambridge
| University of Oxford

Meaning is often agreed on through negotiation, whose purpose can be clarification or joint construction of what starts as a ‘fuzzy thought’, or settling on a mutually acceptable way forward in communication and establishing common ground. The paper offers a critical introduction to main approaches to negotiating meaning, focusing on concepts that help explicate it, such as conventions, intentions, and meaning co-construction on one hand, and accountability, perception of authority, and normative expectations on the other. It then moves to the question of negotiating commitments, in particular as applied to Doctor-Patient Talk. It concludes with outlining the advantages of providing doctors with an understanding of dynamic pragmatics, highlighting that negotiating meaning does not inevitably lead to a loss of authority.

Keywords: meaning negotiation, intentions, conventions, meaning co-construction, accountability, normative expectations, dynamic pragmatics, Doctor-Patient Interaction (DPT)
Article outline
  • 1.Emergent meanings: A preamble
  • 2.Problems with “static meaning”: From intentions and conventions to … the unknown
    • 2.1Intentions and inferences
    • 2.2Focus on convention
    • 2.3Speaker meaning or addressee meaning? (or asking a wrong question)
    • 2.4Interactively achieved functional proposition
  • 3.Interaction and meaning negotiation
    • 3.1Co-construction models
    • 3.2Negotiation and context parameters
    • 3.3Negotiation and defaults
  • 4.The question of accountability
    • 4.1Negotiating norms and interpersonal standards
    • 4.2Accountability, but for what exactly? Commitment, but to what exactly?
    • 4.3Negotiating commitments
  • 5.Doctor-Patient talk, dynamic meaning, and metadiscursive awareness
    • 5.1Negotiation and negotiation of meaning
    • 5.2Professional-to-lay and back
    • 5.3Parameters again
    • 5.4Negotiation, implicit meaning, and emotions
    • 5.5Looking forward
  • Acknowledgements
  • Notes
  • References
Published online: 17 November 2023
DOI logo
https://doi.org/10.1075/pbns.338.07jas
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