Who Empowers Who in Co-production?: Surgeons' and Patients' Power Dynamics throughout Clinical Decision Making

Abstract

Co-production tends to assume that co-produced decision-making leads to consensus and equality between actors with different perspectives. Drawing on ethnographic insights into interactions between professionals and patients, this article studies how consensus and equality may manifest in the professional-patient interaction throughout co-produced decision making. Characterized by three power dimensions and structured by problem-based and relation-based reasonings, our findings show how the interactions remained unequal and were directed towards seeking consent instead of consensus. These findings deepen our understanding of professional-patient interaction, not only of co-production but also of street-level work.