The Dispositions of Things: the non-human dimension of power and ethics in patient-centred medicine

John Grant Gardner, Alan Cribb

Research output: Contribution to journalArticlepeer-review


This paper explores power relations between clinicians, patients and families as clinicians engage in patient-centred ethical work. Specifically, we draw on Actor-Network Theory to interrogate the role of non-human elements in distributing power relations within clinical settings as clinicians attempt to manage the expectations of patients and families. Using the activities of a multidisciplinary team providing deep brain stimulation to children with severe movement disorders as an example, we illustrate how a patient-centred tool is implicated in establishing relations that constitute four modes of power: power over, power to, power storage, and power/discretion. We argue that understanding the role of non-human elements in structuring power relations can guide and inform bioethical discussions on the suitability of patient-centred approaches in clinical settings.
Original languageEnglish
Number of pages16
JournalSociology of Health and Illness
Early online date27 Jul 2016
Publication statusE-pub ahead of print - 27 Jul 2016

Bibliographical note

This is an author-produced version of the published paper. Uploaded in accordance with the publisher’s self-archiving policy. Further copying may not be permitted; contact the publisher for details. Date of Acceptance: 06/02/2016. Embargo period: 24 months


  • Actor-Network theory, Empirical ethics; Bioethics; Shared decision-making

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