This article investigates an emerging practice in palliative care: dignity therapy. Dignity therapy is a psychotherapeutic intervention that its proponents assert has clinically significant positive impacts on dying patients. Dignity therapy consists of a physician asking a patient a set of questions about his or her life and returning to the patient with a transcript of the interview. After describing the origins of dignity therapy, the authors use a rhetorical genre studies framework to explore what the dignity interview is doing, how it shapes patients’ responses, and how patients improvise within the dignity interview’s genre ecology. Based on a discourse analysis of the interview protocol and 12 dignity interview transcripts (legacy documents) gathered in two palliative care settings in Canadian hospitals, the findings suggest that these patients appear to be using the material and genre resources (especially eulogistic strategies) associated with dignity therapy to create discursive order out of their life events. This process of genre negotiation may help to explain the positive psychotherapeutic results of dignity therapy.

Using rhetorical genre theory and research on reported speech, this study investigates the citation practices in 81 forensic letters written by paediatricians and nurse practitioners that provide their opinion for the courts as to whether a child has experienced maltreatment. These letters exist in a complex social situation where a lack of clarity exists as to which professional group (healthcare providers, police, social workers) is primarily responsible for gathering accounts of children’s injuries. Yet physicians need these accounts into order to compare them to actual injuries. The study documents the direct and indirect citations that occur in the letters, observes documentation strategies, notes the instances in which partial breakdowns in citation occur, and points to the linguistic factors contributing to these breakdowns.

Physicians write child abuse forensic reports for nonphysicians. We examined 73 forensic reports from a Canadian children's hospital for recurrent strategies geared toward making medical information accessible to nonmedical users; we also interviewed four report writers and five readers. These reports featured unique forensic inserts in addition to headings, lists, and parentheses, which are typical of physician letters for patients. We discuss implications of these strategies that must bridge the communities of medical, social, and legal practice.

This article reports on forensic letters written by physicians specializing in identifying children who have experienced maltreatment. These writers face an extraordinary exigence in that they must provide an opinion as to whether a child has experienced abuse without specifically diagnosing abuse and thus crossing into a legal domain. Their credibility was also at issue because, in this jurisdiction, child abuse identification was not recognized as a medical subspecialty and because the status of expert witnesses is currently being challenged. Through an analysis of 72 forensic letters combined with interview data from six letter writers and five letter readers, we determined that these writers used linguistic and rhetorical strategies that allowed these letters to function as boundary objects or objects that traverse several communities of practice. The most salient strategy was the use of evaluative lexis—adjectives and adverbs which allowed for a range of interpretations and constrained those interpretations at the same time.

This article investigates the contribution visual rhetoric and rhetorical genre studies (RGS) can make to health care education and communication genres. Through a visual rhetorical analysis of a patient record used in an optometry teaching clinic, this article illustrates that a genre's visual representations provide significant insights into the social action of that genre. These insights are deepened by an insider analysis of the patient record that highlights how content analyses of visual designs need to be elaborated by contextual considerations. A combined visual rhetoric and RGS analysis shows that clinical novices learn to interpret the record's visual cues to safely traverse the complex requirements of this apprenticeship genre. The article demonstrates that visual rhetoric research can meaningfully contribute to the understanding of genres by presenting an enriched contextual analysis achieved by consulting with context insiders.

In a pediatric teaching hospital, the authors examined 16 novice medical case presentations that were classified as instances of a hybrid apprenticeship genre. In contrast to strict school and workplace genres, an apprenticeship genre results from the sometimes competing activity systems of student education and patient care. The authors examined these novice case presentations for the amount and patterns of time devoted to student learning and expert teaching, the difficulties created for participants, the sometimes misunderstood implicit messages delivered by experts, and the opportunities to address educational objectives. This study offers professional communication researchers a model that combines quantitative and qualitative methodologies to assess the effects of competing activity systems in the development of communication expertise.