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The dispositions of things: The non-human dimension of power and ethics in patient-centred medicine

Research output: Contribution to journalArticlepeer-review

John Gardner, Alan Cribb

Original languageEnglish
Pages (from-to)1043-1057
JournalSociology of Health and Illness
Issue number7
Early online date27 Jul 2016
Accepted/In press2 May 2016
E-pub ahead of print27 Jul 2016
PublishedSep 2016


King's Authors


This article 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 in 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.

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