Open Access Te Herenga Waka-Victoria University of Wellington
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The Ordering of Medical Things: Medical Practices and Complexity

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thesis
posted on 2021-11-10, 02:50 authored by Gardner, John

This project is an investigation into medicine in action. The aim is to understand how medical interactions generate order via the diagnosis of disease; how the patient, the body, and illness are made intelligible, and how particular courses of action are decided upon as a result. Using video and audio data supplied by the Applied Research on Communication in Health (ARCH) research team, this project follows Simon, a middle aged, Caucasian male with chest pain, as he participates in consultations with his GP and cardiologist, and as he undergoes a cardio treadmill-stress test. This project argues for adopting an Actor-Network theory (ANT) based approach to studying interactions. Unlike more traditional sociology approaches, this project considers the role of non-human objects in interaction. Non-human objects are often key actors in the interactions that provide the world with a sense of order. I will provide an epistemological justification for ANT's key premises and outline the method that these premises entail. Following three interactions, this project illustrates that the principal actors involved in producing intelligibility varies. In the GP consultation, the GP and Simon were principal actors in rendering chest pain intelligible. In the treadmill stress test, the material instrumentation, carefully aligned with the Simon's body by the cardiologist, was vital to ensuring a particular account of the heart was produced. Simon was little more than a compliant body in this interaction. In the final interaction, the cardiologist was the principal actor in making sense of these accounts of chest pain and the potentially conflicting picture of the "healthy" heart. The cardiologist suggests that the account of the heart produced by the treadmill-stress test may be flawed, and encourages Simon to self-monitor and self-regulate. I will argue that the uncertainty generated by conflicting accounts is common to medical practices. Medical professionals respond to this by encouraging individuals to monitor and reduce risk. By adopting the ANT approach, I found that the patient and his body are sometimes intelligible as somatic entities, sometimes as an expressive, accounting agent, and sometimes as a self-responsible individual. These various renditions hold together as a being a single individual "Simon".

History

Copyright Date

2009-01-01

Date of Award

2009-01-01

Publisher

Te Herenga Waka—Victoria University of Wellington

Rights License

Author Retains Copyright

Degree Discipline

Sociology

Degree Grantor

Te Herenga Waka—Victoria University of Wellington

Degree Level

Masters

Degree Name

Master of Arts

Victoria University of Wellington Item Type

Awarded Research Masters Thesis

Language

en_NZ

Victoria University of Wellington School

School of Social and Cultural Studies

Advisors

Dew, Kevin; Lloyd, Mike