Medical talk and moral order: Social interaction and collaborative clinical work

Medical problem solving is to a large extent accomplished through interprofessional collaboration. It may be imagined as a socially distributed cognitive process. Discourse provides access to this process while it also is the major tool for accomplishing collaborative work. The major topic of the article is the role played by moral discourses in collaborative medical reasoning and problem solving in a hospital setting. It is claimed that the medical order of collaborative work in hospitals is also a moral order. When disruption of the medical order occurs, it generates a disruption of the moral order. Hence, monitoring and regulation of the moral order turns out to be an important part of the collaborative clinical work. Another claim is that the moral order acts as a medical problem solving resource. It allows assignment, management and negotiations of statuses and identities for doctors as well as for patients. Through talk or formulations and reformulations, medical practitioners move in and out of moral frames, fabricate necessary and accountable facts, and produce and reproduce a flexible medical problem solving system.