문화간 진료 담화에 나타난 국내 체류 외국인 환자의 무표적 포지셔닝 연구 = Unmarked Positioning of International Patients in Intercultural Medical Discourse in Korea

다국어 초록 (Multilingual Abstract)

This study examines the unmarked positioning of migrant worker patients during their English consultations with Korean domestic doctors at three medical institutions. Using the framework proposed by Davies and Harré (1990/1999), and more specifically, by van Langenhove and Harré (1999), three positioning modes were qualitatively analyzed. The findings reveal the emergence of intercultural posi- tioning in various ways. First-order positioning occurs when patients engage in medical consultations in English, despite being in a domestic healthcare setting. Second-order positioning involves patients complying with domestic doctors’ recommendations while negotiating intercultural modifications. Third-order positioning arises when patients discuss previous medical experiences in their home country or share experiences related to their home country during the ongoing interaction. Additionally, performative positioning occurs when patients accept medical recommendations while engaging in negotiation, and accountive positioning emerges when patients discuss their home country’s medical discourse or experiences. Notably, patients’ accountive positioning may function as per- formative positioning during local consultations. Furthermore, patients’ personal positioning within the medical discourse context may conflict with their moral positioning at the societal level of their life stories, leading to navigation and negotiation within multiple dimensions of moral obligations. The study discusses these findings in relation to discourse structure, institutional ethnography, and the patients’ socio-cultural backgrounds and disease characteristics. The impli- cations underscore the importance of considering patients’ intercultural posi- tioning in understanding their non-compliance. This research contributes to a deeper understanding of the intercultural dynamics and communication com- plexities between migrant worker patients and Korean domestic doctors in healthcare settings.

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