Analyzing argumentation in medical consultations within a health communication ecosystem

Abstract The paper proposes that argumentation in medical consultations should be analyzed by considering consultations as part of a health communication ecosystem in which institutional norms and circulating discourses shape argumentative practices. It outlines a framework that conceptualizes medical consultations as sites where argumentative practices emerge from the interaction between three analytically distinct but interdependent layers: the interactional organization of talk, the institutional structuring of roles and norms, and the broader discursive environment in which medical knowledge circulates. These layers are linked through mechanisms of recontextualization, normative filtering, and epistemic positioning, which account for how external discourses and institutional constraints are selectively mobilized and transformed within situated interaction.