“Diagnosing Myself to be Heard”: The Collapse of Physician-Patient Dialogue and the Reconfiguration of Rhetorical Agency and Trust in Migrant Women’s Healthcare in Norway

This article examines the way the erosion of dialogic space in Norwegian primary care reshapes the rhetorical agency and trust of educated Middle Eastern migrant women. Drawing on interviews with ten participants, the study analyzes narratives of clinical encounters with general practitioners, where stories of illness were consistently intertwined with experiences of vulnerability. Four forms of vulnerability (physical, financial, psychological, and cognitive) emerged as the terrain on which rhetorical agency was enacted. Using rhetorical agency as performative and dialectical, alongside conceptualizations of trust, the analysis demonstrates three rhetorical configurations: (1) agency under constraint , where patients script the self into care; (2) collapse of dialogic ethos , where physician presence is reduced to procedural compliance; and (3) epistemic displacement , where trust is rerouted into transnational, informal, and digital networks. These findings highlight how trust is not lost but recalibrated, indicating that institutional investment in dialogic space is essential for equitable and responsive healthcare.