Shirokov2025
| Shirokov2025 | |
|---|---|
| BibType | ARTICLE |
| Key | Shirokov2025 |
| Author(s) | Aleksandr Shirokov |
| Title | “I read a bit of information”: Epistemic markers as a resource for enacting patients’ agency |
| Editor(s) | |
| Tag(s) | EMCA, Doctor-patient interaction, Video-recorded consultations, Conversation analysis, Treatment requests, Diagnostic assertions, Epistemic markers, Asymmetry |
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| Year | 2025 |
| Language | English |
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| Journal | Social Science & Medicine |
| Volume | 386 |
| Number | December 2025 |
| Pages | 118639 |
| URL | Link |
| DOI | 10.1016/j.socscimed.2025.118639 |
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Abstract
As access to online health information grows, patients increasingly arrive at medical consultations informed but uncertain about how to display their knowledge without undermining the doctor's authority. This paper examines how patients navigate this tension by analyzing 151 video-recorded Russian-language consultations using Conversation Analysis. Focusing on the use of epistemic markers like “I read,” “I heard,” and “I was told,” the study shows how patients perform delicate actions such as treatment requests, diagnostic assertions, and resistance to medical advice. By using the epistemic markers, patients construct these actions as actions they have limited rights to engage in, displaying their orientation to the doctor's authority. Epistemic markers allow patients to simultaneously achieve two things that can be seen as contradictory to each other: acknowledging the authority of the doctor while also asserting their own agency and doing actions they are not expected to have authority to do. The study expands the understanding of patient agency in clinical encounters, particularly in underexamined non-English-speaking contexts, and contributes to research on how interactional asymmetry is (re)produced in healthcare settings.
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