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Moral judgements as organizational accomplishments : insights from a focused ethnography in the English healthcare sector

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Gkeredakis, Emmanouil, Swan, Jacky and Nicolini, Davide (2014) Moral judgements as organizational accomplishments : insights from a focused ethnography in the English healthcare sector. In: Cooren, François and Vaara, Eero and Langley, Ann and Tsoukas, Haridimos, (eds.) Language and Communication at Work : Discourse, Narrativity, and Organizing. Perspectives on Process Organization Studies, 4 . Oxford: Oxford University Press, pp. 293-324. ISBN 9780198703082

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Official URL: http://dx.doi.org/10.1093/acprof:oso/9780198703082...

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Abstract

In this chapter, we aim to deepen our understanding of judgments in organizations. Whilst previous studies have underscored the situated nature of individual judgments exercised by e.g. leaders or managers, our research focuses on how judgments emerge as organizational responses to recurrently emerging moral dilemmas. Accordingly, we study a setting—decision practices in the English healthcare sector—where moral puzzles (to fund or not to fund healthcare for apparently atypical patients) demand ongoing attention and systemic handling. We conducted (and present findings of) a focused ethnography of the ways expert decision-making panels in three health authorities confronted, engaged, and coped with morally perplexed situations. The moral perplexity there lay in that panels were called upon to prudently and demonstrably determine whether a particular patient deserved or not exceptional investment; and do so by taking into consideration the healthcare needs and rights of all patients under the same health system. By adopting a practice perspective (Schatzki, 2002), we develop an analytical account of the effortful accomplishments (sociomaterial activities or intertwined “projects” in practice theory terms), which enabled the recurrent collective exercise of judgments in accordance with publicly recognizable moral expectations—namely notions of fairness. Our main contribution lies in conceptualizing the work of rendering moral judgments as organized pursuits possible and meaningful and hence in complementing current “ecological understandings” of individual judgment-making in organizations.

Item Type: Book Item
Subjects: H Social Sciences > HD Industries. Land use. Labor
Divisions: Faculty of Social Sciences > Warwick Business School > Innovation, Knowledge & Organisational Networks Research Unit
Faculty of Social Sciences > Warwick Business School
Library of Congress Subject Headings (LCSH): Communication in organizations, Organizational behavior
Series Name: Perspectives on Process Organization Studies
Publisher: Oxford University Press
Place of Publication: Oxford
ISBN: 9780198703082
Book Title: Language and Communication at Work : Discourse, Narrativity, and Organizing
Editor: Cooren, François and Vaara, Eero and Langley, Ann and Tsoukas, Haridimos
Official Date: 8 May 2014
Dates:
DateEvent
8 May 2014Published
15 April 2014Accepted
Volume: 4
Page Range: pp. 293-324
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Restricted or Subscription Access
Date of first compliant deposit: 16 February 2016
Date of first compliant Open Access: 28 July 2016
Funder: National Institute for Health Research (Great Britain) (NIHR)
Grant number: SDO 08/1808/244 (NIHR)
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