Purpose: The purpose of the paper is to show power mechanisms of in- and exclusion in moments where certain participants appeared to be othered in two collaborative research and development projects in a healthcare setting. Design/methodology/approach: The paper contributes to critical-reflexive analyses of reflexive processes within collaborative knowledge production. The authors use an analytical framework combining Bakhtin and Foucault to investigate processes of inclusion and exclusion in the interplay between dominant and subordinated voices in a moment-by-moment analysis of two incidents from interdisciplinary workshops. Findings: The analysis illuminates how differences between voices challenge participants' reflexive awareness and lead to the reproduction of contextual power and knowledge hierarchies and the concomitant silencing of particular participants. Thus, the findings draw attention to the complex and ethical nature of collaborative knowledge production. Practical implications: To invite researchers to be reflexive about the complex, situated and emergent character of reflexive processes and consider ethics to be a critical stance that encourages continuous reflection and critique of collaborative knowledge production. Originality/value: To show the importance of not sweeping incidents in which participants are othered "under the carpet" in collaborative research. To present an analytical framework for analysing the contextual and emergent nature of collaborative research processes and discuss the ethical conundrums, which arise in the research process.