2022 pre-print Page 1 of 23 Negotiation and Joint Construction of Meaning (or Why Health Providers Need Philosophy of Communication) Kasia M. Jaszczolt (University of Cambridge) and Lidia Berthon (University of Oxford) forthcoming in: S. Bigi and M. G. Rossi (eds). A Pragmatic Agenda for Healthcare. Amsterdam: J. Benjamins 1. Emergent meanings: A preamble The dynamic nature of meaning in discourse cannot be overestimated. This applies both to spontaneous conversation and to professional interaction. However, traditionally, pragmatics tended to be rather static, often focusing on speaker (intended) meaning or on addressee (recovered) meaning. It is only relatively recently that the dynamic perspective has become foregrounded across a variety of approaches that are coming to terms with the fact that meaning is not a ready, fixed abstract object to be shared. Instead, it is often something agreed on, or settled on through negotiation, whose purpose can be clarification, or joint construction of what starts as a ‘fuzzy thought’, resolving misunderstanding, settling on a mutually acceptable way forward in communication, and as such establishing common ground. In the process, communicators undertake commitments and face accountability. They may also negotiate epistemic or ethical norms (what we later call meta-negotiation of meaning). Understanding these processes and underlying principles and norms is still very much an unfulfilled objective. And this is where this chapter fits in. Its main aim is to offer a critical introduction to main current approaches to negotiating meaning in discourse in the context of relevant concepts that help explicate it, such as conventions, intentions and meaning co- construction on one side, and accountability and normative expectations on the other. The second aim is to demonstrate that understanding what ‘meaning’ means in a specialist discourse setting is not merely a philosophical-linguistic issue that is tangential to the concerns to practitioners of this specialist field. Rather, it is the foundation stone that enables a metadiscursive understanding of ‘what works’ in such situated discourse and why. The structure of the paper is as follows. In Section 2, we begin with a critical discussion of what are normally considered to be main explanantia of discourse meaning: (i) meaning intentions and the principles governing their recognition and (ii) linguistic and social conventions governing discourse. We point out that both types of approaches, those focusing on (i) and those focusing on (ii), are found wanting on account of their rigidity in answering the question ‘whose meaning’ a pragmatic theory ought to adopt as its object of analysis. It is not a choice between ‘speaker-meaning pragmatics’ à la Grice and ‘addressee-meaning pragmatics’ à la some post-Griceans; meaning is jointly constructed (or co-constructed) in discourse interaction. We also introduce new concepts relevant for this discussion, such as that of an interactively achieved functional proposition. This provides the necessary background for introducing the concept of negotiation of meaning. In Section 3, we discuss some approaches that focus on such joint, interactive, dynamic meaning, beginning with an analysis of co-construction models and following up with remarks on the parameters along which negotiation can be analysed and on default interpretations. In Section 4, we demonstrate that questions of accountability, commitment, and perceptions of authority,