Summary 

While most discussions treat moderation on platforms as a mechanical rule-enforcement task, we argue that it involves significant emotional work, which in turn shapes the content of narratives before it reaches the public domain. In our recent article, published in the Journal of Management Studies, we investigated the hidden emotional dimension of content moderation on an online health platform that publishes patients’ stories of their healthcare experiences. The topic is relevant and significant because content moderation affects the quality of information users consume and supports users’ safety online. On health platforms moderators have limited but important discretion; they may make changes in the content of patient stories (often deeply personal or distressing) and decisions to withdraw or reject stories from being published and they may even undertake a duty of care to safeguard the authors of stories if they sense vulnerability. Understanding the emotional toll and the discretionary practices they employ helps us design better systems to support moderators and thus ensure the reporting of reliable and empathetic information. 

Beyond the platform economy: content moderation as emotional work 

We conducted a qualitative study of a UK-based digital health platform. We collected rich, in-depth data on moderators’ daily practices through interviews and documentary analysis of platform guidelines. This approach allowed us to trace how moderators undertake emotional work whilst they follow well-defined rules and criteria of what to moderate and how. 

We found that moderators engage in five main practices as part of their work: a) application of rules, i.e. ensuring submissions meet explicit guidelines; b) quantification, i.e. scoring or categorizing content; c) objectification, i.e. treating personal narratives impersonally to maintain consistency; d) verification, i.e. fact-checking or ensuring authenticity; and e) care, i.e. attuning to the emotional weight of patient stories. The paper also argues that emotion work is central to moderators’ work. Far from being emotionless cogs, moderators experience both managed emotions (e.g., enforcing a neutral stance as per policy) and unmanaged authentic emotions (e.g., genuine empathy or distress) as they read and make decisions about health narratives. 

Finally, we offer a conceptual model showing that emotion work serves as a sense-making mechanism. By engaging emotionally, moderators carve out small pockets of discretion which allow them to bend rules in order to offer care. This “emotional discretion” lets them bypass rigid regulatory prescriptions occasionally, giving them autonomy within a tightly controlled system. 

Actionable takeaways for stakeholders 

Our findings are relevant not only for existing theory in the field, but also translate into implications and recommendations for different stakeholders: 

For platform operators & designers:  

• Design support systems: Recognize the centrality of emotion in moderation and embed features (e.g., well-being check-ins, debrief tools) into moderator dashboards. 

• Skills and training modules: Develop training programmes on emotion regulation and empathetic communication, not just rule interpretation. 

For policy makers & regulators: 

• Employment protections: Craft regulations or standards (akin to digital occupational safety and health) that mandate emotional-health safeguards (e.g., rotation policies, access to counselling). 

• Governance frameworks: Incorporate emotional-labour metrics when evaluating platform responsibility and transparency. 

For content moderators themselves: 

• Professional identity: Validate the skilled, relational work they perform, beyond simplistic “rule-enforcer” narratives 

• Collective support: Encourage peer communities of practice for sharing coping strategies and reinforcing a duty of care. 

For academics and the informed public: 

• New research agendas: Academics may explore the nature of moderation work through comparative studies across sectors (e.g., social media vs. other platforms) and across different country contexts that exhibit institutional and cultural variety. 

• Re-humanizing moderation: Public discourse often treats moderation as faceless automation. Demonstrating its emotional complexity offers a more nuanced understanding of how online health spaces are curated and the importance of human judgment versus AI-led moderation. 

Concluding Remarks 

Content moderation, especially when it is automated, is often framed as emotionless and dispassionate; however, human moderators face emotionally charged content. Unpacking their emotional work is critical both for platform efficacy and moderators’ mental health. Our study contributes to understanding these hidden intricacies of digital work in the platform economy. Particularly, content moderation in health platforms is an important new form of work as it shapes what health advice and experiences are visible. These decisions directly affect patient trust, healthcare quality, and public perceptions of the NHS and other healthcare providers.