Negotiations, work objects, and the unborn patient: The interactional scaffolding of fetal surgery

This article examines the interactional scaffolding of fetal surgery, an emergent medical specialty focused on the unborn patient. Drawing on work in symbolic interaction, especially that of Mead and Strauss, the article focuses on the social organization of work in a Fetal Treatment Unit at an urban teaching hospital. The major types of interactions among participants are cooperation and conflict, illustrating the many differences among actors in this social world and their need to work together to successfully build their specialty. Differences discussed in this article center on the work object in fetal surgery (who is considered the patient?), criteria for patient selection, and definitions of disease and treatment. Actors must continually negotiate these and other differences as they create the social order of fetal surgery in a politicized context, both locally at Capital Hospital and for the specialty more generally.